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Healthcare Costs

First, I should explain – The NHS is not free. We do not pay for GP visits, specialist visits, or hospital stays out of pocket, but we do pay for prescriptions (at least in England), eye exams, dental exams, and a few other things. Even with few out of pocket expenses, it still does not make healthcare in the UK free.

The NHS is funding through taxation, which is paid by most residents automatically through their employer via paycheck deductions (similar to SS contributions in the US). You need to be an “ordinary resident”* of the UK in order to access the NHS for “free”. Visitors are limited to not being charged for a visit to A&E (but you will get charged if you have to be admitted), treatment for communicable diseases, and family planning.

I was recently in hospital for three days (two nights) following a visit to A&E. Technically, I was admitted and discharged while I was sitting in A&E since I was finally sent home to sleep and come back. The following day, I reported to the EAU (Emergency Assessment Unit), which is a branch of A&E. I do not know if the five hours we spent in the EAU would count as an A&E visit or as part of my hospital admittance. I also had the following:

-IV drip of paracetamol (3)
-ultrasound
-blood tests, urine tests, MRSA test
-saline drip (3)
-“meal in a bag” drip (2)
-anaesthesia
-oxygen
-anti-nausea medicine
-paracetamol (16 doses of 2 pills)
-dihydrocodine (1 dose)
-“meals” – cups of tea, sandwiches, biscuits. (no hot meals)
-sponge bag kit (shampoo, soap, toothbrush, toothpaste, comb)
-surgery/abscess drainage (with dressing after)

To my knowledge, I saw 7 doctors, 3 junior doctors, 2 ward sisters, 1 nurse constantly (i was assigned to her), and about 12 other nurses sporadically, including the ones at my surgery.

And the only thing we had to pay out of pocket for was £10 for two days of use of the telly/phone/internet.

It’s absolutely shocking that once I started to google around for the “average cost of US hospital stay” I found astonishing figures….

-$85 for an IV
-$5 per pill of pain relief (Tylenol in the US, but is the equivalent to paracetamol)
-$150 just for the use of a bed
-$45 for a “wash bag”

And one site suggests that I might have been charged $16,000 for my three-day stay, based on their figures they posted for the average cost of a five-day stay. Of course, I would assume that if I was in the US, I would have had insurance to cover some of that, but I also know US insurance companies are shady and won’t agree to pay for certain things and will just make up the rules as they go along, so I can’t even begin to estimate what out of that $16k we might have had to pay.

Would I have had the surgery if we were living in the US and I didn’t have insurance? Probably not. I can still remember my ER bill from when I broke my foot in Michigan (and had no insurance). I was only in the ER for about 30 minutes because it was empty and had 2 x-rays done and I received a bill for $1000. I have relatives who with insurance received bills for hundreds of thousands of dollars. I know some people who would have just taken a pin or knife to the abscess and attempted to drain it themselves because of a lack of insurance…or even if they had insurance because insurance doesn’t cover everything.

I’d have to look at one of Tim’s paystubs to find out how much we contribute in taxes, and then I’d have to try to figure out how much of that goes to the NHS, so I won’t bother. But people who hate the idea of socialized medicine and think the US shouldn’t do it need to take a step back and look at the solid facts – a socialized healthcare system means that anyone who needs care will receive it when they need it. Yes, I was stuck waiting in a hospital for three days for my surgery because emergencies came in that took priority, but if this had been a life-threatening emergency, I’d have been at the top of the queue.

Websites I looked at while writing this post:
http://en.wikipedia.org/wiki/National_Health_Service_%28England%29
http://en.wikipedia.org/wiki/Acute_assessment_unit
http://www.wehct.nhs.uk/index/your_care/wards/emau.htm
http://www.dh.gov.uk/en/Healthcare/Entitlementsandcharges/OverseasVisitors/Browsable/DH_074374
http://www.cancercompass.com/message-board/message/all,5782,0.htm
http://www.georgiainjurylawyerblog.com/2010/03/outrageous_hospital_charges_ex.html
http://www.usatoday.com/money/industries/health/2004-04-13-rising-hospital-costs_x.htm

*“Ordinarily resident” is a common law concept interpreted by the House of Lords in 1982 as someone who is living lawfully in the United Kingdom voluntarily and for settled purposes as part of the regular order of their life for the time being, with an identifiable purpose for their residence here which has a sufficient degree of continuity to be properly described as settled. (http://www.dh.gov.uk/en/Healthcare/Entitlementsandcharges/OverseasVisitors/Browsable/DH_074374)

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3 Comments so far

  1. miss m April 4th, 2011 14:20

    Love had surgery a couple years ago to remove three lipomas. A lipoma is a non-cancerous mass and some people just grow them. He’s one of those people. He lived with them for years but two were on his ribs and one on his back and they were starting to interfere and cause pain so he saw a surgeon and scheduled to get them out.

    It’s a simple surgery. Slice, cut out, stitch, repeat. He was under for about a half an hour. He has insurance. We got a copay bill from the hospital for $2,000. And another from the surgeon for about another $1,000. $3,000 we got billed out of pocket! And that doesn’t include the copays we paid for the office visits and imaging (sonograms, xrays, etc.) we paid leading UP to the surgery.

    Why people think that the US healthcare system is so wonderful is beyond me.

  2. Rebecca April 4th, 2011 15:11

    Absolutely crazy that they expect someone WITH INSURANCE to shell out $3000 when you already pay x each month for the insurance. I remember when he had that done, I can’t believe it’s been that long since!

    And you’re not on his insurance ,are you? So anything you need anything, you have to pay out of pocket for the whole thing, right? I think that is just so many shades of wrong!

  3. Rebecca April 4th, 2011 15:12

    Oh, and my surgery took all of 10 minutes. The longest part was waiting for me to wake up from the anaesthesic, apparently. Tim says I was gone for three hours!

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