Friday, 15 July 2016

A question you can all help with

Hello again. I have had an email from a reader in the US, she asks a question. I will try and answer as best I can, but I don't know everything, so perhaps some of our UK readers can help me out here. Please comment with your own experiences of our UK healthcare system. Are you using the NHS at present, no need to go into details about your condition), are you an NHS or private patient? Do you need ongoing treatment or is it a one off? Have you insurance to cover the cost? How do you rate your care? If you don't want to write too much about it you could just answer the US readers question. Thank you for your responses.  

 I live in the US and have been thinking about the differences in our health care systems since we visited your country in April.  I have searched your blog to see if you have posted about this subject and how you deal with the possibility of a health issue in the future.  I know you lead a very healthy lifestyle and that you have a NHS in your country.  The thing I hear most (and feel myself) is the fear that one illness could ruin a person financially. 

Right. How do I deal with the possibility of a health issue in the future? I do not know what the future holds for me, so I don't spend too much time worrying about it. Up to now I have only been a hospital in patient three times in my life. I had my tonsils out at age 10, I had a sterilization at 37, and I had a hysterectomy at 59. The first two were planned, the last one was a shock because up to that time I had been healthy for most of my life. With this track record I am optimistic that my good luck will continue. However, saying that, it may not. 

I don't feel the need to do any prepping for something that may or may not happen. If I became ill, I would expect the NHS to look after me, and I will put myself in their hands, and hope they would do their best. I don't have any private insurance to pay for any care I might need. I have an NHS dentist that looks after my teeth, I don't pay a monthly scheme, I pay for checkups and treatment as and when required. Luckily I haven't needed any treatment for about five or six years. 

If I were to become ill I would still get my pension. If I needed pills I wouldn't have to pay. I'm not sure if there are things to pay for when in hospital because the last time I was in there eight years ago everything was free. I don't know if it is different now. Perhaps others will know. 

I hope to be able to stay in my house for a long time yet, hope that my health holds out and that I can wash, dress, and feed myself. I may have to move to a smaller more easily managed house eventually. I haven't thought about what might happen beyond that, it's too far into the future. One thing I will consider is to find a way to release money from my house and spend some of it to make my life easier. Ideally I would like to die penniless, if that happens then I will have gone full circle, coming in with nothing and going out with nothing. That's fine by me, I can't take it with me and I have no dependents. 

You mention that one illness could ruin a person financially. The only thing I know about the US system is that you have to pay for your healthcare through an insurance. I was taken to hospital in an ambulance once while on holiday, in Ohio I think. It was a minor illness that just required antibiotics, the first thing they asked was have I got insurance, and when I answered yes and showed the certificate, they went right over the top, flashing lights, siren, etc. I didn't actually need to go to hospital but they insisted. It must be a worry for you that at anytime you could become ill and your ability to pay would determine what treatment is available to you. 

When you think about it I have paid for my healthcare throughout my working life. Luckily I haven't needed to use it very much, but our system where we pay as a collective means that others not so lucky can have access to the care they need. I don't know how much longer that will continue, that's another debate which I don't want to discuss here, so please don't get political. I've had enough of politics. 

So, to sum up, the question from our US reader is, How do you deal with the possibility of a health issue in the future? Thank you for the question, and your replies.

It's Tesco night tonight. My fridge is bare and I have a £4 off voucher. I'll go on the yellow sticker hunt. We'll catch up soon. 
Toodle pip.    

74 comments:

  1. I get regular prescriptions and have just reached the age where I don't need to pay for them :) I also have private insurance that we pay for in part as my husband is employed by a US company in the UK, and healthcare is part of his compensation package. We generally go privately when we have a specific issue, for example I have seen consultants and had treatment for dermatology, shoulder and knee problems. But in the future we won't have this coverage and I will do everything I can to keep myself healthy, and trust in the NHS if I have a medical issue. I will also ensure that I am well informed and will insist on being seen and treated within the accepted timelines. In my experience the NHS in my area does the very best it can, and I have no complaints.

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  2. Patricia Brambley15 July 2016 at 19:04

    My experience of nhs healthcare has been brilliant. I have lived through 15 operations, all free, even drugs free as well. I would never want to be ill in the usa, I have a cousin who has lived her whole life, 60+ yrs in P.A. Who needs drugs and treatment for an ongoing illness, who cannot afford to even contemplate some of the trearment as they are too coostly.
    Britain has the best health service in the world, I wouldn't want ro be anywhere else if taken ill.
    I have never had health insurance, I paid my dues whilst I was working, so have no fears over my health treatments.
    Long live the NHS.
    Pat Brambley

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  3. I can speak more about the US health system and my experiences with insurance if you ever want to know more, Ilona. People can and indeed do go broke often even with insurance in this country, unfortunately. You are extremely lucky to have national healthcare for everyone. That is what we should have as well. Have a good weekend!

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  4. I was a nurse for 40 years and have also spent time as a patient. I have a brother and sister-in-law in Florida who need medical care and know where I would rather be! Our healthcare is the best in the world - both the organisation and the delivery. When we need it, it is there and is not going to bankrupt us. Poor and rich are treated alike in the same facilities. I consider myself to be extremely lucky.

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  5. I have to say my family were very lucky to have been treated in the UK under the NHS - dad 2 bypass surgeries, mom hiatus hernia, removal of a kidney, pleurisy and so on. Sister with peritonitis, another sister with several NHS funded IVF treatments. I lived in the UK until I was 21 but thankfully never needed anything. I also lived in the States for a while and while I had excellent insurance (my son was born "free of charge" through Kaeser permanente) I would hate to have faced more serious problems as an older person. I saw my in-laws stressing about their Blue Cross/Blue Shield coverage when Pap was ill. But what horrified me most was an uncle who lost his job one Monday morning and then lost his health insurance. Well, in order to maintain the insurance he had he had to pay an absolute fortune as his wife was already a diagnosed diabetic. I think they were very, very stressful times for them indeed. In fact, the wife had NEVER worked outside the home in her married life and suddenly in her late 50s had to get a job as a cashier just in order for them to maintain their medical insurance. So the NHS might not be perfect, but don't knock it. It could be a life-saver. That being said, I would be very worried about the TTIP (Transatlantic Trade and Investment Partnership) being negotiated "in secret" - not for the immediate future but I wouldn't trust the outcome one bit. Anna

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  6. Hi Ilona
    I'm happy to give a few details of my experiences.
    As a child and a student I was able to access my GP, dentist and emergency dept free.
    When I started working, it was only the dentist I had to start paying for, along with any prescription medications I needed. (I believe this to be the norm.)
    During this time I had several hospital procedures - all essential, and all free - on the NHS, and one cosmetic procedure done privately that I paid for myself from initial consultation through to prescription medications (which I believe is right, as it was my choice to have the procedure, it was non-essential).
    Now I am unable to work, any treatment I have as a disabled person is on the NHS, and I pay an amount monthly for my medication.
    The treatment I have received from the NHS has always been outstanding.
    We pay into the NHS through our taxes and through National Insurance contributions, I believe, when we are in work.

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  7. We are blessed here in Canada to have everything paid for. My husband recently had to have an operation on his shoulder. Everything free from start to finish. We do have a drug and dental plan that we pay a modest amount for every month but once we reach a certain age our drugs (if we are on any by that time) will be free. Yahoo,Canadian Health Care System!

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    1. You must not live in B.C. We pay $150. per month. We are well over retirement age and drugs are not free unless your income is vey low. Neither is home care or any additional health needs outside of the hospital and doctors visits.

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  8. Our NHS is brilliant I had to use it in 2010 and 2012, fantastic service ran by fantastic staff.

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  9. I know a little about the US system, a lot about the NHS and central Europe systems. I would not want to live in the US because I think the healthcare system is incredibly unfare. I find the NHS adequate though I think central European healthcare is better, particularly the quality of women and children health and most of all dentistry.

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  10. my SIL is American he and my daughter live near Dallas. I have high blood pressure, high cholesterol and am type 2 diabetic. and on 13 tablets over the day. my brother also has these problems plus heart attacks. neither of us need to pay for any meds as diabetic patents get free meds on NHS. we are genetically programmed to these problems. My SIL when over here one time had meat stuck in his throat. It had to be operated on, he had no insurance so our credit card got hit for £750.00. SIL was impressed at the cheapness and the treatment. said it was better than at home. I am grateful for the NHS every day.

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  11. Patricia Brambley15 July 2016 at 20:24

    Isnt that what Obama tried to introduce, but I thought the rich people in the States didn't want it. A badly missed opportunity if you ask me.
    Pat Brambley

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  12. I agree with the comment above. It's unfortunate the way our healthcare is set up in the US. My monthly health insurance premium doubled under Obama care and costs me over $500 a month with a huge deductible. I wish I could have your NHS. Pat

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    1. Patricia Brambley15 July 2016 at 21:50

      I wish you could too, it works so well for everyone.

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    2. It is surprising to me how many Americans are strongly against an NHS-type system. The Republicans call it "socialized medicine" and they act like it is poison.

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    3. Too many stories of NHS and other national healthcare systems "choosing to treat" or not treat as the case may be (as in "Oh you're old. Forget it. Go home and die.") along with tales of people "working the system" (pill mills, medical fraud schemes, etc.). That's my guess anyway.

      We live in the US and spend $1500/month on medical insurance for our family of 4, an additional $90/month for dental and we don't have any type of vision insurance. We're mostly healthy - I have chronic shingles but that's apparently not considered a "serious" illness (HA!) and does not effect our rates. Under Obama care our rates dropped to $1000/mo which was a huge blessing. And our children now have dental and vision insurance through required coverage. I'm grateful - both my son and my husband have an eye condition that requires specialized lenses and cost at least $900/pair. My son's are now free to us. We pay about $150/month for prescriptions and visits out of pocket total. Without insurance, we'd have to do without medicine or go broke.

      Employers usually cover a large portion of the insurance premium or all of it. And many, many people have had to choose between paying for medications and paying for groceries or having to take an awful job just to have medical care. Others have lost everything because they were ill and couldn't work.

      My father had chemotherapy three years ago and the cost per dose out of pocket for his medications would have been $15,000 each dose! No, that's not a typo. My mother just about had a heart attack. Fortunately, their insurance covered everything. Mother's mammogram would have been $8000 out of pocket - simply crazy! They are in the 80's and pay roughly $800/month for their medical insurance.

      I, too, wish we had your NHS!
      Lea

      PS Sorry for the super long rant - I'm more than a little irritated that we don't have a national system! :)

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    4. For those interested in comparing costs, in the UK NHS treatment is available to everyone, no matter what you have paid in taxes. Generally prescription charges are £8.40 per item, but you don't have to pay for the drugs themselves.

      People who are employed and earn more than £155 a week pay National Insurance - usually 12%. Provided they have paid in enough years, this covers their state pension, maternity allowance, bereavement benefits, and an allowance if they become unemployed.
      People also have to pay an income tax. This generally 20% on income above £11,000 a year and 40% on any income over £32,000 a year.
      The government also gets money from lots of other sources eg corporation tax, inheritance tax etc. They decide how much money they need to fund the NHS and it all comes out of the big general pot rather than being from any particular tax source.

      I think that our NHS system is great and although I have hardly ever had to use it. I feel that I am getting value for money for my taxes.

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  13. The one thing about our fantastic NHS is that we're all hopefully living longer than ever before, so obviously thought arise about our future health in old age. I've never had private medical or dental insurance. Received excellent care on the NHS and have worked in the NHS for 30 years and paid my dues! I know that the NHS would be there for me if I needed it. I never understood why some patients paid for private insurance anyway. In my experience it was just to queue jump the system, eg. They'd see the consultant privately then get transferred to the NHS for the remainder of treatment. The treatment itself would be the same and with the time scale targets set, the wait from referral to first appointment was negligible.

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  14. Without the NHS My husband wouldn't be here. Plain and simple.
    Yes we moan about delays, the hospital food etc but I would rather have our system than the US. I believe the wealthy in the States couldn't imagine poor people being treated as well as them without paying. (an awful generalization I know but that was the impression I got from a penfriend "we've been paying insurance all these years so why should they now get health care free"?)

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    1. I think you are misinformed. Those without money in the US have the best option since Obama care is income based. Those with any means have to pay full amount. It's not a fair system by any means. Pat

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    2. Here in Oregon "Obamacare" operates on a sliding scale, so that a varying amount of the monthly premium is paid, depending upon income level. This way those with moderate incomes may get some help - not just very low income. It is much fairer than it was, especially since you cannot be penalized because of a pre-existing condition. I was a nurse in the NHS before moving to US 30 years ago. The system here is terrible, I'd take the NHS any day.

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  15. I have nothing but praise for the NHS. My GP surgery has just two doctors and it feels more like the old fashioned family doctor there used to be and nothing is too much trouble for them. Nor can I fault my local hospital of which I have been a frequent visitor and had excellent service from the different departments I've been referred to.

    Joan (Wales)

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  16. I have a cousin in the States. The husband of a friend of hers developed leukemia. They had insurance but it still bankrupted them literally - they lost their house and car and are now living on handouts. Shocking so I'd rather have the NHS even with all its faults.

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  17. In the UK we all pay National Insurance when we are working which is deducted from your pay according to how much you earn. Hospitals, GPs, operations, Physiotherapy etc is all free as are ambulances - tho I think ambulances charge for a road traffic accident. Prescriptions are charged per item at a set rate for each item, same for everything. Birth control is free, medicines for under 16s is free and free for over 60s and pregnant women, and those not working. Sounds good but there are often long waiting lists over a year is not unusual. My Jamaican work colleague had a brother who while on holiday abroad (Spain) had a heart attack. He was told he needed surgury when back home as within 6 months it would be terminal without. On return to UK he saw his GP within a week, a consultant heart specialist within 2 weeks and was then told it would be 18 months minimum on the waiting list (which meant he would literally have died waiting for surgury) Consultant agreed it was urgent but there were no beds available for 18 months. His whole extended family raised the money for a private operation so he was OK. But my colleague said in Jamaica there are at least charity hospitals where you may wait in a corridor for 3 or 4 days but they will treat you they don't let you die like here in the UK. However I have always had very good treatment from the NHS and have had no problems, perhaps I have been lucky.

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  18. Our NHS is one reason I am proud to be British. I paid my dues throughout my working life and now need to use the Health Service. It seems a more humane and civilised system than the USA.

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  19. Be thankful that you have the NHS. I'm in the USA. Our health care insurance costs just keep going up in price, our deductibles keep getting higher, and many of the prescription drugs are sky rocketing in price.

    Many people didn't want The Affordable Care Act (Obama Care) to go into effect. It did; and people have been trying to put a stop to it ever since. I wish we could agree here in the US that something needs to be done, if not Obama Care, then get together and figure something out, but it seems these days that our leaders cannot work together on anything for the betterment of our nation. So many people here are just one major medical emergency away from losing everything they have worked for, and many others have already lost almost everything due to medical expenses.

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  20. I am in the U.S. and just want to say that those of you in the UK are very fortunate to have the NHS.

    Healthcare has been a big issue for me since my mother had to go without insurance for 7 years in her late 50s-early 60s. My dad was 7 years older and when he retired at 65 went on Medicare, the old-age health insurance available to everyone at 65. But since mom was not 65 she applied for private insurance and was turned down. So for 7 years she had to pay out of pocket for all doctor and Rx bills. Thankfully she did not have a major illness or my parents would have been bankrupt.

    I am very thankful for the provision of Obamacare that now does not allow people with pre-existing conditions to be turned down. i hope it stays that way but it is still very uncertain.

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  21. I think when you are seriously ill, it must be awful thinking about how to pay the household bills without the additional worry of how to pay for any treatment.
    I have had three children on the NHS, an eye operation, done on the day of diagnosis, cancer operation, chemotherapy and radiotherapy and a few minor ops. I think the NHS is something we in this country should be very proud and very protective of.

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  22. As a British person currently living in the US, I'd say that there are pluses to both systems. The US has better care if you have a serious condition, but the NHS is better at delivering everyday care. What I resent about US health care is that you have to pay for insurance, but then pay again when you visit the doctor etc., so you can never budget for your health bills; they also tend to over treat you. I avoid going to the doctor if possible. I called the other day to get a tetanus shot, but they told me that it was so long since I'd been to the surgery that I had to also meet with the doctor (and pay extra). I declined.
    P.S. I'm newish to your blog, and am very much enjoying it!

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    1. What makes you say you get better care for serious conditions in the US? During my cancer treatment i was a member of a support group which included patients from the US. I would suggest there was little difference, only I did not know what each of my treatments cost and that was at the forefront of their minds.

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  23. Ilona, wouldn't it save you lots of money if you moved to a smaller house (no stairs) now instead of waiting? Then if you had any mobility issues in future, you would already be in the appropriate home.??? You could probably still have a small garden.

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    1. Completely disagree with this, not a good idea, having stairs is what keeps you fit in the first place. My 83 year old mother has three flights of stairs in her terraced house, uses them every day. Getting rid of stairs is the downward slope I feel, likewise the garden, it's what keeps you fit, don't downsize!

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    2. Hi Lana. It would cost me lots of money if I moved to a smaller house now. The equity in my house is not enough to downsize and stay in the area I like. Yes I could buy a small terraced house for cash, but it would be in a back to back area with no garden, in a place where I wouldn't want to live. At the moment I have very low outgoings, no mortgage or rent, so I will stay here, and be happy.

      As regards buying a bungalow, no stairs, Sue G is right. I can run up and down stairs no problem, I often take stairs as opposed to using the lift in public buildings. A bit of puffing and panting is good for the heart. I am not ready to give up just yet.

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  24. "is the fear that one illness could ruin a person financially" yes, here in the states one illness can ruin you if you don't have insurance....I don't have insurance anymore, I take 3 medications that I can't afford any longer....I don't know what I will do, I will manage somehow I suppose.....but you all are very lucky, blessed, whatever, to have your NHS......I wish I could move to a country that takes care of it's people...but I don't...so be it....life goes on....... KarenV

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    1. Karen, check with your doctor to see if there are lower-priced generic Rx that are at least similar to the ones you are taking. Or, find the name of the pharmaceutical company that makes your Rx and see if they have a program to help with costs. Finally, you can use GoodRx.com to see if another pharmacy offers your Rx at a lower cost. It is amazing that the price of Rx varies so much from pharmacy to pharmacy. I have heard that Costco pharmacy is very good but there is not one in my area so can't speak from experience. Good luck.

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    2. Thank you so much Barbara! I will look into this <3 KarenV

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    3. GoodRX was a Godsend during the couple of months that my family did not have health insurance last year. We still use the GoodRX card to pay for a few things, mainly the drugs prescribed for our dog with arthritis and cat with thyroid issues because they're dispensed by a regular drugstore.

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  25. Our nhs is often criticised but my experience has been brilliant. Over the last 10 years I have had both knee joints replaced and been treated for breast cancer. The care I received every time was speedy and appropriate and I'm now really well - I walked 8 miles yesterday. Financially it hasn't been a problem as even the hospital parking is free for cancer patients and my salary was paid in full before I retired. Now I get free prescriptions if I need them and only use a private dentist because I choose to.
    I know the nhs is under strain and the staff overworked but the care is always there if you really need it.

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  26. Isn't it nice to hear everybody praising the NHS, you hear all this stuff on the news about it being not good enough but it seems 'real' people are very happy with it. Me too!

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  27. Many years ago my stepson unfortunately had to have a heart transplant operation and we saw the NHS at its very best. I think we are very lucky in this country. He is still going strong! SueM

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    1. Yes, we are very lucky. I hope your stepson is still going strong for many years to come.

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  28. The NHS is absolutely fantastic; have had tonsils out, appendix, spinal fusion and hysterectomy, have 'paid in' to system through National Insurance contributions for 34 years and don't have any complaints at all. There are funding problems but, the staff are dedicated and caring, they really go the extra mile (in my experience). I do hope that the UK does not end up with a privatised system, but no politics today. We really are blessed here with the NHS, if you need treatment or have an accident the organisation is there to help and hopefully give you a full recovery. My dental practice has a compulsory scheme, it's NHS but there are 'bands' of care e.g. I pay £6 a month for 2 check-ups a year, anything else is extra (filling; scale and polish etc). Again, more than happy to pay for that and the surgery staff are all friendly and give brilliant advice. Amanda

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  29. Patricia Brambley16 July 2016 at 13:35

    Isn't this a fantastic Island to live. Where else could we be this happy, virtually worry free as to how we are going to survive, if seriously ill.
    Long live this beautiful Island, and all that it stands for.
    Well done the NHS, you make us proud to be British 🇬🇧👏🏻

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  30. I am so happy to see this post as this is near and dear to my heart. I live in the USA and am on Obamacare. As a single woman, I pay $250 (will be going up in 2017) a month premium but THEN have a $6000 deductible and that deductible applies to EVERYTHING. Meaning that I have to spend $6k out of pocket before insurance will start picking up the tab. Obamacare is a step in the right direction but needs serious tweaking. I am really glad to hear people in the UK praising your system because over here the "talking heads" make us feel that Universal healthcare will mean astronomical taxes and that we will not have access to care due to wait times, etc. I am a huge advocate of Universal care and pray that we will get it in the US so all people can have the right to the care they need. I work for a nonprofit primary care clinic that provides medical care to the working uninsured and also those who are insured but can't afford their copays and co-insurance. How sad is it that a country can't provide basic medical care to all of its citizens!

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  31. A recent example.....My better half was feeling unwell our GP diagnosed (from his symptoms) a possible slight stroke. Over the next 7-10 days he had been to cardiology had blood tests, CT & MRI scans non showing a stroke, around day 20 from the original GP's appointment a call to say come into the surgery tomorrow you'll need a jab for a vitamin deficiency. How can you fault that an exceptional all round treatment and all on the NHS. Yes it needs more funding and there are obviously flaws and faults a plenty but when it's working well it's brilliant. Rae x

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  32. The odd thing about health care in the US is it varies from state to state. At the time Obamacare began our state opted to expand medicaid services (for the low income, which my husband and I are as we are now retired) and we receive healthcare and dental care for free.

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    1. That is so awesome! My state (TN) did not expand Medicare and our residents are suffering because of that. So many people fall into the gap.

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    2. My son falls into that gap. He's a college student working part-time, and we're having to pick up the cost of his insurance (about $200 a month) because of the gap.

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  33. My hubs had wonderful treatement last year when it could have been the very worst of news, but ended up being nothing like. I would never criticise them after that or they way we were treated and helped when I lost two babies.

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  34. I am so grateful for "Obamacare"! It came too late to save all the money I paid into the high premiums after I lost my full-time job with benefits. I always had to pay but never as much as I wound up with when paying on my own. I am a two time cancer survivor and had to keep paying the rising premiums because no other insurance company would take me with my pre-existing conditions.
    Thanks to Obamacare, when I went onto Medicare at 65, I was able to shop for a better policy despite my health history. It's still pricey because I'm paying Medicare, my supplemental insurance premium and insurance for prescriptions. (After seeing what my chemo cost when I had company insurance and hearing people without insurance discussing what they went through to get their meds, I'm afraid to go without the prescription coverage.) I don't have vision or dental coverage. I need new glasses because I'm having trouble reading. I haven't been to the dentist in several years. I just cross my fingers and hope for the best. I've had several root canals and cost is unbelievable.
    I wish we had NHS in the US!
    Joan from Michigan

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  35. Long live the NHS. I have nothing but praise; my family and me have all been well cared for when we have had to have treatment for everything from a broken finger (re-set and fixed by a top hand surgeon who happened to be at the hospital to teach!) to a stroke. I had my children in hospital and had super care as did they when looked after in a special care baby unit. I never paid a penny for treatment save for my taxes. I know the NHS is much maligned and people think private health care is the way forward, but we'd miss it if we lost it.

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  36. I live in the US and have no problem with our system. When I worked, my insurance costs were nominal because of employer subsidized premiums. When I because contract labor (selling real estate), I insured myself for major medical only because I'm not one to run to the doctor every time I have a sniffle.

    When I because eligible for Medicare at 65, I had to pay for Part B Medicare ( now at 78, I pay $109 per month) and I have a supplemental policy which has no premium (they assume the liability).

    My brother was involved in an auto accident on Jan 29 which left him in a coma. He died on Feb 9. His hospital bills were over $150,000, and his part was around $4,000. He had exactly the same insurance I do, so he was paying $109 per month.

    In our system, everyone who goes to an emergency facility, whether they are legal or not, must be treated. Maybe they've never paid a dime for insurance and will never pay the hospital bill, but they must be treated. How does the UK handle that situation?

    And I've heard that UK taxes are very high to cover the cost of NHS. Is this correct? Can you see any doctor you want? This is an interesting subject.

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    1. I can see that you have no problem with your own part or experience of the US system. The stories in other comments on this blog post tell of very different experiences for many others, unfortunately.

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    2. Yes, we do treat everyone who needs treatment on the premise that it is bad enough being ill without suffering financial stress too. Our taxes are not being stretched because of the NHS but rather the incompetence of our politicians who spend far more on meddling in wars which kill people than saving lives through the NHS. And, yes, you can choose your doctor but the standard of care, generally, in the NHS is excellent. It is to do with the excellence of the medical staff........they are a dedicated lot.

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    3. I love hearing the pro and cons of touchy subjects. Thank you for your replies.

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  37. Very interesting to read all the comments!

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  38. I love,love ,love the NHS. No one in the UK has to worry that medical care is not available because they are not wealthy. Rich and poor use the same service. We will not become bankrupt if we need life saving treatment, surgery or therapy or help.
    Our medical staff are not motivated by fees and payments,they are paid a salary all the same!.

    I would hate to think my doctor thought of me as a cash cow!.
    Exchange of money I feel would tarnish a doctor patient relationship.
    In UK a pastime is to criticise the NHS, I,m not saying it is perfect, but is a scenario a bit like families can criticise their own mum, but woe betide anyone else who does, because we are immensely proud of everyone having equal care.
    Flaws and all its OUR NHS.

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  39. I work in the NHS , adore the ethos. My salary would perhaps be x3 more perhaps more in US. We who work in the NHS do so because we agree with the prinnciples. All people matter.

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  40. Hi. Susan from Canberra Australia. We have Medicare here which sounds just like NHS. We also have private health insurance but nowhere near the costs the US people are quoting.
    In 2012 while visiting my son in Houston, I had a bad asthma attack. They took me to A&E where I was treated for five hours. I received bills totalling $10 000. Thank goodness for travel insurance. Only this weekend I ended up in A&E here in Canberra for the same issue, again taking about five hours and including chest xrays etc and walked out the door without paying a cent. I say we like in a very lucky country.

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  41. I live and work in the US...in a hospital Er and can tell you the healthcare system here is a complete mess...everyone is treated the same in the ER, we don't know or care if you have insurance...but an ER is only to stabilize you...after that you're on your own with follow up visits to doctors...many people don't understand this...those with good insurance are out of touch with the reality of unemployment and underemployment...the working poor have it the worst...struggling to cover premiums and deductibles if they have insurance, worries of losing everything if they don't...

    I work full time, have insurance with low premiums but high deductibles, medications run me over $2000 a year and I don't bother with our dental insurance as only one root canal or cap is covered...not per year, per forever...Obamacare has made it more expensive to run the hospital (I work in a not for profit facility) with lower payments from the government...it loses millions per year treating the poor...

    I'd gladly pay higher taxes for universal coverage...but don't see it happening in my lifetime...

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  42. I saw an article in our local paper today for a benefit golf outing planned for a popular local kids sports coach. He is dying of a brain tumor. The golf outing is to help with his medical expenses as the article clearly stated that his health insurance policy has an $8000 deductible. Every week the local paper lists benefits - spaghetti dinners, silent auctions, bowl-a-thons - to raise money for other families. Is this common in other countries?
    Joan in Michigan

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    1. Joan not in UK no need medical care is not charged!. Sounds horrific! Bloody hell is all I can say if health care depends on spaghetti dinners .fuck!.

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    2. What if someone does not have family to do a spaghetti dinner for treatment?.They die?. Horrific scenario. I despair one of the wealthiest countries and it,s people do spaghetti dinners for health care!.
      Sorry for swearing before, sounds crazy that people in US think that is ok!.

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    3. Actually sometimes we do have fundraisers, tends to be for children who have had every available treatment, but child is terminal, then parents reads about snake oil in India , benefit of air in Switzerland, all clutching at tiny straws, but they feel may help and they are doing something, anything!. More for the parent than child!.

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  43. Ilona, medical expenses are the leading cause of people filing for bankruptcy in the United States. Now that health insurance requires us to spend thousands of dollars upfront in the form of deductibles (the amount we must pay before the insurance starts working) and then rarely fully covers an expense, it's very easy to fall deeply into debt with a major illness.

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  44. Another American here. We have ObamaCare and are grateful for it. We have high deductibles, like another American mentioned. Otherwise, we would have nothing. Before the ObamaCare, we tried to pay our own through my husbands work. The premiums were going up every year. At the end, they were about 30% of take-home pay. We couldn't sustain that. I do wish we had a NHS here. I think it's the only way to go. We joke about moving to Canada for the health care but we're only half kidding!

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  45. Ilona, Thank you so much for making my question a post on your blog. I only hope we in the US can someday have the same peace of mind that the UK has in terms of medical expenses. It was one of the many things that impressed me when we visited your lovely country earlier this year.

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  46. My mother had a painfully hip but it took a year to get an appointment with an orthopedic surgeon. She got less mobile as the months went on,she died aged 89 a week before her appointment. Due to her age her appointment was not a priority. My wife was told last September she needed a hip replacement and as she was just 66 the waiting would not be long 6 months. We have private medical insurance in South Africa,we made an appointment to see the surgeon on 7 January (a few days waiting for appointment) operation done on 14 January. She spent a week in hospital. No cost to us all paid by the insurance.The NHS is very good in an emergency situation,but there are problems the older you get. My wife was also treated for a bone disease in the 1960's and has not recovered phycologicaly from the experience. Being kept for months in a ward with no view from windows being served mince and potatoes every day for five months. If she dfid north like the menu getting nothing else. If delayed at exray etc and missed measl time having to wait until next meal. And ad she was a child was not asble to keep fruit etc brought by visitors. When we pay foir our treatment we are treated as valued customers not beggars. Medical treatment is not cheap whether NHS or private insurance, the NHS is a good idea but requires fixing, don't compare it to the USA system there are lots of better run systems throughout the world South Africa and Australia are two good examples though I only felt with the Australian once when I brokje my leg.

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    1. I expect everywhere is different now from the 1960s - which are now more than 50 years ago. My own experience of being in hospital then was not great. They were fairly early days for the NHS of course.

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  47. Hi Ilona,

    Love your blog. Very interesting subject. I love our NHS, even with its current problems. I worked in the NHS for 15 years so know what it is like from both sides of the coin so to speak. My husband 6 years ago got picked up on the bowel screening programme for the over 60's (all free) turned out to be bowel cancer in early stages (he had no symptoms) he then had major surgery, 6 months chemo, and amazing follow up tests, scans and scopes for the last 5 years now down to just one annual scope, scan, blood tests and consultant appointment for the next 5 years. Amazing care, treatment, hospital experience all at our local hospital in Sussex. We cannot praise the NHS enough. We feel truly blessed to be in a country that has this service to offer. Sue

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  48. Oh well done, tell them all about our free healthcare and there will be even more coming. Why do you think anyone would ask the question in the first place? Obviously you don't live in an area where the NHS is swamped and you have to queue around the block at 7 am to get an appointment with a GP.
    Sometimes you can be so naïve it's unbelievable.

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    1. Buzz off troll, you can be such an arse sometimes. It's unbelievable that you can be so critical yet still keep coming back to read my posts. Get a life.

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  49. I used to live in the U.S. and have first-hand experience of its healthcare system as a patient and hospital employee. To make a long story short, its healthcare system is a big reason why I have no desire to live in the U.S. again.

    I also lived in Britain for over a year as a student. During that time I used the NHS quite a bit and always got good service. I had to pay for my prescriptions, but thought it was fair compared to what I'd have to pay for the same medication in the U.S.

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  50. I live and work in the US. The problem with our system is it is for profit. For the past 20 years the two parties have fought against universal healthcare and Obama finally pushed it through. Many middle class people here work well past retirement age (for me it is 67 yrs 10mos) because of healthcare. If you do not have insurance and you have any assets you lose everything you worked for to pay for your treatments if it is a catastrophic illness. If you do not have assets then it is free. Medicaid pays for it. In my state we have many poor uninsured people that were able to get healthcare with Obamacare, but since it is state based it is now on the chopping block because of the new governor (he's from the anti-side). Over here it isn't about taking care of our citizens it is about money. A sad truth that doesn't make me proud. We have great disparity in income. Unfortunately, the politicians that oppose universal healthcare have been millionaires or billionaires who do not understand the plight of the poor. Obamacare is a start. As for me, I will work until I'm 68 before I can even consider retirement.

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