Money is the lifeblood of healthcare in the US | letters

I live in the US, and everything Arwa Mahdawi says about its unpredictable and cruelly expensive healthcare industry is familiar (My wife almost died because I delayed a visit to ER – but there’s a reason I avoid US hospitals, 25 October). An unanticipated event during a recent vacation gave me a close look at Britain’s healthcare. I had a heart attack and was admitted to Royal United hospitals in Bath. From intake to discharge, I witnessed the impressive skill and unwavering kindness of NHS staff.

In what seemed like no time at all, they identified and stented a blocked artery, and settled me into a coronary unit where I was closely monitored – and given a cup of tea.

How wonderful that the patients around me weren’t thinking about whether they would be discharged as soon as they were stabilized because they couldn’t pay for the full course of treatment, or whether they could afford the drugs they’d need after discharge, or whether the hospital would turn them over to a collections agency for non-payment. Ask Americans about medical bankruptcy and they’ll know exactly what you mean.

As the new UK government sets priorities and allocates resources, it should seize this opportunity to care for the NHS as well as it cares for everyone.
Carol Newhouse
Ballston Spa, New York, US

Arwa Mahdawi’s account underscores a maddening truth about America: our health system is dangerously ill, and the prognosis worsens. A tale of two appendectomies highlights the decline. On holiday in 1996, I left my appendix in San Francisco. Other than having to wait until 5am so we could get the insurance green light to go to the emergency room, my appendectomy experience was straightforward. We paid a small co-payment and made Tony Bennett jokes, and moved on.

Seventeen years later, my wife had her appendix erroneously removed in a North Carolina hospital because the surgeon failed to read the results of her scan. Five surgeries, many hospital stays, tens of thousands of dollars and seven months later, my wife was (mostly) restored physically. At no step did anyone acknowledge mistakes made. At every step we paid good money for suboptimal care.

We’ve learned to advocate for ourselves and champion our own outcomes. And we pay an inordinate amount of money in monthly premiums and in shared care costs for this privilege. It is inaccurate to declare that the US healthcare system is broken. It operates exactly as designed and maintained.
Kevin Reeve
Winston-Salem, North Carolina, US

I lived in the US for 50 years, and now in England for five. In the US, around 10% of people lack health insurance so have precarious access to care – an outrage. The promise of universal care in the NHS is part of a civilized society. But is the promise fulfilled? Arwa Mahdawi speaks of a friend in the US denied payment by her insurance who had to argue on the phone for hours to get it remedied. In the UK making an appointment to see a GP can take many hours, sometimes days.

My wife and I recently had a medical emergency in Philadelphia, when she broke her humerus. An ambulance arrived within 15 minutes. At the hospital, she was seen by an ER doctor within 45 minutes and then had X-rays and a consultation with a specialist. It all took about four hours. Is this an NHS experience?

This had nothing to do with being paying customers. The ambulance service didn’t know our status and the hospital provided service upfront with no immediate demand for payment. The cost of health insurance in the US is high, but medical care is not free in the UK. We pay a much higher rate of tax here. I’m happy to pay for everyone to have access, but the NHS hardly lives up to its promise of universal care. How many people give up trying to access their GP and live with a treatable condition? How many don’t make it waiting for an ambulance for an inhumane length of time? Both societies need to provide universal access to good quality healthcare. Neither is achieving that.
Jorge Rogachevsky
Lytham St Annes, Lancashire

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