Yes We Need Heath Care Reform, But Not to Look Like London

In February, 2002, my family traveled from Chicago to visit our daughter in London where she was studying abroad for the semester.

We were hurrying to the theater when our son, then 10, was hit by a motorcycle while crossing the street.

His leg was badly broken, he went into shock, and we were taken by ambulance to St. Thomas' Hospital south of Westminster Bridge, a short walk from the Houses of Parliament. St. Thomas' is not some community hospital, but a major National Health Service center. With its sister institution Guy's, the hospitals are advertised on their NHS web page as "two of London's most well known teaching hospitals."

Our son was seen quickly, his leg was set in a cast that extended just above his knee, and he was transported to a children's ward -- a bleak room with rows of beds and little privacy. There he remained for about a week, with me sleeping at his bedside, usually on the dusty floor. For the first couple of days he was in such excruciating pain that the movement of air from anyone approaching was enough to cause him to scream out in agony.

He was vomiting and the need to change him and his bed made things worse. Clean linens were in short supply; one particularly bad night a hospital aide and I turned the bottom sheet so that the vomit was away from his face.

The public restrooms were frequently out of toilet paper, paper towels, and soap. I switched to the restrooms reserved for staff which were generally better supplied. Meals were served from a wheeled cart that stopped at the door. Relatives would ladle up what appeared to be soups and stews. No one in our family ever ventured close enough to get a clear look.

Our son's pain persisted and he and I were sent to the cast department for a consultation. The technician was a friendly young African who looked at the cast and the x-rays and instantly stopped the pain by adding a section to the existing cast. It was the first time since the accident that I saw my son smile, as the technician engaged him in talk of the 1990s Chicago Bulls and Michael Jordan.

I wrote down the tech's name and promised that when we returned home my son and I would go NikeTown and buy him the best Bulls hat in the store.

The technician's impressive skills would not have saved our son from being permanently disabled. As soon as he could travel, we got him back to Chicago's Children's Memorial Hospital and to a talented pediatric orthopedist recommended by our pediatrician.

We arrived home on a Saturday night and the next Monday morning we saw the orthopedist who studied the x-rays we brought with us from London, took his own, and told us the leg would not heal normally. That Wednesday we sat in the waiting room at Children's while our son's leg was re-broken and re-casted. Both were done so well that after the general anesthesia wore off he didn't require as much as a Tylenol. We took him home very late that night after meeting with a physical therapist, and his uneventful recovery commenced.

By the time school was out for the summer, the cast was off and, with excellent physical therapy at Children's, he regained his normal gait.

As he gets ready now to leave for his first year of college, we look at him and thank American medicine that his legs are straight and strong. (I had to ask him today which leg was broken.)

American friends who have an apartment in London and visited our son in the hospital -- the wife berated a doctor who loudly discussed with a colleague at our son's bedside the possibility of a rare complication that could require amputation of the leg -- asked us why we didn't do what people of means do there; seek medical care from a private hospital and private physicians, many of whom have offices along the same street in Central London.

We didn't know about that two-tier system, and with our son slipping into shock, we did what we would have done in America -- sat with him in the back of an ambulance that took him to the nearest hospital.

I felt gratitude to the dedicated nurses at St. Thomas' and I hugged several of them goodbye as we left. St. Thomas' has a rich history dating to the 12th century and is famous for its association with Florence Nightingale, who founded the first nursing school at the hospital in 1860. She would have been proud of these nurses. Still the doctor who set the leg did not do a competent job, and a 10-year-old with his life in front of him would have had to live with that poor technique for the rest of his life.

Once he could get around reasonably well on crutches, he and I went to the Nike store, bought the hat, gift wrapped it, and mailed it to the cast technician. I also wrote a letter to a top administrator at the hospital telling her how brilliant this young man was. She wrote me back to thank me for my letter and to tell me that the technician had been promoted because of it.

I do not mean to argue that health care reform is not needed here, but rather that the British model, in most respects, is not one to emulate.

That same first-rate children's hospital in Chicago to which we rushed so many times with our children as they suffered the usual range of fractured bones and cuts deep enough to require stitches, was always crowded with uninsured parents and their ailing children. Late at night these exhausted looking working people cradled children who seemed more likely to have a routine malady -- ear infection, strep throat, rash -- than a ligament torn playing soccer or Little League.

For them, the ER was the only option.

As we left the hospital, we were handed a bill from the NHS for around $3000, which covered everything, including the ambulance. We handed over our credit card. Our private insurance carrier eventually reimbursed us. The price would seem like a bargain, but, obviously, it would have been no bargain for our son.

Comments

[DocTwain]

This post contains several obvious logical fallacies. The first is called "Hasty Generalization." The author assumes that the NHS is bad based on a single experience--yet about100,000 cases of doctor or hospital error resulting in death or injury to the patient occur in the U.S. each year. Her evidence is anecdotal and does not suffice to prove her point.

Second, she is arguing apples and oranges. The small amount of evidence she offers concerns medical malpractice, which is a function of the training of providers. There is no clear direct correlation between that problem and the question of how health care is paid for. Yet the author provides no evidence to suggest such a connection.

Finally, the author implies (though she does not state) at the end of her article that a participant in the NHS also would have been billed $3000 for treatments including ambulance service, complex surgery and other procedures, and a week-long hospital stay. This simply isn't true. A citizen of the UK would not have received a bill at all.

That said, I agree that the NHS is not the best model for us to follow. Single payer is the way.

[Eric Roberts]

So my question to you is, what if you didn't have the insurance (or the funds available) to take him to Children's Hospital? He would still have an improperly set leg. The point is not everyone has access to the healthcare that you do.

I am a web developer and do mostly contract work. Sometimes I have acces to healthcare plans through the company i am contracting through. Iam a diabetic and asthmatic, so getting my own insuarnce just isn't going to happen (yes...I tried and was told by insurance companies that they couldn't help me). The problem lies in that there are too many people like me that don't have access to an employer sponsored plan, can't afford to buy thier own, or are denied coverage because of chronic health care issues.

I think you do a great disservice here by making greal leaps of illogic. Doctors screwing up is a problem with doctors...not with health care systems. Look at the outrageous amount of malpractice insurance doctors and nurses have to have here. To tie in your badluck in getting a bad doctor with a system being bad isa logical fallacy and intellectually dishonest. If the system was so bad, then why are people so happy with it?. There is really no andecotal evidence that shows, by customer dissatisfaction, that the UKCanadian healthcare system is bad...in fact, the evidence shows thatit is a really good system thatin the overall scheme of things, works really well.

[Carol Felsenthal - Huffpost Blogger]

There's plenty of evidence that people aren't so happy with NHS. Spend some time in an ill-equipped, ill-maintained NHS hospital and that will become apparently quickly.

As I wrote, I believe health care reform is a necessity here. As the committees of the U.S. House and the Senate draft bills to reform health care and as they are eventually meshed into a single bill for the president's pen, the weaknesses of other systems in other countries must be factored in.

I have spent a lot of time in American hospitals since last April (looking after a relative). In the intensive care unit, there were people of all socio-economic classes. Everyone was getting state-of-the-art care. (The hospital is a major urban teaching hospital, as St. Thomas' is in London.) I did not go searching for a private hospital to care for my relative. Mistakes were made--a big one in my relative's case--but the facility was modern and clean and the patients were treated with a great deal of dignity.

[Eric Roberts]

So the fact of the matter is that mistakes are made, regardless. It has nothing to do with private vs. socialized medicine.

Yes, they do get state of the art healthcare here, but the difference is that when you get helathcare here, if you aren't covered by insurance or independantly wealthy, you are bankrupted. I spent 4 days at a hospital out in Aurora for a leg infection brought on by diabetes. It cost me $20,000 (and that did not include the ER or the charge for the doctor or the x-rays they took...that came out to another 3k) for that stay. Looking at the charges, I was charged 125 dollars every time a nurse came to check my blood glucose levels. This was with a standard meter like I use at home (I think it even was the same brand)...no lab tests or anything like that. The material cost of that test was about .12 cents. They were charging 30.00/pill for metformin. I can go to Walgreens, which is arguably the more expensive pharmacy in the Chicago area and buy a 30 day supply (90 pills) for 57.50. I also checked some of the other meds and compared them with retail prices and the costs the hospital charged me for where all inflated 4-5 times the retail cost. To me that is price gouging. For profit health care is criminal...plain and simple. Anyting is better than this.

[Paradym]

So, you don't like "London's" system. Ok. How about France? Japan? Canada? Switzerland? Or better yet, we learn from all of them, incorporate what works and figure out solutions to the parts that haven't worked?

That a particular system isn't perfect does not negate it's overall worthiness. That there are horror stories in every system does not argue for their merit in theory. Do we abolish air travel because we have delays, some planes crash, and some people are inconvenienced? No, we learn what went wrong and continue to try to improve. That the U.S. health care system is profit based should be disconcerting to us, and that it's increasingly difficult to obtain and maintain coverage should be of great concern to every citizen.

[Myshkin57]

You provide a fallacious argument here. You do not demonstrate that the incompetence of the doctor that set your son's leg was a product of the NHS. Further, how many times do patients die in the U.S. because of complications cause by negligence or incompetence?

Really, you're drawing a lot of conclusions from one incident. I can name several incidents of American doctors doing things much worse than what the doctor who treated your son did. Incompetence is incompetence and suggesting that the doctor was incompetent BECAUSE he was working within thee NHS is just playing into the hands of the irrational.

[creolechild]

If you are concerned about receiving "real" health care reform in this country, please take the time to watch a video on our current system. The video was created by Oregon physicians who are advocating for the single-payer option. The video is very informative and helped me to gain a better understanding of various aspect of health care, as we know now it.

https://www.madashelldoctorstour.com/Mad_as_Hell_Video.html

These Oregon physicians are in the process of organizing a caravan designed to inform the public about the benefits of the single-payer option. At last count they will be stopping in approximately 23 states, on their way to demonstrate in Washington. They need volunteers and our support. Please spread the word.

[KEMLoyola]

And when Republicans propose tax cuts, we can't pass them because the way they plan to make your taxes lower is to cap everyone's salary at $15,000 a year.

The health care debate is not advanced by misrepresenting what's being proposed. British people are pretty happy with the NHS, but that's irrelevant because no one here is suggesting recreating the British system.

In the end, warning about the alleged horrors of the British system to defend the current system is no more honest than warning about mandatory euthanasia. There might be a legitimate argument to be had against the public option, but I have yet to see it because people keep trying to argue against imaginary legislation.

[KEMLoyola]

No one is proposing a system like Britain's, even though it would be miles ahead of the current U.S. system. In Britain, the government directly employs the health care providers. That system is such a horror show that we only subject prisoners and our nation's veterans to it.

The "public option" people overwhelmingly want here is just letting people who want to do so get their health insurance from the government rather than from a company the bottom line of which is improved if they don't actually provide coverage.

Most British folks, though, are quite happy with their system (as are most Europeans in general, Canadians, and everywhere else the government has a hand in health care), and find our system barbaric.

Heck, just look at the older town hall loons protesting that they don't want their government-run Medicare taken from them. People the world over LOVE when the government gets involved in health care, your anecdotal experience aside.

[Carol Felsenthal - Huffpost Blogger]

I take your point about the Medicare scare; it's unbelievable that some town hall screamers don't know that Medicare is a government program. ON the other hand, I know many people on Medicare who buy private supplemental insurance, without which they would not think their Medicare was so wonderful.

[DocTwain]

If the problem is that Medicare is not comprehensive, then let's fix it and make it comprehensive. Or let seniors buy the additional coverage directly from the government, which can offer it more cheaply than any for-profit private insurer could.

[Harold Moore]

Carol,

Congrats on your son being well. While I appreciate your testament I think you miss the point. The current administration is not pushing for a UK style system. Their public option would be very similar to Canada's health system or would look like universal Medicare where private doctors and hospitals still exist and are paid from a single (likely government). And while I have heard rumors that UK hospitals can be dirty and barebones, the appeal is in their affordability. America is the only Western country with a for-profit health system. That systems bankrupts thousands, refuses services, and ultimately kills people.

While I'd personally see this debate shift towards a Swiss/Massachusetts model where everyone is mandated to purchase insurance and we change the health insurance industry standards to move towards a less profit based industry, that isn't on the table. Neither is the UK system and I think we need to make that distinction clear.

[trainunderwater]

What an incredibly brave child. I would never have been able to survive the horrors of that system. And say what you will about anecdotes, but Felsenthal at least has stories to back her opinions up, while many of you simply have vague policies and a complete lack of personal experience

[jhNY]

Anecdotal evidence does not prove a general truth, your experiences notwithstanding. And as I think you were trying to point out, but maybe not, you witnessed a two-tier system here in the US as well, with the harried ER staff being the medical care for the poor, and a team of privately paid professionals for your family.

And I hardly think anybody is going to legislate away the right of those who can pay for it to buy their own medical care.

[Awake-and-Sing]

I lived in London and I had great experiences with the NHS.

[classicalgeek]

I am happy that your son is fine now.

But the point of this is, that you think bad experiences with doctors are unique to the NHS? I'm sure tens of thousands of people right here in the USA have horrifying stories to tell of doctors. I know I have dozens of instances where my life, or the life of a close relative, was endangered, and it was only because of my pre-med training that I was able to convince doctors to take a closer look. For someone who was not accustomed to reading medical journals, citing references, and standing up to doctors, the outcomes would have been much worse than an improperly healed leg.

It was a French doctor, that, in three minutes, diagnosed an underlying condition I had, which in the USA had required eighteen visits to a GP, followed by eighteen visits to specialists, who each wrote me a prescription for a symptom, so that by the time I saw the French doctor, I was taking eighteen medications, each with a host of side-effects that was making my health more debilitated than ever. The French doctor correctly took me off all eighteen medications, and prescribed three ounces of a certain plant per week. Voila, as they would say, I am now in perfect health.

[UrbaneMeyer]

So you criticize the post for its anecdotal evidence condemning the British system, then back that up with anecdotal evidence praising a French doctor. Great logic. I think the Dickensian condition of the entire children's ward is the main point here, and I found this story quite enlightening. I think most people can agree that the NHS is not the ideal model for us to emulate.

[Myshkin57]

You miss the point. He's demonstrating that you can have anecdotal evidence that suggests either that single-payer systems work better or worse than private-insurance systems.

[Carol Felsenthal - Huffpost Blogger]

I understand that one family's experience in a NHS hospital is one family's experience--but there was something so different about St. Thomas' ; even if I stick only to housekeeping details. Yes, patients get awful staph infections in the best American hospitals, but I've not been to a hospital in America that lacked basics such as soap and towels.

When you're with your child in a ward as opposed to a private or semi-private room, you have much more communication with other adults watching after their children. One said to my husband, "This is one of the better hospitals. You should see some of the others."

Also, "improperly healed leg" doesn't describe our son's treatment. The orthopedist we saw in Chicago told us, as I recall it, that our son's leg was set at a 15 degrees angle; three degrees should be the maximum.

[Harold Moore]

Carol,

Congrats on your son being well. While I appreciate your testament I think you miss the point. The current administration is not pushing for a UK style system. Their public option would be very similar to Canada's health system or would look like universal Medicare where private doctors and hospitals still exist and are paid from a single (likely government). And while I have heard rumors that UK hospitals can be dirty and barebones, the appeal is in their affordability. America is the only Western country with a for-profit health system. That systems bankrupts thousands, refuses services, and ultimately kills people.

While I'd personally see this debate shift towards a Swiss/Massachusetts model where everyone is mandated to purchase insurance and we change the health insurance industry standards to move towards a less profit based industry, that isn't on the table. Neither is the UK system and I think we need to make that distinction clear.