Many of you know that I passed a kidney stone a while back, a painful but nonlife-threatening event. I was seen in the A&E (ER) the same night and discharged home for an outpatient followup the next day. Imaging revealed a blockage and I was immediately admitted for surgery. More detailed imaging in preparation for surgery revealed that a noninvasive treatment would likely solve the problem, and it did: that night. I was seen about a month later for a follow up appointment, which revealed that the remaining stones in my kidney are too small to treat with the shock wave procedure. So they want to monitor me with follow up appointments every six months. There were no attempts to bill me for any services even though I used the A&E (ER) for nonemergency treatment. There were no copays or premiums and no harassing from private insurers. I am continuing to receive followup care. All of the above services are funded by a tax. For the both of us, that tax currently comes to about £140 per month.
The prequel to this story was that one day while I was at OT school I urinated blood. I was scared and I went to the ER (A&E). I was also discharged home for an outpatient followup. That followup was about a month later. I was diagnosed with kidney stones but they were too small to treat. Case closed: no follow up. There were letters from my private insurer related to the appropriate use of emergency services. At the time, I was paying a monthly COBRA premium of $1200 per month to cover my wife and I, and there was $30 in copays for the two visits. There was only the one followup visit.
Admittedly, putting these two events side by side is unfair. The timing of these two events has my family in decided different financial situations. We could easily afford that COBRA payment at the time, so it was not the financial strain that it appears. Also, the recent event included passing a stone, and the prequel did not. My only experience with kidney stones is personal, but I suspect that many stones are too small to treat. With no history of passing stones, it might be reasonable to just leave it be. I was certainly happy with the care in both countries. While I suspect that I would not be getting followup visits every six months in the US even after passing a stone, I am willing to consider the care in these two instances as roughly equivalent. I do not know which country's healthcare provision costs more. I suppose I could get all riled up about having to pay an additional tax for healthcare, but my wallet sees no benefit when eliminating that tax requires me to purchase more expensive private insurance, which by the way is available here (complete with premiums and copays that allow access to private hospitals) despite statements by some to the contrary. I can report that I am relieved to have a baseline of coverage no matter what. Both my wife and I have gambled with our healthcare coverage in the US before. It is a scary prospect, and I am not looking forward to having to do it again on our return.
The elephant in the room is that healthcare is a costly and limited resource. One view is to spread that limited resource along a baseline of minimum coverage that all citizens get. Another is to restrict that resource to a portion of the nation's citizens so that the minimum coverage is higher for those who have access. Of those two lousy options, I prefer the first because I think it is wrong for people like me, who are relatively well off, to get better healthcare by denying it to the less fortunate. I find it disturbing and perplexing that such a view inspires intense vitriol and hatred.Photo Credits:
Coconut-sized Kidney Stone
Banksy's Elephant in the Room
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