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A few months after moving to London in 2013, I was diagnosed with testicular cancer. It was not particularly bad, but I felt like I was thinking about mortality and a crash course in the British health sector almost before I paid my Oyster card.
I am reflecting on my experience since returning to the United States last year, where health care is once again at the forefront of the political agenda. For those entering a crowded Democratic primary domain, support for a form of single payer system, especially on the model of the National Health Service, is becoming a litmus test of a progressive commitment.
That Americans are not happy with their health system is not surprising. The United States spent $ 10,224 per person on health care in 2017, double the average spent by other rich countries and compared to $ 4,246 in the United Kingdom, according to the Peterson Health Monitoring System -Kaiser.
Despite all the additional expenses incurred, 9% of Americans do not have health insurance and the results obtained in the United States are generally not better – although there are so many parameters that I hesitated to make radical statements.
The feelings of the British for the NHS are complicated. Most seem to cherish the idea of service, I discovered, while being dismayed by the state of the service. Horror stories about the NHS goofs are a staple of the British media – especially during the annual "winter crisis" when gurneys of stuck-up patients line up in overcrowded corridors, such as jumbo jets outbound parked on a snowy trail of JFK.
I remember a Midland hospital chief who had told me that the hospital was the worst place to bring a sick grandmother during the holidays. "Potentially, you start a process where she might never come home," he explained politely.
My own relationship with the NHS has not started in a rebaduring way. After filing a complaint with my local GP about the discomfort of my groin, I was referred for a scan. I had to receive a letter in the mail to confirm the appointment. Weeks pbaded without any sign of the important letter and I wondered how an entire health system could depend on the reliability of the Royal Mail.
"And if I have a tumor?", I asked a secretary, almost certain that it was not the case. A replacement letter finally arrived and I went to get scanned. In less than four seconds, the technician's wide-eyed eyes announced the news.
Members of my family have urged me to return to the United States. But, after consulting colleagues, I trusted the NHS. Within a few days, I underwent surgery and, after my recovery, chemotherapy.
There were more scans and too many blood tests to remember. The chain of generally humorous doctors and nurses who treated me spread across the Commonwealth – from my South African general practitioner to the South Asian urologist, a West Indian surgeon and an English nurse who chirped: "Y 'Awright?
I am still not sure – given the circumstances – how to respond to this British greeting.
Here is another thing that puzzles me: how could I consume so much medical care so soon after setting foot in a foreign country without any cost, without even discussing it? This is probably because I was a taxpayer, although nascent. Still, I had the impression of having arrived in a desert village, of smiling at the inhabitants and of drawing water in their well. I was ashamed (and enormously grateful).
Five years later, I am at home and in good health and the American medical system is now disconcerting. Unlike London, there is no time limit for each appointment. A visit to the GP is therefore luxurious. I sometimes wonder if American doctors are alone because they seem to want to spend as much time talking to me.
They wear iPads and offer dazzling possibilities: why not try genetic tests, suggested a doctor. How about a nutrition review?
But it is not so simple. I had been waiting for weeks to hear about a scanner and the problem of genetics was gone. The limiting factor is not an NHS bureaucrat, but a private insurance company administrator.
For the treatments they cover, my insurer regularly sends a letter detailing the fees and the amount of the invoice they paid. The tone is self-congratulatory: look how we helped you! But I find them especially menacing. Each of them reminds me how financially vulnerable I am without them.
I have not (yet) benefited from advanced robotic surgery. The costs have instead involved several hundred dollars to confirm that a child is struggling to see the table, over a thousand to replace some old fillings, a few hundred dollars for an inhaler for the first time. asthma, etc. With each bill, I feel more like a customer than a patient.
The NHS does not make big promises and can sometimes surprise you. Before the chemo, I was offered to keep my sperm if my wife and I had decided to have more kids – an unexpected kindness.
In the morning agreed, I took my letter to the fertility clinic and took me to a private room. I discovered a leatherette wallet containing a collection of rather obsolete badgraphic magazines.
I thought they looked a bit like the British health system: a little worn, but most of the time, they always did the work.
Follow Joshua on @ JoshuaChaffin or write to him at [email protected]
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