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.