expatdoc

As someone certified in both countries thought would try and give my own perspective of working in both countries. Generally the vibe from Brits towards US healthcare is negative which is slightly unfair in my opinion. From a perspective of working in both countries here is what I think

USA

Healthcare technology and innovation superior in a lot of aspects
Direct access to specialists and follow up unlike the UK where the GP is whole and soul
Salaries 2-3x higher than the UK - minimum salary is 250k for anywhere in the US - immigration was easy cap exempt h1 and Green cards were dished out out like candy by any employer
Americans seem generally more grateful than Brits for the care they get, perhaps 'free at point of use' makes you take it for granted

UK

Waiting lists going up and now lots of meds unavailable with brexit going to make it worse
GP numbers plummeting - not surprising the idea that something as complex as healthcare should be dealt with in a 10 minute appointment is ludicrous
Whistleblow against dangerous healthcare in the UK and get branded as a troublemaker, lose job and other such treatment for daring to speak out for patient safety
NHS spin machine more prevalent than ever it is in the media everyday practically in the UK, rarely hear about healthcare in the US media
Definite sense of entitlement in the UK, honestly even a small co-pay would bring some sense of value to the system and stop frivolous visits for minor ailments

From a physician perspective I feel the opportunities and salary are far superior in the US compared to the UK and with brexit likely to devalue the UK further there is little incentive to return. Immigration for a physician here is far more straightforward with GC issued within a year, compared to a several year wait in the UK for overseas docs.

Just food for thought

Giantaxe

That's very dependent on insurance, unless you can afford to pay for a specialist regardless of insurance. For many, a primary care physician is a gatekeeper for specialist care in the same way a GP is in England. And, of course, many of the uninsured have no reasonable way to access a specialist.
The US rations by cost, the UK attempts to ration by need.

Doctor's salaries are part of the reason that the US spends way more on healthcare as a percentage of GDP than any other western country.

vespucci

Interesting to hear from a doctor who's worked in both countries.

As a consumer, I prefer the UK. To mention just one thing, the stress of dealing with billing has been far worse than the only advantage that I have experienced, being able to see a specialist quickly.

Pollyana

Thats the biggest point in favour of NHS. If you need medical help, its there, free at point of use.
As someone who currently cannot afford the medical care she needs, due to the cost of using the system in Australia, I have to say I will never complain about the NHS again.

scrubbedexpat099

I think the USA comments need to be prefaced by if you can afford it and if you live in the right spot.

Our last GP retired and they have been unable to find anyone to replace, has been a few years, Rumour that we may have a Nurse Practitioner starting this year. Anything serious and you are on the Helicopter at $20,000 a pop, the logic of which escapes me. I am no fan of the NHS but on balance would prefer it to the US non system, my real preference would be for something very different to both.

scrubbedexpat091

If I had large sums of money and could afford any and all healthcare without insurance, I would rather have the US system.

Since I am not independently wealthy, as a patient, I prefer universal access at a relatively low cost to the patient, although I am comparing Canada vs the US.

civilservant

'Physician prefers salary thats 3x higher shocker'

Unfortunately it's the rest of us shmucks that have to pay your exorbitant salaries.

And I work in healthcare finance, so yes, I know your ilk.

This is a joke, right?!

durham_lad

Are you kidding? I have been a member of one of, if not the, largest US Early Retirement sites since 2005 and healthcare is by far the most active forum on the site. Loads of US media articles linked and discussed every month, and loads of threads on the best ways to get your income low enough to qualify for ACA subsidies because we have plenty of millionaires in the US who can legally keep their MAGI low enough to qualify for healthcare subsidies. (My wife and I couldn't as we have traditional pensions taxed as regular income)

We lived in the USA, wife and 2 kids, for 29 years, and we were big users over that time of healthcare. Having excellent employee insurance (Big Chemical) then no problem with affordability or access to specialists. Once we retired at age 55 and moved out of State then what a nightmare. Expensive, constantly analyzing and keeping track of insurance claims, fighting and appealing charges etc. In the last 3 years before moving back to England it cost us $39,468 in out of pocket costs which includes premiums, co-pays, prescriptions etc.

For all its faults I much prefer the NHS.

Guindalf

Four days in ICU with Sepsis - bill = $23,500! Without insurance, we'd probably be bankrupt!
Ads on TV for toenail fungus pills?
More ads that encourage you to ask your doctor for drugs that the ad doesn't even tell you what it's for (yes, I've really seen this!).
Doctors earning a quarter mil a year and still looking for more freebies from the drug companies!
$10 for an aspirin.

Yes, I'll take UK healthcare over the US system ant day. I hate greedy doctors!

spouse of scouse

There's no doubt that GPs in the US will achieve greater financial rewards than their UK counterparts. Also no doubt the UK GPs are under the cosh with regards to allocated time with their patients.

But you lost me with your statements that 'Americans seem generally more grateful than Brits for the care they get' and that there's a 'Definite sense of entitlement in the UK'. I hope you didn't/don't interact with your patients in the respective countries on this basis. It just seems a strange bias for a physician to have.

petitefrancaise

I'll take french healthcare over either the US or UK one.
Didn't expatdoc do one of these ridiculous posts before? Can't be bothered with him tbh. I think he sounds a bit bitter because the UK didn't go so well for him. ah tant pis as they say.

petitefrancaise

have you thought about going to France for treatment? It is surprisingly inexpensive (although the french don't think so!) even if you have to pay the full bill - drs/hospital charges are capped by the government. I have often thought that if I needed an elective op then I might just go to France since I reckon it will still be cheaper than paying the various charges here ( even with very good insurance). I know someone who has a business doing this and last I heard Walmart were offering their employees to go to France to get stuff done with them since it is so much cheaper.

expatdoc

Given it costs $500k+ to get through med school in the US not sure how you can then somehow begrudge the salary a physician can make especially coming from fatcat finance world!

The finance world has repeatedly raped the Western population for decades then gone to the Government for handouts when they f up with a rinse and repeat phenomenon while coining your 8-9 figure bonuses in the background.

civilservant

It doesn't cost that in the UK. Nor will you find physicians in hock to pharmaceutical companies prescribing drugs that they know to be less effective than others but that happen to be more expensive. Let's face it, that's corruption, pure and simple. All in service to the almighty $.

I happen to work for a non-for profit healthcare system. So you can throw around works like 'fatcat' and I assure you they land wide of the mark.

Suffice to say, shock horror that you prefer the US. The NHS exists to serve the population. The US system exists to fill pockets and it's rotten to the core.

Burn it all down.

expatdoc

As an example I saw last week an individual case of a patient who had a delay of 4 days to find a mental health bed and that made the front page of a national newspaper in the UK. No way period would such a thing be reported in the NY Times for example.

Thats part of the problem this idea that the NHS is the only way healthcare should be done. Its like kafkaesque regime where you cant speak out when things are just so blatantly wrong in it, look at the fate of any whistleblower there - shambolic. It is absolutely true if you dont pay anything out of pocket then there is no sense of responsibility in using the service thats why its overwhelmed.

Given the mass exodus of doctors at the minute out of the UK and the perilous state of the country post brexit its unlikely the NHS can be sustained much longer