Britain’s National Health Service, or Socialized Medicine is the Best Thing Since Sliced Bread

Lately I’ve been seeing a fair few doctors, which is far from an ideal way to live.  For one thing, I’d produce more blog posts if I weren’t spending so much time being prodded by this one or sitting in the waiting room to see that one.  But when I need the care of doctors, I’m tremendously grateful that I’m in the hands of the British National Health Service.  Coming from the US, where even in affluent, high-tech Silicon Valley I had serious problems getting the care I needed via employee plans and HMOs, the NHS seems nearly miraculous.  It’s given me excellent care, and given me far and away the best access to care I’ve ever had.

What follows the first image below is a post about the NHS that I wrote in March 2012  when I was guest blogger at Vie Hebdomadaires.

If all remains well, I’ll be back in the saddle here next week, with new posts about my Anglo-American Experience, but for now, here’s a bit about the wonderful ‘socialized’ health service that keeps me going:

The main entrance to the Royal Surrey County Hospital, the big local hospital which I'd rather see a bit less of, though I'm grateful to have it!

The main entrance to the Royal Surrey County Hospital, the big local hospital which I’d rather see a bit less of, though I’m grateful to have it!

When health care was a hot topic during the 2008 presidential campaign, I made some remark on Facebook about getting fabulous government-paid-for health care here in the UK, and how I wished everybody in the US could have the same.  But a friend in New England popped up to say “Go ahead and ask for socialized medicine, if you want Americans to have the same crappy health care you get over there.”

Huh?

Why would she think I would go to the trouble of posting a recommendation for a system that’s not any good?  Okay, we can agree to disagree about where healthcare should come from—no problem there—but why would she think that I would say the UK’s National Health Service is great if it isn’t?  Her belief that government health care must be bad seemed to be so strong that it was easier for her to believe I would say “vote for socialized medicine, even though it’s awful” than for her to believe that I get great health care from Britain’s National Health Services (NHS).

It was and is great to be at some remove from the US election process, but it can be difficult when my British neighbors ask me to explain American views and all I can say is that I don’t get it, either.  Most British people can’t understand why Americans don’t want a government-funded health care system.  We have roads, don’t we?  And nobody complains about socialized road maintenance, do they?  Isn’t peoples’ health more important than the roads?

(One of the presidential candidates spoke during the primaries for the 2008 election about how we aren’t willing to pay $150 to care for a diabetic’s feet but we’ll pay $30,000 when that uninsured diabetic has to have a foot amputated at the county general hospital.  I mentioned that to a friend who got quiet and then eventually told me “That very thing happened to my mother in New York”.  All the doctors except the anaesthesiologist waived their fees in that case because her mother couldn’t pay anything—laudable, but not really very fair to anyone, and wouldn’t it be better if we’d paid less and the lady kept both feet?)

A British mother with two toddlers said to me “Surely there’s health care for children, though, isn’t there?”  I explained that there was a proposal to extend a Medicare-type program to children, but President Bush vetoed it.  She kept saying “But the little children…” in a way that would have been comical if she hadn’t been so obviously shaken by the idea that there are children in the developed world who don’t get health care because their families can’t afford it, and that the society they live in, given the choice, allows that situation to continue.

(A friend in California was pregnant a few years ago when her company changed health care systems.  She had a choice of two plans, but her long-time family GP was on one and her obstetrician was on the other.  She couldn’t keep seeing them both.)

We may not be living in a total paradise here, but I definitely get care as good as I’ve ever had in my life, and without doubt I have awesomely, unbelievably better access to doctors and hospitals and scans and all kinds of medical services than I ever had when I lived in either Kentucky or California.

Yesterday was my birthday.  Now, it’s not very festive to run errands on your birthday, but off I went to get things done, and my first tasks were to schedule an eye test—which is free, because I have a family history of glaucoma—and to pick up my refilled prescriptions—also free.

(I’ve read that over 40% of US bankruptcies are caused by medical debt.  Almost no one in the UK goes bankrupt because of medical bills.)

The Fairlands Medical and Dental Centre, home to my GP's practice

The Fairlands Medical and Dental Centre, home to my GP’s practice; the blue sign on the right-hand side is for the in-house pharmacy.

Prescriptions are free here to everyone under 16 or over 60, anyone who’s pregnant or recently had a baby, who’s undergoing cancer treatment, who is permanently disabled with certain disabilities, or who has certain medical conditions. I get free prescriptions because I take thyroid hormones, but it could be diabetes, or epilepsy, or any of several particular conditions.  If you have to have thyroid supplements to live, they’re willing to give them to you, and for other prescriptions, well, the NHS thinks it’s cheaper and more fair to pay for all of your prescriptions, because who can say which of your other ailments aren’t ultimately a result of your thyroid problem?

(A cousin of mine in the US, in his 40s and employed full time with benefits, has just had to go on insulin, and the cost of prescriptions means he can no longer afford to live on his own, so he’s moved back in with his parents.)

I have never once since moving to the UK asked to see a GP and not gotten in the same day, though of course I don’t ask for an immediate appointment unless it’s urgent.  I won’t necessarily see my own GP, but I’ll see another partner in the practice, and that’s fine with me.  I haven’t run into a dud yet.

(At the California HMO I had last, before I moved here, I usually had to wait three weeks to see the doctor.  For recurring painful problems, she told me to write to her by fax because her staff wouldn’t screen out faxes from patients like they screen out phone calls from patients, and she could then phone the pharmacy with a prescription for what I needed.  If we didn’t do an end-run around her staff, I’d have to go to Urgent Care.)

Here in the UK there are restrictions on what doctor you can see, but they might not be ones you’d expect.  Mainly, there is a defined “catchment area” for my doctor’s surgery (US: doctor’s office); they won’t take you on as a patient if you don’t live within that area.  Why?  They make house calls.  NHS GPs generally do.  I’ve never seen a US doctor who made house calls; it’s something from the mythic past, tales handed down from grandparents.  And my doctor’s practice is not the only one operating in my neighborhood; I’ve got a lot of choice.

(The first HMO I belonged to in California didn’t allow me to switch doctors until the yearly open enrollment period in October, but when October rolled around one year, I wasn’t allowed to switch doctors because none of the other doctors in my area who were on my company’s plan were taking new patients. I had to stay, for another whole year, with a doctor I didn’t like.)

Life is just…completely different when you don’t worry about pre-existing conditions, or losing your health care along with your job.  If you get laid off in the UK, you’re still completely covered. You can change jobs at will and—here’s one for “job creators”—you can start your own business without wondering how you’re going to pay the doctor if something happens, or provide health care to employees.

(An American uncle retired to Colorado to be near his grandchildren, but it turned out his retirement health care plan from his employer only paid for care in the state in which he’d been employed, even though the same provider operated in Colorado. Oops.)

This is our village clinic--a little satellite of the larger clinic at Fairlands (in previous photo).  The sign says Glaziers Lane Surgery; the doctors from Fairlands cycle through this surgery (also called the Normandy Surgery), and we have a small dispensary there for prescriptions.  The staff there is second to none!

This is our village clinic–a little satellite of the larger clinic at Fairlands (in previous photo). The sign says Glaziers Lane Surgery; the doctors from Fairlands cycle through this surgery (also called the Normandy Surgery), and we have a small dispensary there for prescriptions. The staff there is second to none!

But you’ve probably heard we have horrendous waiting times for operations here.  Well, we used to.  That’s outdated information, but you don’t get headlines screaming “No unreasonable delays for health care in Britain anymore”.

And admittedly, there is a so-called postcode lottery, which means that depending on where you live, the NHS might provide better care or worse care than the average.  I’ve never been dissatisfied with the care, so I don’t have anything to offer except that most large services do have local variations, though you hope that everything meets at least minimum standards.

When minimum standards aren’t upheld, it’s national news and the headlines are huge.  A few years ago someone who wasn’t happy with the hospital care for her elderly mother ran up to the prime minister while cameras were rolling and asked him what he was going to do about it.  If the care isn’t good, you can write to your member of parliament, who can get involved in your case.  The newspapers like nothing better than to ask why the government isn’t doing more to help some sick and vulnerable person.

And you may have heard that some large percentage of British people are unsatisfied with the NHS.  There are lots of British people; some probably are dissatisfied at any given time.  But one study a couple of years ago asked people whether the NHS was doing a good job, and people said no, a terrible job, the hospitals aren’t sanitary, the waiting times are long.  But when the same people were asked what they thought of the care they got personally, they said it was great!  Their local doctor?  Just fine.  Local hospital?  Doing a first class job.  Maybe it’s a case of people believing the worst, or at least fearing the worst.

(Another California friend told her husband he’d have to give up his consulting business and get a job with benefits, because medical insurance was costing them as much as some people make in a year and covered just the parents and one child—the other kid had asthma, and she couldn’t find insurance that would take him—and keeping up with the claim paperwork had turned into a half time job for her.)

I have heard religious people in the Bible belt say that the government has no responsibility to help the sick, and that Jesus’ parable of the Good Samaritan teaches us that we should perform personal acts of charity; it has nothing to do with the government.

Well, I can’t personally go out and help everybody who needs care, so I’m very happy that the government will do that for me.

Yes, we pay high taxes here, but those taxes buy me a lot of obviously good things, including knowing that I and all my neighbors will have medical care free at the point of delivery.  I don’t worry about other government services being “socialized”—paving the roads, training firefighters, policing the streets—so why should “socialized medicine” be seen as such a threat?  I’m here to tell you, socialized medicine is great where I live.

The first time after we moved here that I walked out of an NHS doctor’s surgery (US: doctor’s office), I kept looking over my shoulder.  Were they going to come chasing after me?  I couldn’t just leave, surely; I went back in and asked at the desk.  Was there really no co-payment?  Nope, nothing to pay.  Don’t I at least have to sign something, or fill in a form?  No, no forms, you can just go on with your day.

Wow.

It’s really the people who make the NHS what it is, and I regret that I didn’t get permission to use photos of the staff at the wonderful Glaziers Lane/Normandy surgery.  Maybe next time!  For now, I apologize for only offering you photos of buildings.

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20 Comments

Filed under Culture, Law/Politics/Government, My Life & Stuff That Happened

20 responses to “Britain’s National Health Service, or Socialized Medicine is the Best Thing Since Sliced Bread

  1. Your insight is spot on. As a doctor I had a patient who moved to the US with her boyfriend and I suppose would eventually be a US citizen. She broke up with the boyfriend but stayed in the US because of her job. She took a better job but thats when trouble started. Her new job did not give her health insurance until she worked there for a year. Her old health insurance stopped when she quit the previous job. On the way to work she slipped on the ice and broke her leg (femur). The surgery was very expensive and she could not work for months. The doctor refused to see her again without insurance. She went broke with medical bills and was being evicted from her house. Her mother paid her plane ticket back to the UK so she could get health care and some compensation until she found another job. Life was much better — unfortunately, Americans don’t have the NHS as a backup plan!

  2. Malcolm

    Even I, who was born before the NHS was even thought of, can still be amazed. Though still British, my wife and I live in Ireland, where they’re still working toward universal healthcare. But when we have needed to visit a doctor in Britain, it has still amazed us that all our treatment and drugs are free and we don’t need to sign a thing.
    America spends as much per head on merely administering healthcare as Britain spends per head on the entire NHS–admin, consultation, treatment, and drugs.

  3. Jocelyn

    LISTEN TO THIS WOMAN. Yes, the NHS has problems, but they are nothing at all compared to the problems in the American system. I’ve experienced both and thank my lucky stars for the NHS on a regular basis. The last thing this system needs is privatisation!!!

  4. Mary Ellen, I second everything you’ve written here. It should be pointed out that the UK does have private medical services and sometimes it makes sense to use them (ie, private physiotherapy if you’ve had an injury and want to begin rehab as soon as possible)..

  5. As a Brit who grew up with the NHS, I think it’s marvellous – and so does everyone I know. Of course there are problems – how could there not be – but to my mind free, universal health-care is symbolic of a civilized society.

    Like most Brits, I have been shocked at the, to our minds insane, opposition to Obama’s health care reforms. But I have been even more shocked and angered by the language of some on the right, characterising political support for socialised health care as “tyranny”. Not only does such language undermine any serious point they might possibly have but it is insulting to all those who have died and suffered under genuine tyrants.

    • I know Im late to tge party, but not all is as it seems with Obama’s grat heakthcare program.
      I lost my health insurance because I worked 29.7 hours per week instead of 30. I lost work hours because reducing my work hours releases my employer from offering insurance. More importantly, dur to know being reduced to care from the Veterans Adm., I lost ALL of my specialist including my psychiatrist, rheumatologist, oncologist, and opthamologist. Read the latest on VA xare ifvyou wonder why Im upset. Obamacare has done nothing but take a life that was difficult and make it much harder. At the rate things are going I may find myself living out of my car within the not to distant future. Sad thought for a person that has taken care of herself and work since I was 14.

      • Obviously you’re angry, but equally obviously there’s more going on in modern life to make you angry than just Obamacare. It’s not unreasonable for the Obamacare system depends on Veterans’ services to provide care; what’s unreasonable is that the Veteran’s services care is underfunded and poor. The Republican congress that won’t pass a decent budget, and cowardly politicians of all parties who are scared of the word “taxes” have something to do with that.

        Yes, as you say in another comment, someone has to pay for free health care. In the same way that someone has to pay for the free fire department and the free mowing on the verges of the highways. Why is it so hard for Americans to wrap their heads around the idea that taxes are just a way of sharing the cost of services we all need?? You’re willing to pay taxes to fill potholes, but not for health care? Those are some weird priorities…

  6. I just wrote an article about the Affordable Care Act here in the US, and I was pleasantly surprised by much of it. I had had a generally disappointed feeling that it was just a cave-in to special interests, and I know that some of it is. But things are changing. First of all, everyone will get preventive health care free of charge. I was standing in line at the pediatricians’ office not too long ago and heard the woman ahead of me react in shock as she tried to pass over her credit card to the office staff. “It’s free,” the woman behind the counter said. “Free?” The mother was dumbfounded. But of course preventive care MUST be free in any functional healthcare system. That’s how you get people in the door before they end up in the emergency room like the woman you mention above. The next thing the ACA has done is to get rid of the pre-existing condition and lifetime cap clauses in ALL health insurance. Anyone will be able to buy insurance and no one will be turned away. And if you get sick, they won’t start footing you with the bill if you get too expensive.

    My belief is that Americans generally have a Groucho Marx, “Whatever it is, I’m against it” reaction to changes in their basic lifestyle. But once the changes actually happen, most of the resistance will fizzle. It’s like the idea of gay rights: unthinkable a generation ago, but now pretty much a non-issue with the younger set. So I see a future in which a Democratic president and congress push through a single payer option, now that there is a crack in the veneer. Notice that the Republican governors who’d said that their states aren’t going to take part are now caving in, one by one. How can they justify bad healthcare in their states when the next-door neighbors are talking about how great it is? Especially since the most conservative states in the US are more likely to take more government handouts (something that irks me to no end). They complain about big government, but when the money gets handed out, they’re the first in line to grab it. Here in liberal California, we send more money to the Feds than we get back. That money is given to… you guessed it… conservative southern welfare states that elect Republicans who say they want a smaller government…

    OK, I’m with you, Mary Ellen. When people ask why Americans are so crazy, just go ahead and shrug. It’s really inexplicable!

  7. Ella

    My daughter was born with milk intolerance. In the US, her replacement milk would cost us $120/week. And not be covered by insurance.
    In the UK, it was free – and I know some of my tax money has partially paid towards other children like her, who would have either have to starve or suffer with disastrous health issues in adulthood,
    That’s ok by me.

    • There is no such thing as “FREE”; someone pays the bill. Since many Americans now collect from the government, because they are illiterate, because tgey will not work a job beneath their skill level, because tgere are no full tyime jobs, just who, exactly , is going to pay for your free preventive healthchealth care; you?

      • Over here, we do it by having higher taxes on richer people and corporations. I’ve got free health care, and it’s paid for. You seem to think it won’t work, but it’s already working, so that’s kind of a non-argument…

    • It’s called WIC dear and it is free. Also, it does not cost 120.00 a week for soy milk because I had two on it at one time and they are now 25 and 27 years old. As a matter of fact my youngest was on pregestamil while my next in line was on soy milk, and WIC helped us with all of it.

      • She said replacement milk, not WIC or soy milk. You don’t know what kind of special milk-replacement formula her kid needed. I expect people who discuss things here to play fair and not be snotty to each other (that ‘dear’ was not an endearment, I think). That’s a warning, after your first three comments–in fact you’re the first commenter I’ve ever felt I had to warn.

        ADDENDUM: I took a look at the info re WIC on Wikipedia. The program was phased in over time, and for many years didn’t cover all states. At times you had to meet a low-income threshold. It’s clear that a lot of children/families at a lot of times since WIC first came in wouldn’t’ve been eligible, and we don’t know when or where this person was when her child needed a milk substitute.

        I’d like to hope that people in discussions here can give each other the benefit of the doubt most of the time…

  8. Rod Cuff

    (As Mary-Ellen knows, I wanted to comment on the first day I read her post, many weeks ago, but hit technical troubles …)

    This entry deserves to be praised from the rooftops, and your American readers need to know that you are telling it EXACTLY as it is — and that just about everyone in the UK seems baffled by why healthcare reform in the USA is battled against so vociferously.

    The delay in my posting this has fortuitously enabled me to add a couple more things. Firstly, there’s what lookm from the first programme to be an excellent series about the NHS, warts and wonders and all, on BBC2 TV, called Keeping Britain Alive: The NHS in a Day (www.bbc.co.uk/programmes/b01rk2d0). A hundred camera crews spread around the UK on a single day, with excellent access to NHS facilities and activities and patients, and this work has been turned into eight one-hour programmes. Frustratingly, I doubt that it’s available easily at the moment outside the UK, but if PBS (the only likely US channel) shows it, I urge any American sceptics reading this to try out an episode or two. What gets done free of charge at the point of need in the NHS is humbling.

    Secondly, a (second-hand) personal story. In mid-December, my nearly 7-months-pregnant daughter and her partner, based in Europe, decided (unwisely) to take a short break in New York before parenthood makes that sort of things a trickier prospect. Alas, things went badly wrong after a couple of days, and she ended up in a (good) Manhattan hospital for 5 weeks, finally giving birth at the second induction attempt in mid-January, and miraculously being able to come home with the baby a couple of weeks later. The staff at the hospital were wonderful to her and her partner, and she couldn’t have had better care. But had she not been insured, her hospital bill would have been $75,000 just for her, and around $2,000 per day for her baby in intensive care. She spent a frightened and very tense three weeks or so before she knew for certain that the insurance company would cover the medical costs. Had this happened in England to a visiting American citizen, everything would have been free, as far as I’m aware — and the quality of care would have been very unlikely to be much different.

    The NHS, with the faults it has, is still a miracle, and one that my parents, myself and my family over decades have been thankful for to an immeasurable degree. It probably saved my life at age 7, and that was just the start.

  9. Cathy Jaspers

    Nothing is “free”. Interesting that no one has brought up the subject of individual tax rates in the U.K. Or that you can die waiting for surgery to be scheduled…..

    • Tax rates: Yep, we pay a high rate of tax. We also get a lot for our money. There aren’t beggars at every stoplight here, like I see when I visit the Bay Area. The crime rate is lower. And everybody — *everybody* — gets their health care paid for.

      As for dying while waiting for surgery: my grandfather in Mississippi died while waiting for insurance approval for medical care. Yes, people occasionally fall through the cracks of any system. On the other hand, one of my best friends had a seizure out of the blue the other day — 43yo, never smoke, barely drinks, doesn’t own a car and, in a slow week, bicycles at least 100 miles on her commute. She was at the hospital in minutes and had X-ray, CT, and MRI scans within an hour. The next day they did a different CT scan (different dye). Today is her 4th day in the hospital, and they’ll decide whether to send her home or move her to a hospital that specializes in neurology.

      Her bill for this is zero, zip, nada.

      So yes, we pay high taxes and the system isn’t perfect. On the other hand, I can create my own business out of nothing but brainpower and elbow-grease, and not have to worry about where my health care is coming from, and I’m getting better care than I did when I lived in Palo Alto, and went to a clinic where the specialists came from Stanford’s Medical School.

      I know you won’t believe me, but this is, by far, the better system.

      • Not only do people in the US die waiting for surgery – they bankrupt their families by getting cancer, they have to choose between healthcare and paying their mortgage, they avoid getting diagnoses for conditions that would be seen as “pre-existing conditions” by insurance companies. The Republican line that “everyone gets great healthcare here” has an understood “who deserves it” in there. We have simultaneously some of the best and the worst healthcare in the world.

        Everything is changing now, though. The Republicans are absolutely DESPERATE to stop the Affordable Care Act now, because people are starting to get used to it already. For example, I just wrote an article on teenage mental health. Turns out that until now, families would avoid getting mental health diagnoses for their kids because once you get “bipolar” or something similar, something seen as a lifetime condition, on a kid’s record, they would never, ever be able to get insurance again! So families would deny their kids necessary care. That is now illegal.

        It used to be that families would forego preventive care because they couldn’t afford it, then end up in the emergency room with preventable illnesses. With kids, this was most often the case with asthma. A cheap, easy disease to maintain, it becomes very expensive when not treated. Again, that has already changed: Everyone in this country now gets a free preventive care visit once a year if they want it.

        It used to be that families would just have to pray that their young adult children wouldn’t get in an accident or get a terrible disease, because they couldn’t keep them on their insurance even if they were living at home. That has changed and now young adults to 26 years old can be on their parents’ policy.

        I have to admit, I prefer a single payer option. But already, with only little pieces of the legislation implemented, things are improving. Already, if the Republicans do gain control in 2014, they will not be able to take these things away from people or they would be completely destroyed as a party.

        The way I see it, conservatives, esp. libertarians, think this way: “If everyone were just like me, everything would be fine.” But you can’t legislate on wishful thinking.

  10. The public’s perception of a National Health System in the USA has been and is being corrupted by among many things, the enormous power medial companies have in the USA (Both Rx & OTC products). Theses companies sponsor 70+ % of the ads on “all” the TV networks national news and a high percentage of Internet news websites too. This in turn corrupts truth in reporting by said outlets as the last thing they want to do is have 70% of their funding move to a different network if they promote in anyway, a less profitable health care system for their sponsors.

    Theses media outlets manipulate & exaggerate stories about poor care, waiting room times, death boards… to bring fear into the minds of the American public. Look at all the hoopla about the rollout of website that the government only gave about 2 months to perfect after finalizing what they wanted it to do, instead of the needed 6-12 months. With trillions at stake over time, the healthcare merchants won’t be fighting fair, that i’m sure of. If you are a US citizen and can’t see any truth in what I say here, you have been deceived.

    I have had more than one prescription that costs over $20 A DAY ($600 a month each). Worse yet the prices for these drugs can vary from as low as a $10 deductible a month to $600 or more for the exact same (generic) Rx. This is just my personal experience, I’m sure there are even worse examples.

    Yes healthcare in the USA is among the best in the world if you can afford it; if only the cost per benefit was also the best in the world; instead of the worst.

    I’ve voted mostly Independent or Republican all my life, but I am all for a well run National Health Care System, but I very sceptical if that’s possible.

  11. KMN

    I am surprised the people in the Bible belt area of the US don’t like the NHS or the Welfare state as alongside state education, because instead of Communism the reforms were born from the ideas of late Victorian / Edwardian Christian philanthropists that wanted to, out of the goodness of Christian duty, to help the people of Britain when they needed help the most. They wanted to stop the easiness of falling to poverty and disease which were huge problems at the time especially in crowed, squalor filled cities like London and to move away from the cruel institutions such as the workhouse which instead of helping people get out of bad situations, only punished them further.

  12. Pingback: US Citizens: Be Suspicious of Socialized Medicine | Budget Nomad

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