by Anne-Marie Varga
Medically Reviewed by:
Cynthia Taylor Chavoustie, MPAS, PA-C
by Anne-Marie Varga
Medically Reviewed by:
Cynthia Taylor Chavoustie, MPAS, PA-C
Without employer-sponsored insurance in the United States, I needed a new option. The system in the U.K. isn’t perfect, but it won’t bankrupt me.
Ah, England. It’s the land of lush countryside, red phone booths, and Big Ben. Tasty tarts and decadent teas, royal guards and regal palaces. It also happens to be the land of universal healthcare.
I came to live in London in September 2023. I recently quit my corporate job and qualified for a new type of visa. It was a brave and terrifying decision; I was losing my steady income and my wonderful benefits — including healthcare.
I’ve always had a genuine interest in England — I have a mild obsession with Jane Austen, I think the accents are hilarious, and vintage teacups are scattered everywhere around my apartment. I chose to come to this country, however, because I needed its medical services.
Now, you may be asking, “Anne-Marie, why don’t you just pay out of pocket for your infusions?” Excellent question, dear reader! Let me break it down for you:
For my Crohn’s disease, I take 800 mg of a medication called infliximab. I take it intravenously every 8 weeks at a hospital infusion suite. It takes about 2 hours each time.
I recently pulled up my past insurance claims, just for kicks and giggles. Here’s the breakdown of what I would have to pay without health insurance:
That means that one infusion costs a total of $8,715. I need at least six a year. That puts me at $52,290 per year.
Now, reader, you may be thinking, “Anne-Marie, that’s a lot of money! Does that include blood work as well?”
I’m so glad you asked! It does not. The cost of simply getting blood drawn can range widely. For the tests I need, each of my blood draws comes out to be about $1,760. I get my blood drawn quarterly, so that puts me at $7,040 annually, for blood tests.
One infusion, total, costs $8,715. I need at least six a year. That puts me at $52,290 per year. And that doesn’t even include bloodwork or my colonoscopies.
So, a bit of math here … This plus that … carry the 1 … it comes out to a sh*t ton of money. $59,330 a year to be exact. And we didn’t even get into my colonoscopies every 2 years (*cough* $18,000 each).
My yearly income in 2023 before taxes was $53,000. I suppose, when I left my job, I could have enrolled in private health insurance. I now make about $14 an hour, and at 40 hours a week, that gets me to about $2,240 a month. After rent, food, and general life expenses (and mind you, I’ve cut back on outings, travel, etc., substantially), we’re looking at less than $1,000 a month.
A private healthcare plan, which can cost anywhere between $400–$800 a month, is sadly not an option for me at this time.
In the United Kingdom, it’s a different story. Before I left the United States, I applied for a visa so I could stay longer than the 6 months allowed for tourists.
My visa cost me a one-time payment of roughly $1,200 (a substantial amount, yes, but it sure as hell beats a $400 monthly health insurance plan.) With my visa, I have the right to work in the United Kingdom and access the National Health Service (NHS) for the next 2 years.
I am incredibly privileged that I found care in a country that uses my native tongue as its language. Navigating a foreign healthcare system is wildly intimidating; I didn’t know where to start. Google became my best friend. I joined Facebook groups. I cold-queried a U.K. Crohn’s support site (they responded and gave me a step-by-step breakdown of what to do).
Upon receiving my visa, I immediately registered online, with an NHS clinic. A few weeks later, after I arrived in London, I called the clinic to make a phone appointment with a general practitioner (GP) in London. During this appointment, I explained my chronic condition. The GP then referred me to an NHS gastro consultant (comparable to a gastroenterologist in the United States).
Within 3 weeks, I had my first appointment with my consultant. Though, I later learned this efficiency was somewhat unusual. He was informative and kind and fielded my many, many questions about alternative treatment options, as well as next steps for receiving my infusions in the United Kingdom. He ordered a chest scan, as well as a blood draw, and a stool test to check for levels of inflammation.
I was immediately sent upstairs for my chest X-ray. It was quick and efficient and I was finished within 5 minutes.
In fact, the entire appointment — consultation, X-ray, bloodwork — took me no longer than an hour. My cost: zero.
I knew that the NHS was free, but I imagined that I would owe something at the hospital — especially for my infusions. When I asked my consultant if there was any cost — even a hundred quid — he simply shook his head, seemingly surprised by my question. I was baffled.
Out of curiosity, I asked him how much prescriptions might cost me at the pharmacy. I told him about the antidepressants I am on (which cost, without insurance, close to $700 per refill in the States.) The U.K. cost? Just 10 pounds (or $12.75 USD).
My care was good, and it was paid for. I knew there had to be a catch. And I was right.
I had been told — by the internet, by friends, and by NHS employees — that the NHS was slooooooooooooow.
Because I didn’t have to initially field many hurdles when I first arrived, I imagined all of those warnings had been dramatized.
I’m learning, as I’m here, that they were, indeed, not dramatic. The NHS is, indeed, slow. The NHS constitution previously set a standard that 92% of referred patients should not wait more than 18 weeks for an appointment. In 2023, the 92nd percentile waiting time was 46 weeks.
Given the above stats, I feel lucky that it took less than a month for me to see my consultant. I’m convinced this luck is in part due to my persistence; due to the move, I was a bit late in receiving my medication and was very anxious about it. I emailed the office daily until they booked me an appointment.
Once I saw my consultant and expressed my anxiety, he calmly assured me that I didn’t have to worry; he didn’t anticipate me having any negative effects as I waited for the medication. However, he did say it would take time — at least 4 weeks — for him to get me an appointment for my infusion.
As the days and weeks passed, I received little in the way of updates from him. Though my anxiety rose as time passed with no appointment, they finally contacted me — about 4 weeks to the day — to schedule my infusion.
Once there, I waited, alongside five or six other patients, as one nurse rushed around the room, trying to take care of us all. He apologized profusely for the wait and for the chaos; they were understaffed.
The office felt disorganized throughout that waiting time. They were slow to return my messages; I would hear back 4r or 5 days after I sent them. What’s more, the reports that I sent him from my U.S. doctors have not been entered into his system.
When it was finally time for my infusion, I arrived at the office 10 minutes early and waited another 40 minutes before being called back into the infusion room. Once there, I waited, alongside five or six other patients, as one nurse rushed around the room, trying to take care of us all. He apologized profusely for the wait and for the chaos; they were understaffed.
Phones were continuously ringing and being unanswered. Constant (and annoying) beeping noises sang through the room — signifying an infusion drip was complete — as patients not-so-patiently waited for the one nurse to assist them.
My appointment was scheduled to be over at 11 a.m. I left the hospital at 1 p.m.
I don’t say these things as complaints, but simply as observations.
The NHS is a universal healthcare system, meaning it provides care for any patient, at any time. It sees, on average, 1.3 million patients a day, which is a 4% increase since 2012.
Aside from treating every U.K. patient who seeks help, the NHS also offers general care and emergency care, free of charge, to those visiting the United Kingdom.
It’s admirable, I think, to offer care to anyone who needs it, regardless of socioeconomic status. In my opinion, the U.S. healthcare system is broken; it’s run as a capitalist business and is designed to bankrupt its patients.
However, the U.K.’s universal benefits come with an extreme cost. The NHS is reported to be struggling more in 2023 than it has since the pandemic. Hospitals and clinics are understaffed, and there aren’t enough beds to meet demand. Resources are low, and wait times are at an all-time high.
Staff morale is low, too, and many professionals are paid too little or are not paid overtime for their work. As such, they are leaving. Professionals say the NHS needs more longer-term investment to meet demand and deliver efficient care; however, this will require increased government borrowing, increased taxes, or cost cuts in other areas.
It’s wild for me to live in a country with universal healthcare. Many of my British friends are boggled by the healthcare costs of the States. I tell them stories about friends who Uber to the hospital, because ambulances cost close to $1,000, and about friends who’ve received medical bills close to $30,000 after delivering babies.
My mind is blown when my British friends tell me that they never pay a penny after receiving surgery, or that they have chosen to pay less than 800 pounds (roughly $1,000 USD) a year for private healthcare, which helps them avoid long wait times.
We share the same mother tongue, but we’re speaking different languages.
Medically reviewed on January 17, 2024
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About the author
Anne-Marie Varga has a dual degree in English Literature and French from the University of Michigan and a Master’s in Digital Media from New York University. She’s an aspiring novelist based in Brooklyn, New York, and is currently working in children’s book publishing. When she’s not writing, she’s most likely watching the Great British Bakeoff or doing her part to dismantle the patriarchy. You can check her out on Instagram, Twitter, or at her website.