Friday, August 10, 2012

If only we had the NHS

I'm not going off on a political rant here, but for those in the USA who sniff at Obamacare, call him a "socialist/communist" and refer to the healthcare system in the UK as the perfect example of where the US could end up (and not in a good way), here's a story:

Took the two teens to the dermatologist yesterday. Like many their age, their skins are playing up and despite fairly scrupulous cleansing routines (well, by the Queenager at least) the improvements are not what they should be.  They were both prescribed new creams and gels, but we were given teeny samples first, just to make sure they were OK for them. Along with the samples came a couple of coupons with the dreaded words "If you use these coupons you should be able to manage the cost quite well". Alarm bells going off all over the place.

About two hours later, the lovely lady at my local pharmacy called to say the dermatology office had sent the prescriptions through. I explained that we would be trying out the samples first before I ordered the full tubes of cream, at which point she said "Well, let me tell you what it's going to cost because you might want to think about that."

Listen to this -

The cream that they have both been prescribed costs $260 each. (Acanya)
The gel for the Man-Child is $450. (Tazorac)
The Queenager's gel is $240. (Differin)

And no, there are no typos up there. Those numbers are correct. And no, it very clearly states on each coupon that there are no generics (substitutes), natch.

Now, with the coupons, I can in theory get massive deductions on these prices - the cost is just passed on to the health insurance company. Except that, like many people here and with many insurance policies, we have a deductible (or excess) to pay first; since we haven't hit that deductible yet, the above costs will have to be paid my yours truly.

What am I supposed to do?

Can you Adam and Eve it that one cream can cost $450?????????

Never, ever complain about the NHS again people. And for Americans who criticize Obama for trying to  bring some kind of regulation into the health care system - this is what happens when no one's watching the big pharmaceuticals.

OK, so that was a bit of a rant, but can you blame me?


  1. Hmm - told you yesterday about our wonderful health insurance plan - looked up Acanya and found that our plan wouldn't cover it at all - so I'd be paying the full whack, just like you! So much for insurance :-(

  2. Oh, and because it's not covered, it wouldn't even count towards our deductible!!

  3. I agree. Having experienced the US system, I can't imagine ever complaining about the National Health Service ever again - you really don't appreciate how good you've got it in the UK!

    Apart from the prices, which are bad enough. There is a tendency in the US for unnecessary work to be done, because it means more profit - even when this isn't happening, you aren't always sure what to believe, which undermines your trust levels.

  4. AA - now that I think about it, the last time I had this problem my very expensive PPO excluded it too! Pah.

    Paul - totally agree. They spend money likes it magically appears out of thin air. I don't think doctors always appreciate that not everyone has a 100% covering health plan.

  5. That is not just outrageous, it is criminal! What kind of magic potion is in those tubes?

  6. My MIL was rushed from Lincolnshire to Birmingham via ambulance two days ago. She had had a MASSIVE surgery, is in ICU, and will be in hospital for the forseeable future. All of this will not cost her one single penny. Sure, they have paid into the NHS for all these years, but nothing like what this level of care would cost her if there were no NHS. I say thank goodness for th NHS every time I have to go to the doctor, even if the system is flawed.

  7. Blimey! How big are these tubes of cream? Are they designed to last for a year?

  8. Totally agree. One of my first experiences of the healthcare system here is being prescribed a headache pill by my doctor - I went to the pharmacy and they said it would be $90, please, even with my insurance card. I left it.

    American healthcare is crazy. Every time I go to the doctor I have no idea what I will have to pay, or co-pay, and nor, seemingly, does the receptionist. The insurance companies have a stranglehold, and everything Obama has done to try and break that is good - just a shame he couldn't do more.

  9. I'm an expat in Saudi Arabia and I definitely don't complain about the NHS anymore!

  10. Trish and Pm - apparently the tubes will last about 3 months. So that's $1800 per year just for one of the tubes.

    NVG - That is the real problem, - the insurance companies basically pick and choose what they will cover and what medication you can buy. Sometimes there is no real reason either. I remember when my allergies were really bad and they would cover a few meds, but not Zyrtec, which was prescription at the time, and the only one that worked for me.

  11. As an American who lived for years in Germany (and who is presently living in South Korea,) I couldn't agree with you more. We just got a statement from our (American) health insurance listing the lab work done at our college son's recent physical in the US: one of the lab tests allegedly cost $480 - and yes, that was just ONE of the tests. Compare that to the $84 I paid last winter here in Korea for a consultation, xrays, 2 nebulizer treatments and an injection - it's ridiculous.
    We are fortunate to have very good health insurance, but (unlike many of our friends and acquaintances) I am well aware that this is really a matter of chance and luck. I tell anyone who will listen that all it takes in the US to bankrupt you is one job loss + one illness or accident. Americans seem to be so terrified of the concept of managed care - yet most of them will depend on Medicare for some or all of their health care once they retire.

  12. Amazing how much costs have increased since I was a teenager. Would love to have single payer insurance here in the states, but politically it's still a hot potato. Kudos to Danny Boyle for celebrating the NHS in the Olympics.

  13. This resonates - I spent the last week trying to decide on my health insurance plan for the coming year - the only one I could afford (and I am a medical practice manager) would mean $10,000 out of pocket to have another baby. Bye bye third child. Plus I can't even tell you how many patients I talk to each month who face losing their house due to a stroke or other serious medical issue. It's only the best medical care in the world if you can afford it.

  14. Ali - I'm not even sure why it got the label as being the best in the world since the life expectancy is no better than anywhere else. OK, so a diagnosis might be more accurate but in the meantime hundreds of thousands of dollars are wasted in tests that "rule out" issues, but in reality are really the docs covering their own asses. And in my case, my insurance doesn't cover tests for ruling things out anyway.
    Sorry about the third baby news, BTW.

  15. Earlier this year on a trip to the U.S., I came down with a fever and sore throat.
    It got rapidly worse, and my beloved insisted on taking me to a nurse/practitioner clinic in a large pharmacy...
    She took my history, examined me, exclaimed that I had an off the scale temperature and white spots on the back of my throat. Which she swabbed with a twenty-dollar test, and proclaimed that there was no strep present, therefore I had 'flu, and here's a prescription for eye-wateringly expensive Tamiflu.
    It was a holiday weekend, and I got worse. fever, sweats, inability to swallow, inability to walk upright without holding on.
    By this time my beloved's very concerned, she drags me, half dressed and in zombied mental state to a real medical clinic with real doctors.
    Where in moments, the doc diagnoses the classic symptoms of strep throat, points out that the strep screening test that I'd paid for is regarded by the profession as useless because of the high number of erroneous results. You might as well toss a coin.
    Whereas, he says, white spots on the back of the throat and a sustained high fever? Perfect symptoms for an accurate diagnosis.So, I get a huge antibiotic load, and more to take daily for a week.
    He wants me to get hooked up to a drip, to rehydrate, but I promise to drink, continuously, which is enough to get me released.
    The next week of my stay is better, but not great, because everything I try to eat feels like a handful of broken glass in my throat. I'm back in britain before I can eat properly. And I reflect that here, I'd have gone to see my doctor at the start, and had antibiotics prescribed, and the infection would have been stopped before the real misery could start.
    And it would not have been delayed out of fear of doctors fees.

  16. I LOVE LOVE the NHS. The NHS rocks my world. I always give people the side-eye when they ask if I miss living in America. Um no. I like it here just fine thanks! (except the appliances...but you knew that!)

  17. I love the NHS and always sing its praises to my fellow Americans- who never believe me! I am about to have my 3 child, at home, with no out of pcoket cost to me- not possible in the US. As an aside, I used to have terrible acne when I was younger (used all sorts of prescription meds incl Accutane) and the best thing I ever tried is Proactiv. Genuinely amazing stuff and much cheaper than those creams!

  18. Soubriquet - that's unfortunate. I have used those walk-in clinics on numerous occasions but usually when I know what's wrong (eg. eye infection). Sometimes, even when my child is sick, I can't get him or her in to the doc on the same day, the school has sent them home because of pink eye (conjunctivitis) or something like that, and all you need is a quick check and some anti-biotics. They are quick and cheap but I wouldn't go there for anything other than a really simple issue.
    And yes, all - with regard to childbirth, two out of my three have been c-sections, where we had to pick up 20% of the bill. Of course, when you don't plan to have a c-section, (as with me) it's eye-watering when you get the bill and I hate to think how some people manage.

  19. It's just better if health care is provided by people who aren't in the business of making money out of it. Seems pretty obvious to me. It's not an area where consumer competition works, so it's not like supermarkets. Duh...

  20. Flaming nora! Had no idea what the going rate for pimple cream was. I hope my teens stay pimple free (fat chance)

    Like MsCaroline I have very good health insurance, but know I am one of the lucky ones. I know many people who have bad luck with insurance and some who, before going into surgery have to pay most of the costs upfront which is a bit of a nightmare for those involved.

  21. I bristled when I read earlier this week Romney's comments on health care. Yeah, that NHS - boy it's terrible to be able to afford your prescriptions and be able to see your doctor for preventative measures and to go into hospital without private insurance and not come out a pauper.

    It's not as if Romney & Team have some other version to offer the American public. It's all just rhetoric with words that are supposed to scare people without illuminating anything.

    And Expat Mum, I'm not at all surprised about that cream. I went to a dermatologist in the U.S. (before I moved to the UK) and once they accidentally sent me the bill instead of my insurance company - it came to $1,000 for a regular visit.


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