Image via Wikipedia
This is for all my American friends who are wondering right now what to make of a national health service. This debate has made a splash in the news here, particularly since it has 'turned ugly' (to quote a major newspaper, which also published some very ugly pictures). Y'all should be ashamed of yourselves.
I've lived in the UK over a decade now, so I know what it's like on both sides of the pond, and I can tell you this: The NHS is OK. It's not perfect--and I'll get to that--but it's far better, USA, than what you've got now.
When I was last employed in the US, some $400 each month was deducted from my salary to pay for a company-sponsored health plan which did not provide much protection. In addition to my $400 monthly premium, I also had a $1,000 'deductible', meaning the first $1,000 in medical bills each year came out of my own pocket. After that, I had what's called 'major medical' coverage (80/20), which meant if I got hit by a bus or had any other sort of medical emergency, the plan would pay 80 per cent of the bills and I would pay 20 per cent.
There's more. Of my two children, only one was covered under this health plan. The other had what is known as a 'pre-existing condition' (acquired before I went to work for this employer) and therefore was denied coverage. My previous employer had offered me the right to extend my health insurance coverage when I left at a cost of well over $500 each month, which was, at that time, far more than my housing costs and not affordable.
To put this situation in perspective, one hospital stay for my uninsured child cost almost $20,000. I had to quit my job and draw benefits to get help for this child, which shocked my health-insurance-covered friends, who saw me as a 'slacker'. It was hard going for a very long time, but it does teach you who your real friend are.
So some years later, I married a man I'd known a long time and came to stay in Scotland. It's an outspoken country. People at the NHS and people I met elsewhere said to my face in a particularly nasty way that I had obviously come to this country because their health service was so good...and so free.
To be perfectly honest, I had no idea what it was. It was the NHS. I was terrified of getting hit by a bus because I was 'foreign' and I was equally frightened of just getting sick. I trusted our doctor at home, whom we only went to see in dire emergencies (because we could not afford to go otherwise) and I did not know what to expect of this socialist service that treated everybody.
I am not a socialist. I don't like socialism. I particularly don't like working to support people who refuse to work for no good reason or, as happens here, for teenagers to have babies just so they can be awarded a free house, like it's a game show. I fiercely object to that. But National Insurance is fine.
National Insurance is deducted from your paycheck. It's like Social Security and Medicare rolled into one (not exactly, but close enough). Everybody pays and everybody gets.
The first time I saw my doctor, I thought she was a wee girl. Not old enough to be a doctor. But that's how it is here. She's still my doctor and I like her very much.
Any time I want to see my doctor, I call to make an appointment and I get one within a day or two.
If I'm off sick for more than a week, I need what's called a doctor's 'line' to return to work--a piece of paper that says, yes, I was ill. Anything less can be 'self-certified'. (You say, yes, I was ill, but you'll get in trouble if you make a habit of it.)
When your doctor goes on holiday or is otherwise unavailable, you get what's called a 'locum' (another doctor). I've had a few of those and I'd give them mixed reviews: one splendid, one a bit too eager to prescribe, one OK and a wretched woman I never want to see again. All in all, a better average than the time I was a member of an HMO (health maintenance organisation) in the US. Now, if I can, I wait until my doctor gets back.
In 10 years, I've had a range of reasons to see a doctor (from bad flu onwards) and have always been treated well. Once I was referred to a consultant, which took a long time, but he was most helpful. Once I needed a bit of physical therapy for a knee injury and was sent to a Muslim woman who was brilliant.
I've heard people at work talk about private health insurance as if it is golden--and I think they are off their heads. At very least, hopelessly naive about this issue. One, they do not make enough money in salary to pay what I paid in the USA for so little health care coverage. Two, they would lose the NHS. Three, they can go to Bupa (a private health insurance provider), for example, if they want and some employers do offer reduced-rate Bupa plans.
The middle way, I think, is dangerous. It's like the US concept of providing vouchers so parents can choose to send their children to private schools (which was popular when I left). All that does is create a two-tier system, leaving public schools to rot. A good education should be free to all...and so should good health care.
There are problems with the NHS and I will list just a few:
- There are many more administrators than doctors, which is costly and inefficient
- There's what's called a 'postcode lottery' (postcode = zip code = what area you happen to stay in) where it is claimed that some people are treated better than others
- There are some silly elective procedures available on the NHS that should be cut out
- Some people cannot get the medication or treatment they expect
- A current controversy is the question of whether people should be treated for free if they cause their own illness (i.e. making the rest of us pay)--smokers, overweight people as examples--but, so the arguments go, what about sports injuries? And on and on and on....
I just hope you have an honest discussion about it...without all the ugliness. Maybe it would help to have town meetings and listen carefully--really listen--to people without health insurance. One day that might be you.
![Reblog this post [with Zemanta]](http://img.zemanta.com/reblog_e.png?x-id=66ed53a2-b84a-4e53-bded-24731c8d2a27)
Posts
