by Max Brantley
A former Arkansan who's lived in England for three decades wrote to a friend recently about his experiences with its National Health Service. Very interesting account.
All medical service, everywhere, is subject to cost control. In Britain we tend to have relatively shabby, crowded hospitals with few frills. On the other hand the medical treatment is usually excellent. My wife is recovering from near kidney failure; along the way she was treated by our general practitioner, then sent to a local hospital. We had good, detailed, ongoing communication from the medical staff regarding her treatment. Following the treatment on the internet suggested strongly that all of the procedures and medication were up to date and thorough. She had endless inconclusive scans of various types, x-rays, blood tests and other examinations. Faced with difficulty the staff in the hospital in Kent liaised with the leading teaching and research hospital for kidney problems, Guy’s Hospital in London. After she stabilised and began some recovery she started outpatient treatment with Guy’s, which is ongoing.
The woman’s acute ward she experienced was unpleasant. As we have supplementary private health insurance we investigated moving her to a private room in a nearby private hospital. The word from her consultant, who worked out of both, was that while patients are at risk they are much better off in the NHS hospital which offers a lower level of comfort but a higher level of technical care. When she was in less risk it turned out that the private hospital was reluctant to take ‘medical’ cases which are high on overheads and low on ‘big ticket’ charges. Most private hospitals in the UK exist for queue jumping on non critical operations for which there may be a waiting list.
Adults, with a reasonable income, do have to pay a fixed charge for prescription medicines but there is an upper limit that they may be charged. If they require multiple medications it would never come to the point of doing without for economic reason. For the poor, children and oldies like myself there is no charge. Without concern for cost my GP wants me to continue to take beta blocker, statin and stomach pills (PPI) each day to keep away illness. There will be a free flu jab in the autumn, though if we want to go abroad on holiday we pay a reasonable amount for inoculations, malaria pills, etc. not required here but there is no charge for prescribing according to the latest world conditions.
The key to the NHS is that it should be “free at the point of delivery” for anyone. We pay for the NHS in our taxes and if you are here, even as a visitor, we believe it is right that you should get complete health care. In addition, when we travel in European Union countries we have reciprocal rights to what is essentially the same health care delivered through various methods. In most of the EU countries this is to a very high standard, in some cases probably better than that in Britain.
The health reforms in the US are clearly necessary in a country that has a higher infant mortality rate and lower life expectancy than Cuba. It is clear to me that the basic problem is a ‘free market’ in medicine. Such an approach is lacking in balance; when they say ‘your kid has cancer, how much can you afford’ the answer is all you’ve got. Governmental regulation of healthcare across Europe is the primary reason for the success of the systems. Given the current state in the USA I don’t know what changes should be made at the moment to the American medical establishment but if I had magic I would make a wish and you would have the NHS.