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.

… and all the other countries with higher rate tax payers leaving? Anything to say about them? Because it is very clear that France was not my bar. I would have just mentioned France and not the other 5 or 6 countries that immediately came to mind. But selectively using information to build a one-eyed argument is par for the course for the ‘true patriot’.

Bond markets trade heavily on confidence - that IS the real world. I’m not sure you understand the words you are using.

We are returning to the U.K. from the US in a month.
I guess my big question is: if you stay in the US, are you in a financial position where you’ll be able to handle the very real possibility that your insurance premium may well double or triple in price as a result of the current tit-for-tat over healthcare at the centre of the government shutdown?
If the subsidies don’t get approved, the insurance companies will absolutely say “well, we are going to make our money from somewhere”……and that somewhere is going to be people’s premiums.
The most alarming report I’ve seen so far is a couple in their 60’s, previously paying $400-something per month, are now being quoted over $2k per month.
One of my biggest gripes of life in the US is the for-profit healthcare system. It’s completely inhumane. Yeah, you can see a doctor when you want to and can get treatment for non-emergent stuff in a timely manner…..but the financial burden on the average earner who doesn’t qualify for MediCare/MedicAid is crippling. My DH used to be a firefighter/EMT and it wasn’t uncommon for them to be called by people’s neighbours/family members, show up to the address and find the person literally on the brink of death because they were worried about the cost of calling an ambulance and the subsequent treatment in a hospital.

oh is this like, when raging, screaming hysterics turn up at the service counter of a shop, don’t get a refund for the manky old coat they’ve clear worn for weeks, and then say ‘I’m a manager in retail you know, I wanna speak to your manager’.

‘I work for a US company’ is that meant to be some kind of flex? If that’s your come back after you tried to hurl insults, then I’m embarrassed for you.

My and my family’s recent experiences of the NHS in different specialities in three separate regions have been generally good to excellent, including GP services. I’m scheduled for a procedure this week that I know would cost me £2000-£3000 privately and would have saved me only about a fortnight’s wait had I gone down the private route.
Where things go wrong they can go badly wrong, and staff are often overworked and poorly treated. I feel for them. But when the NHS works well it can work very well, and I suspect that it mostly does.

Oh you mentioned France without knowing what you were talking about about and now you want to say you didn’t really mean to talk about France. Cute.

Look I have plenty to say about the other countries, but it’s not my job to educate you about the basics. You could educate yourself, rather than embarrassing yourself.

You could easily look at Eurozone performance and debt to GDP ratio. As for bond markets, you seem to be triggered by the use of that. Is that because you accidentally googled it just now and saw UK’s gilt yields. Did you figure out what you read. Do you now understand how dire the situation is? I suspect not.

@WhatIsTheCharge i completely agree that the NHS model is the better one when it works well.

Ha! I have the reverse situation where I would like to move back to the US. Born in Britain, spent a good chunk of adult life living on both coasts, then came back here to have kids. Now desperate to leave UK but realistically it has to be here or the US and the political situation there is even more dire than here.

If you are a high earner and have no chronic health conditions that limit your ability to work, you are much better off in the US. Have you investigated just how much lower your salary will be here? Certainly in my industry the difference is insane. It’s hard to compare cost of living because it so depends on the two areas you are comparing, different things are expensive and lifestyles are different anyway. But generally taxes and cost of living are very high here and you don’t get good public services to match. State education is generally better here or at least there is less inequality, private school fees vs earnings are insane.

For people saying you can pay for private healthcare here just like you can in the US, have you actually experienced both systems? I have good BUPA and Medicare coverage here but good private infrastructure simply doesn’t exist in the UK. If I needed a serious op I would not want to have it in a private hospital. For things like gynae, routine stuff, yes BUPA and a private GP is fine.

I never understand all these ‘massive bill’ statements for the US healthcare posts. My employer pays 85% of my insurance premium. They put money into a medical savings account every paycheck which can be used on medical, dental, or vision. Insurance has a max out of pocket, so your insurance might be billed a lot, but you don’t personally pay it. Plus our income is 3x it was in the UK so even if we met our out of pocket every year, which we have never even been close, then we’d still be quids in. Personally I think you’d be kind of crazy moving back to the UK. The majority of my UK relatives are just fed up with the way things are over there. I absolutely love my life in the US and feel very grateful to have had this opportunity.

It’s a shame you won’t educate me because you’re a natural teacher. I think it’s the warm charm. I’m just hanging on your every word…

I've just got chat GTP. (I know, but it's the best estimate I could come up with) To estimate the cost of the hospital treatment child had went seriously ill. You're looking at $3-4 million. The likely out of pocket expense with reasonably good health insurance would be $30,000 to $100,000.

In the UK, our only expense was car parking and our food, excluding lots of earnings. In America I would have had to have continued working or risk losing the health insurance for my child. Or she would have been covered under public programs, that would have been an administrative hell at a time when my only care was whether she would live.

No, it's not perfect, but when it needs to be it can be and often is amazing. There's no way I'd move to somewhere like America with a health condition. I have peace of mind here.

I’m so grateful for it.
They saved my DS’s life when he was just a tiny baby, the ongoing specialist care from his consultant and the dietetics department was outstanding for the years they were looking after him. The NHS midwives who attended my home births. The paramedic who held my hand the entire way to the hospital while I held my baby during the scariest medical emergency I’ve ever experienced - incredible people doing their best with the shit-sandwich they are presented with every single day.
Also quite lovely to not have extortionate medical bills arrive in the post.
My SIL had a baby a couple of weeks ago - hospital birth with an epidural. She has health insurance but it’s still going to cost her $4500 out of pocket after insurance 🫣🫣🫣🫣

Coming back to the thread now, had a quick look through all the replies and will read more later. Thanks for sharing all your experiences!

To clarify, I would definitely get private insurance (either paying on my own, or more likely through employer) so I wouldn't be relying on "just" the NHS. But I know that at the end of the day, the resources/doctors are the same regardless of NHS-only or private, but having private insurance provides faster appointments. (Please correct me if I'm wrong.)

As I mentioned in an earlier post, I am healthy and have no chronic conditions, thankfully. But I have had many one-off issues needing urgent treatment at an urgent care or emergency room if it was a weekend / late night (such as a fracture, infection and sudden swelling, severe pneumonia, etc.) Also, wait times in the US, even at top hospitals and with referrals, to see specialists or have surgery can be pretty long (several months). I know of one case where an operation was needed to diagnose an anomaly that showed up on a scan during an emergency visit, but the surgeon was on holiday so it was delayed by a month. After the operation revealed cancer, there was again a few months' delay before chemotherapy could begin due to lack of available appointments. And the patient's stay in the hospital was terrible -- very poorly staffed with nurses, even if the patient pressed the call button for something urgent (vomiting, IV drip disconnected, alarm beeping, etc.), help would take more than 30 min to arrive, etc. All this was in a major US city with excellent hospitals! So I'm worried that the situation in London/Southeast might be even worse, with longer delays, lack of follow-up appointments, etc. Hopefully I won't need any of this, but I would feel safer knowing that reasonably timely, good-quality care is available at least in a way comparable to what we have in the US.

There was a thread on MN the other day about a lady whose DH spent over a day waiting in A&E with a perforated bowel and had no choice but to sleep on the floor...which is terrible. I know someone who went to the emergency room here in the US with a bowel obstruction and they were triaged and given a bed almost immediately.

@WildLimePoet You're clearly deluded but I'll humour you momentarily...

Do you not think the reason I mentioned working in the US for a US employer might be because your whole premise is that the US is so great while the UK and Europe are utterly crap, when in fact some of us see exactly what is going on 'on the ground'?

The US economy is not "doing great under Trump" at all. US stocks are currently flying but that's not 'the US economy'.

Instead of telling the rest of us how stupid we are and how you have all the facts, you should do some work on the veracity of what you're posting.

Maybe I've been lucky but in my family any issues in the last few years have been dealt with by the NHS well and very promptly. Both me and DH have had cancer scares in the last 2 years and were both seen within 2 weeks. I was seen by a consultant 10 days after being referred by a GP after an issue picked up on ultrasound. The next day I had an MRI and although it fortunately wasn't cancer was referred to to the relevant department and has surgery within 6 months. The surgeon was fantastic and even took 30 mins from his busy day to call me to go over all my concerns and extra information I wanted him to have. Ok so the nurses in the post op ward weren't amazing (bed side manner wise) but they did their job.

DH was found to be anaemic after finding blood in his poo. He had a FIT test within a week and was fast tracked for an endoscopy and colononscopy this month. The people in that department were lovely. So kind and caring. He had a large adenoma removed there and then and because of that they are rechecking him in 3 years.

These are 2 of many experiences in my family recently. I know some people have issues and I know the NHS is struggling but it is still a damn good institution and I would chose it over private 95% of the time.

There are obviously issues with the NHS. But you will read about the bad more than the good.

I’ve had two life threatening health issues in the last year. Once my GP arranged for me to have a blood test the day I went in, the out of hours GP called me that night to tell me to go to a&e and I went straight there and was immediately given a bed. The second was cancer where I had surgery within 3 weeks of diagnosis, delayed only by needing an mri and some other tests. I think mostly (not always) it works well where there’s a genuine emergency.

but having private insurance provides faster appointments. (Please correct me if I'm wrong.)
Private will often get you faster appts or surgeries and it’s good to have a second opinion easily, my cancer was diagnosed privately due to having issues with getting my gp to take me seriously and I think this may depend on what company you go with but lots (all?) will let you choose your surgeon/specialist to see if that’s important to you

A couple of weeks ago I had pins and needles in my hands and bruising on my legs. I used my GP’s online ‘describe your symptoms and we’ll triage you’ system.

They invited me for an appointment within the hour. I was with my GP two hours after I’d submitted the form. She referred me for same day emergency care. 5 hours after I sent my form, I was in hospital.

I know it’s not the same for everyone. But you only hear the dramatic ‘14 hours in A&E without a chair’ bad news stories. There are plenty - PLENTY - of good news stories. They’re just not as headline grabbing.

I know it’s not the same for everyone. But you only hear the dramatic ‘14 hours in A&E without a chair’ bad news stories. There are plenty - PLENTY - of good news stories. They’re just not as headline grabbing.

@Bloozie I agree. It’s the same in the US, the worst healthcare stories are the ones that get reported here too.

My son had a bowel obstruction last year which turned out to be caused by cancer and he was triaged and given a bed almost immediately and that was actually when it was suspected to be gastroenteritis.

His case became complicated as unbeknown to us, the cancer had caused a twist in his bowel which caused some of his bowel to begin to die which then caused septic shock. My son had a cardiac arrest in the middle of a children's assessment ward and their outstanding care meant that they got him back.

He was transferred to a children's hospital with a PICU as soon as he was stable enough with a critical care team in the ambulance rather than a standard hospital transfer. He then had 2 high risk surgeries within the next 2 days to remove the dead part of his bowel and fit a stoma to allow his bowel time to heal and rest, both times I was told that it's possible he wouldn't survive as he was in multi organ failure due to septic shock and against all of the odds, he made it through both surgeries. Not long after the 2nd surgery, he declined again and they put him on ECMO to rest his heart and lungs which is what slowly began to stabilise him and it was able to be removed after about a week. We then found out a few days after that it was cancer that had caused all of this.

He was too unwell for chemotherapy at this point and as the cancer was all removed during his surgery and scans kept coming up clear, we all decided that chemotherapy when everything looked clear was a bad idea. Unfortunately, it came back 4 months later and steroids were started the same day, chemotherapy a few days later because they didn't want to start it over the weekend with less staff as he was at risk for bowel perforation and tumor lysis.

7 weeks in PICU
3 months inpatient chemotherapy
10 months in hospital overall
1 year in remission as of last month

They performed a miracle on my son.

For every bad experience, there's an experience like my son's but they don't get talked about as much and I feel like it's only the bad experiences you hear.

My recent NHS experience has been brilliant. Saw a GP with a breast lump on a Wednesday afternoon in February, seen at breast clinic on the Friday morning. I’ve since had surgery, chemotherapy and radiotherapy and the only thing it cost me was my train fare to one of the hospitals.

Private medical insurance is good for non emergency treatments. Dh saved a wait for a hernia op that way. Even paying out of pocket for treatments isn’t that expensive comparatively.

Having lived in the US and Uk as an adult the UK far outweighs the US for me and my family. It seems like a cliche but I was afraid of ‘shootings’ and the healthcare system seems better in some ways but so many people wouldn’t dream of going to a Dr or getting a prescription for fear of cost. And one of the reasons people get treated so badly at work is because they are scared to death of losing their jobs (a lot of this is to do with health/dental), so put up with shit working hours, and low annual leave and really crappy maternity. They are conditioned to put up and shut up.

for me the UK even with its issues is far better for a safer happier family life than the US.

(not to mention the UK has a much better sense of humour and generally don’t take religion quite so seriously either).

edited to add I had to call an ambulance when my waters broke quickly and I couldn’t make it to hospital, the paramedics arrived in seven minutes and delivered my DD before midwife could attended. They were wonderful and I named my DD after the female paramedic.

i live in SE london, NHS is brilliant, it’s better than when I’m from (Ireland) never had much of a problem. I have some health problems and always get appointments quite quickly, doctors are generally good, spoke to my neurologist on the phone recently, very personable I thought to be able to arrange phone calls with them. GPs are hit and miss but I get appointments fast. Free medication if you’re pregnant and one year postpartum, same with dental care.

The simplest way to think about it:

If all you’ve ever known is the NHS, the US system is very scary.

If all you've ever known is the US system, you will cycle between marvelling at what you get on the NHS to being mildly horrified.

If you can look at both with an objective lens you will see there are pluses and negatives to both depending on your circumstances.

As I see it, healthcare doesn’t factor in

Reasons to leave/not move the US:
The horrifying political situation and racism (however don’t kid yourself that that can’t/wont happen in the UK)
Work culture, employment rights and crap holidays
Most of the other things (educational choices, culture) can be offset a bit by moving to a major coastal city and travelling

Reasons to leave/not move to the UK:
Parochialism, racism and a stupid political situation/race to the bottom
Taxes and what you get in return for them
Miserable salaries
The climate
Disingenuous British communication style

@OneZanyPoet We disagree on the British climate, I love it!

Me too 😂

I currently live in a desert state and the summers are beyond brutal. It’s rained twice this year.
It’s currently still 83°F outside. I’m looking forward to coming back to the U.K. and October actually October-ing properly 😂