this post: http://mevennen.livejournal.com/828534.h
tml?view=6007926#t6007926 was very interesting to me. A good perspective of how the NHS works in Britain, debunking the myths we hear in the US.
This, of course, is nothing new to me.
When I lived in Italy, I would often complain about the service I got at the hospitals. Since I wasn't very sick, I've had to share a room with 6 people before. During that same hospital stay, the doctor suggested I get some kind of test, I don't remember what, probably a CAT scan. He told me I could spend a few more days in the hospital for observation and get the test done. I was adamant about leaving. He told me that if I left AMA, I would likely have to wait a few months on the scan, because at that point it would be considered non-urgent. I was 16, and felt this was a great big inconvenience and a waste of my time. After all, I felt better, so why not let me leave and come back in a day or two to have the scan? I now understand their reasoning much better.
I had a similar problem with seeing a Gynecologist in Rome. In order to get a new one assigned to me, I had to go on a waiting list, which was about 6 weeks long. I wanted to see one in a few days because I wanted to get a prescription for the pill right then and there. Again, at about 17, 6 weeks of waiting before I could have sex without a condom seemed like an eternity. Besides, because I would get one assigned, I had no idea who I would get. I already had had a bad experience with a GYN who didn't seem sympathetic to the idea of a young girl having sex. I also had gone to the (state-run) equivalent of Planned Parenthood, where the GYN only saw me for 15 minutes, and sent me home with the pill. Since it was a walk-in place, and I had to wait for about an hour to see the doctor, I was very pissed that I hadn't gotten more attentive care. So a family member suggested her own GYN. She told me this lady was very caring, and had a private practice where I could likely be seen within days. Indeed, the doctor worked at the state-run hospital five days a week, and ran her own private practice the other two, plus a few hours after her shifts at the hospital. She charged about $50 for a visit, which was astronomical compared to free, but, as soon as I saw her, I knew it was totally worth it. She spent an hour with me, talking about all kinds of things related to female health and sexuality. She was very gentle in doing the pelvic exam. She gave me a breast exam and taught me how to do it for myself. Her office was spacious, and filled with posters, teaching models, and several trial packages of medicine, so as to avoid me the inconvenience of going to the pharmacy for something I was just trying out.
Now compare this to my experience in the US... When I moved here, I was put on my husband's fantastic health insurance. As a union carpenter, he had some of the best insurance available. It was an HMO/PPO plan which meant that I had several networks of providers to choose from. I also found out, by calling the insurance, that I could see a GYN without a referral twice a year. Sweet, right? Since I didn't have a PCP when I first got a pelvic infection, it was a great reassurance I could go see a GYN "right away" because there were waiting lists for all PCPs even remotely close to my house. To get an initial new patient appointment with a PCP I had to wait anywhere between 4 and 10 weeks. So I started calling several places to get a GYN appointment. Everywhere I called, the wait time for a non-urgent appointment was 6 weeks or more. Mind you, non-urgent basically meant you were not pregnant. I had already gone to the ER for a pain I had in my lower abdomen. When I went to the ER, I thought I was having an ectopic, because the pain was excruciating. At the ER, I was not examined at all. The doctor spoke to me, took my medical history, and decided this must be a UTI (urinary tract infection or bladder infection), because I had a history of recurring UTIs. He would not listen to my argument that, because I had had several UTIs, I knew what they felt like, and this was not it. He would not listen, would not even take a urine sample, and sent me home with a prescription of antibiotics and ordered me to take massive doses of Tylenol. The antibiotic regimen did indeed lessen the pain, but after 3-4 days, I was still in considerable pain. That is when I tried getting a GYN appointment, which I thought was pretty darn urgent. Over and over, they told me that if it was truly urgent, then I should go to the ER. If not, I could wait weeks. Sound familiar?
In that particular situation, having gone to the ER, and having had the doctor there tell me that I was clogging up the works with a simple infection, I was really not about to go back there, you know? I did try to call back the doctor who had seen me in the ER, who suggested I see a specialist, because this was not his field.
When I finally got to see a GYN, I was rushed into the hospital where I was put on a 24-hour antibiotic drip because I had a raging pelvic infection. The GYN told me I might not ever be able to have children because of this. Afterwards, I was left with a nagging pelvic ache, and a pain in my cervix which made intercourse painful. GYNs I have seen since assume the extensive scarring due to the infection probably caused this. 7 years after the incident, the pain finally started to subside, and now it only occasionally hits me. The jury is still out on whether I will be able to have children.
Thankfully, all this BS was covered by the insurance... Oh, wait, not really. I had to pay a $200 deductible, plus a $100 copay for the ER visit, plus a $25 deductible for the doctor's visit. I subsequently also had to go see doctors and get all kinds of tests to see what the heck was causing all this pain I was having--all of which cost me copays and deductibles.
Recently, too, I had a talk with someone who encouraged me not to seek work because of insurance. He told me he pays only $85 for "catastrophic" coverage. I tried getting such insurance a few years ago. 30 years old, non-smoker, no pre-existing conditions. I was quoted about $300 a month. Another $150 a month on top of that if I wanted pregnancy coverage. Said coverage would not go into effect until one year into the insurance being bought of course, because otherwise one could buy insurance, get pregnant, and then get rid of it. Now, since this is catastrophic coverage, it means that there is a $5000 deductible, and pretty hefty copays. But, heck, it will save you hundreds of thousands if you get into an accident. It will still add about $4000-$9000 to your regular bills if you wanna go see the doctor every once in a while, though. I was thinking if this was a worthwhile investment when I applied. But I guess the choice got made for me--in one of my doc's files, I had disclosed having smoked pot in the past. That made me instantly ineligible.
So, you know, I'll take that crappy socialized medicine any time. At least there would be something for me to fall back on.
And, if the number from the UK is about correct, that keeping the NHS alive costs every UK citizen about 11% of their income in taxes... Sounds to me that is a good deal, too. In my case, with my $300 premium (and this is only catastrophic coverage, remember?) that would mean that I would have to make $3300 a month for that to be my "premium" through the NHS. Pretty nice. According to
www.finweb.com/insurance/average-health-insurance-cost-by-country.html the average cost in the US is about $440, so that, then, is also about 11% of the average income in the US, which is about 50K a year or so. Only difference, of course, being that not everyone is insured.
Once again, I think it's time to really examine how profoundly skewed our ideas about health care in this country are. And to examine how there are ways to make it work for us. For instance, the system in Holland is a mix of public and private, with a HMO-like model, and it works quite well although Dutch women have recently been given the middle finger by having had hormonal birth control taken off the covered medications list).
I'd love to hear some good arguments about why our current system here is so wonderful, by the way.
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contemplative
curious
irritated