Thank you NHS! This week we found out that Patrick’s braces will be 100% paid for by the NHS. He gets started in 3 weeks! During the healthcare reform debates in the US I was shocked by how resistant to universal healthcare people are/were and when we considering moving to the UK the National Healthcare System (NHS) was a major benefit we considered. Now that we have been here for a while and have experienced kid’s appointments, injuries and orthodontics I would say our view of the NHS is now a little more complicated.
Knowing that regardless of where we work or what happens we will not find ourselves in a situation where we face high medical bills is an incredible feeling. Even having had amazing benefits through Microsoft in the US there is always the chance of layoffs or unexpectedly needing care while out of network. Watching friends and family members find themselves in situations where they didn’t have health insurance or having health insurance but experiencing serious illness and then having to make tough trade-offs to continue their care, it just isn’t right.
There are big positives to the way the system here works. When babies are first born a health visitor will come to your home to do your first well baby visits. New moms don’t have to make it into the paediatricians and if you have concerns or issues health visitors will continue to come to your home as needed. There are also baby clinics located in the local villages that have open hours each week so that you can stop by at any time to have your baby weighed or get questions answered by RNs that specialize in baby/toddler care. No appointment needed, you can just stop by with any concerns you might have. The clinics also run additional resource programs like speech therapy or parents support programs. When I fell and broke my toe there was no hesitation to go the ER or A&E (Accident & Emergency) as they call it here. There was no additional cost associated with A&E and there doesn’t seem to be an urgent care type of practice, it is either your general practitioners office or the hospital.
There are also some negatives to the system. You don’t have a paediatrician and a series of well-baby visits like you do in the states. With the Kellen we had so many appointments those first 2 years where he was checked head to toe by the doctor, his developmental stages were recorded and I was reassured that he was on track. Here you go to your doctor for immunizations and other then that you can go to the clinic if you have any concerns. There are a few well child appointments; I think the first one is at 12 months so we will see how that goes. Luckily since Ella isn’t a first baby we are a lot more comfortable that she is reaching all of her milestones and don’t have quite as many questions as we did with Kellen. Having talked to women who have had their children here it sounds kind of miserable. The birthing rooms are shared, because the rooms aren’t private husbands can’t stay overnight once the baby is born so poor mom is on her own outside of visiting hours. There are news stories about too many patients not enough doctors but that is the same back home too.
My perception is that if you have good insurance then you can get ‘better’ care in the States. The actual medical attention is probably the similar but I think you can get more individual care in the States. Having a dedicated paediatrician to spend time with your children, nicer hospital facilities, etc. But if you don’t have insurance or not enough insurance then the cost of seeking care is prohibitive. The way I think about it is that in the States some people get great care and some get poor care/no care. In the UK everyone gets good care.
The trade-off is the tax rate. We are currently being taxed at 40% and that can be shocking when you really look at the gross vs. net pay. But we also see the Patrick getting an outstanding education, Kellen starting his free preschool next year and now everything from dental to prescriptions being covered in full. Suddenly 40% doesn’t feel too bad anymore.