Wednesday, September 09, 2009

National Healthcare: An Important Observation from an American in Britain

If you keep track of my blog, you know that my experiences of dealing with procedures and systems in the UK has been a mixture of dread, frustration, amusement and eventual resignation and acceptance of the inefficient, prosaic bureaucracy that permeate so much of what could be streamlined. The banks appall me, the royal mail frightens me, and the airlines never cease to bring new levels of degradation and humiliation to paying customers.

With that stated, and with much irony, I want to write on a recent experience with a lot of relevance to a very serious issue in my home country; national healthcare. The other day I had the misfortune of coming down with some fairly serious symptoms, maybe related to an outbreak of illness in my office last week, maybe not, but they were causing me a lot of pain. I want to put this in the context that last week a lot of people in my office came down with random illnesses; gastro-intestinal viral infections, tonsillitis, pneumonia, and the basic cold and flu.

To briefly summarize my own issue, I came down with very severe watery dry and red eyes on Monday, waking up early Tuesday with excruciating burning and sharp pain, unable to fall back asleep again. When I got into work on Tuesday, hoping it would pass, the pain and redness only became worse and my colleagues convinced me to call my GP (General Practitioner) at my local NHS in Clapham. I knew this wasn’t conjunctivitis (pink eye) as I’ve had that before as a child and in university. The symptoms were never this severe, especially in regards to pain, and I didn’t have the usual discharge build-up on the outside of the eye. Instead the whites of my eyes were a deep vampire red, I had a constant stream of tears down my face, all accompanied by a throbbing burning sensation with occasional sharp sensations through the middle of the eye. Very distracting and not comfortable at all, trust me!

When I called my local NHS GP in Clapham at around noon I wasn’t sure what to expect besides the worse. My previous experiences with private sector organizations like my bank, credit card, internet provider, etc. have proved to be frustrating and circular beyond belief. When I was told they could see me at 4:30 pm, the same day, I was a bit thrown off and pleasantly surprised. I expected that when I arrived I would certainly be met by long queues and hours in a crowded waiting room. In fact my total wait time couldn’t have been longer than five minutes (I was a bit early) and I was seen at exactly 4:30 pm, as promised.

When I described to the doctor my symptoms and when she inspected my eye, she immediately pressed the urgency that I see a specialized ophthalmologist right away. She got on the phone with Moorfield Eye Hospital, located near Old Street in the City of London, told them to anticipate me, wrote my referral letter, and told me to head there straight away. At this point, part of me was relieved that I would be seen by a specialist, but also a bit nervous about how long the process could take at the A&E (Accidents & Emergency) wing of Moorfield and how useful the outcome would be. I’ve heard horror stories from the US media about filthy NHS hospital facilities, incompetent and uncaring doctors, and an overall lack of urgency towards treatment. In the total span of one hour, I was treated by a nurse, consulted with an ophthalmologist, given a variety of tests, and finally diagnosed with corneal ulcers and provided an antibiotic prescription that was ready in the on-site pharmacy within fifteen minutes. And by the way, I didn’t pay for anything.

The use of the prescription eye drops is intensive, once each hour every hour for the next forty-eight hours, even during the night. As a result, I can already see and feel the improvement in my eyes.

I’d like to compare this experience with my experiences back home in California with my expensive, employer-provided PPO. I had never once called my doctor in California and received a same-day appointment, despite even being a member of a quasi-exclusive medical boutique in San Francisco that boasted guaranteed same-day appointments and the best and brightest doctors in the city. I also recall showing up to appointments early or on time and still waiting upwards of a half an hour to be consulted by a nurse, then waiting longer to see the doctor. If I had to compare this experience with my very good health coverage back home, my NHS encounter wins across the board, providing the most efficient, immediate and successful results.

My intention isn't to overly politicize this issue on partisan grounds. Indeed, I believe that in order to have an effective dialogue and to reach an agreeable solution, we have to stop thinking about this issue as a political one, and identify it as a moral concern of human rights. Also, my intention is not to imply that replication of the UK healthcare system is the only option for the US. Indeed, there are plenty of issues that need to be worked out with the UK NHS and Britons are fully aware of this.

I felt the need to write this blog because I have read so many exaggerated tales from the US about the horrors of universal healthcare and since I’m on the ground here, I hoped my experiences would be informative to friends and family back home without any direct experience with a national healthcare system. I know there are those of you who will look for loopholes and are expecting a catch somewhere, but unfortunately I don’t have one to report just yet. I don’t think I was treated because I’m young; in fact I felt a little silly at Moorfield Hospital because I was probably one of the youngest people there. From what I could tell, a lot of people there were in fact the elderly and they were all being treated at the A&E by specialists just like I was. This observation doesn’t jive with the alarmists back home who claim that universal healthcare is out to “kill Grandma”.

I really think there is a lot of ignorance in the United States about how national healthcare works. I think it is made worse by an alarmed and uninformed public that has thrown reasonable dialogue and debate out the window in favor of tactics of intimidation and child-like tantrums during town hall meetings. Half-truths, false data, and blatant lies are being used by special interest groups led by the big pharmaceuticals and insurance companies to scare Americans into submission so that the end result is the status quo. I ask that Americans verify the information they receive before making a judgment because there are a lot of falsities floating around, including for example a mailer blatantly lying that individuals over 59 years of age in the UK are ineligible for treatment for heart disease. “Conservatives for Patient’s Rights”, a conservative group, has already retracted this statement after leading physicians in the UK responded to the inaccuracy.

An editorial at “Investor’s Business Daily” indicated that Stephen Hawking would be denied healthcare in the UK and would perish because of his disabilities due to a “rationing” of healthcare that prioritizes the young and healthy. Washington Post blogger Ezra Klein brought up a good point when she stated “"It's not just that they didn't know that Stephen Hawking was born in England. It's that the underlying point was wrong, as you'll note from the continued existence of Stephen Hawking. They didn't choose an unfortunate example for an accurate point. They simply lied." Truth is that Hawking was born in the UK and has worked and lived here his entire life. I’d highly recommend that these conservative interest groups double check their facts before spreading embarrassing inaccuracies. Unfortunately there are people in America who will continue to believe things like this along with the misconception that President Obama is attempting to create an American NHS when indeed what he has offered is much less and much more compromised than that.

According to the World Health Organization, the UK healthcare system is ranked 18th in the world while the US system is ranked 37th although Americans pay more per head than the British for the care they do receive. A study from the “Journal of the American Medical Association” recently found that the United States spends $5,274 per person, per year and the United Kingdom spends $2,164 per person, per year, or less than half the amount, although the same study highlights that Americans are generally unhealthier with much higher rates of heart disease, diabetes, obesity, and stroke. The current cost of US healthcare amounts to approximately 15 percent of GDP (approximately $2.2 trillion) of which around 50 percent (approximately $1.1 trillion) is spent by the government. In contrast, healthcare spending in the UK amounts to 8 percent of GDP with the Department of Health NHS budget spending at around $155 billion. When you consider that the English NHS treats 49 million people (100 percent of the population) and US public healthcare treats 83 million (approximately 28 percent of the population), combined with the respective costs, it seems the “free-market” system at home is less efficient and considerably more expensive than the “socialized” one here in the UK.

The bottom line is that there are a lot of statistics and stories presented to the public, but whether we follow the UK NHS model or not (which isn’t even what President Obama is proposing), I think it’s fairly obvious that America is in desperate need of comprehensive healthcare reform. Until then, I hope Americans can tone down the immature, counterproductive, and even dangerous rhetoric being used against this campaign and return to a process of rational and productive dialogue over an extremely challenging issue currently facing our country. Sadly, even President Bush with all of his controversies and failures, didn’t receive as nasty a public backlash as President Obama’s efforts to reform a broken healthcare system. Comparisons between our President’s efforts at greater healthcare coverage and the actions of some of the most nefarious dictators from the twentieth century are not only inappropriate, but they cheapen the spirit of the democratic process and the role of the public forum. In the big picture, aside from the issue of healthcare, this trend in American politics and public debate is alarming.


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