To hesitate to move back from US to UK because of terrible state of NHS

[Star555]

(Apologies for the double post; posted on Living Overseas board but realised it's probably better to post here to get the perspective of MNers who currently live in the UK rather than the US)

I'm a long-term expat (in my 30s) living in the US. My parents and I moved to the US many years ago when I was in school, and although I have always thought about moving back home as an adult (I love history and culture and easy access to Europe, which the US woefully lacks), my parents are settled in the US and don't want to move back because they think the UK is in a bad state (failing NHS, high taxes, older infrastructure, etc.) One parent had a major operation recently and is under ongoing treatment at a top hospital here in America, and they think they would not have had received timely care like this in the UK given the current state of the NHS.

I have been on the fence about whether moving back home would be a good choice or not, and am thinking about it more seriously now given the US government situation, although my parents are against the idea. I don't mind the lower salaries in the UK so much (I have a STEM postgraduate degree and would likely have a job at a company in/near London), but I am mainly concerned about the state of healthcare. I have heard so many horror stories about overflowing A&Es and huge waits for life-saving treatments in the UK. I am currently single and don't have any close family or friends in the UK that I could count on for support if I were to need major medical treatment (touch wood). I would be willing to pay (or my employer would pay) for private insurance, but am not sure how much it would truly help.

Has anyone else decided against moving back to the UK, or decided to move out of the UK, primarily because of the sorry state of the NHS? Is access to timely medical care really that bad in London and the South in general? On one hand, I want to return to my homeland and raise (future) children there because of the culture, etc. but on the other hand I want reliable, high-quality medical care for myself and any kids I might have.

This is a joke, right? My family lives in the US and I'm very familiar with the weird way healthcare works there. Getting appointments, getting treatments approved, constant fights with the insurance company to make them pay, headache when they refuse to pay for medication or treatment which always costs thousands. Every time I talk to them it makes me feel so grateful we have the NHS...

And no, my relatives are not poor. They have very good quality expensive insurance. But having private healthcare system does not mean you will be seen instantly, or will have guaranteed treatment, or get to see a good doctor. You still have to wait, you have to shop around to find a good specialist, and you have to be prepared you might have to pay some of the costs, or even all of it.

In any case, you can always get BUPA here or some other scheme. Its not that expensive, and a lot of companies have a family scheme. I had it as an added bonus in several companies I worked with - but I actually never felt the need to use it.

It really is not the same system here. Even if you have private health care insurance it’s not the same system and can’t compare the 2.

My recent experiences:
DS1 fell and hurt his foot. Couldn’t weight bear. Took him to minor injuries/urgent care (right next door to A&E) at 9pm on a Friday. Booked in, triaged, x rayed, diagnosed and left at 11.30pm.
DS2 - lots of nosebleeds. School concerned. In May Got GP appointment for following week. Blood pressure high-ish. Referred to children’s hospital, with appointment 2 weeks later. Given 24 hour monitor there and then, collected by courier next day. Been on two separate medications. Has been part of a trial on hypertension in kids. Has had 3 consultant appointments, with ECGs at each time along with an MRI. All since May.
me - just had gynae surgery. Have been seeing gynae consultant for about 18 months. Trying to avoid hysterectomy. Last appointment needed a scan booked - happened the next day. As well as blood test etc. yes have been delays in the meantime. But that’s because not on the 2 week cancer pathway.
mother - has survived ovarian and bowel cancers including major surgery in the last 10 years. More recently, home GP visits, visits from the repiratory team (has also had recent COPD onset). Also needed an ambulance about 3 months ago - terrible sats. Came within 20 mins, following NHS111 call and referral.
I could go on and on.
yes, my gynae stuff has taken a long time overall. And ds1 has ADHD and needs medication and we’ve gone private for this while waiting for NHS to confirm they will take on the prescribing.
but when push comes to shove, general experience has been excellent - especially for the kids (who are 20 and 16).
south east London. So aware that are lucky to have local hospital and GP services but access to the London teaching/research hospitals too. Might mean less stretched.

In the US health insurance is usually through your employer. If you pay yourself its something like 2k/ month per person. Seeing a dr without insurance is around $700 for one 20min consultation. I had an emergency check up at a hospital for bleeding while pregnant and got a £15k bill (thanks fuck I had good travel insurance) - all it was just a quick check on baby's heartbeat and my blood pressure.

I would.stay in the US no way would I come back to the UK atm.

I might be deluded, but you’re ridiculous. The drama of it! Third world country…? Do you realise how utterly ridiculous that sounds? Look around the room you are in, the chair you are sat on, and give your head a wobble.

Also ‘Two Tier’… Ridiculous. Do you need someone to give you a slap on the back? You’ve swallowed GB News whole - you need to be careful you don’t choke.

The current government really isn’t great. We’ve had worse in the last 5 years. The economy is shite. Couldn’t give a shiny shit about rich people leaving it.

Times are hard. You know what’s not going to turn them around? Hyperbolic overly dramatic carping on about third world fucking countries, talking us down, crushing confidence when we desperately need it.

...on the good side, you don’t send kids to school fearing a mass shooting, but Knife crime is rife.

Knife crime is more prevalent in the US @Mumsgirls

It's just that the rampant shooting statistics so dwarf all other violent crime that it's not spoken about so much.

My friend was diagnosed with breast cancer after a routine mammogram. Surgery was prompt, radiotherapy afterwards. Her only complaint was lack of support afterwards - but not sure what she expects. They do follow-up checks but they can’t be an emotional crutch.
My own DD had numbness on her right side . A call to 111 after a couple days of this and trip to A&E. Next day MRI scan and she was admitted that day for more tests. She was diagnosed with MS relatively quickly (she was about to start her A levels and needed to get some measures put in place in time). She is on expensive medication that costs £1500/injection.
I was six months pregnant when the nurse sent me for a glucose tolerance test because I was measuring big. I was diagnosed with gestational diabetes (eventually developing in to type 1). Immediately put on a different track and went to hospital every week after that. I am now on two kinds of insulins. I also had two caesarean sections.
The cost if all this? Nothing. Sure it’s paid through tax contributions, but if I had never paid a cent into it I’d still get it all for free as a British citizen.
My sister in the US has a child with profound autism. She pays more than $2000/month in health insurance and still has to copay thousands a year for her DD’s medication. She still has to wait for appointments and treatments. Her induced birth cost get close to $6000.
The NHS is far from perfect. It is a safety net not available to many uninsured in the US. But bottom line is I could not afford to live in the US and co pay for insulin or my DD’s medication and regular MRIs. Thank God for the NHS.
Also I took a pay cut when I moved to the US for five years, pay isn’t always less.

@localnotail Are you in a state without a healthcare exchange?

This is bullshit. As someone with several long term health conditions I have nothing but the prise for the NHS.

But judging by the rest of your rant you just there to vent... not to be factual.

I live in the UK. My family are in California.

Don’t care about rich people leaving? So you’re deluded and economically and fiscally illiterate.

Really showing yourself up there.

No point talking to someone with such limited knowledge about the fact that top rate taxpayers who contribute so much are leaving or that the top companies in FTSE are also diverting their investment to the US, many are talking about leaving the stock market altogether, or that Poland’s economy is on track to be bigger than UK’s by 2035.

I imagine you wouldn’t know or care much about that. You know…because confidence is all it takes.

How is that relevant to the OP if she is in a position to pay for private healthcare?

@localnotail Ah. I was really taken aback by the health insurance premiums that you quoted ($2K/month) if you’re not insured through your employer. The premiums are far lower for a Gold (top-of the-range) plan where I live, even for an oldie (51) like me!

Nigel..? Is that you..?

Because the OP literally refers to “the sorry state of the NHS”.

I know that France, Spain, Germany, Sweden, Ireland, Norway and Denmark, among others, are also seeing HNWI leaving in number, in pursuit of more favourable tax arrangements. Also third world countries, I suppose.

I know that the gap between the rich and poor in the UK is one of the widest in the world - trickle down ain’t trickling, and running the country in deference of rich folk hasn’t benefited anyone other than rich folk. You doff your cap though.

Confidence isn’t all it takes. But it is what the markets trade on.

Anyway. This is a pointless conversation. I’ll just say that your perspective on the UK is unpatriotic and toxic. I’m sad you hate your country so much.

Did you know that for people like you, who struggle with imagination and originality, there are now tools like chat GPT that you can use.

You’re discussing A&E and life-saving care, OP. It differs.
A&E for example will always triage patients based on severity. Yes there can be long waits, mainly due to people not always using the service for accidents and emergencies. For example, I had pneumonia which was treated initially via my GP and I was then transferred directly to SDEC (same day emergency care) for x-rays and a scan.

I currently am in treatment for breast cancer within the NHS, and things are moving quickly. I was diagnosed at the start of August, two months on I’ve already had two surgeries and genetic testing, and one set of results.

I do have private healthcare via my work but actually chose to stay in the NHS for my cancer treatment, I’m lucky to live in an area of the U.K. with incredible cancer centres.

Well, this is what I was told! I doubt anyone I know pays it themselves - but I was told this is what it would be if paid privately. I would tell you the name of the insurance but I cant remember )))

We have no complaints about the NHS. When I suddenly fell very ill a couple of years ago, a call to 111 quickly brought an ambulance, I was bluelighted to hospital, where I stayed for 3 weeks. TBH I couldn’t fault the care I received. Maybe I was lucky, but dh had similar for a more minor illness.

I think a lot of Brits would avoid the US in part because of it's healthcare system which seems to put profit above care.
As lots have said there is much wrong with the NHS but you will never be refused care until you show insurance.
It's at it's worst for long waits for none critical conditions. People who need surgery or treatment for a condition which isn't life threatening but is painful. You can always pay for those.
It's at it's best for the urgent.
I've a long list of health conditions, including a history of breast cancer. I doubt any insurance company would touch me.

Last week I rang my GP at 10am about a matter which could have been serious. I saw her at 11am and she sent me to the local SDEC (same day emergency care) who were expecting me. I was seen by a doctor and had bloods and x-ray and was discharged with drugs within 90 minutes. Seriously impressed with the whole system.

So because France is a basket case with the debt to GDP ratio, that’s your bar?

I suspect basic fiscal and economic facts and reality is lost on you too, and you probably have no clue about the basics.

You seem to be confusing confidence with magical fantasy. Like lala land. That’s not how the bond markets work. The real world with real money is a tad different.

@localnotail Tbf, California is an extortionate state to live in, v. beautiful but so expensive. Health insurance could be that expensive there.

That’s another reason why this US vs. UK healthcare debate is complicated, because the American regional differences are also huge. The OP might be getting a good deal where she currently lives. 🤷

Given that I and DH are both the 'top rate' (additional rate) tax payers you talk about and both work for US companies with mostly US colleagues - and I myself work in the US and further afield 4+ months p/year, I see your posts for exactly what they are.

"People like you" are the ones who need to broaden your horizons and realise that what you're being fed by GBeebies and Reform Ltd are maybe not the gospel you take them to be.