NHS: rationing

Just doing a bit of research on these things I know now that I should probably have my wife knees worked on (if they need it) over here before/if I move.

I'm dealing with knee problems in the UK, and I knew it would be a problem before I came (though it's worse dealing with it here than I imagined), but we had a specific set of circumstances and decided to come -- though the sad fact is that no matter how much hubby loves his job here, we'll probably need to get back to the States in 2 or 3 years just so I can get good insurance again without dealing with all the hassles I have right now by being overseas and using my U.S. insurance. These knee problems are why I pay $400 a month to continue my private insurance through COBRA, except that because I now live overseas the insurance company can't seem to get things straight in their system -- refund checks never carry the zip code or country name, and so they don't make it to me (they enter my zip code, the system doesn't recognize it and the zip is replaced automatically with zeros, and the post office in the U.S. doesn't know what to do with it). Because I'm overseas, everything is "out of network" and I have to pay upfront and file for refunds. I'm trying to work out the problems, but it's really a nightmare and highly stressful. And I did look into seeing a specialist through the NHS, and was told there was no point even getting on a list, the wait was just ridiculous.

I say all that to say that I can relate to having pre-existing health issues, and can tell you unless the knee problem is something due to an accident (meaning you fix the problem and the knee doesn't continue to deteriorate and get bad again due to various medical conditions), keep in mind that your wife may need more knee work in the future even if you do surgery now. And getting it on the NHS won't be a feasible option, most likely. Any private insurance you buy here in the UK will not cover pre-existing conditions, so if you want coverage for any future knee problems she might have you will have to continue (at a high rate) your old insurance through COBRA (which only lasts about 18 months, though at the end of that time you can swap it to another plan with the same company). The other option is just to save up and pay out of pocket for any procedures you need, which is something many Brits resort to because they simply can't get the care they need through the NHS -- and a simple procedure like knee debridement and lavage (for instance) costs $8,000. And that's before you pay for physical therapy afterwards, which in my experience costs $168 per one hour session. So much for a "free" system that takes care of everyone in the UK. It really is true that there's no way any system could give everyone good care, the funds just don't exist. Here everyone gets care, it's just not that good, access-wise; however, the medical professionals are as good as you get in the States -- if you can get in to see the ones you need.

What I'm trying to say (and probably not doing so well at), is really consider hard your wife's current medical needs and her future needs, and what stresses it will put on both of you to deal with those needs in a socialist country.

As to your friend who has to keep working for the health insurance, consider this: How much would the average Brit with a median income pay into health insurance (basically) by way of taxes to the NHS in his or her lifetime? How much is the average American paying in, by way of payroll deductions and co-pays? I bet you'd find that many Brits pay more, but get less for their money. In America, if one took some of that extra money he wasn't paying into taxes like the Brits are and actually planned for the future, he'd have the funds to buy adequate health insurance when he retired (and that's if he didn't retire from a job that lets him continue healthcare through the company). Just a thought.

"a socialist country"??  If only!

thanks for the info groovy_yank. I will definetly take to heart what you have said and talk to my wife about that when we get closer to making a decision.

hiya

I don't want to start a heated discussion on various elements but I just wanted to add in a couple of points

I have family members working in the NHS as Docs and friends who are 'managers' as well. Also, have alot of family members in the USA who are doc's as well so I get to hear the behind the scenes elements of both places.

Without a doubt, the UK does indeed have some highly respected and capable docs and specialists - but they're much rarer here than they are in the US. The US medical knowledge is substantially more advanced than here - so getting specific knowledge about rarer or maybe even more general problems is more likely there than here.

I do know of someone here who was a keen keep fit enthusiast and a frequent cyclist. Except by the age of 36 his knees were shot. After seeing NHS docs and consultants and having therapy after therapy he was basically told you'll not cycle again. A job transfer ensued and off to the US he went, I can't remember if the insurance he got covered his existed problem or not, but he had treatment there and within 8 months was cycling again and to my knowledge still does.

I'm not saying every case is like that but it does make you think. As I've mentioned before, 2 of my cousins here in the UK right now who are (at) Consultants level back home in India are now leaving the UK to go to the USA to practice there. There's simply too much red tape, unhelpful procedures, problems, stifling of innovation for their skills within the NHS that they've had enough and want out. On top of that, the government's crazy decisions about job allocation to 'foriegn doctors' (way before the current concerns following the terrorist attacks involving forign doctors) plus the fact they'll be paid 3-4 times more than the highest earners here in the UK make it a relatively simple decision to move there.

This leads to the possibility that the 'brains' and 'innovation' and 'research and development' of healthcare in the UK will be severely reduced as many look to leave. The NHS faces the threat of becoming one giant GP and if you need specialist or advanced treatment, then off you go to another country providing it and if you can afford it etc.

As always in threads like this, I always do mention the work that the NHS does well should'nt ever go unnoticed. the NHS does do certain things well and when the vast majority of users come away with a positive experience rather than a bad one then 'overall' it is doing a good job - it's just other aspects are threatening to really limit and reduce that effectiveness to a level approaching the 'not really worth it' level for which it would be a shame to happen, things need to be done effectively so that it's the other direction the NHS goes..

Good luck!

Cheers! DtM! West London & Slough UK!

I have seen two separate NHS news articles on the BBC about elderly folks that are suffering from age-related macular degeneration and if untreated they will go blind. One was a woman somewhere in the south and the other (yesterday on BBC morning) an elderly man looking after his ill wife) living in Oxfordshire. IF they lived in Berkshire they would be getting the necessary treatment. Meanwhile, both are losing (the gent, has almost lost all of his), while they fight for their treatment. Post code lottery's are very scary.

Jules, I wonder if one of those cases was in Bath. There is an elderly couple who are both facing blindness. Due to the length of the waiting list for treatment, one of them (the gentlemen) is higher up on the list and is going to sacrifice his place (and sight) for his wife, so that she will not go blind. When  I read that in the paper it brought me to tears.
Also in Bath, I've been told that I will have to wait 'years' to see a podiatrist... which isn't so helpful when I can barely wear any of my shoes due to the pain in my foot!

Jules, I wonder if one of those cases was in Bath. There is an elderly couple who are both facing blindness. Due to the length of the waiting list for treatment, one of them (the gentlemen) is higher up on the list and is going to sacrifice his place (and sight) for his wife, so that she will not go blind. When  I read that in the paper it brought me to tears.

Smootie, I am not sure I saw it on "South Today" after the BBC evening news a couple of weeks ago. I think it was just a lady in that clip.

How incredibly sad for that couple....its tragic.  :\\\'(


Wow, very sorry to hear about your foot! I wonder how much it would cost to pay privately? It may be worth calling around just to see about it.

thanks for the info groovy_yank. I will definetly take to heart what you have said and talk to my wife about that when we get closer to making a decision.

You're welcome. Preparing for health care needs, now and for the future, is an important decision for all of us.

yes the nhs may not be the best in the world but it beats insure care in the usa the insurees companys are geting richer ever day by not covering opts .when it comes out in the uk you have to go and see michael  moors sicko also tell family and friends in the usa to go and see it  out now in the usa.




our house is up for sale ,so hopefuly will not be long to come back home to the uk after over 16 years in the usa

For what its worth here's my 2 cents...Im a dual citizen, currently living in the US, have been living here for many years now, previously lived in the UK. I have had experiences with the NHS as well as having great insurance, mediocre ins. and no insurance in the US. Hands down the NHS beats the US in so many ways. I even got to see a doctor faster and more efficiently in the UK than I ever  did in the US (maybe because the docs in the US are so busy half the time arguing with ins. reps).

Although I see many positives in the US, I have to say that a huge factor that would play a role in a move to the UK would be healthcare access. The UK may not be perfect, but its light years better than what exists in the US. Its just frightening how things are done (or not done) herel. You don't realize how vulnerable you are until you experience being uninsured in the US.

Admittedly, I am a young, healthy male and thankfully have not yet had the need to require extensive medical attention, so couldn't give a full review of all systems. However what good is it for us here to boast about our "*1 healthcare" if I, a healthy 28 year old, have to worry about cost and access to even basic healthcare (not to mention such worry will only increase with the passage of time).

Also, with the UK horror stories....I bet for every UK healthcare horror story, you can top it with 100 US horror stories (I even have one!) Rationing does indeed exist in the US, and its a much crueller and inhumane system than that in place in the UK.

Thanks for your post DX, and welcome to UKY

Having been uninsured in the US, I couldn't agree more, dx.

My lack of insurance came about in the usual way: I was made redundant and had difficulty getting another job - dot.bomb time.  I was working temp and couldn't afford COBRA payments or to buy privately - I was able to buy privately later.

I have a bankrupcy from a medical emergency whilst uninsured.  Now, however, you can't go bankrupt due to medical debt.

I'll never forget how fearful and vulnerable it felt to be uninsured.  And I was single with no kids at the time.

"a socialist country"??  If only!

 

  Now, however, you can't go bankrupt due to medical debt.

Really, is that a new federal law and if so very new?? 

No, you can still declare Chapter 7 for medical bills, now there is a means test.  It is still not impossible, there was a great deal of fraud, but now more innocent people have been caught up in the net.  Mainly, they are interested in consumer debt, not medical.

http://en.wikipedia.org/wiki/Chapter_7