Tag Archives: birth

But What About…? Part 4a: Healthcare Introduction, Part 1

Having lived in England for most of my life, and America for a significant number of years, I have had some experience of the different medical systems, some good and some bad. Thus, this subject of healthcare is somewhat personal to me, and it’s easy to get wrapped up in it. I might be a bit more opinionated than usual. There’s a chance your reactions will be more charged than usual (I have seen many heated posts on my Facebook feed when someone dares threaten the sacred cow that is the NHS). Please grant me some extra patience, then, as we discuss this topic.

The US and UK healthcare systems are, in some ways, vastly different. In other ways, they are very similar. Some of the ways they are similar aren’t very good at all. I’ll talk about these some over a few posts.

A pitfall of both the NHS system in the UK, and the insurance system in the US, is it disrupts the business/customer aspect of the doctor/patient relationship. Broadly speaking, the business answers to the one who pays the bills, and if you’re not paying the bills directly, then your say is greatly reduced.

Take birth, for instance. You might not like the hospital version of birth (put you on a clock, monitor so you can’t move like you need to, drugs to speed you up, drugs to stop the pain, highly unscientific breaking of waters, you’re taking too long so cut the baby out). My experience of hospitals in both countries, were that they tended to be like this.

The World Health Organisation put out literature saying that a caesarean rate of more than 10-15% was not medically necessary. I think the 15% was a concession, I seem to recall another document being more hardline with 10%. I checked up on the UK hospitals we used, they were higher than that.

In the NHS, and in the US insurance system, there are people who decide what kinds of treatments they will pay for. Insurance in the US might very well not cover safer, cheaper, maternity alternatives. VBAC is even worse. The NHS at least on paper supports homebirth, though the vibes we got from some of the midwives we were dealing with led us to not trust them.

In neither country are the hospitals and medical staff accountable to you for an unnecaesarean.

I find the “cascade of interventions”-style treatment unethical. Profitable for surgeons and drug companies, yes, ethical, no. I have no desire to fund or support it. If you like it and want to use it, that’s your choice to make. I don’t want to force what I think is best onto you.

But statism doesn’t return the favour. In the UK, I must fund the system I don’t like, and if I want something better, I pay for that on top.

In the US, the governmental interference (“Affordable Care Act”) has caused all sorts of problems. People required to have some coverages they don’t need or want.

That’s not to say there aren’t people who have been helped. There are those, for example, with pre-existing conditions that can get coverage, who couldn’t get it before. The underlying issue of just why a doctor’s visit and a few tests costed (and still costs) an arm and a leg, has been entirely undealt with. Insurance companies decide what they will or will not pay for, and hospitals charge the insurance companies more because they can afford it.

The waters are further muddied when employers are brought into the mix.

I know I’m kind of cutting off in mid-stream here, but come back tomorrow for more!