US Healthcare and deciding to move to the UK

That said, the US system really needs an overhaul but I worry that they are trying to push the reforms through too quickly. It's a mess and will take more than just a few months to sort out.

I agree with this. I must say something in defense of Medicaid though (or Medi-Cal in California). I have great private insurance and have for a number of years, but when my daughters were younger, we all were on Medi-Cal and we received equal if not better care than with private insurance. In all honestly, my youngest daughter's delivery on Medi-Cal was better than my oldest daughter's birth on private insurance. The Healthy Families programs was wonderful too.

The healthcare situation in the US is not the reason I moved to the UK or that my husband and I decided to stay in the UK (it had more to do with the fact that I love living here and my husband had more family here) but it is a big reason why I won't seriously consider moving back to live permanently.  

I've lived in the UK my whole independent (non-student) adult life, and I love not having my health insurance tied to employment or having to fuss about trying to sort out individual coverage.  I love that either of us can quit our jobs, work temp, be self employed, or work part time without worrying about insurance coverage. I love not having to worry about pre existing conditions and gaps in coverage.  I am terrified by the prospect of living in a country where you can be bankrupted by medical debt.

If the insurance situation changed in the US so that everyone had access to some kind of decent medical insurance no matter what their situation, I'd certainly be more likely to live there again in the future.

So I guess the answer is, I'd rather be in the US on Blue Cross than in the UK on the NHS. But I'd rather be in the UK on the NHS than the US without a premium insurance plan.

I totally agree! I would rather be in the US with my previous insurer than in the UK on the NHS.

While the NHS had no bearing on our choice to live in Scotland, I will say that after friends and family had several negative experiences with the NHS, I was really nervous about moving to the UK and having to rely on it. One friend had to wait nearly 3 months to get her painful cancerous tumor removed. While she waited it grew from the size of a walnut to the size of a large melon and because it had grown so large they ended up having to remove her whole ovary. My husband had a horrible NHS GP, who misdiagnosed him several times over the course of 6 months, without running a single test to confirm his diagnosis, each time prescribing him different medications, which only created new problems. His actual problem wasn't sorted out until he ended up in a US Emergency Room (on Christmas Day no less) for a seemingly unrelated problem that it turns out was created by his poor care. Thankfully his new GP seems to be much better.

I've only been here for a short time and haven't needed healthcare, so I can't confirm or deny my fears. Time will tell.

But I do not have pre-existing conditions that would prevent me from getting or affording quality health insurance in the US. I can imagine that would make things significantly more difficult and I can see how the NHS might seem like a better option. And certainly we will take healthcare into consideration before we ever think about moving back to the US.  

I think Marlespo said it best, "There are good and bad things about both systems." In both countries it really does vary from place to place and doctor to doctor. Some are great and some are just plain awful.

Modified to say: I had to go private for the mammogram because the NHS wouldn't give me one  (you have to be over 50) even though I had a family history of breast cancer.

Just wondering where you live, I have a wonderful family history clinic that I go to and I have gotten a Mammogram every year since I was 32. My doctor referred me and the waiting list was quite long, but I get amazing service through them. Its worth asking about a family history clinic in your area, the one where I live is called the Nightengale clinic.

I do think care varies widely from trust to trust.  At least that has been my impression via my involvement on another forum of immigrants to the US.  My husband was generally satisfied with his care in Northern Ireland. 

I think my husband finds it frustrating in the US to have his current job search involve not only finding a good job, but one that offers a good health plan.  And I feel helpless and not a small portion of guilt - if I took the health coverage offered at my place of employment it would eat up about 1/3 of my take-home wages.  With only one of us working right now that is not an option so we go uninsured and begging to drug companies for indigent meds.

I find the feedback in this thread interesting, especially from the perspective that some of you express a general dissatisfaction with the NHS yet state the benefits of it would be a consideration in a return to the US.

I have always stated there are pluses and minuses to each system.  I guess when I began the thread I was wondering how the generally 'healthy' population regards the benefit of socialized medicine as an immigration matter.  Such a discussion may not be relevant to the case of an UK expat in the US with a chronic condition and his US wife wondering what is the best to do for her husband.

Just wondering where you live, I have a wonderful family history clinic that I go to and I have gotten a Mammogram every year since I was 32. My doctor referred me and the waiting list was quite long, but I get amazing service through them. Its worth asking about a family history clinic in your area, the one where I live is called the Nightengale clinic.

When I was in the UK, I lived in Reading. Like I said, the surgery we went to was terrible but at least the GP gave me a referral to use my BUPA (private insurance) since he said the NHS wouldn't provide me with one until age 50. It was the private Consultant that gave me the really hard time about wanting a mamo even given my age/family history.

So I guess the answer is, I'd rather be in the US on Blue Cross than in the UK on the NHS. But I'd rather be in the UK on the NHS than the US without a premium insurance plan.

Agreed.  Unfortunately DH has kidney disease.  I could put him on my insurance but I believe the drill is that Medicare covers renal disease not insurance.  And he would not be eligible for Medicare, having never worked here.

When I was in the UK, I lived in Reading. Like I said, the surgery we went to was terrible but at least the GP gave me a referral to use my BUPA (private insurance) since he said the NHS wouldn't provide me with one until age 50. It was the private Consultant that gave me the really hard time about wanting a mamo even given my age/family history.

I also have a family history of breast cancer (my mom) and they wouldn't give me a mammogram when they found a lump at my post-partum checkup. They referred me to the breast center, told me they don't do mammograms under the age of 50, and did an ultrasond on my breast instead. This was at St Georges in Tooting, my GP was in Wimbledon.

I also have a family history of breast cancer (my mom) and they wouldn't give me a mammogram when they found a lump at my post-partum checkup. They referred me to the breast center, told me they don't do mammograms under the age of 50, and did an ultrasond on my breast instead. This was at St Georges in Tooting, my GP was in Wimbledon.

Very glad to hear that you received an ultra-sound once they discovered the lump!

My major concern is waiting to be 50 with or without a history. Similar to the pap spear issue in the UK...waiting until a later age to get one. 

Now see, I've recounted my tales countless times, but the brilliant,brilliant care I received in the brain tumour years will make me love the NHS forever (i.e I'm very biased, so don't trust my opinion too much )

When I was sick, nothing was every too much trouble, and I couldn't imagine the amount of money the NHS spent keeping me alive; several seizures which needed me to be picked up by paramedics/ambulances, for instance - god knows how much those would have cost on their own, without adding prescriptions, radiation therapy, surgery, and countless scans, blood tests etc.

That time of my life was so incredibly horrible,  I can't imagine what it would have been like to do it with the worry of co-pays or insurance, I needed all the energy I had just to get up and shower each day (most days ).

When you're sick and everyone is doing everything for you, you can feel guilty enough, but the idea of dying in my 20s and leaving my family with thousands in health care bills would have been absolutely abhorrent to me and pushed me over the edge.

Generally I think that navigating the NHS can be complicated, especially as an American who may have had little/no experience of it.

I very quickly learned never to take no for an answer.
Whenever I move, I am very careful to shop around for GPs, I ask friends for recommendations, I go on-line, asses the facilities and age of the practice, the qualifications of the GPs and their specialities. I have asked to meet the GPs before signing up to a practice as well - so far I have not been refused

I am an advocate for doing your research, if other NHS trusts offer things that yours then challenge those decisions (if possible).

Yes it absolutely rubbish that you have to do that and that a postcode lottery is in effect, but unfortunately it's the way the NHS currently works, it is huge glaring, obvious flaw which needs to be addressed.

My general opinion of the NHS is that it seems to be good at keeping people alive when they're sick, but not really very good at stopping people from getting sick in the first place.

Doctors are not gods, if you feel your GP is rude, not taking you seriously etc, then make a complaint, ask to be switched to another GP, ask for a second opinion etc. Know what you're entitled to and push to get that.

I must admit, healthcare is the number one thing that bothers me about moving to the US, as an overweight, diabetic, former cancer patient with PCOS, I am absolutely terrified about not being able to get coverage or having to pay for prescriptions.

That everything you've worked hard for, your house, your financial security etc, can be taken from you for simply falling ill in this day and age frankly disgusts me.

That everything you've worked hard for, your house, your financial security etc, can be taken from you for simply falling ill in this day and age frankly disgusts me.

.....and not just 10 minutes ago were the DH and I sitting in our little family room in our little house here in the US that we have worked so hard for, and uttered those same words.

Hence my thread and my 'angst'.........

cheesebiscuit:  thank you for your reply.  that really puts everything into perspective and i think your attitude towards the NHS is one of the more refreshing i've seen--particularly the advice to be proactive in order to get the care you need. 

Can i ask just how expensive is medical insurance in the US?

I have had no problems with the NHS however i also have private health insurance and will mix and match the two depending on what the problem is.

One example of this would be that i saw my GP about a stomach complaint and he wanted me to have an endoscopy to check things out. He said that he could get me an appointment within 1 month. He then said if i had private cover i would probably be seen earlier. The doctor did not think it urgent and if the NHS appointment had been within a couple of weeks i would have been fine with that - but I'm a bit of a hypochondriac. I opted to pay the £100 excess on my BUPA cover and had the procedure within 10 days.

Another time i decided that after breaking my nose for the third time i wanted to get it straightened (it was so bad i could smell round corners) and this would obviously need to be done privately. I had an appointment with a consultant via BUPA who (as most do) also did work for the NHS. He said that because i had a dislocated septum which affected my breathing he could do the op on the NHS for nothing thus saving me about £1500. I simply had to go back to my GP to get the referral back to the consultant and within 2 weeks had the op.

The point here is that the NHS is a great service but its wise to have a backup. Ive never had problems with any NHS services however if i want to get something checked out quicker than the NHS can offer and pay a little extra then my BUPA cover gives me peace of mind. The above examples show how well this combination has worked for me personally.

I am 43 and pay about £75 per month for my BUPA cover - is that cheap compared to health cover in the US?

I am 43 and pay about £75 per month for my BUPA cover - is that cheap compared to health cover in the US?

Extraordinarily cheap. But we're probably comparing apples and oranges.

If you wanted to buy private health insurance in the US that replicates the range of services the NHS provides, it would probably be many hundreds of dollars a month. However, you'll find individual procedures paid out of pocket are surprisingly inexpensive.

I went without full coverage in the States for a while (long story). A full blood workup cost me a bit over $100. An office visit, $60. A tetanus shot, $35. A mammogram, $300. That's been a while ago, but the principle is the same.

If I ever went back -- assuming the system doesn't drastically change -- I'd buy health insurance with a VERY high deductible, for if something serious happened, and pay the rest out of pocket. That would be the best level of care for the least money.

And if the US government looked to dealing with uninsured people who become very ill, instead of trying to cobble together a complete US version of the NHS, we could whittle down the problem to something everyone could agree on.

I am terrified by the prospect of living in a country where you can be bankrupted by medical debt.

That everything you've worked hard for, your house, your financial security etc, can be taken from you for simply falling ill in this day and age frankly disgusts me.

This is exactly why DH and I would never move to the US unless the healthcare situation were better. My mom had brain surgery five years ago (with "good" health insurance), and my parents are still swimming in debt. They are essentially living on the bones of their ar$e. Now mom has other health problems, and they are just getting more and more in the hole over her care. Meanwhile, my stepfather hasn't even gone to the doctor in years because he has a heart condition, and he is too worried they will want to treat him for something that he can't afford to pay for. It's sad when hardworking people have to live that way, sick, but too broke to afford to go to the doctor, or too worried over what it will end up costing.