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Brits Americans
Quick Health Question 
11th-Oct-2004 11:38 pm
I'm having a debate elsewhere about socialized medicine.

What do you folks think of the UK health system vs the US health system?
11th-Oct-2004 08:59 pm (UTC)
Having had my first experience of the US health system, both through myself trying to get my various insurance parts sorted out, and the trouble my wife has had with getting referrals without incurring fees, having to bounce through different doctors and trying to get emergency referrals dealt with in the sort of timely manner which the insurance system requires, plus the monstrocity which seems to be the administrative behemoth created by health insurance.... I have to believe that the only reason Americans tolerate a private health insurance system is that they've never been somewhere with even a mediocre national health service. The American system, even laying aside the moral horror I associate with depriving people of healthcare on grounds of finance, is a beurocratic nightmare that I cannot view as anything other than a danger to those who are unfortunate enough to have to use it.

I hate the American system with all my being.
(Deleted comment)
11th-Oct-2004 10:08 pm (UTC)
The US has a health care system???

12th-Oct-2004 02:49 am (UTC) - as an american ...:
i could not help but laugh when reading this comment.
not in the funny way, but more in the 'you hit the nail on the head' kinda way.
12th-Oct-2004 12:00 am (UTC)
I've had better health care and, most importantly better preventative health care in the UK than I had for 20 years in the US. And reasonably priced prescription medicine.

I worked 2 jobs in the US with no insurance (it would have cost me 1 weeks' pay a month to get it for myself!) and worried about getting seriously ill.

If one is rich in the US, healthcare is great...otherwise, forget it.

12th-Oct-2004 01:09 am (UTC)
I completely agree with that.
When we lived in the US, we went 4 years without insurance for either of us because it would have sucked too much of our paycheck.
When we got back here, I found out I was pregnant and had amazing care.
12th-Oct-2004 01:07 am (UTC)
I haven't had any first-hand experience of the US healthcare system, so it's difficult for me to compare how they function.
The principles of the two can be pretty easily compared, though, and I was appalled to find out a) Americans have to pay, b) How much Americans have to pay, and c) How much you have to spend on health insurance if it isn't paid by your employers. As a nation, you should be storming the Whitehouse with torches and pitchforks!

The UK system can be slow at times, especially if your condition isn't what they consider to be all that pressing. For potentially serious conditions, the UK system works fast - I had a breast lump spotted, biopsied and removed within 8 weeks. The other week I had pain in one calf so they dispatched me off to the hospital the same morning for a DVT scan. All free. The staff are usually friendly and courteous and the only things that lets the NHS down is the state of the buildings and furniture inside them. This, however, is a cosmetic problem and only makes the waiting rooms rather more depressing than they could be. A pretty minor issue when you're having your health looked after for nothing.

The other (large) difference, as I understand it [and I could be wrong, please correct me if I am!], lies in the way you go about seeing a doctor. In the UK you head straight for your GP for everything, who then either treats you or refers you elsewhere. I gather that in the US you head straight for a specialist. I can't help feeling that the UK's system is better in terms of keeping an overall eye on your health and your medical history - who keeps all your medical records in the US? Do you keep it yourself or do you have to ask all the separate specialists for their files on you?
12th-Oct-2004 04:18 am (UTC)
I gather that in the US you head straight for a specialist.

Depends on the insurance. The insurance I, and my wife, have require a referral from our Primary Care Physicial (GP equivalent) before insurance will pay for the visit. This became a huge problem for us recently, because one specialist she was seeing wanted to send her, the same day, to another specialist. However, her PCP office was closing, and we had a very difficult time getting there in time for us to get the referral before the weekend. If we hadn't made it, an urgent appointment would have had to be missed as insurance wouldn't have paid without the referral.
12th-Oct-2004 01:36 am (UTC)
Having been in the US health care "system" for most of my life and then moving to the UK last year...

NHS all the way! Yes, it does have its flaws, and yes, changes need to be made...but the concept of going to the emergency room when I was desperately ill, being given the medication I needed, and treated well ALL without paying a penny was just incredible to me. No co-pay for visits to my GP. No worry about whether or not I can afford to see the doctor or whether the costs of those tests to determine what's wrong with me will be so outrageous that I can't afford them.

For chronic illnesses that aren't life-threatening, the process *is* longer than it should be...but at least I know that in case of an emergency my husband and I will be cared for. At least I know that when we finally start a family, we won't be bankrupted by the cost of HAVING a child in the first place. At least poor parents here know that if their child falls ill, they can seek care without worrying about paying for food or paying for treatment.

I acknowledge the flaws in this system...but there are a lot of positives too, enough that I don't want to go back to a non-nationalized system any time soon!
12th-Oct-2004 01:11 pm (UTC)
I agree with your statements, esp. in regards to providing care for the poor (in the US, if you are poor and have a broken arm, your choices are duct tape or a six grand medical bill). The NHS can afford to pay for these costs because the prices are not artificially jacked up as they are in the US.


12th-Oct-2004 01:55 am (UTC)
UK all the way...I *hate* having to have health insurance - my health insurance costs more than my tuition, and if I get seriously ill it would be far cheaper for me to just fly home and stumble into the nearest A&E. I used to think my university health service was ok, until they tried to charge me $300 for some blood tests which they well and truly botched. To make matters worse, this was about 2 weeks after I had emptied my bank account to pay my insurance premium.
Bring on John Kerry I say.
It's most annoying because I could get non-essential procedures done here more readily than in the UK, but I can't afford the co-pay because my premium is so high. And don't even get me started on optical/dental care. Also, people in the states seem to be very cavalier about handing out medicines - I've been given tranks and all sorts without being asked anything about my medical history.
Oh, and perhaps the most important thing - free contraception!! Of course $8/mo isn't that much to be paying, but why can't it just be free?
12th-Oct-2004 12:14 pm (UTC)
You can get free contraception!! Try Planned Parenthood or any other similar organizations.
12th-Oct-2004 02:31 am (UTC)
I moved to the UK a year ago, and I'm still flabbergasted by how thoroughly the NHS kicks the US' health care system's butt. There's no contest. American health care is a nightmare. The NHS has some problems and quirks but is reasonable and workable.
12th-Oct-2004 02:34 am (UTC)
Read the 'deaf' and 'hard_of_hearing' LJ communities and weep for the children and adults who can't get hearing aids because insurance doesn't cover them, leading to them being unable to get jobs etc.

The more I find out about the US health 'system', the more I feel ashamed to be American.

I'm not saying the UK system is perfect, and I'm really glad I have private insurance through my partner's job, because waiting for consultant appointments can take forever, but the system exists and people don't suffer in pain for lack of money, unlike several Americans I know who can't afford their asthma inhalers/painkillers/contraceptives/etc.

And how the f is it that insurers in the US can cover Viagra but not contraceptives? Not to mention abortion services. The best thing about state-run healthcare would be the churches having to butt out.
12th-Oct-2004 10:12 am (UTC)
We have a friend who has a prosthetic leg. Her insurance covers it--with a 20% copay. A leg from the knee down costs something like $20,000; a really good leg with a mechanical knee costs $100,000: or $20,000 WITH insurance.
12th-Oct-2004 04:05 am (UTC)
Having lived a "wealthy" life the last 28 years or so I'd say the healthcare system in the US for upper and upper middle class is great...but I am about to become poor so I guess I'll find out the truth now!
I don't know much about the UK system other then my boyfriend has been in huge amounts of pain for the last couple weeks due to a very bad toothache and they refuse to get him into a dentist right away to fix it. I mean due to the amount of pain he is in I would think of it as an "emergency" but instead he will be coming over to the US in 2 days with a temporary filling whatever the heck that is!
14th-Oct-2004 12:37 pm (UTC)
I don't understand this comment of yours : "they refuse to get him into a dentist right away to fix it." Who is 'they'? I would assume if your boyfriend is registered with a local dental practice, and he phoned up to get an appointment they would give one to him as soon as possible.
12th-Oct-2004 04:33 am (UTC) - Quick Question
That's funny. This subject can fill volumes!
12th-Oct-2004 07:10 pm (UTC) - Re: Quick Question
And so it is!

But that's OK. I proved my point. In my debate elsewhere, someone called the UK health system a 'failure'. Taking an aggregate read of all of these posts, I'd say that there's at least enough good in the system for it to rate better than 'failure'.
12th-Oct-2004 05:01 am (UTC)
I've lived in both places and also work in healthcare in the U.S. I don't think the American healthcare system is quite as bad nationwide as it's generally made out to be, as our practice treats quite a few lower-income families and state-by-state coverage differs, but things are overall a lot easier in the U.K. You're not absolutely screwed in the U.S. if you've not got insurance - hospitals are still obligated to treat you for emergency care - but this winds up costing taxpayers billions in unreimbursed hospital funds that we'd be spending anyway on a national health system.

And to complicate the situation: That being said, since governmental money doesn't go toward a socialized health system in the U.S., it frees up a lot more for research, and of course private research exceeds even that. Canada, France, and the U.K. have nationalized health systems that are much better than the insurance-or-out-of-pocket system in the U.S., but they tend to take most of their bigger medical discoveries, new drugs, and new treatments from the U.S. So even if you're covered under a national health system elsewhere, in some ways your health system is still dependent on the American system. As with the economy, socializing services in health has a tendency to slow innovation somewhat.

So I don't know. I think overall I'd prefer to have an NHS-style system in the U.S. but there are obviously complications.

- Madox
12th-Oct-2004 06:13 am (UTC)
Being English ans asthmatic I am far better off under the US health sytem,
In England I was given the very basic medication I needed, I was having 4-5 attacks a day but my medication was never upgraded because of budgets given to each doctor by the NHS.
In the USA I have been put on better medication and my asthma is getting much better, when I go to a doctor over here I am given a thorough medical examination, in the UK it the most they could do to take my blood presure.
Many years ago in UK i was crushed up against a wall by a truck, and the "care" I received at the hospital? a doctor came pulled my leg around a bit made me screem like a girl, and told me to take asprin and rest it I suffer daily pain and all the UK doc's give me is pain killers. now in the US one doc's visit and I am going to a specialist to get x-rays, MRI's to find out what is wrong.
US health-care is by far much better, even though you have to pay for insurance.
12th-Oct-2004 06:59 am (UTC)
Well, don't have any first-hand experience of the NHS, but I'd like to offer another view of the US system.

I've never had any real problems with health care in the US. Never had insurance that required me to get a referral. Never had to wait more than a day or so for an appointment (unlike what I hear about the NHS). Never had any problem seeing a doctor I wanted to see, when I wanted to see them, at a cost I considered reasonable. And it's not like I was working some fancy high-paying job; it's been a $7.50/hr bagel shop job and a $23,000/yr admin position. I don't think my experience is absolutely typical, but then again, I don't think it's terribly uncommon, either.

And people without insurance aren't left completely out in the cold. There are free and sliding scale clinics, and hospitals will give emergency care on the spot, and work out payment details later (sliding scale and payment plans are often options). It's not a great system, and I would love to see proper coverage for those without insurance, but it's really not so dire as many seem to think.

There are going to be horror stories with any system. I've heard them about the NHS, as well as the US. I don't know. The US system has its strengths and weaknesses. I'd imagine so does the NHS.
12th-Oct-2004 10:37 am (UTC)
The only thing I don't like about the US health system, is the cost. It is so expensive for everything. Not everyone has insurance. And the free ones aren't as easy to get as some people make out. You have to earn under a certain amount, and that doesn't include what goes to bills each month. And you can pay out of pocket to be in the hospital, but it can cost thousands. Insurance is a must, or you will be left in the cold. My mom didn't have insurance for a long time, and she only went to the doctor if it was really bad, because she couldn't afford the visit, and the medicine(if she needed any). She's lucky she has it now, she doesn'y have to worry about getting ill and the huge bills she'll be left with. I'm lucky that I get it from the government. I've had 4 wisdom teeth out, and upper GI, I had to see a urologist and a kidney doctor. I can't imagine how much it would cost if I had to pay for all of that.
Iv'e been to the docotr in England, and I was very surprised that they didn't want money as soon as you walked through the door. I paid about £7 antibiotics. I'm going to the dentist for a check up in a week and it's going to cost less than £10. The doctors I've seen were really nice, too. I don't have to worry about paying shit loads of money if I get sick. I'd prefer the NHS anyday. You don't have to worry about insurance, and if you don't have it, you don't have to decide what bill you can afford to pay if you ever get sick.
The end.
12th-Oct-2004 02:23 pm (UTC)
having just moved from the US to the uk, i have to say i like the idea of a government funded system better. there were a lot of headaches surrounding my health insurance in the US during this period of about 6 months where i wasn't a student so i wasn't covered under my mom's insurance, and my job didn't offer any health insurance benefits at all. so i was completely without any health insurance, and was freaking out about getting seriously injured or ill. luckily nothing happened though.

i'm covered under the NHS over here in the uk, even without having to be a UK citizen! when i came to the university here, they gave me my meningitis, MMR, and hepatitis B immunisations for free... i was going to get them in the US before i left, but they would have cost about $80 each. it's really nice not having to worry about health insurance of any sort while i'm here, i have enough things to worry about/pay for being an international student!

the only thing that kind of irks me about the UK is the fact that flu immunisations are REALLY hard to get here. i've gotten one the past 8 years in a row in the US, just by simply walking into any drug store/supermarket, and paying $20. here they give them out for free, but you have to be either old or high risk to be eligible. as far as i know, there's no way to get one otherwise, even if i want to pay them for it.
12th-Oct-2004 06:34 pm (UTC)
Call your GP about the flu vaccine, or the University health service. It may be limited this year because of supply problems (I know that that's the case in the US, and the US supply comes from the UK, so I imagine it's the same there), but I was always able to get a flu jab at work or at University.
12th-Oct-2004 03:45 pm (UTC)
I have not been impressed with my visits to my UK doctor. For my initial visit, I went in with dizziness, low blood sugar, fever, and nauseousness. My (voodoo) doctor had already diagnosed me and printed out my prescription before he even met me! He didn't check my vitals, he spent a record 7 minutes talking to me, and then handed me a script for an antidepressant. His diagnosis? Anxiety and depression because I had suffered from the two during college. His parting words? "If it's something serious, it will still be around when I see you in two weeks time."

What was actually wrong with me? Metabolic syndrome- the pre stages of diabetes. I had to change my diet, exercise, and switch to a less stressful and demanding job. I'm currently in the process of finding a doctor that I actually have some kind of faith in...it's not going too well. Apparently, finding a doctor who is both English and educated in England or America is quite a stretch.

I will not be having any babies in the UK, that's for damn sure. =)

(Sorry if I sound a little bitter...my dad's a doctor, so I've become accustomed to the highest standard possible...it's been difficult to see someone who isn't as invested in finding out what's wrong.)
12th-Oct-2004 06:36 pm (UTC)
Hmm, sorry to hear you've been having a hard time in the UK. I have to say that my experience with doctors in the UK, apart from a couple of isolated cases, has been excellent. Good luck with your search.
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