I've been thinking about the healthcare debate and how disappointing that "reform" is turning out to be. The debate about a public option, now dead and buried, inspired me to think about how nationalized medicine has affected my life. Twenty years ago I moved to the UK where I married a Brit and became a permanent resident, though still a proud US citizen. This is my experience of the National Health Service (NHS) during those years.
To begin, we register with the local general practitioners, with the emphasis on "local" because, believe it or not, the doctors here still make house calls. That's right, if you are eighty years old or just find it difficult to get out, you can call the doctor and he/she will come to your house, black bag in tow, to examine you. Our practice is in a new purpose-built medical building with a pharmacy, housing perhaps a dozen GP's, nurses, and staff.
Let's say you think you have the flu so you go to your GP. You see the doctor, get a diagnosis, and walk out of his/her office. You pay nothing. You may have a prescription in hand, which you duly take to the drug store. If you are over the age of 65, under the age of 18 or in full time education, pregnant, disabled, or otherwise exempt, the prescription will be filled at the pharmacy and you will pay nothing. If you are not in any of these categories, you will pay a prescription charge, which is £7.50 per item, approximately $12.00 at today's exchange rate.
If you have something more serious or require more advanced treatment, your GP will refer you to a specialist who you will see at the local hospital. Again, if you are old and infirm, the NHS will send out a special bus which will transport you to and from your outpatient appointment. From there on, you will be under the care of the specialist, who will keep your GP informed of your condition, until you are discharged from specialist care.
My personal experience encompasses the births of three babies at one of Europe's largest teaching hospitals, and the pre-natal and post-natal care for each pregnancy. Midwives play a major role in the NHS, conducting pre-natal classes about pregnancy and labour, exercise and nutrition classes, and question and answer sessions for pregnant women. All of my children were delivered by midwives in the hospital, the first with an epidural, the other two rapidly without. Because I had no complications, an obstetrician was not in the room at the time of the births, which was fine with me. My midwives, all specialized, highly experienced nurses, had everything under control. If an emergency had arisen, the obstetrician would have been there. After each birth, I requested a private side room, although there are also wards in NHS hospitals which contain maybe six or eight beds.
At home afterwards, I was visited every day by a community midwife, one of the same ones who had conducted the pre-natal classes. She weighed the baby, checked my stitches, and generally provided reassurance on a whole range of things from showing me how to bathe the baby, to telling me what to do about some of the unpleasant after-effects from childbirth, which I won't go into. After about a week, she signed me off and handed my name over to a health visitor who I could call on if I needed help.
After that I took the baby to be weighed each week at a post-natal class, where we new mothers could air our anxieties and talk about the colour of our babies' poop and other topics no sane person would be remotely interested in, bar this particular group.
All of this was provided by the NHS, therefore free at the point of delivery.
I have experienced the NHS primarily through my children, in their vaccinations, routine illnesses, and occasional accidents. One child had recurrent ear infections requiring numerous courses of antibiotics which I was relieved not to be paying out for every time. Others required specialist treatment from the dermatologist. I was happy with all the treatment they received.
One child required an overnight stay in the hospital and surgery on his hand due to an accident. He was on a children's ward with perhaps five other children. The experience was as pleasant as it could have been in those circumstances and the care I saw going on around us in the ward was superb. I repeat myself in saying that there was no charge for this treatment or for the follow-up appointments afterwards.
I can only relay my own personal experiences here, but there are many aspects of care which I haven't touched upon, like the nurses who visit people at home to dress wounds, etc., for however long the healing process takes, all included in the NHS, free at the point of delivery.
Though originally controversial, the NHS is now a much revered institution, supported by probably 100% of the population even though it is far from perfect. Like any big bureaucracy, it is full of inefficiencies. The bottom line is the care is excellent and nobody falls through the cracks.
I have repeated the phrase "free at the point of delivery" several times because that is how the NHS works. Of course it is not strictly speaking "free." Like our US health care system, it is incredibly expensive. The difference is that the NHS is funded by tax money. All taxpayers pay into it. Not everyone will use it to the same degree but if you or your family need it, it is there and it is the same system for everyone, from your poorest neighbour to your Member of Parliament.
The basic income tax ranges from 10 to 25% with a marginal tax rate on income over £50,000 (about $84,000) of approximately40%. However, there are no health insurance premiums to pay and if you lose your job and don't pay income tax, you still have your healthcare.
Those who receive the top level of American healthcare are probably getting the best treatment medicine has to offer but what about those Americans who cannot afford it? They get nothing. I am as big a sceptic as anyone but twenty years of experience has shown me that nationalized healthcare is nothing to be afraid of.
I admire the British for their civilized attitude that says in their country, no person deserves to suffer or to see their children suffer because they can not afford a doctor. In their country no child dies from an infection caused by an abscessed tooth because their parents can not afford medical care. (That particular US story made the news here in Britain where people were shocked by it.)
I am ashamed of those in my own country who think only the fortunate deserve healthcare and those who feel threatened by an irrational fear that in a country as wealthy as the United States, there are not enough resources to alleviate the most basic human suffering for everyone. We should be better than that.
© Julia Barr 2010
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