I wanted to make sure people understand that I wasn’t displeased with my NHS visit yesterday.   Not at all, actually.  

What you have to understand is that I view access to the NHS as an incredible privilege.  I know people have their doubts about it;  When I posted about my upcoming appointment on Facebook, one of my american friends simply scoffed, “Good luck with socialized medicine.”   This made me very angry, because to me, this is obviously the statement of someone who has been fortunate enough not to be left in the cold by the system we use in the states, and doesn’t consider all the people who have been.

I disagree with the notion of health insurance, at least in its current state in the US.  For starters, most insurance comes along as a benefit from your employer.  Just stop and think for a moment what that means:  Your boss directly holds the cards to your health.  I doubt that’s a good thing.   More practically, what it means is that if you change jobs or lose one, you lose your health care.  Legally, your employer is obligated to continue providing your health care for six months after you leave, under a scheme called COBRA, but you pay it out of pocket.   For an average person, I think the monthly COBRA payment is something like $400?  It used to be last time I cared, anyway.   That’s for a single person, not including their family/kids.

You would normally have to work 40 hours a week to qualify for health benefits at a job.  Part-time health benefits are rare enough that they get written up in the paper.  This makes it pretty hard for someone like the 22 year old student, who might not be covered on their parents’ insurance anymore, to keep their coverage.  Contraceptives are frequently not covered, and pre-natal care is almost always an add-on package that is RIDICULOUSLY priced and must be maintained for about a year before you’re eligible to actually USE it.

But these people are the lucky people.

There are legions of people in the states who do not qualify for health insurance.  For some, it’s because they are unemployed… and the first daft argument against socialized care in the states is always that if someone isn’t contributing, they should.. I dunno.. bleed to death in the streets or something.  My counter argument to that is that when your unemployed neighbor gets swine flu, you’re probably going to want him to get treated for it, even if it comes from your tax money, because his virus doesn’t CARE that YOU’RE lucky and insured.

But there are others.  Even if you are working a full-time job and have been paying into the system for years, you can be denied coverage if you have a pre-existing condition.  This might be diabetes, history of heart attack, some kind of chronic illness, if you’re over or underweight.  If you are already pregnant, you might also have trouble getting insurance, as pregnancy is considered a pre-existing condition, too.   I once had massive issues getting blue cross to cover me because I had once, three years earlier, had my foot x-rayed when it swelled up… even though it was fine a week later and that was that.

Here is an even better one:   Say you work for company A for years, and while you are there, you develop diabetes.  Your employer lays you off and you find work with company B.   When you go to apply for insurance with company B, you might find that suddenly, you can’t have any.  Is that fair?

Without insurance, you start to play a game of chicken between your health and your wallet.  Most people I know refuse to seek treatment for things that aren’t bleeding because they simply cannot afford to.    A simple office visit can be $60-$130, depending what you’re in for, and that won’t include testing or medications, which will typically run you hundreds more.  (I will save my “pharmaceutical companies are horrible crooks that should die in a fire” rant for another day.)  

SO

I don’t CARE that my doctor is a bit abrupt.  (My husband says he’s just like that with everyone, anyway.)   I was able to get in to see him quickly, he has made sure I have nothing life threatening, and suggestions for what to try, and it didn’t cost me two hundred pounds to hear his advice.  I haven’t gone to fill my prescription yet but I imagine it will be laughably cheap to me.  My migraine meds in the states were $20 a pill, and you need two pills when you need them.   You end up debating if you have a $40 headache or not… and wouldn’t it just be better to debate what you’re going to do when it subsides?

I am endlessly amazed and grateful to now live in a place where rich and poor, healthy and sick alike are all able to get medical care.   It’s barbaric to do otherwise, and the health system in the states is one of my greatest sources of frustration and shame as an American.  If you live in the UK, you should treasure the NHS.