nun

I work for state of MA and I'm on the state health plan. I also get half my premiums paid by the state agency I work for so I only pay 1/8th the cost of the insurance premium and that works out to be $55/month. I have no deductible either. I've had great care for some out patient surgery, but some poor care from my initial Primary Care Physician who ordered useless tests and tried to give me drugs that I didn't need.

My experience of the NHS has been as a child with orthodentic work which was good and with family members. Their care has also been good with the proviso that wait for non-critical surgeries like my mum's cataracts were a couple of months. My mum also has drug/diet controlled diabetes and here doctors are excellent at monitoring her blood. I visited her a year ago and she complained that she's had a sore on her shin for about a week. This is dangerous for diabetics because of poor circulation and healing so I insisted she call the doctor and he came to the house that morning and dressed the wound. A nurse followed up visiting every other day for a couple of weeks to change the dressing and make sure it was healing.

My experience is that the NHS is that treatment is good, but it's sometimes inconvenient, whereas when you have care in the US it's good and you can get things done quicker......if you have good insurance.

The guarantee of universal care and lack of worry when out of work make the UK system better in my book, but we have to make sure those things are not lost. Having access to the NHS is a big reason for me planning to retire in the UK as U plan to do that a number of years before I reach medicare age. Living in MA you must be insured and cannot be refused coverage, but it will still cost me $500/month for a high deductible policy if I leave work and have to buy on the private market.

BritinFLUSA

*disbelief* - NO DEDUCTIBLE?

Not to politicise this thread but you said you work for the state and get a great deal on insurance... surprise surprise politicians making sure that government departments get a "cushdy" (to quote Del Boy) deal on healthcare...bad luck if in the private sector like the rest of us! ;-)

Also $500 per month "on your own" is actually a good deal too - Florida has ridiculous rates because of the number of OAP's/Senior Citizens.

I pay for my health insurance myself as I am classified as self employed...however even when I had employer health insurance they would review it each year and at one time the new company they were bringing on was going to triple premiums...so we all were forced to drop it...and get our own plans (if we could, many couldn't..I had to fight to get mine!)

Anyhow...I shall just say...

$55 per month sounds lovely mate...! Enjoy it! :-)

Perhaps now that I am a dual citizen I should look for a nice cushdy govt. job with such nice beneifts.

nun

MA provides good benefits to it's employees. The fact that most US employers provide terrible health benefits that are expensive should not be a reason to reduce the reasonable benefits of others. In the US health insurance market I am glad of my benefits and know they are far better than most people's, but that does not make them excessive. It just points out the very poor nature of health insurance coverage for most Americans.

MA has Romneycare and mandates that everyone must have health insurance so 98% of MA residents have it. If you loose your job you have to buy a state approved insurance plan. You can compare plans and costs on a state website.

https://www.mahealthconnector.org/portal/site/connector

As a 51 year old single male I can get a $2k deductible and $5k annual out of pocket max plan for between $350 and $650 a month depending on the insurer and network of hospitals I can automatically access. Also if you have income below 3x poverty level you qualify for the state's own subsidized plan called Commonwealth Care.

The second phase of reform is now in process that will try to control costs. MA is moving away form fee for service and is about to mandate that premiums can not increase more than the state's annual GDP growth.

BritinFLUSA

Thanks for providing detail. I certainly appreciate it. Particularly right now there are so many people blurring the facts on healthcare in this country. :-)

BritinFLUSA

Wouldn't it be nice if there was a decrease of GDP for the state, premiums decreased!

However, I hardly think that would happen. Wishful thinking!

holly2234

My family hasn't had a great time with the NHS.

My husband went to the dentist in Feb 2011 with a tooth that needed to be pulled out. It wouldnt numb with local anaesthetic and the dentist was unable to pull it because of that and the state of the tooth. It needed to be done under general. It took them until march 2012 to get it sorted and they sent him to a private hospital because there werent the resources at the NHS one. He was on so many painkillers that he ended up with a stomach ulcer which is STILL being treated now from March.

When my daughter was born in March 2011, they refused to have me at hospital because i "wasnt in labour". Suddenly they see a head and believe me... Turns out they were full and the only room left had a broken shower so they didnt want to use it. I go to use the shower in the corridor leaving my baby with my mum and the midwife. I come back and they have MOVED my baby without my permission and all of my belongings and put it all in the staff room. I wasnt even dressed and had nowhere private to dress. I got sent home 3 hours after the birth.

My daughter had a dairy allergy from birth to 15 months. Everybody refused to believe me until a very kind health visitor forced the doctor to listen.

So in all, we have been treated like numbers and not people with needs. Other than these things, we dont really have hospital or doctor visits so it probably isnt the service on a whole.

I have had 90% positive experiences with staff members too. It is not their fault, there simply seems to be too many people and not enough money. We have a very good dentist and GP (after weeding out a few horrendous ones in the area) and we appreciate what they do for us.

BritinFLUSA

Sorry you have had a tough time. My heart goes out to you. Particularly the dental problems, the UK has issues with teeth and dentists while the US has dentists, they are out of reach financially for those without good dental care.

Interesting that yours is one of the few true negative experiences of the NHS on this thread. As others have said it is a postcode lottery.

I know it shouldn't come down to money, but I have to say that although your experience is bad, a lady I worked with here (another Brit Expat in the US) told me the horrific story of her Granddaughters birth here in the US, the bill? $1.25 million. Thank God it was over a decade ago when the system somewhat worked and insurance covered most of it. Similarly some other Brit Expats I know had a baby a couple of years ago - they prepaid for the birth, a cheaper way of doing it. They paid somewhere around $5-$6k to cover it all. However a small complication involved a night and a day in Hospital. Bill, nothing major. - The bill? $25,000.

These days... you would be lucky to not lose everything in the US if you get a sniffle!

I'd take the NHS any day.

holly2234

Youre right! The bills are insane, especially for births. Any more children we have will be born in the US (we're waiting for my visa to go over there) and im dreading the bills! I wont even contemplate having another without knowing i have good insurance that will cover it (or most of it) and i know im able to pay the rest.

BritinFLUSA

holly2234 - I notice you are still therefore in the UK, have you had any experience with the US system? I'm just warning you, it isn't pretty and everyone is out to rip you off. If you have good employer based insurance it can be ok, [Employer health insurance is hard to come by these days] but still astronomically expensive. Don't expect also that you are paying for something that you get better service, the NHS often excels in knowledge and service compared to some US providers.

I have another expat friend has heath issues with her husband here, who after numerous visits to specialists over months in lots of pain was told he has liver problems and must drink too much - despite being a teetotaller! She was so worried after getting nowhere here with so many doctors and specialists that she sent him to live in the UK for a while with their grown up daughter and after a trip to Casualty in the UK, they diagnosed him within 10 minutes with congestive heart failure and treated him! NHS 1 US Healthcare 0.

My parents are looking at moving back to the UK for their older years because of the state of healthcare in this country.

PM me if you want any more realistic advice on your move and of course post in the US Immigration section if you haven't already. :-)

holly2234

Thanks

No i personally haven't had much to do with healthcare in the US. My husband lived in the US for his whole life up until two years ago when he came here to live with me and he didnt have much to do with it either since we has been fit and well apart from the above mentioned.

His new employer (when we get there) thankfully provides insurance after 3 months of working for them so that is one bonus! Our daughter is eligible for CHIP (just need to set it up when we get there.)

moi

You had better pray that nothing happens during that first 3 months.

BritinFLUSA

Correct!

nun

The thing with US health insurance is you have to pay for most small stuff yourself. You'll pay a premium each month and your employer generally contributes something towards that, but you still might end up paying $1000/month for a family plan. Then you will have to pay for your care up to some deductible amount, which might be $5k/year for a family only then would insurance start. Often they will pay a percentage of your costs above $5k until you reach an "out of pocket annual maximum" which might be $10k per year. You also usually have to pay for lab tests and pay maybe $20 for each doctor visit. So simple health issues could easily cost you $22k because you pay $12k in premiums and you can rack up $10k in bills easily. this is part of the reason pregnancy is expensive in the US.

With the NHS you never see a bill. You might have to wait longer than in the US and have to deal with old waiting rooms, but if you get pregnant the NHS is not going to give you a $22k bill at the end of it. You won't get access to certain cutting edge drugs on the NHS, but US insurance companies also won't pay for many treatments and drugs. You can also be refused coverage if you have a pre-existing condition or didn't disclose an illness you have on the insurance application.

You have to be very proactive in the US system and know about your coverage and how to ensure you stay insured during job changes or unemployment. Also if you get ill be prepared for a mountain of paperwork and bills even if you have good insurance.

BritinFLUSA

nun is right - proactive! Which is fine if you are healthy.. but not if you are unwell.

holly2234

Thanks both of you. We've looked into it and its all good. If we get ill in the first 3 months then we will just have to pay.

Im not going to compare because it is what it is in whatever country we live in. I cant change the world all by myself so i will take it as it comes. I dont see the point in feeling bad about what i have or dont.