There's No Place Like Home: An American couple's encounters with the British Health Service
Asman, David
There's No Place Lilce Home An American couple's encounters with the British Health Service. BY DAVID ASMAN MR. ASMAN, COULD YOU come down to the gym? Your wife appears to be having a small...
...On the other hand my wife was wheeled into Cornell and managed to partially walk out after a relatively pleasant stay in a relatively clean environment...
...Since we returned to the States, we've actually had two American physical therapists who did just that—one who told my wife that she'd never use her hand again and another who said she'd never bend her ankle again...
...David Asman is an anchor at the Fox News Channel and host of Forbes on Fox...
...We thus havehad a chance to sample the health diet available under two very different systems of health care...
...In the case of these EMTs, I kick myself for not having noticed their names to later thank them, for almost as soon as they dropped us off at the emergency room of the University College of London Hospital (UCL), they disappeared...
...my wife was officially admitted to a British public hospital...
...We spent almost a full month in a British public hospital...
...You'd have better luck breaking out of prison...
...ered that treatment exists for thwarting the effects of blood clots in the brain if administered shortly after a stroke...
...The Neurologist on call that night looked at the same MRI where the emergency doctors saw nothing and immediately saw that my wife had suffered a severe stroke...
...And perhaps most important, it included the loving care of the finest nurses we'd encountered anywhere...
...I didn't know that...
...Forms, permission slips, and guards at the gate all conspire to keep you in bounds...
...Since there's no real money to be made in the system, those who get into public medicine do so as a pure vocation...
...But their professionalism in immediately stabilizing my wife and taking her vitals was matched with exceptional kindness...
...And even after having given her an MRI, the doctors could not tell if she had a stroke...
...Marcello did the best that he could...
...Such treatment was never mentioned, even after we were admitted to the Neurology hospital...
...It also helped restore a bit of fun in our relationship, which too often slips away when you just see your loved one in a hospital setting...
...But British health care is not "free...
...Based on my Latin American scale, Queen's Square would rate somewhere in the middle...
...The emergency workers who came within five minutes were wonderful, The two young East Enders looked and sounded for all the world like a couple of skinhead soccer fans, cockney accents and all...
...As we were feasting on our fancy new digs, Dr...
...I didn't know what Izzy meant, but I wrote down the initials and later found out that a PFO (a Patent Foramen Ovale) is a flap-like opening in the heart through which we get our oxygen in utero...
...As far as we could tell in our month at Queen's Square, the only method of keeping the floors clean was an industrious worker from the Philippines named Marcello, equipped with a mop and pail...
...Despite her protestations that everything was fine, her left side was paralyzed and her eyes were rolling around unfocused...
...Sometimes it's a bit over the top, such as when the physical or occupational therapists compliment any tiny achievement with a "Brilliant...
...Free health care" is a mantra that one hears all the time from advocates of the British system...
...On occasion my wife and I would giggle at heart and blood pressure monitors that were liter-ally taped together and would come apart as they were being moved into place...
...Uninsured Americans are not left on the street to die...
...But there's only so much a single worker can do with a mop and pail against a ward full of germ-laden filth...
...In fact, they passed right over my wife's insistence that prayer played a part in what they had to admit was a miraculously quick return of movement to her left side...
...In fact, once a week at Queen's Square, all the hospital's health workers—from high to low—would assemble for an open forum on each patient in the ward...
...As for the quality of British health care, advocates of socialized medicine point out that while the British system may not be as rich as U.S...
...Not to say that they bring religion into the ward...
...It's not hard to see why...
...It certainly wasn't as bad as public hospitals in, say, El Salvador, where patients often share beds...
...Now, the smartest thing I did before we left the hotel was to delay the ambulance driver long enough to run back to my room and grab my wife's cell phone...
...Then there was the condition of Queen's Square compared to the physical plant of the New York hospitals...
...Of course, U.S...
...The cardiologist responsible for the procedure, Dr...
...Can one really put a price on that...
...I pitched in as best as I could with simple things, like fixing the wiring for the one TV in the ward...
...Isadore Rosenfeld, who I'm lucky enough to have as my GP...
...The acute brain injury ward to which my wife was assigned the next day consisted of four sections, each having six beds...
...They were shining...
...And with salaries tending to be about 20 percent lower in England than they are here, the purchasing power of Brits must be close to what we would define as the poverty level...
...Both of these therapists were wrong, but they succeeded in depressing my wife's spirits and delaying her recovery for a considerable period...
...But to put this in context, the cost of just ten physical therapy sessions at New York's Cornell University Hospital came to $27,000—greater than the entire bill from British Health Service...
...That's when I started dialing furiously again, tracking down contacts and calling in chits with any influential con4 D. THERE'S NO PLACE LIKE HOME tact around the world for whom I'd ever done a favor...
...But in Britain, hospital-borne infections are getting out of control...
...THAT FIRST NIGHT (or what was left of it) my wife was sent off to intensive care, and the nurses convinced me that I should get a few hours sleep...
...But on our return, one of the ever-accommodating nurses had found us a single room in the back of the ward where they usually throw rowdy patients...
...I decided to take a nap, but my wife wanted to get in a workout in the hotel's gym before theater...
...But it wasn't as nice as some of the hospitals I've seen in Buenos Aires or southern Brazil...
...The enormous costs of socialized medicine explain at least some of this disparity in the standard of living...
...We also arranged for a complex medical procedure to be done in one of the few remaining private hospitals in Britain...
...We'd take off in a wheelchair for two-hour lunches in the lovely little park outside, and three-hour dinners at a nice Japanese restaurant located at a hotel down the street...
...We were giddy with the prospect of not constantly engaging in germ warfare...
...At least 100,000 British patients a year are hit by hospital-acquired infections, including the penicillin-resistant "super bug" MRSA...
...As I was to discover time and again in the British health system, despite the often deplorable conditions of a bankrupt infrastructure, British caregivers—whether nurses, doctors, or ambulance drivers—are extraordinarily kind and hard working...
...And they show it...
...As it happened, the best such hospital in England, Queen's Square Hospital for Neurology, was a short distance away, but they had no beds available...
...With that phone I began making about a thousanddollars worth of trans-Atlantic calls, the first of which was to the world-renowned cardiologist Dr...
...She was making sense, but her words were slurred...
...Only one, we both thought to ask: Is this a dream...
...Infections in hospitals are, of course, a problem everywhere...
...But I did know that I was not about to admit my wife to a hospital that could not diagnose an obviously life-threatening affliction...
...I can only guess that Britain's practice of forcing losers in civil cases to pay for court costs has lessened the number of lawsuits, and thus the paranoia about lawsuits from which medical services in the States suffer...
...doctors tend to be pill pushers, but that's a different discussion...
...The bill included all doctors' costs, two MRI scans, more than a dozen physical therapy sessions, numerous blood and pathology tests, and of course room and board in the hospital for a month...
...The loving attention of these nurses was touching...
...Also, British nurses have far more direct managerial control over how the hospital wards are run...
...Seamus Cullen, worked in both the public system For the last five days, my wife and I prayed for well-behaved patients...
...Now, treating stroke victims is tricky business...
...Something is clearly wrong with medical pricing over here...
...He informed us that the waiting line to perform the procedure in a public hospital would take days if not weeks, but we could have the procedure done in a private hospital almost immediately...
...He actually paused to ask us whether we understood him completely and had any questions...
...Folks like to blame an overvalued pound (or undervalued dollar...
...Before she could travel back home, my wife needMAY 2005 THE AMERICAN SPECTATOR 31 THERE'S NO PLACE LIKE HOME ed to have the weak wall in her heart fortified with a metal clamp...
...The equipment wasn't ancient, but it was often quite old...
...it's only when one is officially admitted to a hospital that a foreigner begins to pay...
...S I SAW MY WIFE COLLAPSED on the hotel's gym floor, my concern about making the curtain was eplaced by a bone-chilling recognition that my wife was in mortal danger...
...hospitals is immediately apparent to all the senses...
...Since we'd already been separated from our 12-year-old daughter for almost a month, we opted to have the procedure done (with enormous assistance from my employer) at a private hospital...
...and as a private clinician...
...And I'd make frequent trips to the local pharmacies 30 THE AMERICAN SPECTATOR MAY 2005to buy extra tissues and cleaning wipes, which were always in short supply...
...Better yet the window actually opened, which was also a blessing since the smells wafting through the ward were often overwhelming...
...Ten therapy sessions aren't worth $27,000, no matter how shiny the floors are...
...There is also much less of a tendency in British medicine to make decisions on the basis of whether one will be sued for that decision...
...For the last five days, my wife and I prayed for well-behaved patients, and we managed to last out our days at Queen's Square basking in a private room...
...We spent the day sightseeing and were planning to go to the theater...
...For most of us, the opening closes shortly after birth...
...A far larger part of those extra costs come in the hidden VAT taxes—which can add up to 40 percent when you combine costs to consumers and producers...
...I also got my employer News Corp involved, and a team of extremely helpful folks I'd never met worked overtime helping me out...
...As we discovered later, emergency care is free for every-one in Britain...
...Suddenly we were in the hands of British Health Service, and after a battery of tests we were being pressured into officially admitting my wife to UCL...
...We had arrived in London the night before for a two-week vacation...
...To which I would respond that my wife's one roommate at Cornell University Hospital in New York was an uninsured homeless woman, who shared the same spectacular view of the East River and was receiving about the same quality of health care as my wife...
...But in as many as 30 percent of us, the flap doesn't seal tight and that can allow a blood clot to travel through the heart up to the brain...
...heath care, no patient is turned away...
...But that only explains about 30 percent of the extra cost...
...The heart procedure done in the private clinic in London cost about $20,000...
...In typical British understatement, this was the first word I received of my wife's stroke...
...A new study carried out by the British Health Protection Agency says that MRSA plays a part in the deaths of up to 32,000 patients every year...
...or "Fantastic...
...This includes both diagnostic equipment as well as state-of-the-art equipment used for physical therapy...
...There's no reason for her to have a stroke except if it's a PFO...
...And compared to virtually any hospital ward in the U.S., Queen's Square would fall short by a mile...
...But even at lower numbers, Britain has the worst MRSA infection rates in Europe...
...The nurses and hospital technicians had become expert at jerry-rigging temporary fixes for a lot of the damaged equipment...
...J AVING PRAISED THE CAREGIVERS, I'm forced to return to the inefficiencies of a health system devoid of incentives...
...What follows is a sampling of those tradeoffs as we viewed them firsthand...
...When my wife and I walked into Cornell University Hospital in New York after a month in England, the first thing we noticed was the floors...
...Her workout on the "Stairmaster" pumped the clot right through a too-porous wall in the heart on a direct path to the right side of her brain...
...When I covered Latin America for the Wall Street Journal, I'd visit hospitals, prisons, and schools as barometers of public services in the country...
...Checking into the private hospital was like going from a rickety, Third World hovel into a five-star hotel...
...One can tell that the edge has disappeared in treatment in Britain...
...That way each level knows what the other level is up to, something glaringly absent from U.S...
...or "Fantastic...
...There was clean carpeting, more than enough help, a private room (and a private bath...
...Neither system is without its faults and advantages...
...hospital management...
...Anything happens on the outside and folks naturally sue the hospital for not doing their job as the patient's nanny...
...Over her continuing protests, I knew we had to get her to a hospital right away...
...Cullen came by, took my wife's hand, and quietly told us in detail about the procedure...
...For example, as soon as my wife was ambulatory, I was determined D A V D A S M A N to get her out of the hospital as much as possible...
...My wife had a low hemoglobin count, so with all the medications in the world, she still may have been better off with just aspirin...
...To paraphrase Thomas Sowell, there are no solutions to mod-ern health care problems, only tradeoffs...
...Right away I suspected a stroke, even though she is a young, healthy non-smoker...
...Little did either of us know that a tiny blood clot had developed in her leg on the flight to London and was quietly working its way up to her heart...
...The procedure is minimally invasive (in which a catheter is passed up to the heart from a small incision made in the groin), but it requires enormous skill...
...There is something seriously out of whack about ten therapy sessions that cost more than a month's worth of hospital bills in England...
...Instead, our lives were about to change fundamentally and we were both about to experience firsthand the inner workings of British health care...
...Only a constant cleaning by me kept our little corner of the ward relatively germ-free...
...Why are the Brits so less concerned about being sued...
...It was awful news, but I realized we were finally in the right place...
...Since a stroke is all about the brain, I wanted to clear her head of as much sickness as I could...
...That ain't chump change...
...But better that than taking a chance of planting a negative suggestion that can grow quickly and dampen spirits for a long time...
...32 THE AMERICAN SPECTATOR MAY 2005The total cost: $25,752...
...Now try leaving a hospital as an in-patient in the States...
...British doctors, nurses, and physical therapists also seem to put much more stock in the spiritual side of healing...
...We did have one, brief encounter with a more comprehensive type of British medical treatment—a day trip to one of the few remaining private hospitals in London...
...In fact, we did try and were frustrated at every step...
...BUT WHAT OF THE BOTTOM LINE...
...Whether it was dumb luck or some unseen connection, we ended up with a bed next to a window, through which we could catch a glimpse of the sky...
...Suddenly, a bed was found in Queen's Square, and by 2 a.m...
...I mentioned the cost of living in London, which is twice as high for almost any good or service as prices in Manhattan...
...Put simply, they invest a lot of effort at keeping one's spirits up...
...We found a supply closet, in which there was a small examination table, and the nurses helped me fashion fake pillows and blankets from old supplies...
...When I received the bill for my wife's one-month stay at Queen's Square, I thought there was a mistake...
...The exception would appear to be the few remaining private clinics in Britain...
...There is much better teamwork among doctors, nurses, and physical therapists in Britain...
...This may somewhat compensate for their meager wages—which averaged about 20,000 pounds a year (in a city where almost everything costs twice as much as it does in Manhattan...
...I swear those long, leisurely dinners, after which we'd sit in the lobby where I'd smoke a cigar and we'd talk for another hour or so actually helped in my wife's recovery...
...It wasn't long before the dream was over and we were back at Queen's Square...
...They were not only clean...
...But consultations with doctors never brought up the possibilities of alternative drug therapies...
...My wife then spent about three weeks recuperating in a New York City hospital as an in-patient and has since used another NYC hospital for physical therapy as an outpatient...
...It was clear that what prevented us from getting out was the pressing fear on everyone's part of getting sued...
...As it turned out, not only did Izzy diagnose the problem correctly, he even suggested a cause for the stroke, which later turned out to be correct...
...This can lead to a much healthier period of recuperation...
...in which to recover from the procedure, even a choice of wines offered with a wide variety of entrees...
...Indeed, the only medication my wife was given for a severe stroke was a daily dose of aspirin...
...Your wife appears to be having a small problem...
...Still, while costs in U.S...
...I was moved to tears to see how comforting they were both to my wife and to me...
...It made both of us feel, well, normal...
...In fact, cleaning was my main occupation for the month we were at Queen's Square...
...Izzy agreed that I should not admit my wife to UCL but hold out for a hospital that specialized in neurology...
...hospitals may well have become exorbitant because of too few incentives to keep costs down, the British system has simply lost sight of costs and incentives altogether...
...For the life of me, I can't understand how they could have been so insensitive, unless this again was anattempt to forestall a lawsuit...
...But Cornell and New York University hospitals (both of which my wife has been using since we returned to the States) have ready access to technical equipment that is either hard to find or nonexistent in Britain...
...Sometimes it's a bit over the top, such as when the therapists compliment any tiny achievement with a "Brilliant...
...Hurrying down to the gym, I suspected that what-ever the "small" problem was, we might still have time to make the play...
...But the conditions of the hospital were rather shockingly apparent even then...
...For example, when we returned to the States we discovThey invest a lot of effort at keeping one's spirits up...
...S FOR THE CALIBER OF MEDICINE practiced at Queen's Square, we were quite impressed at he collegiality of the doctors and the tendency to make medical judgments based on group consultations...
...As I mentioned, the cleanliness of U.S...
...I never claimed you would walk again...
Vol. 38 • May 2005 • No. 4
