Grow­ing up in Eng­land in my first 26 years, born imme­di­ate­ly post WWII, I was the recip­i­ent of excel­lent health care from the brand new British nation­alised health sys­tem, the NHS (Nation­al Health Ser­vice). There was always the option of pay­ing pri­vate­ly to have any surgery per­formed more prompt­ly and avoid­ing the NHS wait­ing list. Friends of mine even con­sult­ed spe­cial­ty physi­cians (called ‘con­sul­tants’ in the NHS and always titled ‘Mr.’ not ‘Dr.’) pri­vate­ly and then were some­how bumped to the top of the NHS sur­gi­cal list! 

As we were grow­ing up my father com­ment­ed that we should nev­er be reluc­tant to use our fam­i­ly doc­tor when need­ed because he, as the bread­win­ner for our house­hold, paid for the ser­vice through his con­sid­er­able pay­roll deduc­tions. I should remark that we actu­al­ly had very lit­tle need for seri­ous health­care atten­tion, com­pared with oth­er fam­i­lies we knew. But when we need­ed care, even emer­gency care, we cer­tain­ly received excel­lent service.

Recent­ly my moth­er, at 90 still liv­ing in her own house in Eng­land, spent six weeks in hos­pi­tal to resolve a blood clot. Since the NHS has been around for 60+ years and is some­what bro­ken there were some seri­ous frus­tra­tions for my broth­er, her pri­ma­ry car­er, when try­ing to com­mu­ni­cate with doc­tors and nurs­es respon­si­ble for her case — some­thing Pres­i­dent Oba­ma should pay atten­tion to! 

Through the NHS my moth­er’s con­di­tion was sat­is­fac­to­ri­ly resolved and suit­able treat­ment estab­lished and main­tained, along with offi­cial­ly diag­nos­ing her with Alzheimer’s. We have asked our­selves why we kept her pri­vate health insur­ance cov­er­age (now can­celled) all these years “just in case” she need­ed ‘elec­tive’ surgery, like an oper­a­tion on her sec­ond cataract.

The cur­rent push for changes in US health­care does­n’t seem to have tak­en into account the indebt­ed­ness of coun­tries that have offered their entire pop­u­la­tions, immi­grants too, legal or ille­gal, nation­alised health­care for many decades! France and the UK to name just two!

Nation­alised US health­care is being pushed under the guise of need­ing health­care for the one fifth of the US pop­u­la­tion with­out insur­ance. Recent­ly I heard that about 35 mil­lion of those peo­ple will go on Med­ic­aid under the pro­posed new system!

Now to my own sit­u­a­tion — in 37 years of liv­ing in the US I have rarely had good health­care cov­er­age. My hus­band worked for his uncle’s two-man com­pa­ny and insur­ance costs, for our fam­i­ly alone, were very expen­sive — at times $800 a month (paid for by the com­pa­ny, much to his uncle’s con­ster­na­tion!), and that did­n’t cov­er much. As we fre­quent­ly changed insur­ance com­pa­nies, need­ing to reduce com­pa­ny over­heads, we were oblig­ed to change pri­ma­ry care physi­cians too — some were real­ly good, oth­ers were just aver­age or less.

What I did have in that time was an excel­lent Pana­man­ian-born pedi­a­tri­cian, based over 15 miles from our home, and a won­der­ful pri­ma­ry care doc­tor, locat­ed over 30 miles from our home. These physi­cians were rarely on our insur­ance plans but it was my trust in them that aid­ed me while our chil­dren were young and at var­i­ous times when I had seri­ous queries about my own health. 

We paid the reg­u­lar office vis­it fees each time we vis­it­ed them. An office vis­it for two chil­dren with ear infec­tions usu­al­ly came to $100 (we’re talk­ing 1980’s!), not includ­ing med­i­cine, which could be $25 or more. At that time I was at home edu­cat­ing my chil­dren and earn­ing just $65 a week car­ing for one oth­er child.

In the past 11 years our whole fam­i­ly has had only one year of tru­ly com­pre­hen­sive health­care cov­er­age. I am thank­ful for that because with­out it my hus­band would­n’t have sur­vived our fam­i­ly’s biggest med­ical emer­gency and trauma.

How­ev­er in the past 10 years, until 18 months ago, I had no med­ical insur­ance cov­er­age. My hus­band, legal­ly dis­abled from his med­ical con­di­tion, went on Medicare about 9 years ago.

Pri­or to that time we had paid $500 a month for COBRA (Con­sol­i­dat­ed Omnibus Bud­get Rec­on­cil­i­a­tion Act — allow­ing you to main­tain health insur­ance when you lose your job) just to keep him alone insured — had we not paid that mon­ey he would have been con­sid­ered as hav­ing a ‘pre-exist­ing con­di­tion’ and been unin­sur­able ever again had we sought dif­fer­ent pri­vate coverage.

Now to our cur­rent work­ing sta­tus: My hus­band took a part-time (20+ hours a week) job with Star­bucks at $8 an hour sim­ply to gain basic health insur­ance for me — no oth­er rea­son. I am extreme­ly fit (with more ener­gy and brain pow­er than co-work­ers who are half my age!) but at 63 there is always the pos­si­bil­i­ty of need­ing prop­er and effec­tive med­ical coverage. 

In my part-time work (6 hours most days, on occa­sion 9 1/2 hours a day), in ear­ly child­hood care, I am paid $10 an hour but there are no health­care or oth­er ben­e­fits. My hus­band has recent­ly increased our health insur­ance cov­er­age, and thus pay­ments, through Star­bucks increased to $225 a month — this gives us both more com­pre­hen­sive cov­er­age (he does­n’t need more com­pre­hen­sive cov­er­age but he can’t insure me with­out insur­ing himself!). 

Through his med­ical emer­gency in June 1999 we now know a doc­tor in just about every spe­cial­ty we might ever need. Fur­ther­more, we have abun­dant trust in them all. If we ever need­ed an expert physi­cian in anoth­er field I know they would give us the very best advice.

I don’t want to lose any of them by being part of nation­alised healthcare.

The rea­son I feel the need to write about our cur­rent health­care sta­tus is to doc­u­ment any changes that occur in our med­ical and finan­cial sit­u­a­tion as nation­alised health­care invades the US.

Our adult sons are inde­pen­dent of us, but they aren’t mak­ing extra­or­di­nar­i­ly high incomes that would allow them to take out med­ical cov­er­age just for the two of them — cost­ly. Plus, one of our sons has a pre-exist­ing neck con­di­tion. I would hate to see them each assessed a fee or fine for not ‘buy­ing’ Pres­i­dent Oba­ma’s com­pul­so­ry med­ical coverage. 

Right now they at least know that we have access to the best doc­tors in our area should they ever need their ser­vices. I would­n’t want them going to any oth­er doc­tor just because their insur­ance made it cost effective.

We await the future.