The NHS is horrible, unless you've come from America
The National Health Service (NHS) here in the UK gets bashed A LOT, and it's not completely unwarranted. The system is under funded and over-stretched. The huge amounts of money that were supposed to be available to the NHS after BREXIT never appeared, and because of BREXIT, many of the very talented caregivers who would normally come to work for the NHS aren't, due to new requirements and restrictions.
As my husband likes to point out, Brits love to complain about most things, and the NHS is one of the top five. When I share just a little bit of my own experience with US healthcare, most people reply, "Oh. I guess the NHS isn't so bad after all."
If you're not familiar with the concept of universal health coverage, it's a system where all citizens (and in many cases residents) are guaranteed health care regardless of their ability to pay. Here in the UK, there are no billing departments; no cashier to visit before you are allowed to leave (or even before you can get care.) And you don't dread opening the post to find a surprise charge that will clear out your savings. According to a recent articles in Forbes Magazine, about 7.4% of US residents have medical expenses that they are unable to pay/afford every year. The term used is "catastrophic", defined as "out-of-pocket spending exceeding 40% of household income after basic necessities have been met". This results in over half a million personal bankruptcy files every year. While it isn't impossible for this to happen here in the UK, it is very rare.
So now to our personal experiences with US and UK health care:
US health insurance:
While still in the states, I paid about $300/month to cover myself and my husband for the top-tier BCBS plan through my employer. My employer paid about $600, so total cost was around $900/mo. We had a $500 deductible, so when I needed a procedure done last year, my out of pocket was a bit more than that since I had co-pays for other related services such as lab work and scans. I'd guess it cost me about $650 out of pocket in the end.
Appendectomy in the US:
Our eldest was visiting us in the US from Northern Ireland a few years earlier, and had purchased travel health insurance. One night he was feeling really unwell, so his dad took him to emergency. His appendix was inflamed and at risk of rupturing. He ended up having keyhole surgery, spending a single night in the hospital. His bill? $130,000. There's a much longer story about the surgeon never getting paid due to his staff's incompetence, but that's not the point of this post.
Cataracts in the UK:
After we'd been here in the UK a few months, I went for an eye exam since my sight was worsening. I was told I had cataracts in both eyes and asked if I'd like a referral to the NHS. I said yes, and visited a clinic that contracts with the NHS to perform cataract surgery. They give you the option to have it done privately for £3000 or on the NHS. The only drawback is that the NHS only allows a single vision lens, where private gives you the option for a multi-focal one.
I didn't hear back from the clinic in Berkshire until March, when were already in the process of moving North so I asked about a referral to another clinic. That was done last week, I had a new evaluation up here this week, and will have the first cataract removed in two weeks. How much have I paid? Nothing.
Injury in the UK:
The week we moved up here I was out in the garden one night and tripped over patio furniture in the dark, landing hard on my right shoulder. After lying in bed crying for about 20 minutes, Ian decided to call 999 (equivalent to 911 in the US). The person on the phone took all the information and said I should get a call back shortly for further triage. The call came about 20 minutes later, more information was taken, and I was then told to head to A&E (Accident & Emergency) for x-rays. When we arrived, the wait time posted for ambulatory was 3-1/2 hours. I checked in at the front desk with my name, birthday, and address; no credit card, no insurance card. My vitals were taken by a woman in a screened off corner of the reception area, I saw a nurse who confirmed I needed x-rays, went to x-ray, then saw a doctor who confirmed nothing was broken, and someone else came in and fitted me with a sling. I was handed a paper to give to the front desk so a follow up appointment would be made with orthopaedics. We were heading home about 90 minutes after arriving. A couple of days later, someone called to set up the orthopaedic appointment. At that appointment, a specialist confirmed the diagnosis and said he would refer me to physical therapy. I had that appointment two days ago, where that doctor confirmed things were healing fine, and my range of movement was good and should improve over time. How much did I pay? Nothing.
Asthma in the UK:
My husband has asthma and has been needing his inhaler quite a bit lately due to all the pollen in the air.(but DANG, England is beautiful in the spring) His inhaler was out of date, almost empty, and he was feeling like he would need steroids soon. Again, this was just after we moved North, so he wasn't registered at the local GP, and since his prescription was from the US, they couldn't do anything for him right away. This time he called 111, which is for less urgent issues. He got an appointment the same day at A&E. He met with a doctor who confirmed his asthma and gave him a new prescription right away. Cost? Nothing.
Granted, Ian paid into this system when he lived and worked here, and I paid about £3000 for the NHS fee as part of my visa application. That's less than £100($135) per month (my visa is for 33 months). When I was working, I was paying a big chunk of my salary as well, but I'm not complaining since I hadn't been paying into this system previously and it's probably still less that I paid in premiums in the US.
No, this system isn't perfect, and it does fall short in many ways, but no one is dying because they didn't have a credit card on file when they showed up at the hospital or couldn't make the copay for a doctor's visit.
Even if I didn't use the system, I'm happy live in a country that believes that health care is a right, not a privilege.
Next up: the unique experience of buying a house in England.
Happy to be an American living in the Midlands.
Juliette
References:
Forbes: Increasing Burdens Of Medical Debt And Bankruptcy Are Uniquely American
Edge Hill University: Why NHS England is struggling – despite more staff and money
National Humanities Center: The Causes, Controversies, and Consequences of Brexit
Forbes: Increasing Burdens Of Medical Debt And Bankruptcy Are Uniquely American
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