Wednesday, 07 November 2012
The British Healthcare System
By Ian Bertram of Panchromatica
I know that health care is a big issue in the U.S. and one of Ronni's abiding concerns, so I'm sharing my experience of a recent illness to show how things work out here in the U.K.
For a variety of reasons, all linked to a birth condition, I'm prone to infections in my foot. These can get quite serious - on one occasion amputation being a possibility. The last of these was in August/September of this year and led to me being admitted to hospital with a temperature of 39.6°C (104F).
I kept a log of the various treatments and consultations with doctors and others that I have summarised below.
• Attendance by ambulance and paramedic car - via 999 (arrival within 15 minutes) [NOTE: 999 is U.K. equivalent of 911]
• Taken by ambulance to hospital
• ECG by paramedic
• Blood sugar and urine tests by paramedic
• Review by nurses in A&E
• Review by Doctor in A&E
• Chest X ray in A&E
• Transfer to ward
• Two days oral flucloxacillin
• Blood tests (x5)
• Two weeks vancomycin 14 days x 2 doses/day
• MRI scan of foot
• X-ray of foot
• Ultrasound scan of foot
• 16 days general nursing care/accomodation/food/routine dressings, etc.
• 16 days daltaparin
• 16 days other routine medications – painkillers/omeprazole, etc.
• Insertion of cannula (x6)
Consultant visits bed-side:
• Gastroenterology (x2)
• Microbiology (x2)
• Orthopaedics (x1)
Other medical attendance:
• Doctor (x20)
• Podiatry (x1)
• Tissue viability nurse (x2)
• Nurse practitioner (x2)
Insertion of PICC line requiring:
• Consultant radiologist
• Nursing staff (X2)
After care comprising:
• Daily home visit by nurse to administer IV antibiotics (x18)
• Teicoplenin (x18)
All of this was without any requirement to provide evidence of insurance cover, details of insurance providers, hassle to get approval for specific treatments. I was simply admitted, doctors assessed my needs and the treatment was given.
No payment was required at the time nor will it be required if it all happens again. In fact this was the second such episode this year - I was admitted to the same hospital in May for the same problem.
Nor will this have any implications for insurance payments in the future. So long as my income remains liable for income tax, I will have to pay that, and for all my working life I paid into the state run National Insurance scheme, although since I have now retired I no longer make such payments.
I actually have no idea of the cost of the treatment I received although based on such scant information as I have been able to find, I would not be surprised to find the two incidents costing around £75,000 - £100,000 (US$120,224 - $160,299).
Looking at such information as I can find online about U.S. costs, they seem to come out at something like three times the UK equivalent.
I should point out that foreign nationals receive the same level of care when emergencies arise.
If this sounds partisan, that is because it is. The U.K. National Health Service (NHS) is the subject of much moaning but it is like moaning about the weather and very few people would want to lose it.
It protects everyone in the country for about one-third the cost of the U.S. system which, of course, leaves some 60 million people uninsured. When US politicians tried to use the NHS as a political football around the time of the last presidential election, this generated much animosity here.
In an insurance-based system such as in the U.S., because my problems relate to a birth condition, while I may have been covered as a child on my parents health insurance, once I reached 18 I would have been on my own. Certainly at some point I would have become liable for my own insurance payments.
Even assuming I survived to my 50s, as the problems I describe above (and a few other related issues) became more severe, insurance costs would have escalated. As a pre-existing condition I'm not sure how long I would have been covered but I'm convinced that in a system like the U.S., by now I would have been bankrupt or dead - probably both.
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