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Ann Leary

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Britain's National Health Service and the "Appreciation of Life"

Posted: 08/20/09 04:46 PM ET

I don't think that Britain asked to be involved in our national debate over healthcare reform, but comments from certain members of congress, such as Republican Paul Broun of Georgia who claims that the UK and Canada "don't have the appreciation of life as we do in our society, evidently," have put some Brits on the defensive about their National Health Service. I don't know what personal experience Congressman Broun has with the NHS, but I'd like to share ours.

In March of 1990, my family became uninvited guests of the NHS. It wasn't our plan. My husband, Denis Leary, and I were young, broke and I was 6 months pregnant. We had been flown to London by the BBC because Denis, then an unknown comic, had been hired to appear on a television variety show called London Underground. We were supposed to stay for two nights but -- and I wish there was a daintier way to say this -- my water broke as we strolled down Oxford Street, the day after we arrived.

Denis and I took a taxi to University College Hospital in central London and were immediately seen by an obstetrician and admitted. I was given an ultrasound and an amniocentesis test and it was confirmed that I was pregnant with a 26-week-old fetus. The doctor informed us that our baby's chances of survival were less than 50%, if he were to be born during the next few days. I would like Sarah Palin to rest assured that there was no "death panel" to determine whether or not our son was worth saving. On the contrary, I was placed in the maternity ward and received outstanding medical care from UCH's highly qualified and compassionate medical staff. I was given a series of injections of a steroid that had not yet been approved in the United States, but that helped my baby's lungs produce surfactant -- a substance that normally doesn't develop in human lungs until 32 weeks gestation. Because of these injections, my son, who was born at 28 weeks gestation, breathed on his own from birth, and was never placed on a ventilator.

As non-citizens, we were not entitled to receive free services from the NHS, but nobody delayed our admission or emergency medical care to ask how we intended to pay. We had health insurance, but the doctors and nurses actually seemed slightly embarrassed when we brought this up and it was several weeks into my stay at the hospital before an administrator approached me to inquire about the insurance. He assured me that I would receive the same standard of care whether I was insured or not, but if I had insurance, they would like to be reimbursed, if that was possible. Of course we were happy to supply our insurance information and our carrier was more than happy to pay up (you'll see why in a minute).

I was in the hospital for two weeks before delivering, had multiple ultrasounds, the amniocentesis, blood tests, medications and ultimately a caesarian delivery. Our son was in the neonatal intensive care unit for two months, the first weeks in a level one unit where he had 24-hour, one-on-one nursing care. After I recovered from my surgery, I was provided a room in the University College's student dormitory for a very minimal fee. I was given a hospital breast pump and was encouraged, daily, by the midwives and nurses, to keep my milk supply up.

After our son's discharge from the hospital, he still wasn't healthy enough to travel by plane so we had a health professional come to our temporary home -- as they do to every home in Britain after a baby is born -- to see how we were doing. The "health visitor" taught me an infant message technique that she had learned at a seminar in Sweden that was known to improve the muscle development of preterm babies. She taught me how to hold our tiny baby in a way that soothed his colicky belly. She answered my frantic, new-mother questions. She hugged me, because I was a little teary, and so far from home. She gave me her card and told me to call her anytime. She told me where to take our baby for his first vaccinations. Later, she called me to check that our son had received them.

Our bill? 10,000 British pounds. At some point we compared medical bills with an American couple that had had a 28-week preemie at around the same time. Their bill was in the hundreds of thousands of dollars.

But more to the point than the cost of the care, was the value that was placed on our tiny son's life from the moment we walked, dazed and panic-stricken through the doors of University College Hospital. The goal of every person who attended to us, every moment that we were there, was to save this baby and offer him the best medicine had to offer. In some cases, such as with the steroid injections, this was better medicine than would have been available to us in the United States.

I spent many weeks in the neonatal unit and saw many sad cases. Babies with severe birth defects. Babies who were born at 24 weeks gestatation, or even earlier. Some of these babies had been in the NICU for months and months. There was no "death panel" deciding the fate of these most vulnerable lives. No life was considered unworthy of the outstanding care that was being provided. I learned, during our time in the UK, that the British are very proud of the NHS and for good reason. How embarrassing, now, to have to watch our provincial leaders, in the government and the media, try to frighten American voters by making uninformed, extremely negative references to a healthcare system, that, in my experience, far outshines our own.


Ann Leary is the author of the memoir, An Innocent, A Broad, (Morrow, 2004) which details her experiences with the NHS, as well as the novel Outtakes From a Marriage, (Shaye Areheart, 2008).

 

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06:21 PM on 08/25/2009
A wonderful post, thank you. Like you, I gave birth to my son at University College Hospital (having studied a few years earlier at University College London). Like you, I had good care and my son and I were well looked after. I was luckier, in that I live in London and UCH is my local hospital, and that my son was born at term. I'm glad the NHS gave your family proper treatment, and hope your son is healthy and happy to this day.
03:39 AM on 08/23/2009
This is a great post and anyone who hasnt read your book an innocent abroad really should
I love how it highlights the differences between americans and brits
02:26 PM on 08/23/2009
As an old man (87) I am happy with Medicare. I had just been demobilized from the RAF after WW2 when the NHS was started in the UK. Everyone, doctors included were delighted with the service. A short time later I left for the USA, where I was always covered by my employer until I retired. I also lived for a while in Canada. I keep in touch with friends and relations In both the countries, and I can assure my readers that the citizens are generally very satisfied with their medical services. Of course they complain about the delays at times, for example a friend in the UK was diagnosed with cancer and immediately taken into hospital and treatment begun. Another with a knee problem had to wait over two months for treatment. Much has been written on the subject but unfortunately much is also incorrect and only political. Remember in the UK, life expectancy is higher then in the USA, the cost of medical services is lower, and the healthy birth rate also higher.
05:16 PM on 08/21/2009
What an informative piece - first hand information, imagine that. As previously mentioned, it is our fat cat insurance companies and their filthy stinking rich executives who indeed are the "death panels". The insanity of this whole argument just wears me out and I am thankful that Ann can put forth a compelling, rational, hearfelt discourse, on behalf of those of us who are just a little too bitter!
03:01 PM on 08/21/2009
Thank you so much for the information and giving us a chance to hear a different view on your health care experience outside the United States. I read your book last year in one day. I couldn't put it down.
01:48 PM on 08/21/2009
A good change is hopefully coming.
SP seems to put her foot on her mouth way often. I do not understand her thinking..or lack of.

The thing is that doctors have a lot of power.The insurance companies have WAY out of range power as well. At times, they tie in with judges... like the event where the teen/parents did not want chemo and a judge ordered it, cause the doctors said.. And the scary part is to give power or perpetuate it, to a panel of doctors, who may decide whether a patient can benefit from treatment.

The elderly are fearful and mistrustful because they also feel helpless.
When they hear the death panel bit, it is enough to send them into a panic. I understand them. It is unconscionable for these people to put their concern in that fashion and in those words.

Also, the medical field has been very profitable and prestigious. It was not that way in Europe, I do not think. And there is resentment on that end as well. It does take lots of years to train a medical person. It does cost lots of money. Maybe that can be looked into as well.
10:05 AM on 08/21/2009
Great article, Ann. Although my experience having babies in another country (and a different health care system) was not at all like yours (Unlike you, I decided to do it), I applaud your message. My two boys were born in Canada, and the experience couldn’t have been better: the well trained doctors, the loving nurses, the relaxed but attentive atmosphere, and a spanky clean hospital. A fantastic experience at less than half of what it would have cost my insurance company if I had delivered in NYC. When I realized that my first baby was due in August, I decided rather than stay in the sweltering city for the entire summer, to go for it, against the advice of some of the doctors I consulted. “Don’t you realize that they have socialized medicine up there?” one of them said to me. I had my doubts and fears, but I figured that they had been delivering babies in Canada for a long time, so they must know how. And they did. So I had the second one there too. Your heart -felt and articulate account says it all. We need to look beyond our own health care system, which is so flawed, and consider what works well in other countries. It is so easy to be cynical, but so much more constructive to be positive, and to strive to be better.
09:25 AM on 08/21/2009
Bravo.
lastpost
see biography
09:15 AM on 08/21/2009
I wish to associate myself with your sentiments Ann. Though by no means as important as your needs. Effectively crippled, by a sudden yet painless “bucket handle tear” in the knee joint cartilage. I was effectively repaired, within hours of it happening at work. When advised of my employer’s medical insurance cover, the surgeon appeared indifferent. Stating that there would have been no difference whatever in the treatment provided.
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08:52 AM on 08/21/2009
Thank you, Ann, for such a great testimonial! Nice to hear the truth about the NHS.
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Ann Leary
06:30 PM on 08/21/2009
You're very welcome. It's amazing to me how many people have argued with me over the years about my experience with the NHS. Many Americans really don't find it believable that such a high standard of care exists in the UK - or anywhere outside of the United States. . On the other hand, I met a few British people who wouldn't be convinced that the uninsured in America aren't amputating their own limbs on the streets or performing open-heart surgery on their uninsured spouses.
08:50 AM on 08/21/2009
Thanks, Ann, for an informative account of personal experience. It's so easy for us Americans to fall into the trap of believing horror scenarios about how public health care would play out, and so few of us will have a personal experience with it prior to deciding if it's good or bad. I would urge all Americans not to fall prey to the many fabricated lies being fed to them about health care reform and simply read and research the issue on their own, rather than relying on word of mouth or one network's slant. The truth is there for you to discover so please don't trust anything less.

For anyone who is interested in hearing more of Ann's compelling story, be sure to read her book, An Innocent, A Broad.
http://annleary.com/leary-books.htm
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08:14 AM on 08/21/2009
I was a student in Britain in 1989. I became ill, and visited a doctor.

I waited ( with no appointment) for approx. 30 minutes, was seen, diagnosed and prescribed. When I enquired the cost at reception I was given a questionnaire which asked among other things, if I were attending school or college. I was. I did not Pay.

I was a STUDENT - from another country- but I did not PAY. I guess Britain felt that since I was spending my money PAYING THEIR COLLEGE to train me, it was ok for them to give me some health care.

Contrast that with my 3 sons, all of whom studied in the USA. Quite apart from the crippling University fees ( 3 boys- for 8 years each) dad and I had to fork out thousands of dollars each year for very basic health insurance.

Nope, You do NOT have the best health care system in the world. Great resources, but the system to access the resources? You might as well NOT have had the resources for all the good they do the average underpaid American.

Many Americans will turn their noses up at hospitals in other countries, but you know what- IT IS FREE. And the doctors don't really need 500 machines to tell you what is wrong with you.

And if you really need 600 thread count sheets, bring your OWN.
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Ann Leary
09:05 AM on 08/21/2009
I think it's hard for us Americas to come to terms with the fact that we're not the best at everything.
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04:44 PM on 08/21/2009
We are not the best at soccerr. There, I said it.
07:30 AM on 08/21/2009
My 100 year-old uncle just had a heart attack this week. Of course, it happened in the middle of the night. He was immediately taken by ambulance to the hospital and has undergone a series of tests to ascertain how much damage was done to his heart. His care has been timely and appropriate and he is doing well.

This is how we treat elderly people in Canada.

"Death panels" are an American invention. Just ask the insurance companies who use them all the time when making decisions.
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Candace8383
07:51 AM on 08/21/2009
I was in Canada and got ill ..
I went to the hospital and was treated immediately i kept telling the doctor i wasn't Canadian he couldn't have cared less ... ... in fact he recommend i have an operation and was willing to wheel me in right then then ... so when i hear about long waits i can only assume that like so much of the right wing spin on health care ...its a lie
12:04 PM on 08/21/2009
Oh, there are lots of things that require long waits:
Breast implants, Viagra perscriptions, all the urgent care that here in the US we put top priority on!
Why would we want a cure for cancer before a cure for impotance or restless leg syndrome?
HansB
The only good certainty is a dead certainty
04:25 AM on 08/21/2009
The author of this article didn't have medical care abroad on purpose, but a lot of people do. Europeans living in the US don't need to pay for health insurance: if things go wrong, they can always fly home, take up residence and be treated immediately... without having contributed to the system in their home countries. Something like 40 million Americans are eligible for dual nationality, same holds for them. Any American of German descent, for example, can get a German passport and thereby access to excellent, free-of-charge health care (since you don't pay premiums if you live abroad). The US system is not only extremely expensive, it's also indirectly subsidized from abroad.
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Fi
A Gluten-Free life!
03:56 AM on 08/21/2009
Thank you for this, as a nurse working within the NHS, it is good to hear that not all Americans believe the NHS is dreadful. In the UK as a NHS employee, we have what is referred to as "a duty of care", which means we as NHS employees, have a duty to treat the patient, as we ourselves would like to be treated.
I work on a acute cardiac care unit, and we regularly have patients over the age of 90, who are treated just the same as 30 year old would be treated.
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Ann Leary
07:16 AM on 08/21/2009
In my book there is a whole chapter dedicated to the NHS nurses who helped us. One rode to the dorm in which I was staying, after her shift, ON HER BICYCLE, carrying a big, industrial-sized metal breast pump machine for me to use. Another cooked me broccoli at home and brought it to me because I was anemic and only had school cafeteria food to eat. All were highly trained and many of the specialized nurses had done studies abroad and were up to date on all sorts of new treatments for neonates.
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08:18 AM on 08/21/2009
You don't really have to worry about American opinion. Most Americans have never left their hometown, never mind being in a position to compare Health Systems ( or sewage systems for that matter) of other countries to their own.

And they never leave their hometown, because they are SMUG believers in their own Home grown superiority!
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irishgawdess
01:55 AM on 08/21/2009
Thank you Ann, for sharing your personal story.