rebness | NHS = doubleplusbad

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britain's not all bad

NHS = doubleplusbad

Something alarming happened this week, something which has the British media up in arms. Our special friends, our close cousins across the Atlantic, decided that we run an ‘evil’ and ‘Orwellian’ state. The focus of their ire? Our very own NHS.

Brits were baffled. People were genuinely mystified, even hurt, that (some) Americans had turned on us so quickly. The British embassy said that it would ‘quietly correct erroneous reporting’, which came as little comfort. And then came the anger: the Twitter # tags. (welovetheNHS!), Facebook groups, newspaper debates, blogs, the repelling of wankerface Tories trying to paint our healthcare as woefully inadequate. Why would Americans believe this claptrap, people ask?

Of course, very few Americans believe this rubbish. You Americans here on my LJ are my friends because you’re not these hatred-spewing, fact-phobic imbeciles. And if you do have quibbles about socialised healthcare, you debate it. You don't Godwin yourself by comparing Obama to Hitler. However, I am going to write about this and set some things straight because it’s the right thing to do. I am not debating the ins and outs of Obama's healthcare plan (because in truth, I don't know the ins and outs of it), but what I will do is explain Why The NHS is Not a Bad Thing.

First off: prescriptions on the NHS. All prescriptions are at a set price, which admittedly can sometimes work against you (your chemist will usually advise if buying over the counter is cheaper). The set price is ₤7.20 per item in England, ₤4 in Scotland. You pay this for anything from an inhaler to medicine for the most rare conditions. In Wales, by the way, prescriptions cost a big fat 0.

But what about the cost to the NHS itself? Drugs companies certainly don’t charge them ₤0 for their precious pills. Being a nosy sort, I used to enjoy flicking through the drugs index on idle afternoons whilst working at the Mental Health Unit. I remember how surprised I was when I saw the price listings for a 28-day course of something such as Paroxetine: over ₤300. That’s ₤293 cost absorbed by the NHS each month you are on those pills, the full ₤300 if you’re on low income or unemployed. Or Welsh.

This is socialised healthcare.

I have no time for the drugs companies and their strangehold upon healthcare. When I was working in the...*shudder* bowel clinic, the secretaries there talked excitedly of Friday lunch. Friday lunch was laid on by a drugs company every single week – an ostentatious buffet on hospital grounds to say ‘thank you’ and build up a partnership with the consultants. The one I worked for would pointedly refuse to even enter the room during that hour, every week. He would not be bought. He would not be bribed. He would not put his own personal interests (and wealth) above the care of his patients.

This is socialised healthcare.

But what about Spain? Well, Spanish healthcare is ranked higher in WHO than the UK and the US. Let me tell you about it: I take Omeprazole (at 2 euros for a month’s supply!) for chronic acid reflux. One fine day a few months ago, I get to work and vomit blood. I go to the doctor that morning (I am seen within the hour, for free). I am referred to the hospital and sent to triage (free). I have bloods taken (free), x-rays (free), a gastroscopy (free) and I am given a written report (free) and medicines (free!)

This was at a time when I had been very silly with money and didn’t have much in the bank. I would not have been able to be seen even if the cost were 50 euros.

There was a very sick American girl I talked with there (they gave a tentative diagnosis of Crohn’s) who panicked throughout because she was having all these tests, consultations and was being prescribed medicine, but of course she wasn’t a Spanish resident and didn’t have European health insurance. Perhaps she should just forget the treatment and get a flight home to America so she’d be covered by her insurance there?

No need to panic; she paid fourteen euros. She was disbelieving: ‘It would cost me more to be seen at home!’

What is the alternative? Refuse care to her on the grounds of money? The consultants were not interested in her nationality; they rushed her through because they were concerned at her tests.

This is social healthcare.

Back in 2006, my father suffered his first major illness – a stroke. My mum phoned me at work (which just happened to be the hospital where he was admitted) and told me he had fallen and had been taken by ambulance to the hospital. I tore down the stairs and into A&E (ER for Americans) where he was being treated. The care was compassionate, quick, understanding. I was a nervous wreck, my sister crying, my father scared. There was no third-world pushing him to the back of the queue. There was no refusal to treat a pensioner on the grounds that it would cost the NHS too much.

When he was diagnosed with cancer, the consultant asked for us to come in and see him. My family were taken to a private room and had the news broken gently to us. The consultant told us how sorry he was, that he was there to answer any questions, that he would do his best. And he did. I cannot tell you how sensitive and yet strong that consultant is, how much he cares about his patients. Every worried phone call, every bedside question – he was there to answer.

In the UK, cancer is subject to a two-week rule: if you are suspected of cancer, you must be seen by a consultant within two weeks at the absolute maximum. My father was seen within a day. He was operated on within the week.

This year, my father had a heart attack. He also needs an operation for cataracts. This is a man, terminally ill, over sixty. Not once has the NHS suggested he should just let it all go. Not once has there been a quibble about the cost. Oh yes, he had his cataracts operation delayed: not because it wasn’t worth it, but because they were worried about the stress anaesthetic would have on his heart.

What does it do to the psyche in these moments to worry about the cost? Will the insurance company cover this? What if they want to take x-rays? What about the excess?

WHY would these questions ever be appropriate at these times? Why would any society ever even consider this normal?

These moments in hospitals can be humanity at its most broken. I have heard gut-wrenching screaming coming from emergencies when working there. You never think about the cost of life beginning or ending here. You just think, ‘God, please let them be all right.’

Surely that’s the way it should be? It makes me want to cry, to think of ordinary, decent people crippled under the weight of propaganda by these heartless, grasping companies. We’re all used to seeing greedy business riding roughshod over humanity, but this is a matter of life and death. I feel like shaking those morons protesting at Obama daring to consider healthcare a right. I absolutely cannot fathom it.

The Guardian is my favourite online paper not just for the articles, but because of the wonderfully trollish (and surprisingly intolerant) debate that springs up there each day. When the right-wingers trotted out the stories of death panels and older people being killed off and What if Stephen Hawking were British? (lulz), people banded together. Comment after comment after comment: Don’t knock this. The NHS is one of the few things that we’re proud of. Really, why wouldn’t we be? This is progress. This is society doing the right thing.

If you don’t like socialised healthcare, there is always the alternative of private medicine: you can opt for private treatment in any country. Socialised healthcare just means that you will never have to sell up your house to pay hospital bills. If someone you love develops cancer, you worry about the cancer and not the treatment costs. It’s a safety net available to everyone. What is wicked or Orwellian or Hitleresque about this? In the end, it can only be that people are protesting at their money going to fund other people. Think about how very, very wicked that is: rather people die than help your neighbour.

American history and ideology interests me a great deal. It always has. I think it can sometimes be flawed (just like the NHS!) but in general, I actually like the idealism of America. Tell me what is idealistic or egalitarian or American about refusing to help those who need it.

Finally, I also did a tax comparison for UK, Spain and the US on my salary (adjusted for ₤ and $):
Spain: 22.35% (all taxes, including healthcare)
UK: 22% (National Insurance, which partly funds the NHS, is a smaller variable cost based on earnings)
US: 25%

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Not American but well said my dear.

Now a little self-interest - I need some advice. I'm back on the Zoladex injections as my ovaries refuse to die and are still pumping out oestrogen. So I need someone to inject the pellet into my abdomen. I'm too wussie to do it myself and I would be worried I'd not do it right, so need a nurse or a doctor to give me the injection. I know Australians have some deal with the British health system that we can be treated in British hospitals. I heard there are walk-in clinics funded by the NHS in London - can I go to them? Or do I have to go to A&E at a hospital and make my request there? And would it be better to go to a smaller town's hospital than some really busy London hospital?

I'd recommend going to the hospital rather than a walk-in clinic, but that's probably my own prejudices about walk-in clinics being annoying! The hospital would probably be more approachable.

As far as I'm aware, you can attend both. You can't obviously go to a GP (but why would you?)

A&E *tends* to have longer waiting times for non-emergencies, but honestly... it's hugely variable. Perhaps pick a nice sunny day (ha) and the emergency cases tend to go down. ;)

Am doublenonplussed...

While often NHS sucks, I also (double)think NHS is a good thing.

Exactly. :D

The drugs I take cost the NHS approximately a grand a week. Also when I was hospitalised bouncing-off-the-walls mental nobody was telling me I had to ship out when my insurance ran out.

Slap me with democracy and call me a communist, but fuck me, I heart the NHS

Slap me with democracy and call me a communist, but fuck me, I heart the NHS

ROFL! Very succinct, but so true! >:)

Well, I'm thinking you know me well enough to knowwhat side of the ridiculous, wanktastic 'debate' I'm on overe here. I thought once we got Bush II out of the White House we could actualy begin to hold our heads up again instead of cowering in shame.

Now the shame comes from realizing that there is a certain bloc withing our country that is filled with wilfully ignorant racist jerk-offs who would rather believe that there could actually be something called a Death Panel and forced euthanasia not because there is anything like a basis in facts but because they cannot and will not accept that the LEGALLY ELECTED BY A PRETTY DAMN NICE MARGIN President in office that happens to have brown skin, OMG.

The same asshats that thought Bush II did a bang up job are the ones that are running around now howling about all manner of nonsense. Have they read the bill in question? I'm thinking not. Do they understand what a Public Option is? Do they have any inkling of how Britain's NHS is run? Hell, half of them can't name the three branches of government in their own country or locate the countries they are so proud we are at war with on a map.

The same people that are being hereded around like cattle by the patriotic sounding "Freedom Way" (The so-called Grass Roots Movement organization) don't have any idea that that organization is fully funded, backed and rhetoric-fueled by several insurance and pharmaceutical companies. The protesers (more like the crazed mobs, really) are very likely to be in the lower income brackets and many of them do not have health insurance or they depend upon the government funded social program known as Medicare. THey don't know that Medicare is a SOCIALIZED MEDICINE PROGRAM. The big picture is lost upon them because all they know is that there is a black man in the White House and the fear and hatred centered on that one fact is used by the afore mentioned insurance & pharma companies and their polial shills in Congress to keep them in a frothing rage.

The health care bill that's laid out so far has a lot of holes in it. There are things in it that I don't much agree with as well as elements that seem sound and useful. If the elected officials would actually sit down and work for the people that elected them, maybe some of the bigger wrinkles could be ironed out. Instead there is greedy in-fighting (both sides of the aisle) and the digging in of the heels (mostly republicans who will never in a million years vote for anyhting that might make Obama look good in any shape manner or form).

I'm sorry to have jumped in on your rant with yet another of my own.Your points are well said and informative; I understand and agree with you, but I think you know that.

I don't know if anyone outside looking in understands just how goddamn frustrating and bewildering it is to see 20% of ones own country go completely barking mad. Frankly, it's sort of terrifying.

*sigh*

No, no, thanks for commenting -- it's interesting to see an American viewpoint on the lobbyists.

I think Brits have been genuinely shocked at the spiteful rhetoric (how can some people turn so quickly? How can anyone believe them?), but I suppose the question is, are these people also attacking the other socialised healthcare countries so viciously?

France (with a mix of private and social funding) ranks at #1 for world healthcare. I though that country would be their first target! ;)

The pundits in particular had a go at Canada for a while. I'm also surprised they haven't jumped all over France.

Edited 2009-08-13 13:19 (UTC)

Maybe they just hear more about socialised healthcare in other English-speaking countries, so they're the more obvious targets...

I'm just boggling at all this. I think you've nailed what I find so weird: that the idea behind the NHS is such a go-getting, optimistic, expansive one, that it seems like it's exactly the kind of thing that would appeal to American society. As cliched as this will sound, my impression from Americans I've encountered and whose words I've read is that, by and large, they do have that 'can-do' spirit.

Heck, I even found myself defending NICE this week, and you know exactly what I think of their stance on biologics. And also... if the NHS, or any other country's socialised system, has faults, then that's not a reason to reject socialised medicine; it's a reason for the US to come up with a better system that avoids those pitfalls and better answers the needs of their large population. I mean, it figures that certain things (distribution, manufacturing, etc.) are bound to work differently in such a large country, compared with the UK, and that that will add its own costs to the mix.

But I also get the feeling that there are positive aspects of American life and culture that would already work for such a system. For instance, the NHS has huge problems with nurses experiencing burnout, but Anji was telling me recently that in the US the nurses (her brother's one) are well-paid and respected. If budgets for a socialised system there continued to favour front-line workers rather than fat-cat managers, there's no reason they couldn't maintain that satisfied workforce, and thus avoid the problem the NHS has of expensive reliance on agency temps... and there's probably loads of other things about the way stuff works over there which would help ease the transition...

And also... if the NHS, or any other country's socialised system, has faults, then that's not a reason to reject socialised medicine; it's a reason for the US to come up with a better system that avoids those pitfalls and better answers the needs of their large population.

Exactly! America has such a good opportunity to be the world leader on this, to change the system *worldwide* for the better. But I suppose this time ideology comes second to cold, hard money. Hmph.

Do you reckon that the old vestiges of anti-British sentiment come into this at all, btw? It does still seem to be prevelant in US culture in the form of over-generalisation and stereotyping, as a sort of counterpoint to the US admiration of British pop music, heritage, etc...

That's an interesting point - I think it was discussed briefly in the Guardian debates, but with a lot more CAPS.

I think (and this is probably an inflammatory viewpoint) that America probably does harbour that old resentment in some quarters, or at least suspicion - perhaps that we're treating them as a colony (which is ridiculous). The vitriol over France with Iraq was mildly surprising, but I think the British republic has been taken aback by the force and speed of this unfair attack.

I never told you - I got into one of my many silly fights on Youtube, that went along these lines:

Troll: FUCK FRANCE! They say they hate us now, but they were kissing our asses when we saved them in WW2!
Me: Moron, not everyone hates America and America wasn't the only country fighting the Nazis. Also, *they* saved *your* asses in the War of Independence.
Troll: Fuck you, that was ages ago!
Me: ...

But I should also point out that Brits are also pretty bad for stuff like this. Do you remember how insulting it was when the British media outright lied and painted Portugal (Madeleine McCann) and Bulgaria (Michael Shields) as backwards, stupid countries not worth our time?

I'm disgusted by the attitude to other European countries that is prevelant in the UK at the moment. Apparently Portugal's a good enough place to get a tan in, and Bulgaria's a good enough source of cheap holiday homes, but what many Britons really think of those places, and of anything foreign in general, really did come out in the McCann case - and others where something has happened to a Briton abroad. I'm not familiar with Michael Shields, though...

Right now we're having huge problems with anti-other-European-countries sentiment here. It's like, after 30 years of very few people emigrating here, now those who do are viewed with the deepest of suspicion, as if they're sub-human. You probably heard about what happened to the Roma community. I've been trying to find the energy to post comprehensively about that whole can of worms for weeks now...

Born a month prematurely, ruptured appendix at 16, emergency Caesarian at 34, dental and optical care for over 50 years (free until 18) and various ailments requiring visits to and from GP with medicines by prescription; probably more if I care to think about it and that's just me, never mind the rest of my family ranging from a 12 month old who was born with only one working eye to an 80 year old having very expensive tests and treatment (so far successful) for prostate cancer.

Long live the NHS!!!

It seems that those who are making the most noise against socialised healthcare in US are being manipulated by the vested interests in the present system. I wonder if 'ER' and 'House' amongst other hospital-based series ever have episodes highlighting the financial aspects of treatment. I admit I'm not such a fan that I watch every episode. Now, 'Casualty' and 'Holby City' I do watch and many episodes mention that doctors have to justify the reasons for tests they wish to perform because of cost. NHS is perhaps a victim of its own success, in that patients who would have had no chance of a full recovery only decades ago are expected to survive.

I would not object to paying more through my salary if I was sure it was going to NHS. I've had my money's worth.

I wonder if 'ER' and 'House' amongst other hospital-based series ever have episodes highlighting the financial aspects of treatment. I admit I'm not such a fan that I watch every episode. Now, 'Casualty' and 'Holby City' I do watch and many episodes mention that doctors have to justify the reasons for tests they wish to perform because of cost.

That's really interesting - I'd like to know.

One thing I can say is that America does have one advantage (over the UK at least) in that funding for research seems to go a lot further. I have a very rare (go, me!) condition that was practically unheard of, even by consultants, in the UK when I was a child and is still not understood today.

My consultant keeps up-to-date with the research on this condition and treatment for it going on in America that isn't funded so well over here. I hope there's a way that the US can provide for the excellent work it does for research, as well as for general healthcare.

I've never seen these issues addressed on any of the medical shows here, more's the pity.

Think about how very, very wicked that is: rather people die than help your neighbour.

But people who spout this hateful information without any knowledge about it (or, in my opinion, wilfully lie) are hateful and see that as an option they can live with. Which makes me very sad, too.

Exactly, Diana. :(

The hatefulness springs directly from ignorance and fear (as it so often will).

The venom that's being sprayed at the NHS (as well as Canada's health care system; (I'm sorry, I don't know what they officially call it) by US pundits (Rush Limbaugh, Sean Hannity, Glen Beck et al.) and politicians is being used as a way to further stoke the fears of those that have no idea how these systems work. I think a much bigger problem in the US is the fact that the media has not and likely will not called any of the politicians or pundits on the outright lies they are telling in order to get people in line with their agendas.

The members of congress can afford to do this because they have excellent healthcare provided for them BY THE GOVERNMENT. The irony of this also passes right over the heads of the people they are using to derail any sort of reform in the broken system that exists in the US now; in that same vein, those people screaming the loudest are the ones that don't even realize that Medicare is a social program. The word socialism is connected directly in their minds to Communism and Nazism, thus the unhinged accusations and rhetoric drected at the White House and Obama.

It makes your head spin to try and keep up with it--it's more complicated than an attack on another country's health care system---that aspect of the situation is just another smokescreen for the to misdirect.It's very distressing for those of us who are trying to remain sane in an increasing volatile and crazy situation.

Edited 2009-08-13 13:16 (UTC)

Can I just say I am greatly enjoying your plethora of Hyacinth Bucket icons.

Also, agree agree agree etc etc

Perhaps when all this unpleasantness dies down you would enjoy attending a candlelight supper?

(I love Hyacinth. Her facial expressions work so well to convey what I'meeling so much of the time!)

This is the first time I have wished LJ was Facebook so I could click a little button that says 'like'.

Very, very well said.

Hee, thanks. :D

It's one of the things about the UK that I'll defend till I'm blue in the face (and then the doctors can treat me for it, free!)

well written.

its amazing how we have spent the last few years slagging of the NHS, but the moment it is attacked by an outside country we get all defensive. Because at the end of the day, despite the problems its still better than most in the world. Its just under a great deal of strain, and at the moment its struggling to cope with the capacity of people who need treating. If we are not careful the UK will end up having to pay a lot more the NHS, and i shall throw in my controversial ten pennies. 'Those who abuse pay more, the smokers, drinkers, over-eaters, and those who have more than 2 babies for starters' I shall duck.

LMAO! You are so bad! But you're right - though we Brits love to complain, we do it in our own way. The vitriol is ridiculous against the NHS.

Are you around over the August bank holiday week, btw? (Arty Liverpool week!)

im in zante! baking in hotness and drowning in lager with the wasps.

OK, here is my one cent, one because I have been sleeping through most of this debate in the press because its really same shit different day around here.

America will never have a national healthcare system because it does not care about people being healthy and better human beings. It cares about the almighty dollar. The majority of people in med school are not there to cure cancer or make the world a better place for people with spinal cord injuries or heart ailments, they are there because doctors make big bucks, drive Mercedes, and have wives that look like Cindy Crawford. They go on Oprah and write best-selling books and have vacation homes in Alicante and Rio De Janiero.

And dont even get me started on insurance companies, with their outrageous premiums and mediocre care by those crappy doctors I was just talking about. That is if the doctor even takes your insurance. Not all doctors take all insurance so sometimes you have to go very far out of your way to get something as simple as a checkup. And god forbid they find something wrong because then you have to get all kinds of permission slips to see specialists....you cant just walk in and say something is wrong, five people with medical degrees have to say so first. And you are not pushed to the front of the line, I have waited months for appointments.

Rich folks and elected officials have insurance. They have money, and the simple truth is they dont give a damn about people who dont. And that attitude is pervasive. And the worse part is they convince poorer and working class people that its not in their favor to support this either by insisting only poor minorities will really benefit and its not for everyone else. In places like France, Canada, and UK people should just look at the fact that people are covered. Nothing is perfect but people are covered. You wont get a cold that turns to pneumonia and you die at 30 because you have no medical insurance. Period. Ignorance, racism, stupidity, utter chaos....sometimes I feel those were the bricks used to build America's foundation.

Sorry this was so long.

As I said to

gairid, please do rant. Please do give input on this, because it's hard for an outsider looking in to understand all that is going on over there.

I really hope that when the hysteria over OMGSOCIALISM dies down that more people like you two will be listened to.

First off, I didn't know you read twitter. >:

Secondly, I added this entry to my memories because that's the most thorough explanation I've ever had about how the NHS works in the United Kingdom.

Thirdly, I haven't looked at any other comment in this entry yet because I didn't want them to muddle my own thoughts not that I have profound ones about Obama's Healthcare plan which is going to change and twist and change again before it ever hits the congress (or is thrown at the congress to decide) for voting.

I have watched the stupidity of radicals (lulz), er I mean Republican's shouting out about "NOT BEING LIKE RUSSIA!" and other such nonsense. I've watched them yell and scream in the faces of their ELECTED officials at Town Meetings the past few days and I just... shake my head.

Health care is a right not a privilege and something has to be done about our skyrocketing costs for treatment that every human being deserves just because they're human beings.

Death Panels: *EYEROLL O'DOOM!*

Americans must read up a bit more on the 1000+ page bill already set out (the one that's going to change and twist forever) before they start spewing at other countries but remember, Americans though idealistic as you say, happen to hate change and will spew in any direction when it comes.

I am only used to private healthcare but it's my understanding that we will have a choice (as you mentioned above) whether to opt for the government provided healthcare v private healthcare. Being an ex-government employee however does leave some unanswered questions as to what they might do to our healthcare options as the government has been paying quite a bit for my (private) healthcare for years. HOW CONFUSING IS THAT?

But. I end with a question. How to do it?

My God, I don't read Twitter! *Sniff*

I would like to pretend this is snobbishness, but a large part is that I find navigating the feeds near-incomprehensible. :p

Exactly, bb! As you say, the healthcare plan will go through so many changes, so many revisions. What's important is that people are taking a look at it, realising that something is broken and that they need to find a solution. Boo to the morons protesting natural change!

The NHS does have its problems, I know that. However, I cannot fault the treatment my mum received when she was diagnosed with cancer. She thought that the nurses were absolutely excellent and that she was treated with the upmost care and attention. Not only that but the treatment provided was also holistic, including massages and beauty treatments. To my mum these treatments provided a much welcome boost and made her feel like a person rather than a patient.

Wow, I didn't realise about the massage/beauty treatments - that's really, really pleasing to know. Looking after the patient's psyche isn't just excellent care, but actively helping to avoid mental/social problems. Go, NHS!

Yes, the system definitely does have some problems and there are, inevitably, horror stories. But I am so pleased to see things like this go well, on both a national and a personal note. Am glad for your mum. :D

Ugh, you have no idea how much I wish I was back in England and getting birth control for free. My new pill costs an insane amount per month. >:

Daaaaaaamn, I forgot about the free birth control! (I'm considering going on it for my wonderful hormonal imbalance, but I need to check out Spain's policy on that.)

Birth control should always be free. ;_;

Great to read all the rants here. No matter if it doesn't work perfectly - what incredibly complex system does? - , the NHS is fabulous and delivers so much to so many people, *regardless* of their means, their contributions. With my girl's conversion disorder these last two years, plus her dental issues and an emergency appendectomy (she's had it all), we would have been bankrupted, even just for the many consultations we had, let alone the brain-scans, lumbar puncture, opthalmology, ENT investigations etc.

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NHS = doubleplusbad

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