Sunday 23 August 2009

Come back NHS, (almost) all is forgiven...

I know I haven't written anything for absolutely ages... I keep thinking I should write a '1 year on' type update as (not counting a 3-mth trip back to the UK to pack up home) we have lived States-side for a year now. That will come. But for now I wanted to share some of my own first-hand experiences of the US healthcare vs the NHS....

As the daughter of 2 NHS professionals (a GP and a Physiotherapist), I have always been brought up to respect and appreciate the NHS. We know it has many failings but I have to say that, for me, it has always been there when I have needed it and I have many scars on my body which show testament to it's work! For the last few years since D started working in banking we were fortunate to have private healthcare - but I do say 'fortunate' with some hesitation.... Yes, that meant we could jump the queue which for D meant his gall bladder was removed swiftly without a long wait (and a wine list in the hospital - but I digress...). But I still had my appendix out at good-old Queen Mary's NHS in Sidcup. When the emergency arose I was given priority.

I also had all 3 children on the NHS and benefitted from a wonderfully supportive team of midwives who saw me through each pregnancy and birth. I know this is not every woman's experience, but it was wonderful for me to have the same midwife at the birth of my first two children and the same team throughout.

Since moving to the US, negotiating the healthcare system has been one of the things I have left near the bottom of my to-do list purely because it is so difficult to understand how it works. As it is I have gone the complete chicken's route and signed up with the same doctor as a friend as she is with the same insurance company as me and can talk me through each step of the process.

The first thing that strikes one about the healthcare here is simply how expensive it really is. We pay a large amount of money every 2 weeks for our (already highly subsidised by work) insurance. On top of that, each visit to the doctor costs us between $15-25. Prescription charges start at $25. Amazingly, the first check-up at the dentist was free. The optician costs around $50 for an eye-test. All of these costs are the same as children as for adults. So, if we had all had swine flu it would have cost us at least $40 each........

The emphasis is firmly on preventative medicine here which is good - in the UK it is very much a case of dealing with the problem presented and moving on to the next patient. Each of the children has to have an annual medical for school which proved to be a fairly traumatic experience for them - they had to undress and be thoroughly poked and prodded - and also for me as I was quizzed on their diet and exercise programs! They are given more standard vaccinations here, too - poor M had 3 on her first visit. To me, some of this seems rather OTT - especially as it is delivered with such intense sincerity. I am already anticipating a battle of wills with my doctor over whether or not to give the children flu' jabs this winter (whilst I am pro-vaccination, I don't really think this is a necessary one). She is so earnest, I don't think she really understands me at all - when she phoned to deliver my cholesterol results, I joked that since they were good I could continue eating unhealthy foods with abandon but she immediately cautioned me against it. Sense of humour failure - 100%!!

So, all-in-all we are certainly getting more attentive (I still hesitate to say 'better') care here - but at a huge cost! I have no idea how those without insurance cope - it must be terrifying to have to consider finances before seeking emergency medical help. I don't know what chance Obama has of bringing in healthcare change, but those of you who do still have the NHS, spare a thought for those who don't. With all it's strains and problems, it's something many in the world would be hugely grateful to have.