British Health Care as a Consumer
I was curious as to how I would be insured once I actually moved to the UK. I still don't have a national insurance number so I'm not necessarily covered under the NHS yet. My policy from my previous employer doesn't cover overseas treatments. In hindsight I realize that I should've gotten a decent traveler's policy, but I didn't. Instead, I set out to find out about private insurance here in the UK.
Of course my first stop was the Internet where I searched for medical insurance in the UK. I came up with a number of choices and a few that give multiple quotes from multiple insurers. Within a day I had seven companies give me quotes. The coverage was all similar and this is what they offered: Full hospitalization coverage in either an in-network private hospital or a private wing at an NHS hospital, full outpatient coverage for diagnostics like MRI or treatment like PT, and varying degrees of specialist/consultant coverage like a cardiologist or orthopaedist.
There were no copayments and no preauthorization requirements. There was a 200 GBP deductible each year. Primary care is not covered as it is only an NHS service, however a few people do pay out of pocket for a visit to the MD. You would see the same MD, however under NHS payment, you will wait up to two weeks for an appointment, whereas with private pay you will get an appointment within two days. If something is truly urgent then one goes to an NHS walk-in center or to an Accident and Emergency (A&E), their version of an ER.
This insurance would cost me 49.49 GBP/month or the equivalent of about $80.00 USD/month. I got a letter from my previous employer regarding my COBRA benefit. If I wanted to continue coverage, which also includes prescription drugs ($20.00 copayment) and pre-authorizations for all referrals, as well as $500.00 deductible and $20.00 copayment for each MD visit, my premium would be $540.00 / month.
The stories about long waits for service under the NHS and overcrowded hospitals are apparently true from the people I've spoken to so far. Private insurance cuts through the waits and provides for a more pleasant inpatient stay. What I wonder is why the huge cost discrepancy? Is it because there is a baseline of coverage so that private insurance in the UK just doesn't have the market that exists in the US? Does the fact that the government funds the hospitals and offsets the costs affect it to that degree? How about that the pay scales are lower and malpractice incidents are very much lower? There also isn't the huge influence of the medical equipment manufacturers and pharmaceutical companies in the UK as in the US (it is here, just not as big a force as the US).
With the current health care debates going on back home, it is fascinating to see first hand how another system works or fails to work. There is one very important thing that a local pointed out to me the other day, "Not a single British citizen has ever had to file bankruptcy due to medical bills."