MattThere's been a lot of debate in the US about healthcare, and a lot of scare stories about socialized medicine. I'm not even there and it's all I hear about. Even the British newspapers and the BBC are covering it. A large segment of America seems to think that healthcare outside the states is run like a soviet prison camp or something. One American newspaper even reported that disabled people like Stephen Hawking are seen as too expensive to care for over here, and left to die, which is strange since Hawking was still teaching at Cambridge last time I was there.
So, as an American living in Britain, I just want to say to panicked people over in my homeland: calm down. The UK has one of the most 'socialist' healthcare systems in the world - the government runs the hospitals, the doctors, the nurses, the whole works. But if I'm living in a socialist country, then the cold war was much ado about nothing. Calm down.
Let me tell you about our experiences here. The worst experience was when Grace had a very painful ear infection. It was 10 o'clock on Friday night and we realised Grace could not wait until her Monday morning appointment, because the pain was so bad. We called our doctor's 24 hotline, where someone took basic information on Grace's symptoms and said the doctor on call would phone us in 4 hours. They were late, and the phone didn't ring until 4 a.m., by which time we were in bed and Grace in misery. We set up an appointment for 8 a.m. the same day. Four hours later we got up, and Grace walked to the hospital down the road. Grace went to the wrong waiting room by accident, which caused some delays, but she was seen in 20 minutes. Her appointment was perfunctory and she was through in 10 minutes. After that we walked down to the pharmacy, and picked up her medicine. I think we paid 14 pounds, which we could get reimbursed later.
She had a rough week with the earache. The antibiotics made her throw up. When this happened, we called the doctor's 24 hotline again, and once again someone took our basic information. The doctor called us a few hours later. He told Grace to stop taking the oral antibiotics and rely on the ear drops. Grace stopped throwing up. She got better.
In general, it sounds like non-life-threatening things that happen at weird times - at night or on the weekend - are the ones where you will have the most trouble, and our experiences with the painful earache backed this up. We did have to wait a very long time. But how much faster would we have been seen in the USA?
Another story, on the same lines. My co-workers' wife burned her hands picking up a pan from the oven. She ran her hands under cold water for a long time, but woke up in the middle of the night with horrible pain. They went to the A&E (accident and emergency) room, where they stayed up half the night. My co-worker took the morning off, because he got no sleep.
But outside that time, Grace and I have had no problems. Regular check-ups are on time and quick. No one I've ever met has had a problem with the NHS that outstrips the kind of inconveniences you face in any endeavour, in the US or the UK. No one I've ever met has told me about someone they knew who had problems worse than the usual hiccups you sometimes get in any system of healthcare. And I've lived here three years now. And I've talked to people whose parents needed major operations - cancer, surgery, pregnancy. There's never been a problem with the provision of healthcare.
Sometimes you do read about horror stories in the news. People who are denied experimental care that is unproven and expensive. Or people who are denied a liver transplant after they poisoned their liver with alcohol and failed to sober up. But every healthcare system has its own horror stories. Private insurers deny people coverage for all sorts of dubious reasons. And there are always shortages of organ donors.
Finally, as far as I can tell, no one is proposing the US system goes within a mile of the pure socialized care provided by Britain. All that's being proposed is a government run
insurer, along the lines of medicare, to compete with the private sector insurers, to help keep costs down, and a mechanism that voids the ability of insurers to deny coverage to people with pre-existing conditions.
The NHS is not perfect; there
are delays for nonessential services, you
are limited in your choice of doctor, it
is a monopoly that quashes the private sector, and it's a constant struggle on the part of the government to balance costs and service. But the US system is hardly perfect either, as everyone knows. As a young married man without a ton of money, I would choose this system in a heartbeat though.
So, if you are panicked about socialised medicine, calm down. If you meet people who are panicked about socialised medicine, tell them to calm down. Tell them about us. We've been here three years. And it's fine.
GraceHere is what I have to add about universal healthcare.
It seems like a lot of the discussion is being carried out from positions of ignorance about what it is like to live in a country with a universal care system. Let me tell you what it's like.
First, you have to recognise the constraints of the system. The NHS handles all healthcare for 60 million people. I won't lie, it's a busy system. But I don't think much is lacking in terms of the quality of care.
The National Health Service (NHS) is a national service, but it's administered by individual councils, usually defined by cities or counties. We live in London which is really big so our healthcare is administered by the borough we live in, Haringey. When you move into a new borough, you look up on the NHS website the surgeries (a group of doctors who set up a practice together) in your area. You decide which one you want to go to (whichever is closest). You go and register there by proving your address in the borough. They schedule you for an initial screening with a nurse who takes your medical history and talks about any ongoing treatment you're having. They transfer your medical records from your previous surgery. Then you're free to make routine appointments when they come up.
To make a routine appointment, it's as simple as ringing in and asking for the next available appointment. Every surgery does it differently. Our Haringey surgery has online appointment booking, which is very convenient.
When you register you are assigned to one doctor in the practice who oversees your care. But when you book an appointment you get it with whatever doctor is available that day and time. For routine appointments, such as check-ups, coughs and colds, does it matter that you don't see the same doctor? Not a bit. However, if you want, you can request to always see the same doctor. The focus in a universal care system is on preventative medicine. You can make as many appointments as you want. Matt has been to the doctor twice in the last three years. I've been more times than I can remember this year so far alone.
So, you show up for your appointment. Are they running behind schedule? Yes. But so do most of the American doctors offices I've visited. Appointments are for 10 minutes each, which seems like a short amount of time, but a.) you can schedule a longer appointment if you want and b.) most issues are taken care of in that time. You tell the doc what you need, what you want, what's wrong with you. You get your prescription, instructions are given, and you're off. That's it.
And guess what? Prescriptions are cheap, when you have to pay for them at all. Family planning prescription medications are all free. (Because birth control is cheaper than a lot of unwanted pregnancies.) Because of a medical condition that I have which requires lifelong treatment, I am exempted from paying for ANY prescriptions.
Man, this universal healthcare sure is a drag, isn't it?
What I'm trying to say here is that even though it is a busy system the quality of care is not much different from the US if you haven't got a major health problem.
If you've got an emergency or major health problem, it gets more involved. Like I say I have never had a major health problem. I did have an urgent medical problem with an ear infection, as Matt has detailed above, out of clinic hours and on a weekend. But, the NHS in our borough operates a phone line for non-urgent out of hours medical queries. You speak to an actual doctor, describe your symptoms and they tell you whether to go to A and E (accident and emergency) or schedule you an appointment for the next day in the A and E department. Let me tell you, when the doctor called me at 4AM (4 hours late) and told me I could have the first appointment of the day, was I upset? No, I was thanking god for the NHS. When my doc the next day gave me a prescription AND looked up the nearest open pharmacy for me, I was thanking god for the NHS.
A few months ago, there was an accident just outside our street where a car had crashed into a motorcycle. The motorcyclist was sprawled face down on the ground. A girl on a bicycle had stopped and was sitting next to him, talking to him to keep him conscious until the ambulance arrived. When I saw those flashing lights I thought, thank god for the NHS. When we're at home in the States, whenever I see an ambulance speeding to save someone I think, I hope that person has insurance because an ambulance ride costs a fortune. A helicopter ride is in the tens of thousands.
My point is that the NHS covers everyone for every medical treatment they need and no one has to worry about whether or not their insurance will cover this. You pay for this service through taxes, yes, but Britons spend less per person on health care. The emphasis on preventative care pays off. People have free access to what they need to prevent major health complications and detect medical problems before they require major treatments.
Now on to the policy side.
We all know that hospital bills from one illness or one accident can ruin you financially if you're uninsured, which 40 million Americas are. But how many are underinsured? The statistics consider you to be insured even if you can only afford the absolute bare minimum of insurance which doesn't even cover your chronic pre-existed conditions. People who think they have good insurance can be kicked off their insurance or denied coverage for just about anything. Someone please, please, please explain to me why I have to make a co-pay payment every time I go to the doctor? I thought the point of insurance was not to have to pay! The problem is that healthcare is operated in the States as a for-profit business. And in business, the bottom line is the bottom line. Insurance companies will do anything to get out of covering you and your health costs.
I think that healthcare should be seen as a public service, rather than as a commodity. The United States has the best health care you get in the entire world. If you can pay for it. And that I think is the problem. It is, in my opinion, simply immoral for some people to get better healthcare because they can pay for it. If you'll bear with me, I'll give you the rights perspective which I endorse. Obviously we all agree that the right to life is a fundamental right, certainly enshrined in our Constitution. Now healthcare is necessary to maintain life. So rights scholars believe that the right to life contains an implied right to healthcare. The state has an obligation to provide healthcare not just to people who can't afford it, but to everyone. And because the state also has the obligation not to discriminate they have an obligation to provide the same quality of care to everyone. This is basically the accepted understanding of the right to healthcare in Europe. Maybe that aspect of it is too legal, considering the lofty, intellectual debate that has been ongoing in the States about this issue (pfft). Anyway I think the profit motive poisons our healthcare system and I think it's immoral that access to healthcare in the States is dictated by individual wealth.
Now about the debate that is going on the States.
The hyperbolic rhetoric on this from the right is not only based in astounding ignorance, it is completely disconnected from reality.
First, this bill is not a step toward state-run healthcare (let alone socialism). In my opinion it further entrenches our private insurer system by forcing everyone to get insurance from somewhere, usually from private insurers. There is talk of a public option, but all indications are that part will be cut from the final bill.
Second, if you have insurance through your employer and you're happy with it, this bill will not significantly effect you. You will not have to 'give up' your doctor. Your wart removal procedure will not have to go before a death panel.
Third, there's a lot of talk about 'nightmare scenarios' in a universal care system, having to wait unusual amounts of time for procedures, not getting procedures because they're too expensive. First, this is clearly a case of overestimating the frequency of very uncommon occurrences. Second, I understand why the focus is on these but let's be one hundred percent clear: The private insurer system is full of nightmare scenarios too. I heard a guy talking recently about how his mother got ovarian and uterine cancer and had to get immediate treatment. Then the insurance company refused to cover her cancer treatments because they said it was a pre-existing condition even though she had never had signs of cancer before. She had to call them herself in the middle of chemotherapy to ask them to cover it. Okay, this guy was President Obama and this is how his mother died.
Nataline Sarkisyan, a Californian teenager, needed a liver transplant but her insurance wouldn't cover it because they considered it to be 'experimental'. The family went to the media about it and under pressure the insurer changed their mind, only a few hours before she died. Another woman in Texas was denied coverage of her breast cancer treatment because a typo made by her doctor years before gave 'misleading' information about her medical history.
You get my point. The difference is in a universal care system, if there is a screw-up of some sort someone is held responsible. If your insurance company decides it won't pay for a treatment you need in order to live, you have no recourse.
The biggest problem with the debate over these issues is that the Democrats have not been delivering their message clearly or effectively at all. I'm not sure what is required here, but I hope they get themselves in order. This is a good bill, even if it isn't a move toward universal care. I wish it was. But it's a good bill anyway.
By now it was around 3:30AM and we had not yet slept. About an hour later, they started checking people in. An hour later, we were in the duty free shopping area having had no sleep and with only an hour until our flight boarded. We got no sleep other than what few minutes could be snatched during different stages of waiting. 
