Sean Neill is a South African-born, British-trained anesthesiologist, who recently relocated to Midwestern USA. He blogs regularly at OnMedica about his cross-cultural experience, frequently pointing out oddities of American health care.
Having arrived to see the last of the winter snow, we were amazed at how quickly spring and summer evolved. Frozen pavements evolved to lush green grass in a matter of weeks. Work is a 10 minute cycle away and most Americans find it humorous to see you arrive at the hospital in cycling gear. When asking for directions, the reply is always in terms of driving, even if it is just around the corner. One quickly learns to cycle on the wrong (right) side of the road as the vehicles are so large you would not want to make a mistake.
Another noticeable difference between health care in the UK and the USA is in terms of billing. A UK patient can go into an NHS hospital for a big procedure and may not be asked for another penny. It is completely different in America, where charges start from the minute you walk in the door. Each hospital specialty has its own large team of dedicated professionals diligently chasing every possible expense. A short visit to a primary health care facility will be followed by a bill within days.
The patients themselves tend to be sicker than what we are used to in the UK. A lot of them (and there are a lot of them) are simply huge! Nobody bats an eyelid at a BMI of 60.
Of course they all have OSA (obstructive sleep apnoea) and GERD (gastro-oesophageal reflux) and “mild” CHF (congestive heart failure). Clearly, there is nothing mild about having heart failure with one heart and two bodies, you can do the math. Abbreviations are the order of the day and the more abbreviated co-morbidities on the patients’ lists, the more they are charged. No matter how sick you are in the US it appears that if you have insurance you will get your operation.
Current estimates put US health care spending at approximately 16% of GDP. Total spending on health care in the UK rose to an estimated £120bn in 2006, representing 9.4% of GDP — up from 7.1% in 2001.
Perhaps one reason for NHS budget deficiencies is the fact that its billing structure is nowhere near as efficient or organized as the US. If UK citizens were allowed to forgo their National Insurance contributions in lieu of private health insurance, would they receive a better service or simply be charged more?