To date, I've been privileged to experience two different types of healthcare from life overseas. Dubai healthcare is similar to the US in that private insurance is required but the similarities end where pharmaceuticals are involved. Some commonly used medicines (i.e. inhalers) that are available by prescription only in the U.S. are available over the counter and they are cheaper in Dubai. But there is a big difference in insurance coverage in Dubai, and we were very lucky Ram's company supplied us with the best. My entire pregnancy, delivery, private room hospital stay for 10 days plus Riya's 14 day stay in NICU was completely FREE. When we saw the "bill" we were thankful we didn't have to shell out a dime! There is no way we would have had that luck in the U.S.
The UK's healthcare, known as the National Health Service (NHS), is funded by taxes and available to all at no cost. Now free healthcare sounds and is lovely, but as with anything, there are drawbacks. The focus is not on preventive medicine, like in the US, rather they treat your current condition. This also means a trip to the ER can be a nightmare if you need immediate attention. If you go to your GP and ask for that annual checkup with bloodwork and all, it ain't happening. They will not order any tests unless you have a compelling reason. Along the same lines, if you want to see a specialist, you have to see your GP first and convince them you need to see a specialist. For non-urgent matters it can take weeks to see a doctor and you have no choice on the date and time of the appointment. They set the appointment for you. Although it may take a few weeks to actually see the doctor, when you arrive at your appointment the waiting time is minimal, like 10-15 minutes, so the system can be efficient:)
Since I've had a baby under the Dubai healthcare system and will now have one under NHS, I thought it would be fun to compare the two experiences:)
1. Appointments: for first time pregnancies you have 10 appointments, only 3 of which are with a doctor, 6 are with the midwife and 2 with an ultrasound technician (your first midwife appointment is combined with an ultrasound appointment). For second time pregnancies, its only 8 appointments and again mostly with a midwife. In Dubai, all appointments were with a doctor and we had a few where we would go to a speciality clinic to do specific ultrasounds to test for abnormalities. But I definitely got more than 2 ultrasounds! My biggest disappointment was not being able to hear the baby's heartbeat on the first scan (which wasn't until 12 weeks) and I still have no clue as to why. I didn't get to hear the baby until 15 weeks! I'm also hoping my next scan isn't my last (gasp) till I deliver, cause there is no way I can handle that. I will go to a private clinic if I have to. I need to see my baby growing!
2. Snail Mail: all communication here is done by mail. That is also true if the hospital has to reschedule your upcoming appointment. I came back from Paris the day before my doctor's appointment only to get a letter in the mail saying it was rescheduled. I was so annoyed cause I could have stayed a few more days and come back with Ram! Needless to say in Dubai, they had no issues picking up the phone and sending you email/text.
3. Conservative....to a fault: when I found out I was pregnant, I immediately made an appointment to see a GP and requested a blood test to confirm. That's normal in Dubai (and US). But I was shocked when they told me they don't do that. They just take my word for it, will refer me to the hospital where I will get all my pregnancy care and wait until my 11-12th week before I get any formal confirmation of my situation. Say what?! I don't understand the refusal to do a blood test. I guess it's money they don't feel the need to spend. But that's just cruel to make a pregnant woman wait that long.
They are also very anti-intervention. I've heard many stories where doctors refuse to give a cesarean to a women in labor for 12 hours begging for one or where minor complications arise. Nor will they even think about inducing labor until you are almost 2 weeks overdue. YIKES.
4. Postcode Lottery: every city and hospital in the UK is different on certain matters such as cesareans and revealing the gender. We are very lucky that our hospital has nothing against revealing the sex of the baby at your 20 week scan. Just sucks that they make you wait that far into the pregnancy. In Dubai, I knew by 16 weeks and I hear in the US now you can get a blood test confirmation at 12. Boo.
5. Free healthcare = no private delivery. This is something I'm going to have to figure a way out of! In Dubai our insurance afforded us a spacious private room with a bathroom and sofa bed for Ram to sleep on. Over here, I'm told I can forget having any privacy and warned that Ram may not be able to stay with me. The second part is not as scary this time around because we have Riya to consider. But I don't think I could handle a newborn along with 6 other moms and their newborns! (Laine, I still don't know how you did this). Google has given us private insurance, so I am going to start making some enquiries on what we can do to resolve this issue!
Countdown to Houston begins! T-10 days...
The UK's healthcare, known as the National Health Service (NHS), is funded by taxes and available to all at no cost. Now free healthcare sounds and is lovely, but as with anything, there are drawbacks. The focus is not on preventive medicine, like in the US, rather they treat your current condition. This also means a trip to the ER can be a nightmare if you need immediate attention. If you go to your GP and ask for that annual checkup with bloodwork and all, it ain't happening. They will not order any tests unless you have a compelling reason. Along the same lines, if you want to see a specialist, you have to see your GP first and convince them you need to see a specialist. For non-urgent matters it can take weeks to see a doctor and you have no choice on the date and time of the appointment. They set the appointment for you. Although it may take a few weeks to actually see the doctor, when you arrive at your appointment the waiting time is minimal, like 10-15 minutes, so the system can be efficient:)
Since I've had a baby under the Dubai healthcare system and will now have one under NHS, I thought it would be fun to compare the two experiences:)
1. Appointments: for first time pregnancies you have 10 appointments, only 3 of which are with a doctor, 6 are with the midwife and 2 with an ultrasound technician (your first midwife appointment is combined with an ultrasound appointment). For second time pregnancies, its only 8 appointments and again mostly with a midwife. In Dubai, all appointments were with a doctor and we had a few where we would go to a speciality clinic to do specific ultrasounds to test for abnormalities. But I definitely got more than 2 ultrasounds! My biggest disappointment was not being able to hear the baby's heartbeat on the first scan (which wasn't until 12 weeks) and I still have no clue as to why. I didn't get to hear the baby until 15 weeks! I'm also hoping my next scan isn't my last (gasp) till I deliver, cause there is no way I can handle that. I will go to a private clinic if I have to. I need to see my baby growing!
2. Snail Mail: all communication here is done by mail. That is also true if the hospital has to reschedule your upcoming appointment. I came back from Paris the day before my doctor's appointment only to get a letter in the mail saying it was rescheduled. I was so annoyed cause I could have stayed a few more days and come back with Ram! Needless to say in Dubai, they had no issues picking up the phone and sending you email/text.
3. Conservative....to a fault: when I found out I was pregnant, I immediately made an appointment to see a GP and requested a blood test to confirm. That's normal in Dubai (and US). But I was shocked when they told me they don't do that. They just take my word for it, will refer me to the hospital where I will get all my pregnancy care and wait until my 11-12th week before I get any formal confirmation of my situation. Say what?! I don't understand the refusal to do a blood test. I guess it's money they don't feel the need to spend. But that's just cruel to make a pregnant woman wait that long.
They are also very anti-intervention. I've heard many stories where doctors refuse to give a cesarean to a women in labor for 12 hours begging for one or where minor complications arise. Nor will they even think about inducing labor until you are almost 2 weeks overdue. YIKES.
4. Postcode Lottery: every city and hospital in the UK is different on certain matters such as cesareans and revealing the gender. We are very lucky that our hospital has nothing against revealing the sex of the baby at your 20 week scan. Just sucks that they make you wait that far into the pregnancy. In Dubai, I knew by 16 weeks and I hear in the US now you can get a blood test confirmation at 12. Boo.
5. Free healthcare = no private delivery. This is something I'm going to have to figure a way out of! In Dubai our insurance afforded us a spacious private room with a bathroom and sofa bed for Ram to sleep on. Over here, I'm told I can forget having any privacy and warned that Ram may not be able to stay with me. The second part is not as scary this time around because we have Riya to consider. But I don't think I could handle a newborn along with 6 other moms and their newborns! (Laine, I still don't know how you did this). Google has given us private insurance, so I am going to start making some enquiries on what we can do to resolve this issue!
Countdown to Houston begins! T-10 days...
NHS must be different in England than Scotland because I never saw a doctor in my entire pregnancy until I was 10 cm dilated;) . That being said, I really felt like the prenatal care, labor and delivery was just fine, it was the recovery ward that was really hard for me. Hopefully London has some private health care options for delivery. I think they must but not sure about Google's coverage but I think even if you pay out of pocket it is like $3,000 which after my experience I would say is worth every single penny! There is not a single private maternity hospital in all of Scotland (!!!) so we didn't have that option. Also, I was told they wouldn't induce til 2 weeks after the due date, which I was ok with, but when things started to get uncomfortable and we were concerned about F's size at 41 weeks, it didn't take much push from me for them to push my induction up. Don't be afraid to be that pushy American. It makes all the difference. But basically, I heard a lot of horror stories but was pleasantly surprised with my experience....up until the actual birth of the baby. Ha! But yes, it was nice to leave after 5 days in hospital and 48 hours in NICU without a single bill to pay. I just paid a bill for $150 after my $25 co-pay because Forest had a minor ear infection that required the doctor to remove some wax with a q-tip, which apparently counts as 'auditory surgery'. Never thought I'd miss NHS but sometimes I really do.
ReplyDeleteBut you described NHS perfectly, the good with the bad. OMG the appointments by post. Crikey.