Monday, August 30, 2010

Oh how I miss the NHS

They always say you don't miss things till they are gone, well this seems true of the NHS. For those Americans reading this, NHS is the National Health Service in the UK and basically you get national insurance deducted from you salary (its not a large amount) and then all healthcare (including dentists) is FREE - yes i really did say FREE!!

Touch wood we haven't had any major health issues/accidents since moving here, but we have had some dealings with the wonderful American healthcare system. For those of you in the UK, basically here you choose a healthcare scheme, then if you are lucky your employer pays a lump sum each month for healthcare and then you pay a lump sum (tax free), you can then choose which package you want depending on how unhealthy you are! and not forgetting the favourite word here 'co-pay' Im sure an American invented that word. So you basically pay more each month and get fantastic cover or you pay less and hope you don't get sick as you will have to pay more if you do. If you don't have cover than you will get a huge bill, and a lots of people are facing financial hardship here as they cant afford to pay huge medical bills for treatment they have basically needed to stay alive.

My first dealing with the healthcare system was around March time, first of all we had to track down a Dr who is covered by our particular healthcare scheme. We initially were in no hurry to register until Dave hurt his back, so I decided to register at the same time as his appointment. So along we go, also i should add that it seems being rude and unhelpful is a universal trait of a Drs receptionist! So they take $25 (co-pay) from you before you even see the Dr. One thing they do here which I do think is good (although clearly its all about making money in the long run Im sure), they do a full health screen when you register, you get a physical and bloods done and they check for a lot of things, this was all covered by our healthcare scheme (which was good to know), although they do make you go back to the Dr for the results - yes another $25 to be told you are fine! Anyway, Dave went with his back and got sent for x-rays the same day (another $25 co-pay for the x-ray guy), and another appointment back at the Dr for the results - yes you've guessed it another $25 for that (notice a familiar pattern). X-rays are negative, but he did get a prescription for pain meds, so off to the pharmacy with that and guess what - another co-pay, this time only $5 - which technically makes it cheaper than a UK prescription :) They also referred Dave for physio (but he never went!). When i had my health screen, which incidentally they do for you every year (i guess in the hope they find something wrong and invite you back for more appointments), they give you a four page questionnaire to fill in with tick boxes, one of the questions near the end is 'do you feel suicidal?' i felt like writing 'yes after filling in this bloody questionnaire'. I ticked yes to 'do you snore?' So this prompts the Dr to try and send me for a sleep study, which i politely declined - much to her disgust, she then notices I've ticked yes to allergies, and a smile appears on her face, which soon disappears when i tell her I've had allergy testing and don't want it again, she even tries to send me to a dietician, but again i politely decline. Im sure she is taking back handers from all these referrals, hence her annoyance at my declining everyone. Incidentally it seems an asthma inhaler isn't classed as a normal prescription and they wanted $30 for that one!

So down to the nitty gritty as you have read this far, here is a quick recap of some of the costs we have incurred so far.

Trip to ER after our decking collapsed and my leg went through. Visit involved seeing an ER Dr, having 4 x-rays, an ultrasound on each leg, and then seeing the ER Dr again and a prescription for narcotics (i like that word!!) The total bill (i was in there for 2 hours) was $3404.09 - luckily after our insurance we were only left with a $580 co-pay, and there turned out to be nothing wrong with my leg just bad bruising.

Today I went to the dentist, the checkup, x-rays, clean and polish were all covered by my insurance, but my next visit for 3 crowns and a filling is going to cost $1500.

There is a good side to all of this long blog post, and that is that the care here and service of healthcare professionals is excellent, and as a general rule you don't have a long wait, I have had dealings with private hospitals in the UK and the service I received there was also exceptional. I guess its true what they say you get what you pay for.

I would say I miss the NHS overall - especially as they swipe my bank card here and take yet another co-pay, but then I do like the excellent care and speedy service here - I once had to wait 12 weeks for a NHS physio appointment in the UK when my back was bad, I went via our private healthcare in the UK and was seen by a physio the same day. I would definitely say if you can afford it go for the speedier service, Im not saying the service you get from the NHS is rubbish (I've never had a bad experience), its just extremely slow.

Thanks for reading my long post, not really sure what i wanted to say other than to have a little rant I guess, maybe I should blog about vet bills next......


  1. I agree that the cost of seeing a Dr here can be a bit of a shocker when you are used to the NHS. I saw a Dr when I wanted to get a prescription for birth control and I needed to have a well woman check. During the check the Dr noticed a mole and referred me to a dermatologist who in turn referred me to a plastic surgeon and I ended up having it removed. All of the visits to the various Drs was $25 each time. The surgery to have it removed was $6,200 and we had to pay $1,200 after insurance paid their bit. It turns out the mole was pre cancerous and I was lucky it was removed when it was. I am back to the plastic surgeon next week to have a check up to make sure its not growing back. (Another $25!) If I were to have had this done on the NHS even though it would have been free, i would probably still be waiting to see the dermatologist. From me seeing my Dr to have the mole removed it only took about 4 weeks.

  2. It's only slow cos it's clogged up with people that haven't paid into it! Blimey i sound like a Daily Mail reader! I'm lucky my American employer pays for private healthcare but wouldn't be without the NHS. Looks like the ConDems are trying to get rid of NHS direct though, 1st step in privatising the whole thing methinks!
    Sign the petition here...

  3. I always knew health insurance over there was a necessity, but never knew it didn't cover simple things like visits. No wonder they make you go back as many times as they can! That sounds fishy, I wonder if there is any legislation to stop them over using it?

    But to me it all sounds very expensive, even after the insurance has paid their bit - I doubt our family could survive over there with the combined visits to Dr's and Specialists etc! And that is before any treatment.