Special Edition Newsletter: One Person’s Story from Free-Market Healthcare to National Healthcare
Tim Bruce recently moved to the United Kingdom where he was born, after years of living in Dayton, Ohio, and active involvement in HCFAO/SPAN. Below is his comparison of personal healthcare experiences within the United Kingdom and United States:
My wife Nancy and I are about two thirds of the way completing our move from Dayton, Ohio to the small town of Sowerby Bridge in West Yorkshire in the north of England. It’s been a rather long and challenging process which I won’t detail here. It’s not over yet. We will be returning in the spring to dispose of worldly possessions accumulated over many years and sell our house in Dayton.
I’ve been a longtime HCFAO activist, serving as the Region 7 Coordinator for short stints (twice), and on various committees. I also have produced videos in support of SPAN’s goal of a rational not-for-profit healthcare system for all Ohioans.
I got involved with HCFAO because of my own problematic experiences with the US fragmented healthcare system. I taught for 16 years at Sinclair Community College as an adjunct. I was hired from one quarter to the next. If I taught a full load, 15 credit hours or more, (usually more), Sinclair would provide me with health insurance. During the summer I could teach only two classes – 10 credit hours. Being without insurance in the summer was stressful for me given that my health has not always been the best. My heart goes out to those in the US who still lack health insurance year-round.
Marrying Nancy in 2010 allowed me to get on her insurance. That wasn’t the reason I married her, although there maybe many in America where health insurance is a major factor in their choice of partner.
Since 2020 I have been on traditional Medicare for which I have been grateful. I have been diagnosed with Atrial Fibrillation, a debilitating heart condition. Medicare has enabled me to get top notch treatment without incurring huge bills.
Last year my Medicare insurance and Medigap policy cost me $4,980, a bargain considering the actual cost of my care, for a hospital stay of six days, multiple tests including two echo cardiograms and an MRI, and two heart ablations, I’m guessing upwards of $50,000.
I am now on a smorgasbord of medications to keep my 76-year-old body ticking over. My Part D premiums last year were $636. My total prescription drug costs were around $2,100 including the premiums. I must take an expensive blood thinner to lessen the threat of a stroke. That one drug cost me $1,200 last year.
My total healthcare costs last year were $7,000+. In the UK it will be zero. I picked up a month’s supply of all my medications a few days ago. No cost.
I am a joint UK/US citizen. As a British citizen, even after living in the US for 43 years not paying taxes here, I am able to fully access the National Health Service (NHS) without any financial penalty. I did work for ten years in the UK before moving to the US. I don’t know whether that had any affect on my situation. Nancy has been recently granted a spousal visa. The application was complicated and required that we pay an access fee to the NHS for her – $4,100. This is a one-time cost. Now she is completely covered until a review of her visa status in two years.
We were both able to register at the Spring Hall Group Practice about a mile from our home.
As a group practice, we don’t have an individual doctor for primary care. If we need to see a doctor, we call for an appointment and get assigned to one of seven physicians who work there. For me that is a negative and is a change from when I was here last. Then I was on my primary care doctor’s list of patients in Oxford. When I was a child, our local doctor did house calls. No longer. The NHS has changed in that respect, no doubt because of cost. In Dayton I had a primary care doc, Dr. Fujimura who did get to know me. (I had no co-pay because I was on Medicare. Prior to that on private insurance I had a $20 co-pay. No co-pays in the UK.)
When we first arrived last summer, we both had to go to the Halifax Royal Infirmary A&E (ER) on separate occasions. The treatment was free, waiting times around 30 minutes. I broke a bone in my hand. Nancy had a bad allergy reaction. She had to pay £19 ($23.75) for allergy medications. Now she won’t have to pay anything.
I had a medical emergency, sudden bleeding from my groin late at night. We were able to call the NHS 111 emergency line to talk to initially a nurse and then a doctor who determined that I could wait until the next day before seeing a doctor in person.
I have yet to experience here the level of care I received at Premier Health in Dayton. I have not yet had to. My younger brother who lives in Oxford also has Afib. He has received first rate care from the NHS.
Because of Tory austerity policies and their inattention to NHS problems, there has been a lot of grumbling about NHS waiting times for tests like MRIs and for elective procedures like hip replacements, sometimes up to eighteen months for the latter. The new Labor government just announced measures to speed these up, an expansion of community diagnostic centers into locations like shopping centers, increasing daily opening hours and extending them into weekends, and the introduction of surgical hubs (which are expansions at hospitals), all of which should cut waiting times for elective surgery.
They are revamping the NHS app to allow people flexible access to diagnostic centers, including those in the private sector. The hope is that millions more appointments will be provided. They also say they are going to reorganize NHS staffing and other resources to make it more efficient. So far, they have been cagey about providing more money. They are trying to make the system better without raising taxes, given that the British economy has been largely stagnant over the last year.
All in all, we are grateful for the efficient, affordable National Health System available in the UK. Access to quality healthcare is easy for us in England. We now live free of co-pays, deductibles, and the fear of financial ruin; all of which serve as barriers to care for too many of our dear American friends.
Tim Bruce, January 2025
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