The Hippasus Blog

Health costs… The cost of 911 compared to 999

Posted in Uncategorized by pifactory on July 14, 2009

HOW does US health care match up to, say, health care in the UK… so-called “socialized” healthcare?

Well, as a UK citizen now living in the US with my US-born wife I can give some real-life, like-for-like examples.

Some years ago at my home in London, UK, I had chest pains. I also collapsed unconscious in the bathroom. My wife dialled 999.

A year ago in my new home in Portland, Oregon, USA, I had chest pains again. I did not collapse, but in my later 50s I decided it would be prudent to seek some help. This time I did my own dialling, I called 911.

How did the two experiences compare? Well, I’m still alive to write this.

In the UK my recollection is hazy: I woke up facing a guy dressed in a bright green biker suit. In many emergencies UK first-responder help arrives on a motorcycle (with its own flashing lights, sirens… and de-fibrilator). The white ambulance arrived some minutes later. And the police car.

Suitably wired up, I was carried down the stairs and put to bed in the back of the ambulance. Our local casualty department — the UK equivalent of the ER — was about three miles away.

For the next three or four hours I lay in bed trailing wires, curtained off, listening to the steady and reassuring beep of the monitor. Nurses and doctors came and went, questions asked and some tests done.

All clear. A panic attack, the outcome of stress.

In Portland I could hear the fire tender’s siren as I lay on my back on the floor (ready for CPR!), so I knew help was on the way. The white ambulance arrived soon after. So did the police car. Wired up I was driven the three or so miles to the hospital. Again I listened to the monitor. Hours later I was home again. Too much stress.

So, what was the difference? Well, as far as I can recall, medically probably not a lot.

But there was one notable difference. In the US the fire fighters asked for the name of my insurance company. In the ambulance I was asked for the name of my insurance company and told we were going to a nearer hospital than the one run by my insurance company, but not to worry.

At the hospital I was again asked for the name of my insurance company. A nurse phoned to check. Why had I not gone to the other hospital? The guy in the ambulance said the shorter journey would be better.

In the UK I never heard anything more.

In the US the bills started to arrive. One from the fire service. Another from the ambulance company. One from the hospital I’d been taken to. And another from the hospital of my own insurance company, even though I’d never received any care from that hospital. Total: $2,500.

I’m a teacher, so I have decent benefits. I only had to pay $250.

If I were in the UK and I had chest pains? I’d dial 999. In the US? I’d lie down and think about it, picture my orphaned kids, feel my stress level rise… swallow hard and dial 911. Many don’t.

In the UK they call it the NHS — the National Health Service. It’s driving principle is to provide universal health care to all, free at the point of delivery, from the cradle to the grave. Surveys show that it is more popular and dear to the UK citizen than the royal family. Politicians meddle with it at their peril, as they say.

Do the Brits complain about it? Incessantly.

In the US it’s called the health industry. But in a land where the word “service” drips from the lips of every pompous politician I cannot recall it being used in association with health care, indeed you don’t hear the word “care” much either. It’s the health industry. The bottom line is return for the shareholder. It’s not about health, care or service.

There are other examples of the two systems I have experienced.

My dear son was born in the early evening in a London hospital after my wife had been in labour since the early hours. For next six months she and our new baby would be together while she received her full salary (by law). I got two weeks off too (by law). For the following six months my wife received half her salary to care for our son. Her job would have been protected (by law) for a further year had she wanted to take unpaid leave.

When we wanted a second child the natural process didn’t work, despite much effort and numerous (free) tests on the NHS. Even the porn mags (catering to most respectable tastes) to help me do my bit were free. We adopted a dear daughter.

The adoption screening was exhaustive and exhausting over many months, but we weren’t expected to buy our baby and certainly the notion that we should buy a baby from another country was simply viewed by all concerned as beyond the pale.

We have not had a baby in the US. However, several of my colleagues have.

They don’t seem to get paid maternity leave, apart from sick leave they have saved up. They also seem to have to pay bills for the process.

Many also appear to give birth by ceasarean section as a matter of course. Many expectant mothers seem to want a natural birth, but expect a surgical delivery… babies are expected to adhere to a nine-to-five, five-day working week. In the UK a section birth is considered to be an emergency procedure, the preference being for natural birth, even if it is the early hours of a Sunday morning.

Young children also become ill, a great worry for their parents. Fever in the middle of the night. We used to call the doctor and then leave the lights on to identify the house when the night doctor would visit to see our child. I always found it interesting to look out of the window waiting for the night doctor to see neighbouring houses, with their elderly and young, their stressed and eccentric awake.

The night doctor was free. Did we complain? Yes, the night doctor was always too slow in coming. Why weren’t more on duty, isn’t it obvious that children and the elderly get ill in the night and need care?

Of course, my Republican friends (well, I have one) point out that it’s not free. It’s paid for by taxes. And that means people who don’t need these services subsidize those that do.

Well, that’s true. Except UK tax payers who do get an NHS pay less tax than US taxpayers who don’t get health care.

More to follow…


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