Random Thoughts

American Medical Care

Last week in my series about the US and UK when I examined the core value of healthier living, I said that this was my biggest concern when considering a move back to the US. Since being in the UK one of the things I have fallen in absolute love with is the NHS (National Health Service). I have even written letters to British Prime Minister Gordon Brown and Hillary Clinton and Barack Obama when they were both candidates for the Presidency extolling the virtues of nationalized medicine.

After an absolutely spectacular day at the beach on Monday, I had the unfortunate opportunity to find out first hand the state of the American medical system. My daughter had her third seizure, the first without a fever. My ex with whom we are staying took us to the local hospital emergency room. I have to stay that so far the fears that I expressed earlier is without foundation. Granted we have travel insurance through our bank that means we do not have to worry about paying for her medical care.

But there are a couple of concerns that were allayed by this experience. First of all, one of my biggest complaints when comparing American medical care with that we receive in the UK is the bed-side manner of the doctors in the US. Many of them are pompous and condescending. But our experience with the nurse practitioner that was our primary caregiver in the ER was anything but that. He was understanding. He was informative. He was also patient with my questions and concerns. It was exactly the type of old-fashioned caring medical care that I have come to expect in the UK. I can’t say enough about the care we received at Beverly Hospital.

The story does not end there though. It might be odd to say but it was actually fortunate that my daughter had the seizure, because she saved the life of my son’s father. He had been feeling ill since Saturday. He decided that since he was in the emergency room anyway he might as well be seen. It was a good thing too. His appendix had ruptured. The thing of note in this story though is that he does not have medical insurance like we do. Yet his care has been excellent by the non-profit community hospital that is affiliated with a major medical university. His surgery went well and he will be home in a few days.

The lesson that I came away from that five hour ordeal with is that for most Americans they already have a National Health Service. The poor and un-insured always end up in crowded emergency rooms of community or county hospitals such as that one. They are always cared for in an emergency regardless of ability to pay. What is missing for them is the preventative and non-emergent care that we take for granted in the UK. For example, the young mother with her three month old baby that was there because he turned blue and stopped breathing during a coughing spell. He had been sick with that cold for a month. But without the access to primary care that might have managed his illness and prevented that incident, they ended up instead in the emergency room.

Of course, the argument that always arises when the words National Insurance comes up is COST. But if you look at what we pay in NI (National Insurance) cost in the UK versus what American’s pay in Medicare and private insurance then there is little or no difference. In fact for many average Americans, it might actually be a cheaper alternative.

The biggest opponent of nationalized medicine is often the insurance and medical industry, but this too is ignorant misinformation. In countries such as the UK and Canada, there is still a demand for private insurance. But without the undue burden of paying for the un-insured and with primary care provided first by the NHS, such insurance is both cheaper for the insured and more economically viable for the insurers. As for the medical associations’ objections, is it that unreasonable to make a decent living but not become wealthy? After all, under the UK system there is no huge student loans to be re-paid and no equally large mal-practice insurance premiums.

I will say that in one way I am even more concerned about the move back to the US. This was actually considered Emily’s first real seizure; the others were diagnosed as febrile fits. I am more concerned now about how this might effect our ability to insure her in the US with a pre-existing condition. I know that there are legislation pending and compromise from the insurance industry on such things, but they do not go far enough to even compare with the excellent care we have in the UK. I hope that before we return the US will have the will to address these issues for our families and our children’s sake.

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