28 July 2010

Socialised Medicine

The healthcare reform issue was really heating up as a left the US last autumn. I agree that the US healthcare system desperately needed reform. However, I do not necessarily agree with some of the ideas that were on the table (i.e. a completely socialised system like the NHS), and I'm not too sure how I feel about the healthcare reform end state.

What I envisaged was a system that would make access much easier for the unemployed and poor people (a public option), and make it easier (i.e. cheaper) for the rest of us to "top-up" our insurance if we wanted better coverage than what our employer's plans offered. Instead, the US is stuck with some strange system that will fine individuals $95, or up to 1 percent of income for those earning less than $9500, a year beginning 2014 if they do not secure health insurance coverage. How the hell does that make sense? And how the hell is the Government going to enforce this?

I certainly don't like the idea of completely socialised medicine. So what's my beef with the NHS?

I have Crohn's disease. It's a disease that causes scar tissue to build up on the insides of my intestines which causes pain, discomfort and some other unpleasant symptoms (I'll let you look those up on the interwebs yourself). If severe enough, it necessitates hospital visits and potentially surgery.

Before moving to the UK, I had two nasty small bowel obstructions which caused me to stay in the hospital for nearly a week at a time. Despite these episodes, I decided I would still move to the UK as it's a Western country with modern medicine and relatively easy access to healthcare. Turns out, a socialised system has at least as much, if not more, red tape than the screwed up system in the US.

I eventually managed to register for the NHS. The reason it took me nearly six months was due mostly to my own laziness. Once I registered, I scheduled an appointment with my GP. I was hoping the GP would be able to get me in touch with a gastroenterologist and help me get refills for some of the medicines I had been prescribed after my last stint in the hospital.

During my visit with the GP, I found out if you're a foreigner like me, you have to wait a year before you are allowed to see a specialist. That meant I wouldn't be allowed to see someone experienced in treating Crohn's until I had lived in the UK for another six months unless there was some sort of emergency that required a visit to the hospital. So despite paying my share of taxes like UK citizens and other residents legally allowed to work in the country, I wasn't entitled to the same level of treatment. How is that fair?

To top it off, the GP was frank: the UK doesn't believe in proactive treatment. So instead of treating my Crohn's to keep me from needing surgery in the immediate future, they would much prefer to keep it a ticking time bomb. This meant that one of the main medicines I was prescribed in the US wasn't available to me here. Awesome.

The thing about socialised medicine is that there are mounds of red tape to fight through. Cutting-edge medicines will never be available to the average person living here. And private insurance here is pretty useless as it doesn't cover pre-existing conditions. Because I was insured through my employer when I was in the US, I didn't have to worry about my pre-existing condition. Not only was I happy to pay to ensure I had access to my employers best insurance plan, I was happy to pay whatever co-pay my insurer required for medicines. I knew the co-pays meant I had access to the best medicines that could treat my disease.That simply isn't an option in the UK unless I am willing to pay full price, which I simply cannot afford.

So America, consider yourself lucky. Your system might be screwed up, but at least you have some level of choice.

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