So, Let’s Talk About Health Care…

Most of you may not know, but I used to work for Kaiser Permanente in California.  To be specific, I worked for KP-IT, which is exactly what it sounds like KP’s information technology division.

In fact, I just found out that the project I was assigned to, which was called something like NIS (National Insurance System), has finally gone live.  When I left KP in 2003 to move to the UK (well, actually, when I was made redundant, but I digress) the project was about 5 years overdue and about $1m over budget.  It was (and apparently finally is) a system to allow KP’s clients to access their health information online.  It was 99% ready to go when HIPAA was passed and we pretty much had to go back to the drawing board.

Anyway, I only mention this so that you, my lovely readers, realize that I have quite a bit of experience with US healthcare, at least HMOs and of course with the UK system.

Let’s also straighten that out real quick.  I don’t live in Ireland.  I live in Northern Ireland.  They are, in fact, two different countries.  Northern Ireland is part of the UK, and hence part of the NHS.  The Republic of Ireland is its own country and I know nothing about its health care system. Although I hear its about in great of shape as the US’.

Let me also state here that the NHS is a huge organization serving millions of people.  And that I already know that my experiences here in NI can be very different from the services in England.  Each ‘trust’ or area can and does have their own criteria etc.  But for the record? For the most part? The NHS does an amazing job.  For not one penny out of pocket for its users.

Yes, of course, we pay for it through our taxes.  But we don’t miss that money.  You can’t miss what you never had.  It is taken out before the pay goes into our account.  All it really is, is a number on a pay slip.

And because of that number on that pay slip I never have to think ‘OMG Adam is sick, where am I going to get the money to take him to the doctor.’  Or, in our very real case, ‘OMG Adam needs an MRI.  I hope our insurance covers it.’  Because our insurance does cover it.

Yes, we had to wait 3 months for that MRI.  But that’s, really, for a very good reason.  Because there are other people more ill than Adam who need the MRI machine first.  The Lump doesn’t affect Adam at all.  As far as he’s concerned its always been there.  Its grown with him just like his arms and legs have grown with him.  The Lump has stopped growing, which is a bit of a relief for Simon and me, but for Adam? He couldn’t care less.  He rolls onto his left side as easily onto his right.

However, if it was affecting him?  If he had needed to be seen right away? He would have been, of this I have every confidence.  Why? Because when I dropped him and he hit his head? We were seen by a doctor within about 30 minutes.

Not that we haven’t waited ages in A&E.  About 2 years ago Simon cut his finger very badly on a broken coffee mug.  We waited most of the night in A&E that time.  Because, again, there were more urgent cases in front of us.

But what about day to day, non-urgent or usual care?  Well, if I call my doctor on Monday? And I say its fairly urgent? I can usually see one of the GPs by Tuesday.  If I say its very urgent, such as when I had a cyst on my shoulder that got infected and then burst? I was seen within 2 hours.  Just the other week when Adam was exhibiting signs of an ear infection and had a croupy cough, I got him in to see one of the GPs within 2 hours of my call.

Now, it wasn’t his official GP.  But that’s okay, because part of the reason Simon and I are with this GP practice is because we both like all three of the GPs in it.  And Adam is with the same practice.  He doesn’t have a paediatrician he has a GP.

If he needed a paediatrician, like when he broke his skull and his rib, he had one.  And she was lovely as well.

Also, let’s keep in mind that my pregnancy was classed as high risk from the moment that little stick said pregnant, because of my diabetes.  And I had my first OB/Endo appointment about 3 weeks after my GP sent the referral letter.  And, again, paid not one penny out of pocket.

So, yes, you hear bad things about the NHS.  About dirty hospitals and overworked staff without enough resources.  But I haven’t experienced that here in NI.

But I would have to say, in my very humble opinion, it is better than what goes on in the US.  Where it would appear that health care, decent or otherwise, is a privilege and not a right.  Where if you aren’t rich, or don’t have health insurance, as so many don’t, you can’t afford to get sick.  Its disgusting. And heart wrenching.

If I did live in the States I would be happy to have my taxes raised so that those without coverage could get it.  Because there were times when I barely had coverage.  Where I paid outrageous premiums through COBRA or private insurance just to make sure I was covered if something horrible happened to me.  Where I didn’t go to see a doctor for about 2 years just for a check up because I didn’t want to have to pay the money for it.

Yes, people abuse benefits systems.  People abuse it here in the UK as well.  But at least here in the UK we all know, all of us are entitled to the same level of health care as everyone else.  Yes, there is private health care if you want to pay for it.  But you don’t have to have it.  And I don’t.

As an aside, do you know  how KP got started?  The organization that is now Kaiser Permanente began at the height of the Great Depression with a single inventive young surgeon and a 12-bed hospital in the middle of the Mojave Desert. When Sidney Garfield, MD, looked at the thousands of men involved in building the Los Angeles Aqueduct, he saw an opportunity. He borrowed money to build Contractors General Hospital; six miles from a tiny town called Desert Center, and began treating sick and injured workers. But financing was difficult, and Dr. Garfield was having trouble getting the insurance companies to pay his bills in a timely fashion. To compound matters, not all of the men had insurance. Dr. Garfield refused to turn away any sick or injured worker, so he often was left with no payment at all for his services. In no time, the hospital’s expenses were far exceeding its income.

Read the rest of the story.  Its the beginning of the pre-payment and co-payment insurance system.

Too bad the system is now so very broken.