The difference between US and UK healthcare

The difference between US and UK healthcare is astounding.  I don’t know whether or not it has to do with the fact that one is public and one is not, but I’ve encountered plenty of differences in the past year.

In the US growing up I was on my dad’s policy through his work.  He paid part of it out of his salary and then when a doctor visit was needed a co-pay would be paid (anywhere from $20-50 US).  Prescriptions were also paid for with a co pay.  I was lucky and didn’t really need to go to the doctor much as a kid/teen other than annual physicals and shots.  When I was in college I was still covered under their policy, but the moment I finished school, I was no longer covered.

Luckily I had a job right away, and had insurance right away (or close to right away- some companies have a 60 day trial before you can enter into their plan.)  This worked the same way as my dad’s policy had-only I was responsible for paying for it.

This went on throughout my employment and the only time I had hardship was when I was laid off and was put on COBRA.  This plan allows you to keep your insurance coverage but at a HIGH cost.  I think it was around $500 a month.  As a result I didn’t sign up for it.  I was lucky, I stayed healthy until I found a full time job again (after finishing my M.Ed and student teaching).

Three years into my teaching career I was faced with no jobs, therefore no insurance.  At this time states and the US were trying to find a healthcare solution.  I was lucky to live in MA, where I could buy into a state health plan, pay a premium a month, and then pay co-pays as before.  However, what they do not tell you is that it takes several MONTHS to get into the plan.  Had I known that I would have started the process ASAP instead of waiting until my coverage was no longer valid.

The state run program wasn’t great, but it was better than nothing.  I paid about $150/month + copays for doctor visits and meds.  Of course this was during the time when I was trying to resolve the headaches, which meant most of my income (small as I was just a substitute teacher) was going to medical bills.    But if I needed a test done, it was done- no question.  I finally had an MRI to rule out tumours.  I had blood tests and all sorts of tests to make sure I was healthy.  I had my breast reduction to help alleviate the ridiculous shoulder and back pain (which I am unfortunately still dealing with.)  But it was dealt with.  If I had a twisted ankle I’d get an xray, no questions asked.  Referrals were processed quickly to specialists, especially for the neurologist.

A month and change after my breast reduction I moved here to the UK.  It took 3 months + to get into see a neurologist here once I had registered with the GP practice at the university.  I wasn’t able to get after care for my surgery even when I brought it up- it was mostly ignored.  The referral to the neuro was dealt with, but  I felt rushed through, my files were never looked at, and I felt like what I was saying about the PAIN was ignored. (granted I had awful problems with neuro’s before in the US, so this I was used to).

A few months in here and I had lingering shoulder pain, perhaps frozen shoulder.  The GP did NO exam, and sent me off to physio.  I went to an intake and then waited several months to be seen.  The woman was rude, and didn’t DO anything- just told me to do some exercises and I would be fine.  (I still have lingering shoulder pain- infrequent but still there).

Also a few months in here I had foot and ankle pain.  I was told to get shoe inserts and wear a brace.  No xray, etc.  And this is an ankle that I had torn ligaments in about 12 years ago.  My concerns were blown off, and I’ve been to the practice 4 times about it.  The last time I was told again- to go to physio.  Why should I go to physio if no one KNOWS WHAT THE PROBLEM IS?

Today I felt the same- the severe back pain and bilateral leg/foot pain was again sent off to physio.  Friends back in the US have strongly told me to get an MRI- but the NHS says different.  Apparently I could go private and have it done, but my financial situation is not in a place where I could afford to have it done (I understand it is around £3-500 to have an MRI privately.)  I do not know what the physio clinic will do or say.  I do know that it is highly unlikely that any type of relief will be immediate as the last time I waited for months until a spot was open.

This is unfortunate, one, as it hurts to do basic tasks around the home- like cleaning, and it hurts to walk anywhere and I really wanted to get back to working out.

I am going to be looking for a new practice to be seen at.  This is the Uni GP practice and I am sure they are just used to dealing with the usual college complaints, not a nearly 36 year old woman with multiple issues that need more than a 10 minute visit’s attention.

The NHS does have its good qualities- I get free prescriptions which is good.  I can always get an appt at the uni within days of needing it.  But the waiting lists and the scummy ER’s and hospitals (at least the 2 I’ve been in) leave little to be desired compared with the several hospitals I used in Boston, MA USA.

What do you think of US or UK healthcare?  Do you have experience with both?  Please leave a comment in the comment section if you do.  Thanks!  PS: If you are in London, please stay safe.  <3



  1. Lola
    08/08/2011 / 23:28

    I say this not against you in any way, but I hear this so much from people coming from private healthcare to the NHS. Some of what you say reminds me of a Liz Jones article I read a couple of weeks ago – the NHS are being blamed for not solving things which private healthcare also clearly did not resolve. I know you’ve been having issues with the headaches for years, and sought treatment back in MA and they’re persisting. I’m not sure an MRI from the NHS (at a cost of £3k to taxpayers) is going to tell them anything that previous scans haven’t, you know? Unless I’m wrong and this is a different problem to previous.

    Breast reductions are mostly treated as electives here in the UK — mostly only available privately, although that may be shifting slightly. It’s possible that the NHS just isn’t set up to provide aftercare for something they don’t widely provide.

    In Scotland you also get additional freebies (as an American on a student visa) that I don’t living in England. We pay for our prescriptions, for example, admittedly at a flat rate that must be in some way subsidised, but it’s generally about £8 for each pack of pills.

    Again, it’s not a personal thing in any way, but the NHS gets a lot of shit for stuff that it can’t really help. Resources are finite. People abuse the system and take up space other people genuinely need. They’re understaffed and what staff they do have are underpaid. Plus, there’s a government in Westminster with a hard-on for swinging the axe anywhere they can in the NHS.

    Would we like it to be comparable to the fanciest US healthcare? Yes. But the difference is that we don’t ask people to choose between their health and bankrupting themselves. We don’t make people have to sell their cars to afford an MRI when it’s life and death. And our trauma care facilities are amongst the best in the world (and you don’t wake up from a crash or attack with a life-ruining surgical bill, either).

    We could make it better, fancier, and let people have every test they fancy. But we’d have to double the rate of income tax to afford it. As someone who’s already in the higher tax bracket, I’d rather that didn’t happen.

    I really wish YOU could get better treatment, because I hate to think of you suffering. But I don’t think it’s fair to blame the overstretched NHS for not picking up the slack (especially on the headaches and shoulder pain that US healthcare hasn’t fixed). You can say, however, that you get what you pay for. And since it’s completely free, I think it’s doing its best, no?

    • 09/08/2011 / 16:40

      Thank you for commenting! I am glad someone from the UK was able to offer their experiences – as I am still adjusting. You make so many good points and it is helpful to hear them and get a better understanding. I think my concern is sending me (and others) off to physio without knowing what they are really dealing with. I probably don’t have a slipped disk, but if someone does and they start manipulation, etc on someone, how can that be done without seeing what’s going on, on the inside. I think it is more of a used to having tests before treatment approach that I’m used to. (House I am not!) I’m just worried about having real damage done or not having any resolution- or maybe I read far to many whining comments on the sciatica section of the NHS Scotland site.

      The headaches are one thing, as is the reduction- I had just hoped that I could get the revision done here without having go to back home to what is trivialized as having a skin snip and stitch- and I’d be willing to pay- unless it costs more than a plane ticket to the US!

      I think for it being free, it is very well done, it was more of me having to get used to changes in approach; I’m still not used to being rushed through a ten minute appt, but perhaps it’s just the Uni’s practice that is like that as it has to deal with so many students in a short period of time per day.

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