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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsTake it from an American - Britain's NHS is as good as it gets
It's interesting to read a personal experience of Britain's NHS (National Health Service; a single payer healthcare system) written by an American who moved to the UK and was skeptical and wary of the NHS at first. Anyone who reads a few stories like this one will be convinced that the UK system is vastly superior; yes, it has some issues but the free doctor visits, $12 (maximum) charge for each prescription, no deductibles, no copays, in fact no bills, almost no paperwork, more than make up for such issues as being made to wait for non-urgent care (especially when patients can avoid the wait if they want to by paying privately, at a price that is likely lower than the deductible and copay that even an insured American would pay).
Also the UK pays less than half of what the US pays for healthcare and the life expectancy in the UK is longer than that in the US. UK doctors don't have to worry about networks, insurance companies, or masses of paperwork and can focus on treating their patients. No wonder most British people are astonished at the US healthcare system and cannot comprehend why in a rich country like the US there are such things as fundraisers for medical expenses when a child gets cancer.
NOTE: this article is published under a Creative Commons Attribution-NonCommercial 3.0 licence and so the 4 paragraph limit does not apply. http://creativecommons.org/licenses/by-nc/3.0/
As an American, I have followed the debate about the future of the National Health Service with curious fascination. I must say I dont entirely understand why this has even become a question why anyone seriously thinks that privatizing the NHS would be a good idea, or why we have to resort to citizen campaigns simply in order to keep it around. As far as I can tell, the NHS is one of the best things Britain has going for it, and it would be a monumental step backward to let it go.
I havent always held these views. Being on the left, I have long been committed to the principle of socialized healthcare, but, like most of my countrymen, I secretly suspected that such a system could never really work in practice. Before I moved to London in 2011, I had visions of the NHS as a quagmire of forms, queues, and long waiting times. These assumptions affect US progressives as much as they do devotees of Fox News: theyre in the water, part of the commonsense furniture of everyday life. Somehow we all end up believing that Americas private, for-profit healthcare system is our only hope, and without it were likely to end up dying while waiting in line for basic treatment. For most Americans, the specter of socialized healthcare and of the NHS in particular looms like the heavy shadow of Russian bureaucracy in a Gogol novel.
I was forced to confront these assumptions when I made my first visit to the doctor, which I put off for a long time out of sheer fear. I expected to have to take a train to some government complex where I would submit myself before a nameless bureaucrat behind a glass barrier in a brutalist concrete building. I literally thought this. So I was pleasantly surprised when it turned out that all I had to do was walk five minutes down the road to the nearest GP.
Upon arriving, I went straight up to the counter no queuing required and asked to register. Instead of the multiple page forms that I expected to fill out, which I had grown accustomed to completing every time I visited a doctor in the United States, I was presented with a single quarter sheet with the obvious fields: name, date of birth, and address. Nobody asked me for a health insurance card. Nobody asked if I would be able to pay. Nobody asked me for a British passport to prove that I was worthy of care. The edifices of my worldview began to crumble around me.
Fine, I thought: registration may be simple, but surely Ill have to wait weeks for my appointment? Or even months? I was wrong again. I was given a slot that very afternoon.
I did have to sit in the waiting room, Ill admit: for a sum total of 15 minutes. During that time, I marveled at the attractive display of public health information lining the walls something I had never encountered in the US. It struck me, for the first time, that a publically funded healthcare system actually has an incentive to maintain good public health through mass education and preventative care. What a refreshing change from the perverse incentives built into the American model, which not only lacks this motive but operates according to the opposite logic: the more bad health there is in the population, the more money there is to be made from it.
My doctor was warm and professional, set up the referral and ordered my tests, and sent me on my way. As I passed by the receptionist at the front desk I felt almost guilty, and actually stopped to ask her if I needed to pay anything before leaving: surely there must be at least a small fee? She laughed at me. To this day, three years later, I still cant get used to it, to the idea of health as a public good it seems too humane to be true.
Some might rush to conclude that this surprisingly positive experience is probably due to the fact that I live in a posh white part of London. But I dont. I live in Kilburn, and the clinic in question is adjacent to a number of council estates. The vast majority of the clinics patients are working class, and only about half of them are white. The first-rate care I receive is the care that every resident receives, regardless of their race or class as a basic human right, as part of the social contract, as a feature of the collective solidarity that Clement Atlees Labour government forged in the 1940s from the ashes of World War II.
And its not just that this clinic happens to be a good apple in a barrel of bad. Ive been referred to specialists in other units including large hospitals on a number of occasions, and each time Ive found myself amazed at the efficiency of the service. At one point I was referred for a possible case of melanoma. I was seen by a dermatologist at the first break in my schedule. So much for languishing in line for treatment. Why so efficient? Because theres a powerful incentive at work: the NHS saves money by catching cancer early.
And its not just life-threatening illnesses that call forth the best of the NHS. The mundane phlebotomy lab I had to visit recently at the Royal Free Hospital was run like a well-oiled machine, caring for fifty patients an hour at peak time without a glitch. The system just works. We neednt rely on anecdotes to prove this. The Commonwealth Fund recently released a report comparing the health systems of 11 highly industrialized countries. In the category of efficiency, the UK ranked number 1. The US, by contrast, ranked last. So much for the theory that profit stimulates efficiency. The UK also ranks well above the US in terms of timeliness of care, contrary to Fox News propaganda.
I suppose I shouldnt be surprised; while living in the US I spent an astonishing amount of time waiting for appointments and sitting in receptions, even as a paying customer. I sometimes caught myself wondering if things might be different if I were able to pay more.
And its not just in the areas of efficiency and timeliness that the UK performs so well. It comes first in almost every other category equity, access, quality, etc. making it the best overall healthcare system in the world. As for the overall ranking of the US: dead last, again. The Commonwealth study didnt measure bureaucracy, but I suspect that here too the UK would win handily. While living in the States I was regularly frustrated by the amount of time I had to spend not just filling out forms, but reviewing costs, interpreting bills, paying fees, comparing coverage plans, and badgering my insurance company over the phone to shell out for their fair share (an obligation they routinely shirked).
Its no wonder that 30% of healthcare spending in the US is absorbed by bureaucracy nearly twice the proportion that other industrialized countries spend. This is rather strange, given that the chief justification for private healthcare is that it suffers less bureaucracy. It turns out that exactly the opposite is true.
As for how likely a patient is to die for want of life-saving services: I wouldnt choose to take my chances in the US, given that Im not a millionaire. A close friend of mine recently discovered she had a fast-growing mass on her ovary that would lead to swift death if it wasnt removed within the month. It sounds like a no-brainer, but before she scheduled the surgery she had to count the costs: her insurance company agreed to cover 80% (after much pressure from her doctors to get the company to cover it at all), but she would be responsible for the remainder a sobering $40,000. Shes alive today, but shell spend many years working extra hours to pay off the loan she took out just to stay alive.
She is not alone. Millions of Americans are in debt due to healthcare costs, which is the number one cause of personal bankruptcy in the United States. In the UK we dont have to face this terrible anxiety; it would be difficult for me to overstate how liberating this feels.
These are stories and statistics that I regularly wheel out during conversations with my American friends and family. And while they usually accept the evidence that I offer up (albeit somewhat grudgingly), they always insist that, sure, it sounds like a great service, but theres no way it can be financially viable, right? But here again the evidence defies assumptions. The Commonwealth study confirms that the cost the UK pays for delivering the best healthcare in the world is less than any other industrialized nation: only $3,405 per capita. The most expensive healthcare system, by contrast, is the US, at $8,508 per capita more than double the UK, while delivering much worse results.
Critics of the NHS claim that we cant afford to pay for it; but the truth is that we cant afford not to.
These data tell a clear story. But ultimately its not the extrinsic values of efficiency, timeliness, and low cost that make the NHS great. The NHS is great because its built on the principles of solidarity, universality, and equality and because it is staffed by people who believe deeply in its basic moral mission. It is for these reasons that, when the NHS was founded in 1948, the Minister for Health Aneurin Bevan famously proclaimed that it was the most civilized step that any country has ever taken.
Yet, tragically, the present government is doing its best to dismantle the NHS, with the ultimate goal, it would seem, of replacing it with the US model. The Health and Social Care Act of 2012 put an end to the mandate for the state to provide comprehensive healthcare to every resident of England free at the point of use, and has allowed for-profit companies to buy up huge chunks of the NHS (£10 billion worth of contracts have already been handed out since the Act was passed). The Tories know the US system performs worse on every conceivable count, but they are willing to go there anyhow: the healthcare market-in-waiting is just too juicy to leave untapped.
Bevan knew that the NHS would face opposition from powerful private interests, but he was hopeful that it would prevail: The NHS will stand, he said, as long as there are those who will fight for it. Many Britons are doing just that. But, thanks to skillful government subterfuge, the vast majority do not even know that their cherished healthcare system is under threat, and many others dont understand what its like to live with the dysfunctions of a private alternative. Its sometimes hard to realize how good something is until its taken away from you. To England, I say, take it from an American: what you have is as good as it gets, and its worth defending. Your civilization depends on it.
https://www.opendemocracy.net/ournhs/jason-hickel/take-it-from-american-britain%27s-nhs-is-as-good-as-it-gets
This article is published under a Creative Commons Attribution-NonCommercial 3.0 licence: http://creativecommons.org/licenses/by-nc/3.0/
mike_c
(36,281 posts)...and they much prefer the NHS to the health care they struggled to obtain in the U.S. Whenever someone uses the NHS as an example of bad health care delivery, I know they've been swayed by propaganda. No one I know who actually has the NHS wants to trade it for U.S. insurance managed health care.
roguevalley
(40,656 posts)London once and the hotel sent a doctor up. The bill was $10 US and I am still in shock. Bedside visit. Nice man. All was well. Suck on that, America.
(I am an American)
hifiguy
(33,688 posts)who was married to a than-work colleague of mine. This guy was a specialist - radiology - and a Republican doctor from a long line of Republican doctors. He was for single-payer. Very strongly. Why?
His explanation was strikingly simple - countless doctor and staff-hours were wasted every year in arguing with insurance companies and in trying to comply and deal with the umpteen kinds of forms and record-keeping requirements of each one of the insurers, no two of which were remotely the same.
"We could practice better medicine, pay more attention to patients and make as much money, even at lower reimbursement rates, with single payer because everything would be so much simpler and more efficient. We would make back at least as much as we'd lose and maybe more, as a result of the efficiency and we'd see more patients."
Fumesucker
(45,851 posts)roguevalley
(40,656 posts)MEDICAID EXPANSION WON'T ALLOW THE BILL TO REACH THE FLOOR! Our governor Walker wants it majorly. So does everyone I know. There was even picketing on corners to get it passed. REPUBLICANS ARE SATAN!
http://www.adn.com/article/20150514/alaska-house-finance-committee-says-it-wont-advance-medicaid-expansion
everyone who dies now is blood on their fucking hands.
Spitfire of ATJ
(32,723 posts)Nobody could POSSIBLY want to heal the sick without picking their pocket.
KeepItReal
(7,769 posts)My British ex-girlfriend bumped her head getting in a taxi and passed out with a concussion in London. We took an ambulance to the emergency room. I was concerned the whole visit that they had misspelled her name (which was about the only identifying information they asked for). She got X-Rays and an examination and diagnosis from the doctor.
Once she was coherent enough and physically able to leave the hospital, we said goodbye to the attending doctor and just walked right out the door to go pick up her prescription. No billing department to check in or cash out with...No ambulance, emergency room visit and X-ray bills bombarding her later on.
The experience was actually efficient, pleasant and kinda funny (she couldn't remember who I was until hours later and was very opinionated about the X-Ray technician's fashion choices).
Imagine that.
Nye Bevan
(25,406 posts)resulting in a $25,000 non-network deductible payment, either.
This was one of the most telling paragraphs in the article:
As I passed by the receptionist at the front desk I felt almost guilty, and actually stopped to ask her if I needed to pay anything before leaving: surely there must be at least a small fee? She laughed at me. To this day, three years later, I still cant get used to it, to the idea of health as a public good it seems too humane to be true.
KeepItReal
(7,769 posts)I was really trippin at the time that the hospital didn't have my girl ID'ed properly.
But it really didn't matter, since nothing the hospital did was contingent on her ability to pay.
Rolando
(88 posts)One morning in Tucson, AZ, at the checkout line in a supermarket, I suddenly became dizzy and passed out, striking my skull on the concrete floor. When I regained consciousness, four EMT guys were loading me up for a one-mile trip to University Medical Center. I had a concussion, and my brain was swelling. I spent three days and two nights in the hospital. The bill was over $22,000. But they didn't have to operate.
KeepItReal
(7,769 posts)The rest of the civilized, industrial world knows it and works like that.
Our privatized, for-profit health care system sucks.
project_bluebook
(411 posts)Where the citizens go right to a specialist depending on their needs, no $10,000 copay, no corporate middleman.
KeepItReal
(7,769 posts)No for-profit hospitals for our vanquished foes.
Telcontar
(660 posts)They aren't the best examples of free health care you want put out.
PatrickforO
(14,574 posts)That's (gasp!) SOCIALISM (shudder!)
So...here's OUR system...
Here's NHA:
This is why I like Bernie Sanders. He's for single payer because he believes healthcare is a basic right.
GO BERNIE!!!!!
Nye Bevan
(25,406 posts)but I fully understand that there are some things, such as the police, firefighters, and health care, for which free markets do not work, as the US healthcare system tragically proves.
LiberalLovinLug
(14,173 posts)As a Canadian, who would love to see my American friends enjoy the same comfort and access as we do under our own Medicare program, I was flabbergasted when there was no investigative stories about the state of the "socialized" healthcare system in their close neighbors to the north. I remember they had Michael Moore on once only on CNN, but also had on that sellout Dr. Sanjay Gupta at the same time in order to give his "professional" opinion about how terrible Single Payer is and how it can't work in the US. And of course FOX News had on a crazy woman from Canada as their "insider". A woman that was convicted of stalking among other things on a professor in a Canadian University, who went on about all the horrors of our system. I was shouting at the television..couldn't they just have sent a few reporters to ask people on the street what they thought? Because, yes there would be some complaints, but overall, just like the UK, we value our public healthcare system and wouldn't give it up for anything.
Rolando
(88 posts)My sister spent some time in Kamloops on a frolic of her own, but while there she became ill. She went to a doctor for a diagnosis and learned that because she was enrolled in a community college (part time) somehow or other she didn't have to pay, but she also learned that she had cancer. The Canadian doctors treated it (without delay), and she went into remission before (back home in Houston) the illness returned after about three years. She died while under treatment at M.D. Anderson center, one of the best cancer treatment centers in the world.
mahina
(17,653 posts)Thank you for telling us her story, or some of it.
erronis
(15,257 posts)Stephen Hawking both British and not dead
Obama health reform critics face inconvenient truth
In perhaps the most amusing effort to discredit US President Barack Obama's plan for nationalized health care - if not the most ridiculous - US financial newspaper Investor's Business Daily has said that if Stephen Hawking were British, he would be dead.
"The controlling of medical costs in countries such as Britain through rationing, and the health consequences thereof, are legendary," read a recent editorial from the paper. "The stories of people dying on a waiting list or being denied altogether read like a horror script...
"People such as scientist Stephen Hawking wouldn't have a chance in the UK, where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless."
The paper has since been notified that Hawking is both British and still among the living. And it has edited the editorial, acknowledging that the original version incorrectly represented the whereabouts of perhaps the world's most famous scientific mind. But it has not acknowledged that its mention of Hawking misrepresented the NHS as well.
"I wouldnt be here today if it were not for the NHS," Hawking told The Guardian. "I have received a large amount of high-quality treatment without which I would not have survived."
PumpkinAle
(1,210 posts)doing what he can to bring the NHS to its knees.
I have relatives that are in the NHS in various specialties and they are so worried about Cameron and his "republican tendencies". They talk to people and don't realize the extent of the lies put out by the Cons and that for all its faults the NHS is a true jewel and one that should be fought for.
geardaddy
(24,931 posts)Doctor_J
(36,392 posts)valerief
(53,235 posts)countries. We only pay for WAR.
hifiguy
(33,688 posts)yet still pay no taxes.
What an age we live in.
AtheistCrusader
(33,982 posts)I'd rather import a copy of Germany's system.
Nye Bevan
(25,406 posts)I have read quite a bit about the UK's system but am completely unfamiliar with Germany's. What are the advantages of the latter?
AtheistCrusader
(33,982 posts)Incredible results at 5.5% less/GDP than the U.S.
JDPriestly
(57,936 posts)As an expectant mother back some years ago, I along with all the other pregnant women at my stage of pregnancy in our little town was called into the pediatrician's office for a little pep talk and some advice. Our children were to be late summer, early fall children. We were advised not to start them in school too early because each child should be mature enough to succeed. We were given so many helpful hints just in that hour. The personal touch of hearing the information from a pediatrician we could trust was great.
Yes. I held my daughter back a year. When we came to the US, her second grade teacher stayed after school to tutor her and she skipped a grade. She was way ahead in some topics but English was really a challenge.
The pediatrician's advice was great.
cynannmarie
(113 posts)In April, my husband and I flew from CA to London and on the flight my husband fainted on the way to the lav and fell hard against the raised back of the flight attendant's jump seat, causing a large laceration on his eyelid and huge swelling around eye and on nose. After landing, I knew he needed to have medical attention, and sutures. First we went to a neighborhood clinic (near where we were visiting friends) where a nurse cleaned the wounds and a Dr. looked at him. Dr said we needed to go to a ER to have a specialist treat his eye. Off to a small hospital where a nurse practitioner examined him and sent us to larger hospital ER because of the complexity of the eye injury. There he had EKG, blood test and exam and wound treatment by 2 compassionate and competent doctors, was given antibiotic eye gel to take with him. NO CHARGES at any facility. We asked to pay, and it was declined. NO paperwork whatsoever anywhere. He was only asked for his name.
Angel Martin
(942 posts)how long go was this?
my Dad had a heart attack in 2013 while travelling in the UK, and ended up with a 40,000 pound hospital bill
my parents' travel insurance eventually paid it (after getting lawyers involved)
this was a public hospital in London, and the care he had was as good as Canada.
melm00se
(4,992 posts)about something.
With NHS, why, the last time I was in London, were tube stations plastered with advertisements for secondary insurance plans?
muriel_volestrangler
(101,316 posts)You get private rooms, rather than a ward, in hospital stays; they may have a lot shorter waiting lists for non-urgent treatment (eg an anterior cruciate ligament operation; I don't know what the waiting list is like now, but it used to be huge in the 90s; a friend of mine had been waiting over a year in the UK when he got transferred to Italy with company medical care, managed to convince them it wasn't a pre-existing condition, and had it done at once); the plans may cover things the NHS might make you pay for as well, like non-vital physiotherapy, and for some people there's cachet in having private insurance.
treestar
(82,383 posts)I have a friend down under and when I visited, she was talking about having health insurance too.
Joe Chi Minh
(15,229 posts)Nye Bevan
(25,406 posts)quite a lot of people would still want to pay extra for a Mercedes.
pinboy3niner
(53,339 posts)Sorry, couldn't help myself. Can I help it if I'm an NCIS fan?
itcfish
(1,828 posts)for a few years, and their NHS was excellent. Now the rightwing government has destroyed it. No chemo for cancer patients, no meds for hepatitis patients and many other horror stories.
Helen Borg
(3,963 posts)Because they want private insurance companies their buddies own to take over...
Enthusiast
(50,983 posts)TPTB do not want us to have profit free health care in the USA. They are making too much free money.
Joe Chi Minh
(15,229 posts)greatest peace-time politicians in the last century, probably ever, since until recently, the trajectory of the public's lot has been progressive.
"Lloyd George gained a heroic reputation with his energetic work as Minister of Munitions, 191516, setting the stage for his move up.[22]
When the Shell Crisis of 1915 dismayed public opinion with the news that the Army was running short of artillery shells, demands rose for a strong leader to take charge of munitions. The cabinet was reconstituted as the first coalition ministry in May 1915, and Lloyd George was made Minister of Munitions in a new department created after a munitions shortage.[23] In this position he won great applause, which formed the basis for his political ascent. All historians agree that he boosted national morale and focused attention on the urgent need for greater output, but many also say the increase in munitions output in 1915-16 was due largely to reforms already underway, though not yet effective, before he arrived. The Ministry broke through the cumbersome bureaucracy of the War Office, resolved labour problems, rationalised the supply system and dramatically increased production. Within a year it became the largest buyer, seller, and employer in Britain.[24]"
So, he was no slouch as a war leader either.
JDPriestly
(57,936 posts)in Europe, and I will vouch for every word in this article. The European healthcare systems beat ours in terms of compassionate, efficient patient care that is affordable any day.
And I have Kaiser which works in some ways a bit like the European system and is probably the best that the US has to offer. It's not as good as the European system, but it could tell a lot of other health insurance companies how to do business and we would all be a lot better off.
Romulox
(25,960 posts)I don't know how to reconcile the cognitive dissonance of the conventional wisdom.
truebluegreen
(9,033 posts)and without it were likely to end up dying while waiting in line for basic treatment."
No, we don't.
JCMach1
(27,558 posts)(pretty much the same sort of thing you get in the US). Also, Yanks pay full-price for the visit now. Ending-up costing me around $80 and meds around $60.
Even the UAE, with private insurance was 100x better than the system here in the USA. In a private system, the government price controls there actually work. Free market with price controls...
Nye Bevan
(25,406 posts)Pulling all that data together, researchers found that the average charge for an emergency room trip for all these conditions came out to $1,233, which is 40 percent higher than the average American rent right now, $871 per month.
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/02/an-average-er-visit-costs-more-than-an-average-months-rent/
So I'm not sure that your UK experience of a visit costing $80 plus medications costing $60 was all that horrific, when placed in context.
JCMach1
(27,558 posts)but, like I said... Yanks pay full-price now.
Still, for UK Citizens a good bit better than the schizophrenic and dysfunctional US system.
Ruby the Liberal
(26,219 posts)That was a great read.
Sobax
(110 posts)And I can also vouch for every word in this article. Privatizing the NHS would be a disaster. Private companies might be efficient at penny pinching and making a profit the shareholders, but not so much at providing a service to the public. The privatization of the UK rail industry being a good example.