To feel sorry for American's as their healthcare system appears abysmal

[Wowthishurtsalot]

I'm a member of a support group for a health condition I have which is fairly rare, this support group attracts a global network of posters who draw on it for support and advice.

The American posters almost all have the same complaints:
'My insurance won't cover a referral to the right specialists'

'My insurance only covers one prescription a month so I have to pick and choose which attack I use it on' (the condition can mean you'll have several attacks or flares a month)

'I've had to quit work, I have no insurance and therefore no meds'

'My insurance doesn't cover/considers these meds non essential'

It's appalling. Its a condition that renders its sufferers in hospital several times a year but with the right medication can be managed. It can, in its extreme form, kill or trigger a life changing side effect.

How does that country function?! I Really count my blessings and am so grateful for the NHS when I speak to american sufferers or carers. AIBU?

[StarlingMurmuration]

I should add that my care while in hospital, and throughout this pregnancy, has been exemplary aside from that blip. The midwife was really over-worked and there had been two emergencies which she'd had to deal with, which had distracted her. I realise my post seemed pretty critical, and I didn't really mean it that way at all because I think the NHS is great, despite its occasional failings.

[StarlingMurmuration]

Interesting, sashh. I was just thinking of the cost of an extra night in hospital, but you're right, if I hadn't been there, there's no saying whether someone else would have bee.

Obviously I wouldn't expect the doctors or nurses on the ward to know (through I do think they should care if money or resources are wasted due to staff error).

[joanofarchitrave]

I'd be interested to see the itemised bill, but it would have to include lots of other things - like the training of all the staff seeing me etc. I'd also bet that the NHS would seize the opportunity to make a heavy-handed message about 'make sure you don't waste XYZ' which would annoy me.

I don't think Americans are more concerned with number 1 than us, are they? quite the opposite I would have thought. Americans give much more money and much more time to voluntary organisations than UK people do. State provision is often very good as I understand it, they just hate the idea of federal rules, much as people over here often feel about EU provision. And the UK is the size of one state, after all. I yield to no-one in my desire to maintain our system though.

[Siarie]

I'm not sure I would agree that we have the best of both worlds with private and NHS here in the UK.

I have private healthcare but it doesn't cover certain things which you can get in countries like America. Maternity cover for one, so instead if I want private maternity I have to pay around £10k-£15k whereas I would prefer to have it covered in a policy. If nothing else just to make it easier to keep track of.

Not everyone has great NHS choices, certainly my hospital for maternity is lacking whereas if I were to move I could get myself into the right post code for the top NHS maternity hospital in London.

If everything were private I would be able to pick where I wanted to go regardless of area. It's not even like the hospital is actually that much further away.

That said though the problem with these posts is you can't win. There are loads of people who love the NHS and there are those who have tried private healthcare and love that.

I don't dislike the idea of the NHS, I just wish that if we are going to keep it that we get it to same standard of care in emergencies as out of.

[slug]

My cousin who lives in upstate New York has a similar condition to me (there's a genetic element to it). So we can compare fairly closely the different approaches in treatment.

Other issues aside, the biggest problem with our condition is fluctuating blood pressure which can get dangerously high without warning. She has fairly good insurance and is highly medicalised (loads of drugs, constant monitoring at a clinic etc). While, after my initial diagnosis which took 6 months admittedly and included multiple MRIs, heart traces and blood tests, I started off in the same drugs as her. However, what has happened since I think illustrates the difference between the two systems.

My cousin regularly attends clinics. She's constantly monitored and has regular tests. I, however, do all the monitoring myself. I have a blood pressure monitor which I use several times a day. I bought this myself though I could have waited for the NHS to supply one. It wasn't wildly expensive and I track the results via an app. If the readings are abnormal I can extract the data and I email it to my consultant. I also know at what level I need to seek help urgently via A&E. In the past year, because I am constantly monitored, the amount of drugs I take has been gradually reduced. I am aiming to get to the point where I need take no drugs and rely on monitoring only.

My cousin is horrified by this approach. She's constantly been told she needs the drugs to control the condition and reducing them is not an option if she wants to stay healthy. She's also horrified that the NHS expects me to act like an adult monitor myself. Yet I think that goal of reducing my reliance on drugs is a healthy approach, if one not designed to profit from a chronic medical condition. With every prescription I drop the cost to the NHS lessens. Because there is no profit motive there is no need for me to see my consultant in person or constantly have tests for a condition that is unlikely to significantly change in the foreseeable future.

I think because I am not over medicalised my health care is actually better.

[StarlingMurmuration]

Siarie, can't you pick your choice of hospital anyway? I chose a large teaching hospital that's further away but has a better reputation than two similar sized hospitals. It hasn't been an issue at all.

[sashh]

If everything were private I would be able to pick where I wanted to go regardless of area. It's not even like the hospital is actually that much further away

I chose to have one op 50miles from home, it's called 'choose and book' or something. Obviously in an emergency an ambulance takes you to the nearest hospital.

[MrsJonSnow]

I had my dcs privately in London.
The thing that annoyed me is that once you're labelled a private patient you forfeit all the normal NHS benefits even though you paid the same tax. i.e you have to pay for prescriptions etc that would be free on the NHS.
It felt like a punishment.

[PigletJohn]

surely that applies only to the particular thing that you had treated privately. For all your other ailments you can use the NHS.

For example if I had my wart removed privately, all the dressings, pain-killers and follow-ups would be private.

[BlackSwan]

Suzanne - yes, I think the US system, with insurance, is better than UK with insurance. They have facilities we don't. They have scale. They co-ordinate better. Their technical expertise is great. The hospitals are clean and organised. Private here is pretty good too, but you don't have the same facilities as over there.

[Siarie]

Sorry to disappoint you ladies but I tried to pick my preferred hospital and was denied. It's done by area in London, which only furthers my point that the NHS doesn't give you choice.

In comparison I can pick any private hospital to attend with my insurance providing the consultants are covered there.

I would love to be able to pick my maternity ward on the NHS

[Downamongtherednecks]

I had ds in NYC, and dd privately in London. Both emergency c-sections. The care was completely different. The US experience was like an episode of ER with people shouting and I was strapped down (like the crucifixion) in the operating theatre. No support at all for breastfeeding, no midwives, and I was massively over-medicated with morphine, and it was only by luck that I stopped the ob/gyn from circumcising ds.
In the UK (Lindo wing), it couldn't have been better. All the midwives were ex-NHS, experienced, professional and supportive. The c-section was like being at a dinner party, no false panic, informative and calm. While I was in my (lovely) room, the midwives would wander in with cups of tea, and tell me about the Middle Eastern princesses down the hall. (Cost 6k, fortunately my company insurance paid!)

[emilywrites]

YABU. I'm American, and spent the first 24 years of my life in the USA; I was happy with all medical care, both when insured and when not insured. Yes, I was without health insurance in the US at one time. During that time, I developed an illness that required medical attention/medication, so I went to a local clinic that offered medical care to people who do not have health insurance. I saw a doctor within 30 minutes of walking in, and was provided with the medication I needed. The doctor spoke fluent English and the clinic was reassuringly clean, bright, and modern. When I tell this story to people here in Europe, they don't believe me.

I have only been to a doctor in the UK once, and it was an appalling experience. There was a very long wait, and neither the nurse NOR the doctor I saw spoke the English language competently enough that I could understand them, or even be sure that they understood what I was trying to tell them. I had no idea what the doctor was saying, in fact. Perhaps he would have been a very good doctor in a situation in which he spoke and understood the language of the patient and the country in which he was practicing medicine, but I had great reservations about his competency during my appointment. (If the doctor and nurse had been able to speak English competently, the shockingly dingy, run-down setting wouldn't have bothered me, but as I strained to understand the doctor, the hideousness of the setting somehow reinforced my fear that this was not top-notch care...).

[BigglesFliesUndone]

I have a question about USA (and other countries) healthcare. It's probably a really naïve one but here goes! Surely in countries where you pay for healthcare, you don't pay NI as we do, so what you save on that from your salary you pay on health insurance? Is that a ridiculous question??

[CheerfulYank]

What's NI?

In our case, the insurance is offered through my husband's work and is taken directly from his paycheck.

[Wowthishurtsalot]

NI is national insurance and its a tax used to pay for NHS and DWP contributions

[PigletJohn]

National Insurance. You might call it Social Security or Workmen's Comp.

[SconeRhymesWithGone]

In the US, the cost of health insurance for employees is normally shared so the employer pays for some of it. When the employer's dependents are covered, the amount the employee pays can be fairly high, but is less than it would be if the employee had to purchase the insurance separately in the marketplace because group rates are less expensive.

We pay social security tax in the US which funds the pension system.

Medicare, which is the federal insurance program for those 65 and over is funded through pay roll taxes and general revenue. It provides basic hospitalization coverage for free, with the option to pay for additional coverage.

[Carriemac]

The NHS coat for a one area plain MRI is £145

[littlebrownbag]

The NHS is paid for from general taxation, not National Insurance. NI pays for your pension, jsa, benefits etc.

I have lived in both the UK and the US. I summarise my experience as follows: You can get excellent healthcare in the US, but the system for delivering it in an efficient, fair and equitable manner to those who need it is broken. Whereas the system for delivery of healthcare in the UK is fair and gives you more choice (ie NHS, private insurance or cash), but you may find some of the facilities and the resources are stretched if you have a non-urgent healthcare issue.

Anecdotes abound on both sides of the Atlantic for good and bad care. I certainly appreciated getting my smear expertly done by a gynecologist rather than a rushed practice nurse with a cold metal speculum for example. But things that shocked me were medical practices employing more billing clerks than medical staff - insurance company policies are so complex and byzantian that the clerks end up specialising in each of the major companies, one of the reasons you can't just go to any doctor or dentist, they have to be 'in-network' with your insurance company. That's where so much money goes.

And the price of procedures bears little relation to the actual cost, they charge what they can get away with. I had a (bog standard) crown done while in the US, and it cost me around $1200 (£750) - and that's with my super duper insurance policy. Certainly raised eyebrows at my (private) UK dentist! An annual flu jab cost $25-$40 if not covered by your insurance, compared to £8 ($13) here at Asda. etc etc.

[sourdrawers]

Does Ireland not have an NHS type system? I'm a bit shocked.

[hollyisalovelyname]

If you are below a certain income threshold in Ireland you get a medical card that entitles you to free gp services. You get free hospital/ operations but there is a very long waiting list. If you can afford it you can take out health insurance and see consultants privately, which will be much quicker. If you are brought in as an emergency through A& E you will be seen to / operated on.
There seems to be a huge number of medical card holders for the population
With the recession many have opted out of private health insurance.
A visit to the gp costs from 50 euro to 65 euro.

[BigglesFliesUndone]

Thanks for explaining that.

[inconceivableme]

I feel sorry for the Americans who vote Democrat only for healthcare reforms the Democrats try to introduce to be blocked or weakened by the Republicans. I don't feel sorry for Republican voters. They get what they vote for and the rich ones just look after themselves anyway.

[Mampire]

Ireland doesn't have NHS but people under a certain income and people in receipt of social welfare get a medical card.