Creative Strategies for Socialized Medicine

When our children started back to school in London last month, it was time to map out the many routine doctor’s and dentists appointments for the family, ‘to start the school year out right’. Having just completed that task, I had a moment to reflect on how we have managed doctors and dentists, illnesses and operations in the UK over the years. When I was an investment banker in London, I had private insurance and if I wasn’t feeling well, a simple phone call to a private doctor on Harley Street did the trick. It was expensive, but it was mostly covered by insurance, I could get there and back on my lunch hour and ‘time was money’! I didn’t have time to call my local GP, wait days for an appointment and live through the ‘take two aspirin, wait a few days and call us if you think you’re about to die’ routine. Going the private route in London was an experience; specialists felt they needed to make their examining rooms cheerful and cozy rather than medical. As an aside, I didn’t put a high value on the copies of Tattler Magazine in the waiting room, or the plaid wool throw carefully tucked at the foot of my OB/Gyn’s examining table (which gave me pause to think about how many other women had used it) — but I could get in and out in an hour.   Medical care is a big subject of discussion among the expatriate families we meet, whether French parents at the Lycee Francais in London or the American banking crowd: ‘Who do you go to? Is that what their doctor recommended after the fifth visit…?’ A friend and senior partner at a large Investment Bank confided once that whenever anyone in his family needed a doctor, his medical office was ‘Heathrow Terminal 4’ meaning they simply flew to New York to see a doctor rather then subject themselves to the English medical system. I was amazed!   We are now self-employed and the luxury of expensive private health insurance is not an option. I faithfully re-registered with my General Practitioner but her patient list is overflowing and I dread the ordeal of making an appointment and requesting a specialist referral since National Health doctors are discouraged from referring patients to specialists in order to keep costs down. In an attempt to improve medical care, many UK hospitals are converting to independently run trusts, a big improvement — but with its own problems. We have all read about ‘post code medicine’ in the UK, where patients are denied life-saving drugs at one UK hospital when they would have qualified for free at the hospital a post code away. It’s improving but still a mess.   Common wisdom is that UK hospitals do well in emergencies, but we were not so lucky. When our active son was 3, he ran up stairs with a pen in his mouth and fell on it. The wound to his soft palette was horrifying and we rushed to the nearest emergency emergency ward of the well-regarded National Health Hospital nearby. A long story, but after 16 hours, two different hospitals and not being seen by either a Pediatrician or an Ear, Nose and Throat Specialist, spending the night on a hospital ward shared with 30 children who had respiratory infections and asthma, we opted to find a private doctor. We located a private specialist and checked him out of the hospital, all the while pursued by the nursing staff, shouting that it was ‘highly irregular; your son hasn’t been examined by a Doctor yet!’ …. Exactly! The private surgeon took one look and operated on our son immediately. Aside from complications due to the delay, he happily made a complete recovery, but the delays and lack of care frightened us.   We decided that we couldn’t rely on the National Health Service to take care of our medical problems and our solution was simple; pray that we never had an emergency in the UK and cross the Channel to see France doctors privately whenever possible. Going to one of the best ophthalmologists in Paris costs € 60 privately compared to three times that in London. My last mammogram/bone scan at a private clinic in the 7th arrondissement was € 200, versus twice that that in the UK. I won’t even get into the cosmetic surgical procedures that women from London avail themselves of in Paris since the quality is high & the cost is considerably less then in England. Think twice when that friend of yours tells you she’s just returned from a French spa & praises the curative powers of hydrotherapy and massage. That youthful and rejuvenated look didn’t come from mud baths and colonic lavages!   The National Health Service recognized the severity of the problem when the news emerged that waiting lists for knee and hip replacements were measured in years rather than months. The NHS contracted with hospitals in France and Belgium to take some of the overflow. It has been an enormous success and English patients rave about the quality of French/Belgian hospital food and the luxury of TV’s in their rooms, even if they can’t watch the X Factor in English.   When our daughter needed braces, we found an orthodontist in Paris who works on Saturdays. Every six weeks, she hops on the train to get them tightened. It costs 40% less than in London, including train fare and her favorite ‘foie gras chaud’ for lunch. She is under the misguided impression that Paris doesn’t offer cutting edge fashion for girls: may it last until her treatment ends next spring! Friends thought we had entered the rarefied jet set in London until we explained the reason; it’s cheaper.   Our son twisted his ankle and it’s been slow to heal. After a wasted hour trying to get a referral from our GP’s office for an X-ray or MRI, I gave…