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Friday 19 July 2013
Good stuff and bad stuff
I have realised that my previous blogs make it sound as if I am criticising the US. I am not. I was fascinated in the differences between our two cultures for many reasons. Each has some really good points and each some terrible.
For example, sometimes I wish we, in the UK, could choose our clinicians. In theory, you can choose to go to a particular specialist but you have to have good reasons to go out of area, not be satisfied with your own local option and fight the system to be able to change. In the US, it sounds ideal. You can choose who you want to treat you, as long as your insurance covers it. Well, that was my view anyway.
But really it is not like that. The fights with insurance companies, the co-pay, the huge premiums, the exclusions, the difficulty in switching jobs because of switching health insurance, the paying for just going to see the doctor can lead very quickly to bankruptcy and despair. A long term health problem could leave your family destitute.
Neither system is ideal and we have a lot to learn from each other.
The most important difference we discovered whilst meandering through Waitrose was that here in the UK we are very much medicine based for mental health problems, whereas the US tends to be more therapy based. Therapy here is offered: a) grudgingly as an adjunct to more medical based treatments; and b) for far too short a time. Six weeks of CBT to "cure" an eating disorder? Sigh
There were some things in both systems that we both rolled our eyes at and others that we looked longingly at. The medical insurance situation is a nightmare for some parents in the US. People are dying because they can't afford or get the medical care they desperately need. Meanwhile, here in the UK, with our wonderful free healthcare, we are still reeling from the Stafford scandal.
I have just got off the phone with the pharmacy at my hospital. Back in April, a harried A&E doctor didn't sign the right bit of the form to say I didn't have to pay for prescriptions. I have been sent a letter and a form to fill in and sign but the form is not the right one and there is no box to tick saying "Cancer patient". This means another form being sent. Both the lovely Linda on the end of the phone and I agree it would be much simpler if I could just tell her over the phone and she could tick the right box. Sadly, the computer says No. Incidentally, once I have filled in and signed the right form, it gets filed away and should the same thing happen again, there is no cross referencing system so I will be sent the wrong form and then another form to sign again.