If You Want to See What American Healthcare May Look Like in the Future–Look Across the Pond

June 9th, 2014

Returning from a visit to London recently, I found the news filled with stories about the Veteran Affairs scandal.  It was particularly interesting to me since while I was there, I had the opportunity to visit with Americans living in the United Kingdom about the healthcare system there.

The purpose of my trip wasn’t to learn about how the British get their healthcare.  Nevertheless, during our trip, my husband and I happened to visit with friends and former colleagues now living in London, and clearly it’s inevitable that if you encounter an American expatriate living in the UK, the subject naturally comes up.

As it happened, the first woman I asked was actually sick.  We joined her and her boyfriend for lunch.  When she arrived, she apologized profusely for sniffing and possibly exposing us to her illness. Clearly, she felt awful and was looking forward to her doctor’s appointment scheduled for later that day. I asked her how all that worked in the UK, and her response was generally that she wasn’t that crazy about it nor was anyone else she knew in a similar position.

She told me that in order to get the appointment she had to contact the National Health Services that morning and answer a series of questions before they could assign her an appointment later that day. While she didn’t seem to think the care she gets there is incredibly great, she also didn’t say that it was completely terrible, at least if you were like her and needing treatment for something not likely to actually kill you.

Where the care wasn’t so terrific was clearly in everything else.  For example, she told me that while in the United States, insurance covers an annual mammogram, in the United Kingdom you only get the test once every three years.  She said anything beyond the most basic care isn’t comparable to what you get in the United States.

The next day, we met a former colleague of my husband who is studying at the London School of Economics.  She praised one thing about the NHS system.  Apparently, she can get a certain drug quickly and in six month supplies.  In the United States, she needs to visit her doctor frequently in order to be dispensed the same drug in smaller quantities.

That was the extent of her praise.

“Everyone knows here that if you get really sick, you’d rather be in the United States,” she explained.

One morning, an article in the newspaper caught my eye.  It was about a certain hospital in the London area that evidently had been a house of horrors but was now “improving.”  From what I gathered, the only thing that was now clearly better was the food.  Evidently, you might die from many things in that hospital, but starvation wouldn’t be one of them.

From everything I gathered, the NHS sounds like what you’d expect from a government run healthcare program.  Likely, if you live there, you encounter the usual bureaucratic irritations you find anywhere bureaucracy rules. Most likely, in that system you could  receive successful treatment for basic illnesses that you surely would have survived one hundred years ago if you’d gotten sick in your cabin out in the prairie and managed to get the only doctor in town to come out and see you.

One thing I gathered from these conversations and which I already strongly suspected is that the United States is definitely considered the medical nirvana for people suffering from life threatening ailments.  You would think that the world would attempt to emulate the American system instead of the path currently being taken where the U.S. seems bent on becoming just like everyone else.

When I returned, I read analysis of the problems at Veterans Affairs with a different perspective.  In many articles, several commentators attempted to argue that Republicans were trying to taint ObamaCare with the Veterans Affairs scandal. That’s false.  The two are not directly related.  Instead, Republicans compare the problems with Veterans Affairs to the single payer system most Democrats really yearn for which is very much like the NHS system I learned about in England. They argue that if we go to single payer, everyone will be in effect in a Veterans Affairs system.

Eric Shinseki’s resignation took the Veterans Affairs scandal off the front pages which is unfortunate.  We should all pay very close attention to how any fix is achieved there because it may provide a true indication of the direction of healthcare delivery in the United States going forward.

Will we be more like the NHS in the United Kingdom or will remain the gold standard for healthcare worldwide?

Time will tell, but right now, I’m not feeling terribly optimistic.

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