Sick America

Having now lived full time outside of the US for over a decade, in the UK where we have socialised medical care. A word I was taught from all aspects as evil and anti-American. I can say without a doubt, I would never go back.

In 1981 in the US, only 8% of families cited medical bills as reasons for their bankruptcy, by 2009, it was estimated that that was 62.1%¹. I recently saw an old high school friend, who was an avid Trump supporter, who totally opposes ACA and mandated insurance, and I can only assume any form of socialised medicine, re-post someone's GoFundMe page. It was a stark realisation that American's are deluding themselves. After, mostly likely, working hard, paying taxes and living in the greatest country in the world, they would rather value their liberty over security, basically reverting to modern day version of panhandling on the street corner. To add insult to injury, 90% of GoFundMe campaigns feel to meet their target².

I am lucky that my employer provides good medical insurance for those living in the US, but even with that, I had a co-worker need to have his gall bladder removed. It was an interesting experiment, because I had mine removed about 2 and a half years ago. We would be able to compare like for like. His was an outpatient procedure, of which with deductibles and other charges, meant he was out of pocket about $5,000 for the procedure. The insurance company was charged in excess of $35,000 for it.

My gall bladder became an urgent issue and my GP told me to go to the Accident and Emergency (A&E, like the US E.R.). I ended up going to St. George's, which is the busiest hospital in the UK, in South London, near were I live. It is a National Health Service (NHS) hospital. I was seen by a triage nurse and once my medical records got pulled up, and they saw my blood tests, I was back in a room to be seen within about 15 minutes, getting put onto fluids. I got seen by two doctors who were both concerned, suspected my gall bladder, and admitted me. I ended up spending five days in hospital. Paperwork filled out, none. Co-pays, none. Bills in the mail? None. One thing was clear, my gall bladder needed to be removed.

I worked for a different employer at the time I had mine, and we were lucky that they offered private health insurance. Yes, there is private health insurance in the UK. Front line services are still done through the NHS, but if you have private, you can get medically necessary tests and procedures done privately. I mentioned this when I was in hospital, and the head nurse for my area of medicine told me that the consulting physician who had been overseeing my care also did private practice, and likely could perform my removal.

So the day I got out of hospital, I called his secretary who told me what procedure I needed to get authorised with the insurance company, and told me the private hospital I should ask for. A quick call to the insurance company and they said that they didn't want to cover him at that hospital but another one nearby, and their records showed he practiced there as well. Another quick call to the secretary and everything was settled. No paperwork, no billing codes, no hassle. I got a call back a few hours later from the secretary asking if I could go in on Thursday for my pre-operation checks for an operation on a Thursday. Basically a week from when I got out of hospital.

I had to fill out one sheet of paperwork when I went for my pre-operation checks and when I showed up on the Tuesday, I had to sign a couple more medical release forms after they were explained to me. No co-payments, nothing out of pocket. I was put in a private room, backing onto a golf course. I came out of surgery fine and spent two nights in the hospital. They let me eat fairly normally the second night and wow, the food was fantastic. I left with the medicine I needed post-op in hand. No prescriptions to fill.

A few weeks later, I get a bill in the post. The reckoning was due. I had a deductible of £125 to pay. The total amount charged the insurance company? About £6,500.

I was a bit unlucky and had a minor complication. I ended up back at St. George's for another five nights. This was the ugliest part I had with the NHS. While they don't charge you anything, they do work in their little silos. Basically they repeatedly made mistakes about getting me the tests the attending doctor wanted, and they didn't want me to leave until they saw I was ok from the tests. Finally I bartered my way out of the hospital after 5 days of being pumped full of anti-biotics and fluids. Again, no paperwork, no charges, just five days of my life I won't ever get back.

And this isn't my only experience with the NHS. When I was in Scotland, I had kidney stones and came back from Canada with a fractured eye socket. Both of those experiences, fully on the NHS, were really good. Again, all without bills, co-pays, or even paperwork. When I go to visit my GP, I walk up to a machine, type in my birthday, it confirms my appointment time, and usually within 5 minutes of my time, my name pops up on the board to go see my GP. You walk in, you meet your GP, they do what they need to do, and you leave. If it is a prescription, you go to a pharmacy and have it filled. About £9 if you can afford it, or free if you are old or on social welfare (or in Scotland).

Why would I ever want to go back to the system in America? At worst it is like the bad HMOs in the US. Best of all, you don't worry about it. You know if you get sick, you will be taken care of. All these fears of people draining the system. Yeah, you have people who abuse every system there is. Who is to say there aren't people leeching off your private insurance now. Like having a right to be educated, people should have a right to have medical care. It is morally wrong to deny people that freedom.

While, ACA/Obamacare may not be the right solution, the solutions being proposed in the US are only stepping further away from universal healthcare. Individual mandates aren't abridging liberty. I am not sure who is peddling this, but they are ignorant or evil. Healtcare costs in the US are insane though, but healthcare shouldn't be a profit centre, where nameless corporations are making profits. If the only choice we had was for profit education, only the wealthy would benefit from that, because they are the only ones who could afford it. If education is a universal right, why is not healthcare?

Really, if you do not support some form of universal, free at the point of service healthcare, you don't have your head screwed on right, and need to go see a doctor, if you can afford one.