Nice to See You, to See You Nice

Apr 26, 2017 · Unlisted
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My wife was recently diagnosed with glaucoma. Hopefully eyedrops will control the pressure which has been giving her optic nerve a hard time, but if not, the next recommended step is an operation.

The condition was discovered during one of her checkups at the Moorfields Eye Hospital in London, a world class facility. As glaucoma runs in her family, some years ago she was given the opportunity of having regular exams. She’s also been seen by one of the top eye guys in the country.

Have I mentioned her checkups are free? And the operation, if it came to that. Thank the National Health Service. Of course it’s not really free. We pay for healthcare through our taxes. Gladly.

Here’s how the NHS, which turns 70 next year, works in England:

If you need to see a doctor, you make an appointment at your doctor’s office, or surgery, we call it here. Typically it will be the one that’s closest. Ours is a mile down the road. It has a handful of docs to choose from.

Depending how busy they are and how populated the area you live in, you may have to wait a few days or more for your visit (at worst it might be a week or two, though surgeries allow for ‘emergency’ appointments, trusting you not to abuse the ability to jump to the head of the line). We live out in the country, and can almost always get regular appointments the same day; sometimes within an hour or two of calling, if that’s what we want.

Everything is free except for medication, which is capped at a maximum of the equivalent of about $11 per prescription, though the most you’ll be out of pocket is $125 annually, for any and all pills you might need that year. Students, older people, pregnant women, those on very low incomes, and many others aren’t charged. Scotland, Wales and Northern Ireland don’t even have prescription fees.

The doctors are paid by the government. It’s possible to earn quite a good salary, though probably not the equal of a well-off MD in the US.

Some things will take longer than you’ll want them to. For example, you’d likely get a hip replacement faster in the States. It’s roughly a kind of triage system. Those who are deemed to be most need of help, get it more quickly. We don’t have death panels. As it happens, life expectancy outranks the US.

It’s hardly perfect, but nobody is refused care, and nobody goes bankrupt or ever has to decide if they can afford to see a doctor. Even if you’re a tourist needing an emergency room visit, it won’t cost you a dime. In addition, a lot of screening, including for mammograms, cervical cancer, and illnesses that tend to crop up as you get older, is done as a matter of course. Better (not to mention cheaper) to catch this stuff early.

Dentistry, unfortunately, isn’t covered quite so well, which is one reason there are a lot of jokes about the English and bad teeth. If you’re pregnant or have a child less than a year old, though, you’re in luck: no charge.

A private system runs in tandem with the public one. You can, if you wish, buy health insurance for that. Companies are kept on a tight leash.

Going private usually but not always puts you on a faster track for treatments, but you needn’t worry about a laggardly pace if you have, say, breast cancer, like the daughter of a friend of ours. The NHS is quite capable of springing into action when you’ve got something seriously wrong with you.

I once went to the surgery with what turned out to be baseless worries about my heart and found myself in an ambulance to the hospital “just in case” so fast it nearly made my head spin. Which I suppose they would have looked at too, if my head really was spinning.

The NHS is a whole lot cheaper to run than healthcare in the US. Every other industrialized nation can say the same.

Taxes are probably a bit higher here than in the US for most of us, but when you add the costs that go to deductibles and copays and an ‘affordable’ Obamacare policy if that’s what you’ve got, well, I think it’s no contest.

Not that it’s a contest. Nobody who’s sick is going to feel like a winner no matter how happy they are with their system. But it’s nice not to be nauseated by the bill.

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PS. For an American audience


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