You often hear politicians touting “the US has the best health care system in the world”, usually as a preface to explaining why there is no need to improve, or even worse, why they want to cut funding for social programs. You also hear disparaging comments about health care in “socialist hell-holes”, again arguing against providing a reasonable public level of health care for all Americans.
However, it has been our experience when traveling and living overseas that the reality is a bit different from the political talking points.
As I wrote in my book “Living Abroad:Challenging the Myths of Expat Life”, the first phrase should be modified to “the US has the best health care system in the world – for those who can afford it”. And as I’ve written before, Rita and I have both had surgery in Ecuador, and I recently experienced excellent care during a nine-day hospital stay in Riga, Latvia. So although “socialist” public health options in other countries are certainly not without their problems, it is wrong to just dismiss them.
We were reminded of that during our current trip that includes Portugal, Spain, the UK and soon Ireland as well.
Before we left the US, Rita had a mild ear ache. During our trip, it got progressively worse, followed by a persistent cough and sore throat. While still in London we stopped at a pharmacy and spoke to a pharmacist who directed us to Sudafed for congestion and “Chesty Cough Syrup” for the cough. By the time we made it to Oxford, England and there was no change, I had finally convinced her we should seek medical help.
In the UK, if you do not have a GP or cannot reach them, you are advised to call the NHS (National Health System) at 111. They will perform a sort of triage, and refer you to the appropriate location and make an appointment. Having a US cell phone, we were unable to dial 111, so instead we visited a nearby hospital in Oxford.
They were polite and helpful, but since we were foreign nationals without a regular GP, they couldn’t fit us in for a few days. They recommended we go the the A&E (Accident and Emergency) department of another hospital.
We Uber-ed out there, and they asked Rita to fill out a brief form with her basic info. We then were called to talk to a triage nurse, who told us the fastest way to get care was to go to the Urgent Care office across the parking lot, and she wrote us out an appointment slip for 5:30pm. It was 3:30 at the time, but she said if we just showed up, they might take us earlier.
We did, and they did. After a brief wait, the doctor examined her and prescribed a course of antibiotics which we could fill at a pharmacy across a small park.
We thanked him and left, a bit surprised that the receptionist just said good-bye, and didn’t ask for any payment. Like wise when we picked up the prescription, we paid for a box of Kleenex and some cough drops, but there was no charge for the antibiotics.
Unfortunately, after a brief improvement, things started downhill again. By now we were in Swindon near the Cotswold. Since we knew a bit about the system now, but still couldn’t dial 111, we went to an Urgent Care center connected to a hospital that accepted walk-ins.
Another form, another waiting room, but about two hours later we were seen by a doctor. She confirmed the original diagnoses – a bacterial infection – and prescribed a stronger antibiotic. She also ordered a chest x-ray as a precaution.
We didn’t wait more than 20 minutes for the x-ray, which was done in another part of the hospital. We returned to the waiting room, and after a few minutes the doctor came out and told us there was some slight congestion in the lower part of one lung, but that the drug she was giving us should take care of it. She also gave her a codeine-based drug to suppress the cough and help her sleep overnight.
This time we thought at least there would be a charge for the x-ray, but no – we left without a bill and were able to pickup the drugs in a pharmacy right in the parking lot – again, no charge.
Again, brief improvement followed by a relapse. By now we were in Glasgow, Scotland. While part of the ironically entitled “United Kingdom”, it is still a separate country, and things were a bit different. Their NHS system has an “Out of Hours” service, and the only way to get an appointment was to call 111.
Fortunately, I found a work-around. I called the nearest Hospital that had an Out of Hours department, explained that I was on an American cellphone and could not dial 111, and they were able to transfer my call to NHS directly.
It was not a seamless process. I was on hold at least 20 minutes before someone picked up. Then it was an initial interview, a transfer to a triage person, and then a transfer to someone to make the appointment, so all in all I was on the phone over an hour and forty minutes.
But, I did have an appointment for 6pm the same day.
Another doctor, another even stronger antibiotic, and by 7:15 we were back in our AirBnb with a new prescription, three tablets to get us through until the pharmacies open Sunday morning, and still no doctor bills.
Hopefully, the third time is the charm, and this last dose will be the one to set things right for Rita.
So to sum up our experience in this particular socialist hellhole: on the down side, it did take hours to see a doctor in each case, and there were a few hoops to jump through each time. In fairness, part of the reason for the delay was we do not have a local GP and are not registered in the NHS system.
On the plus side, we were able to see three doctors (not nurse practioners), get one x-ray, and multiple prescriptions absolutely free.
Here’s hoping that this last course of antibiotics does the trick, and we can enjoy our month in Ireland.
Although naturally, I’m now starting to feel a slight tickle in the back of my throat, and coughing from time to time.
Hmmm. Maybe we’ll get to see how the Irish health care system works …
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