NHS vs Elsewhere

[Noicant]

If you have experienced both NHS care and care in other countries AIBU to ask whether your experience was better in the UK or abroad? Feel free to elaborate. This is not a thread bashing NHS staff and it’s not a political thread.

For me definitely abroad, I mainly have endocrinology problems - treatment was prompt, I saw a specialist who was able to explain my results in detail and explain dosages and how it may affect other aspects of my health. I did have to pay an excess but one I was happy with.

YANBU - treatment abroad was better
YABU- treatment in the UK was better

I've lived in Austria and experienced healthcare there and it was excellent. Easy to access, state of the art, free at the point of need, fast and efficient. It is paid for by an insurance system with a small number of providers heavily subsidised and regulated by the government, so I saw a health insurance fund deduction itemised on my payslip each month, but it was a pretty small amount. Those on very low incomes had this funded by the state.

Overall most (all?) Western European countries spend more on healthcare than the UK, and I don't argue with the notion that we need to spend more on healthcare. However, for many many reasons, I don't believe that ploughing more money into the current NHS is the answer, so I would never vote for that.

I have experience of NHS in the UK and of Kaiser and blue cross in the US. I'd far rather the NHS.
US:
Insurance part covered by husband's work, but we had to top up 2 grand a month for me & kids (this was around 2010). We had HMO insurance which has minimal copays etc so going to hospital had a copay of 100 dollers a night. I had my DS there so was in hospital two nights for that. I also broke my leg. Some places took our insurance some didn't. We had to go to 5 different places to get treatment. One place could take the cast off, which they did, but not supply the walker boot, even though they had them. They then taped the cast back on and I had to get a taxi to a different place. The admin and dealing with the bills was such a pita that there was a whole industry set up to help people with it.
They were keen for you to have lots of tests so you got more tests. For example DS hitting all his milestones as a baby, but had a big head - they wanted him to have an MRI to check for hydrocephaly without first checking that me and his dad both have a big head too. Getting contraception with Kaiser was dependent on you having a smear & internal exam. The streets (in SF) were full of uninsured people with chronic mental health problems.

Do you view translators as a good use of health funds? I moved here in my 20s. I've never expected anyone to speak English.

When I have encountered the system with non French speakers, as their unofficial translator, I've been surprised by HCW high level of English.

I have an annual smear and mammogram. I've had annual mammograms since I was 29 because my mum had breast cancer. This is in France.

@Justdontask I do like the idea of an annual check up. I have a health condition which was picked up by chance, during tests for something else

I've taken my child to a & e here and in the US. As it was breathing related he was seen immediately at both places. Wait after was about the same. The main difference was the $1200 bill with the US one (mostly paid by insurance, but I had to pay £250), and that they prescribed steroids ($120) and an epi pen ($500).
My father had a stroke in Spain. The hospital was all new and shiny but they basically told my mother to get his kids over and there was minimal nursing - the family are expected to do alot of the actual physical care. We flew him on a medical plane home as soon as he was stable and the care he received at the hospital here was leaps and bounds better. Unfortunately he had another and didn't recover, but the hospital was amazing.
My son was in a motorcycle accident recently and he's had eight X-rays and will have his fifth hospital appointment tomorrow. Yes it's a two hour visit each time for 15minute actual face to face time but it hasn't cost us anything.
The main difference in the US system, other than cost, is access to specialists without the long waiting periods (of weeks or months). But you pay for it dearly. Here I'd rather the NHS and the option for paid for quicker medical care (yes I know that means many people couldn't access it, but they would not be getting even the basic care without paying out for insurance in the US). You can do that now anyway - I paid for a private MRI for my daughter as the wait was three months.
Plus the drugs. I have type 1 diabetes and even with insurance would be paying hundreds a month in the US.

My son got an ear infection in the US. I had to take him to the ER as there was no way to access primary care. Got given antibiotics and ear drops. Prescription cost was over $300 and hospital fees about the same. The exact same medication in the UK would have been free on the NHS and £11. 63 with a private prescription.

My son was injured in Turkey, the ambulance wouldn't take us to hospital without seeing our insurance documents. They drove past 2 local hospitals to take us to one that would accept our insurance. They had a guard at our room door to ensure we didn't leave without paying the £3000 bill, despite having our insurance details.

My Dad lives in the USA and owes £$300k in medical bills. He's diabetic and his medication costs him £700 a month. It would be free here.

My sister in USA has stage 3 cancer and despite having great insurance has to pay 20% of all costs. She is likely to lose her house and still won't be able to pay her medical bills. It would be free here.

The NHS isn't perfect, but it is. Certainly better than that.

Central Europe country( post communist since 1989)
GP walk-in anytime, you will be seen the very same day, morning, afternoon etc depending what time you walked in.
Also you can phone your GP, meaning the actual Dr and speak to him directly- not any rude receptionists in the way to block you.
X-rays - walk in and done in a minutes, the results are ready and handed to you by the time you leave the room!
Blood tests are done at GPs again just walk in and also when your GP request blood test, the nurse who works along him, takes the bloods the very same time so NO need to book blood test appointments for weeks later.
Gynaecology Dr- some are walk in but most are now appointments only which can few days maximum, again all tests are done the same day, i believe this is same here in U.K. too.
(I managed to get Gynae appointment the very same day few times)
But to go to see Gynaecologist Dr you don’t need a referral from GP!
You just go to any gynae dr that suits you anytime you need.
Also all Gynea drs have ultrasounds in their rooms.
Smear Tests are done regularly every year.
Breast ultrasounds cost is very cheap-if privately it is approximately £20, Mammograph appr £35 you can get appointments in a day, there is lots of clinics and hospitals who does these again you don’t need referrals, if with referrals it’s free and again and you will be seen in a days.

I think people should start paying a bit in the U.K., but we keep the NHS. So people start paying for appointments and a basic amount towards a large illness, much like they do in many private systems. That way there will be less wastage and missed appointments and doctors, nurses can be paid more and it will attract better staff. If people have to pay they will also look after themselves a bit more. There has to be an element of taking responsibility to improve healthcare. I don’t think prescriptions should be entirely free either, for anyone. We have to stop taking it for granted.

Needed an ambulance and hospital care in Austria, just had to show EHIC card (obvs no longer available) so all free and vastly superior to NHS. I would so happily pay additional tax if we could have a working NHS, we're in no man's land with my daughter at the mo, she needs to see a specialist, the current NHS wait is 18mnths we looked in to private but in our area of the country (SW) none of the relevant private consultants see children, we could travel to see a private paediatric consultant but it wouldn't be a one off and its a 4hr trip, so frustrating that neither system works here.

New Zealand experience here (dual nationality). Had a scary seizure that caused weakness and slurred speech. I was told to get some lemonade and have a nap after a quick blood pressure test. I felt so unwell I finished my holiday early and flew home.

Came back to the UK and it happened again. Straight to A&E and thoroughly checked for a stroke. Mini stroke confirmed and had brilliant care ever since.

I had private insurance and private healthcare in another country and obviously the NHS here in the UK. In my experience, the NHS is far superior. I've actually never struggled to get access to relatively quick high quality care in the UK on the NHS. My GP is wonderful and relatively easy to book in with (we get a call back the same day and often a same day appointment or at least usually a phone consult within 48 hours). I had an urgent referral to my Gastro a few years ago. I did have to wait about 4 months for the initial appointment, but once he saw me, I had a CT scan, colonoscopy, more bloods and a follow up appointment all within the next week.

In my home country on private healthcare, it's not at all unusual to wait months for each appointment to a specialist due to waiting lists and time for insurance pre-approvals. It's not like just because it's private you can be seen the next day, there's no queue jumping. Quite often I was seeing really junior doctors there and still needing to come back again and again for follow ups with the more senior ones (and paying quite a bit for each visit too!). It could really drag on and it often felt like decisions about my care were made because they made money, not necessarily because they were what was best for me.

The most important thing though is being able to make decisions about care based on what I needed rather than worrying about cost. I had a complicated MC a few years ago and was offered surgery or to wait it out with medical management. I could choose surgery because I didn't have to worry about if I could afford it. They had me in 36 hours later. DD had an injury over the summer which took us to A&E and she needed a hospital stay and surgery. Again, it was stressful enough, but knowing we could just do what was best for her without having to worry about how I was going to pay for a surprise £2000-5000 medical bill in the midst of a cost of living crisis made all the difference.

I truly don't know how my friends back home are managing. The difference in care is negligible and I think in the UK it is often better. But it really is just so stressful to think about how I'd manage if I was still there.

If there is one thing we are good at here, is not implementing "preventative" screening that doesn't make a difference at a population level. So many of the measures mentioned on here are just not a cost or clinically effective way to solve issues.

The barrier to getting nationwide screening programmes rolled out is incredibly high.

Eu developed country test is done annually with your preventative check up

A quick check of the guidelines of any country in the EU will show you that this isn't the recommendation, so if this is happening it's pointless and not evidence based and women are having additional invasive tests for no reason and there are a lot of doctors not practicing evidence based medicine. Annual smear tests are not required for the vast majority of women and don't improve outcomes. This has been known for a long time now.

Yeah great. You don't have to have the test if you don't want to. Your doctor can well agree it's not needed.
But insurance covers it once a year so if you do want it, it's there.

@Wallywobbles

Do you view translators as a good use of health funds? I moved here in my 20s. I've never expected anyone to speak English.

This will probably be a controversial opinion but personally no I don't.

Like you I wouldn't expect a French HCW to speak English.

My American HMOs, funded by employers, offered all members ( including families) a flu jab every year. This is normslbin America, going back decades.

My amazed British DH asked why. He was told, more than once, that studies prove blanket vaccination schemes save more medical resources and more lives than targeting vaccinations to the elderly and vulnerable. Does the UK have studies suggesting otherwise? If not why isn’t everyone offered a flu jab?

My DD was referred to CAMHS and after waiting years and then a handful a appointments her issues were put down to poor parenting and I was sent on a parenting course. They wouldn't help us further, despite me begging them constantly.

Moved to Sweden and straight away school and health visitor started asking about her autism and could not believe that at 15 she hadn't been assessed and diagnosed. She is now.

DS was born here. He was assessed and diagnosed withing 3 months of me raising concerns with the health visitor. We have a hospital unit called Habilitering whose purpose is to support autistic people have the best lives they can. For us they dealt with all the welfare payment issues, school adjustments, training parents in various interventions, social services support worker, respite care, the whole lot. I find it shocking on this forum when I read how parents get their child diagnosed in the UK and are then pretty much left to sink or swim.

May I ask how much you pay for insurance and does that cover prescriptions and everything?

Just wanted to say that if you have an in-date EHIC, it's still valid, and if not, you can apply for a GHIC, which gives your the same cover.

@MMMMMaria I worked for the university whose medical centre was the hub if our excellent HMO in America. As such it incentivised employees to choose this HMO rather than the other one, or traditional insurance. I think the cost for excellent family coverage may have risen to about $1800/yr about 10 yrs ago. Then a small copay for office visits. A small prescription charge, similar to the NHS. No fees for emergency care at uni hospital that I can recall and definitely none for inpatient treatment, with private or semi private room. And of course no NI.

I think other employers may have charged more for the same HMO. I don’t know the details. I do know HMOs are not allowed to raise rates on an individual according to age, pre-existing conditions or current illness, etc, and that if an employer is accepted into an HMO all employees who want coverage must be accepted at predetermined rates.

Small copays for emergency treatment out of network, worldwide

Had excellent care once in Spain, lovely new hospital, all tests done rapidly and follow up treatment all taken care of by the eu card as it was then. didnt pay anything at all, lovely helpful doctors, I speak spanish so it was easier. Needed hospital once in USA...prompt and efficient but wanted to keep me there to run tons of tests which i knew were not needed, to rack up the insurance bill...i had bad food poisoning and they wanted to do scans and xrays and put me in a wheelchair etc, insurance paid upfront for it all.

In the USA treatment can be excellent if you have insurance (I did) private room with jacuzzi bath, food on demand 24 hours a day, named nurse I had a buzzer for etc. but it was $25k charged to my insurance quite a few years ago. My uncle lives there and can't afford his medication because his insurance only covers drs visits and in patient not prescriptions, he drives to Canada every two months because a generic version is available there cheaper, only an option due to location (my parents pay for it too I found out)

I live in Germany, I wouldn't say it's better or worse, but I did leave about 10 years ago so not seen the NHS at current status.