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News and Opinions about MS, Health & Disability

Health: Debate over best system will continue

There is no doubt that I prefer social healthcare. That means I support healthcare funded by countries, such as the UK and Spain, rather than needing to buy private health insurance, as in the US.

Now, that is not to say either healthcare system provides superior medical care. It is purely about the costs.

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An American protester calls for the country to have one health plan.

Neither system is entirely free as workers pay something from their salary or wages as contributions toward the cost. But there are other big differences. Social medicine is free at the point of use, with no charges for doctors’ treatment or hospital care. The same cannot be said of private health care, where even GPs charge fees and you need health insurance. In fact, in the US, not having health cover has legal penalties.

Despite that, many people find the cost of insurance to be prohibitive.

I find it strange, and more than a little ironic, that insurance costs got worse after the US passed the Affordable Care Act, otherwise known as Obamacare. How can ‘affordable’ equal more expensive? Some monthly premiums escalated from less than $60 a month to more than $300. And others cost a lot more.

Let me be clear, I am not saying the American system is flawed. It is just not for me.

Prescription costs a question of health

One item of contention in the UK is the cost of prescriptions. First, you must recognise that the UK IS made up of four healthcountries. A trip to the pharmacist in England will cost you £8.60 per prescription drug or item.  But prescriptions in Scotland, Wales, and Northern Ireland are all free.

Since Lisa and I moved to Spain almost two years ago, we have been surprised by the low prescription charges here. Yes, we do pay – but just cents, certainly not excessive.

The standard of care here is excellent but, as anywhere, it can vary from doctor to doctor. We recently chose to change our doctor to another within the same health centre. It was so simple.

Last week, I had my first appointment with our new doctor. He listened to what I had to say, prescribed a couple of medications, and, as I have MS, he referred me to see a neurologist. Stopping at reception on the way out, I left with a confirmed appointment with a neurologist. It will be my first in 12 years.

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50shadesofsun.com is the personal website of Ian Franks, a freelance medical writer and editor for various health information sites. He enjoyed a successful career as a journalist, from reporter to editor in the print media. He gained a Journalist of the Year award in his native UK. Ian received a diagnosis of MS in 2002 and now lives in the south of Spain. He uses a wheelchair and advocates on mobility and accessibility issues.

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MS Patients in US and UK Face Very Different Treatment

healthcare costs

We may have international cooperation and worldwide this and that, but the fact remains that countries vary drastically from one another in all sorts of ways. Take healthcare as an example, and the costs of treatment.

Yes, we have the World Health Organization and there are various health-related initiatives from the United Nations, but that is about it on the international front.

Let’s have a brief look at healthcare provisions, including how they affect people with multiple sclerosis, in two Western countries said to be close allies and who enjoy what they term a “special relationship.” That’s the United States of America and the United Kingdom.

I was born, and lived my entire life until last year, in the U.K., which is supposedly a welfare state. I say “supposedly” because, at the rate at which David Cameron’s government was cutting the welfare budget, there can be no certainty this will continue.

Anyway, a key element of the founding of the welfare state, just after the Second World War, was the setting up of the National Health Service, which includes all GPs, hospitals, and ambulance services. It is a healthcare service that took good care of me when I lived there.

And everyone living in the U.K. is entitled to the treatment they need absolutely free of charge. Yes, you did read that right. The British do not need private medical insurance, have no co-pay to worry about. If they fall ill they just visit their family doctor, or go to a hospital if their condition’s more serious, where they know all tests, treatments and stay, if admitted, will not cost one penny.

World’s apart

The only expense they may incur is the small cost of prescriptions, and only in England. Charges for these, all of which go to the government, vary by country. Residents of England face a prescription charge of £8.40 (about $11.15) for each medicine or appliance dispensed. In each of the other constituent countries in the U.K., namely, Wales, Scotland and Northern Ireland, all prescriptions are free. There are, however, charges for NHS dental and optician services.

It’s a far different story in the U.S., however. If you live outside that country, as I do, then let me assure you that what became known as Obamacare is far from NHS-style service. It still requires that hefty medical costs be paid.

Americans go to see their GP – they get a bill; they go to a hospital as an outpatient — they get a bill; they see a specialist – they get a bill; they are admitted to a hospital – they get a bill; they have an operation – they get a bill; they are taken to a hospital by ambulance – they get a bill.

The costs go on and on, and can really add up. Then there are prescription costs, which can be tremendous. A study published in May 2013 in the Journal of Medical Economics found that the total cost of healthcare for MS patients in the U.S. ranged from about $8,500 to more than $54,000 per year during the period studied (1999 to 2008), with prescription drugs accounting for a large percentage of those costs.

OK, medical insurance policies may cover most of these costs, but not all. Most policies in the U.S. come with co-pays, sometimes substantial ones. The precise level of a co-pay, or the portion of total health costs carried by patients, depends on the specific insurance policy. And then, again, patients still have to pay for their insurance, except for those whose employer pays or who qualify for help.

Clearly, even among special friends, we’re often worlds apart. And I, at least, find that sad.

 

This article, written by me, firs t appeared on Multiple Sclerosis News Today website.

 

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Ian Franks

Ian Franks is Chief Patient Columnist with MultipleSclerosisNewsToday.com. He has enjoyed a successful career as a journalist, from reporter to editor, in the print media; during which he gained a Journalist of the Year award in his native UK. He was diagnosed with MS in 2002 but continued working until mobility problems forced him to retire early in late 2006. He now lives in the south of Spain and uses his skills to write his own flourishing specialist Health & Disability blog at www.50shadesofsun.com. Besides MS, Ian is also able to write about both epilepsy and cardiovascular matters from a patient’s perspective and is a keen advocate on mobility and accessibility issues.

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MS seems affected by sun; great prescription service

Poached eggs on the way.   Poached eggs on the way.

It was good to get back behind the wheel this morning and drive for the very first time since the automatic gearbox decided enough was enough on Christmas Eve.

It was an early start too. Well, early for me as we needed to be in our nearest town where Lisa had a 9am appointment at the medical centre. Even when we lived in Wales, I was a night owl and not an early riser and there was no need to change habits when we got here. Today was different.

Actually, talking of the appointment, it was just for Lisa to get her repeat prescriptions. Back in the UK, this had to be arranged a month at a time but, here, she came back to the car with a prescription for six months’ supply of her medications. Now, that is service.

The appointment this morning was also quite an achievement for Lisa as she went through it all speaking only Spanish and understanding the doctor’s replies. That’s something I could not do yet but I am working on that.

After leaving there, we returned home and I have to say that the car was an absolute pleasure to drive; I only hope that continues. Arriving home, my beloved headed straight for the kitchen where she prepared breakfast, as we only had a cup of tea before our trip to the medical centre. In fact, breakfast marked Lisa’s second ‘first’ of the day. It was the very first time in her life that she had cooked poached eggs. For a first attempt they turned out brilliantly but the cook wasn’t happy with her own work and says she is determined to do better next time. All I can say is, ‘yes please’ and ‘the sooner the better’; you might guess that I love poached eggs.

Having now lived in Spain for more than two months, during which we have enjoyed the autumn and early winter sunshine, I can say that living in the sun seems to be having a beneficial effect on the multiple sclerosis that affects me.

Sunshine is not a cure for MS but it does have two effects. First of all it helps your body create more vitamin D and, secondly, sunny days generally lift your spirits. Bearing these facts in mind, I feel that I am maintaining my balance better and am certainly falling less frequently. In fact, thinking about it, I have not had a real fall for weeks and even the number of times when my knee has given way has reduced significantly.

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Coffee and orange trees in town centre

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This morning, December 30, Lisa and I went into Cuevas del Almanzora, the nearest town to us, to visit our doctor to obtain the first of our Spanish ‘repeat prescriptions’ since we arrived here.

These are to treat various conditions caused by my Multiple Sclerosis, irregular heartbeat and epilepsy as well as Lisa’s asthma and high cholesterol – and we will shortly be running out of the medications we brought with us from the UK.

So, having previously obtained brief medical reports from our doctor in Colwyn Bay and having had them translated into Spanish, today we could give them to our new doctor.

orange trees2 editedOur doctor works in the town’s health centre and, today, he was not there so we were seen by one of his colleagues who sorted everything out for us; we left with prescriptions for medications to last for two months.

After leaving the surgery, we decided to enjoy a coffee at a nearby café and to drink it outside in the sunshine. As we sat there, I noticed for the first time that the greenery that lines the street is totally made up of orange trees and palm trees.

Truly delightful.

 

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