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PT and the Greater Good

The Culture Differences of Health Care

Published January 11, 2011 5:51 PM by Dean Metz

I'm currently back in the United States to visit family and the university where I'm working on my master's in public health degree. While reading the Sarasota Herald Tribune, my attention focused on an article about patient advocates. I remember these positions well from my work at hospitals in New York City and even had the unfortunate need to utilize one myself in the mid-1990s. Essentially they ensure that patients are not taken advantage of by the health care institutions they seek help from.

No such equivalent exists in the NHS. I find on the whole that British people have a very passive relationship with their health care. It is similar to the way my grandparents dealt with their doctors, the idea that "doctor knows best." It is unusual for the British to question the care provided and even more rare to be assertive about their care. There is no sense that they are consumers of the service. Often I hear people say that they "don't pay for health care" when in actuality they do. Every month a portion of my earnings is deducted for national insurance. I would call that payment for services.

As educated consumers in the US, have we spearheaded the drive for better quality and more innovative care in the process? Have we contributed to the rise in costs and profits as a result? Have we, in turn, also made it less available to those with limited or no means?

There is definitely a two-tier system in the UK; those who rely on the NHS solely for their care and those, like myself, who have chosen to supplement that care with private insurance. Those of us with private insurance have already adopted a more consumer-like approach to our care. The important thing in that schematic is that everyone has care. Would those that rely on the NHS for all of their care, wind up destroying the system if they actually did adopt a more assertive, consumer-based approach?

I've mentioned previously the changes proposed to the NHS by the new government. It sounds as though they are actually working towards a more US-like approach to care. I don't think the British people, on the whole, are ready for that type of dramatic change in the system.


1100/month for insurance?  Seriously?  

Is that dollars?  American dollars?  Or some other monetary measure?  

Is that for individual insurance?  

If that is American dollars, and not a typo, I'll stop whining about our coverage now.  Our insurance just went up-again-and we've been complaining, but we are nowhere near that!  That is more than our house payment!  

On the other hand, we're also about as many miles away from your current plan.

10-15 beds in a room?  wow.  My daughter and I were reading an older book last week.  The character was having a baby and had to switch rooms to deliver and had a roommate (gasp!)  My daughter was beside herself with both conditions.  We are spoiled in that regard.  Here's hoping she doesn't find herself hospitalized in the UK!

Thanks for the info!

Janey Goude January 17, 2011 5:30 PM

With the supplement, you have the choice of either NHS or private hospitals. In the NHS hospitals, there are still "Florence Nightingale Wards" (10-15 beds/rooom) whereas the private hospitals more closely resemble what most of us are used to in the US. You also get elective surgery more quickly. Yes, you will wait for a non-urgent joint replacement in the NHS, with private insurance you'll have your surgery as soon as possible. The same doctors work in both systems so the clinicians are no different.

For the same coverage I had in the US at 1100.00/month with 1000.00 deductible and 25.00 co-payments I get in the UK for the equivalent of 40.00/month and no co-payments.

Cheers, Dean

Dean Metz January 15, 2011 4:52 PM

I didn't realize a supplemental private insurance system existed in the UK.  What are you "buying" with private insurance?  

Janey Goude January 12, 2011 9:32 PM

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About this Blog

    Dean Metz
    Occupation: Staff Development Specialist
    Setting: New York, NY – Newcastle Upon Tyne, Great Britain
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