Pro/Con #1: Socialized Medicine

When I first got to London, completely abuzz and overwhelmed by the size of the city and the unexpected culture shock, I sent an email to one of my dearest friends in SF, summarizing my early assessment of London. It went something like this:

Pro: It's a huge city with tons going on.
Con: It's a huge city with tons going on.

Pro: There are lots of Europeans here.
Con: There are lots of Europeans here.

Con: It's really expensive.
Pro: ... um...

(etc. The list continued for several pages)

In the same vein, I'm going to keep an ongoing pro/con list and actually elaborate on some of these subjects. They're interesting. And if I sound a bit sarcastic at times, I'll fill you in on a little secret. I actually really like it here. Maybe not quite as much as SF, but I like it. Even when I complain and tell you that I'm homesick and hate the weather and don't like it here. It's all true, but I still like it.

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Pro/Con #1

Pro: There's socialized medicine here.
Con: There's socialized medicine here.


On the pro side...
It's not quite the miracle that Michael Moore makes it out to be, but it is a miracle.

When I first signed up for my GP, as all users of the National Health Service are required to do, the nurse in the 'surgery' (surgery in British English just means a doctor's office) took me through my medical history. She then warned me about my doctor. "She's perhaps the best and most attentive GP in all of London," she said, "but she has no sense of time management. Expect to wait. Hours. For any of your appointments." Fair enough, I thought. Honestly, I was simply grateful to have free health insurance. I'm dirt poor trying to make it here on a US research grant (basically double the cost at half the wages)-- so this generosity is a godsend.

I went to see Dr. Berger (not her real name) two days ago and fell in love with her and her quirky, heartfelt style. I did, of course, wait about 45 minutes in the waiting room, even though mine was the first appointment of the day. When she called me in, she apologized profusely, about a million times. "I'm really sorry," she said-- and then again, with her charming accent, "really terribly sorry." I'd already said it was okay a few times, but she continued. "So sorry. Sorry to keep you waiting. Sorry."

She was probably in her fifties and probably Jewish and had ever-so-slightly frazzled brown longish hair and a long stylish skirt and sweater. She moved around her office with frenetic energy. Every time she needed me to do something so she could examine me (like roll up my sleeve for a blood pressure test, or lift my shirt so she could see the skin on my back), she'd also thank my profusely. "Thank you," she'd say, "Thank you very much, thank you."

She cared. She asked me about my research. And my family. And my impressions of the country. And we got into a long discussion about how she'd been tempted to go to the US -- doctors there make much more money. But she couldn't. She never could, she said, because in her eyes, everyone is equal and everyone deserves to be seen by a doctor. She couldn't live with a completely privatized system.

It wasn't hard to see why she keeps her patients waiting hours to get seen on any given day. But that was just her style. Her absolute commitment was that patients should get care, regardless of their background, regardless of the bureaucracy. And there is plenty of bureaucracy, as I will get to shortly. But all in all, I left getting what I needed. And I honestly couldn't have afforded it without the good graces of the socialized system-- as presumably was the case for many people in that waiting room. Pensioners, single mothers, people of all ages, races, and sizes, all entitled to healthcare. I would call that a miracle. Or maybe not. Maybe it's just a travesty that it doesn't exist more broadly, especially in societies as wealthy as the US.

On the con side...
I wrote that I left getting what I needed. That isn't the complete truth. The complete truth is that I left with referrals to go through ridiculous bureaucratic hoops to eventually get what I needed.

For example: My GP in the US, many years back, had noted that I have some moles on my back and I might want to get them looked at every once in a while just to make sure they're not growing or changing shape. It had been a while so I asked Dr. Berger to take a look. "Why?" she asked, furrowing her brow. "Why are you concerned? What's your specific reason for being concerned?"

I explained what my earlier GP had said-- he'd always managed to just look quickly and assure me things looked fine. But Dr. Berger asked me a million detailed questions and finally said she wasn't qualified to take a look, even casually. Instead, she had to refer me to a dermatologist. And I'd have to wait- months and months- to get seen. Unless she stretched my explanation a bit and said instead that I had good reason to think they were cancerous, in which case I could get them seen in a few weeks.

Similarly--(apologies in advance if this is too much information.) I'd injured a toe earlier this year and the toenail was growing back oddly, with a strange color, making me think it was infected. "I need a toenail clipping to test it," Dr. Berger said, "but we're not allowed to do that for you anymore. You'll have to take this specimen folder home and do it yourself, then bring it back. Then call us in two or three weeks to get the results."

Now, I'm a student, and my time is flexible, so it's wasn't a big deal for me to walk back the next day, toe nail specimen in hand. But if I'd had a 9-5 office job, I'd have had to come in late on not one, but two mornings-- first for the appointment, and second to drop off the specimen (since the surgery doesn't open until 9:30 am.) Not exactly ideal for running efficient businesses.

Survey says:
Warts and all, it's a still a miracle, as I said before.
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On a tangential note, Michael Moore makes the UK and French systems out to be angelic and the US system to be demonic. I actually liked the film, but as I watched it last year, I couldn't help but wonder if US citizens (by virtue of our fully privatized system) were funding medical innovation from which the whole world benefited, thereby allowing countries like the UK the luxury of not needing to go the private route themselves. The truth is, the profit motive in pharmaceutical research has saved lives. And without it, we wouldn't have the kinds of medicines we have today. It's also developed wasteful medicines and drugs are shamefully maldistributed... but if all rich country govts had socialized medicine, what would that mean for slowing down innovation in the medical industry? Is there some middle ground?