0:01 Today's video, UK versus US healthc care, my experience. We are Lisa and Greg, an American couple living abroad in Spain. If you are curious about the crazy, funny, and surprising differences between the US and Europe, you came to the right place. We are on the way to 10,000 subscribers. So, go ahead and hit the subscribe button so you can be one of the few that's coming along with us for the ride. All right. This is She's Diabetic and we Lisa, that's the channel's called that. Yeah, it's called. Okay. I was like, why are you saying that part? Lisa will include a link in the description so you can go and show her some love and we'll see about we can get her up to 40,000 subscribers. Yeah. All right. Yeah. And then um I know the UK uh healthcare system is called NHS. I have no idea
0:48 what that stands for. Oh, okay. But um I I didn't know. All I know it's better than in the United States. All right. What I know, that's what you know. All right, let's see what we got. Some of you may know I spent most of my adult life in the UK. So, some of you may know I spent most of my adult life in the UK and I'm a British citizen. So, I uh really only had experience with the NHS in terms of my adult interaction with taking care of my health. And a lot of you guys have asked, what has it been like that transition? And um well hard. First of all, the big difference uh you come to the end of your appointment or your blood test or even before these items and it's money please.
1:34 Right? Better have some money. And that may sound obvious, but it is so much more pervasive than just the act of handing over a credit card or paying your insurance bill every month. you feel like the health care here is a class system and I think that's simply she must be in America. I know. I'm trying to figure out I was literally just trying to figure out where she think she's saying is Yeah. Yeah. Because she's saying it's a class system. So, okay. Which I totally agree. I used to sell Medicare, which is health insurance to people that are over uh 65 and older. And I talk to people all the time. They they when I was picking a doctor for them, they were like, "No, I
2:20 can't go to that doctor because I owe that doctor money." Oh. And so so they would like they wouldn't know who to go to. They wouldn't go to a doctor. It was just a mess cuz it was all and it wasn't a lot of money, but they don't have a lot of money, right? Yeah. Oh my goodness. Simply because it is like you go through these different insurance packages and like maybe they're like bronze, silver, gold, platinum. That's literally how you can filter them on the side of the screen. And I mean, yes, they're they're signifiers to denote how much coverage you're going to have or your I don't even know your deductible shenanigans. I can't even try to stay neutral on this subject. I think it's ridiculous. I know the NHS is not
3:06 perfect and I know the UK and the NHS in general have been in and continue to be in a lot of trouble. So, I'm not just sitting here being I wonder I mean we I wonder if the NHS is like the National Health System or something. Oh, that sounds like a good possible name. Like they got it all figured out and we're screwed up here. No, that's not what I'm saying. But in terms of a care for your people, all I can say is in the UK, I felt universally cared for. And here I feel like if I have the funds to pay for care, then I'm allowed to be healthy. So easily number one, the most confusing thing has been navigating what insurance to get. Luckily through my job, I'm self-employed, but I get insurance
3:51 through my job. Sort of. It is pretty much you get this package and that's that. So I didn't really have to choose so intricately. Number two, we have even with your company um we got to choose and we chose the one with a higher deductible because it was less expensive. Right. And I, you know, we've had bouts of our in our lives where we were self-employed and I know exactly what she's talking about because we would have to go through like einsurance.com or something and they would have tiers of all so many unbelievably uh tons of choices to to choose from with with a to find an insurance
4:37 company. And it was always bronze, gold, platinum, and all these things. And it the variations of deductibles and the variations of so many things. It was overwhelming. Yeah. By the way, you I know we've said this before, but I'll say it every single time we talk about healthcare. We like you said, we had a $5,000 deductible, but we were still paying $1,000 a month. And usually the higher deductible you have, the less amount you pay per month. So without that deductible, I don't know if we would had $1,000 deductible, probably been like $2,500 a month or something. Yeah. I don't remember what it was. It's crazy. And I still had to pay 20 something thousand dollars for a procedure that the doctor made it sound like if I don't have it, I run the risk of dying. Yeah. Heart heart stuff. Yeah. So, has been finding the right doctors.
5:25 That was number two she's talking about right now. Oh, okay. I was like, wait, what? Yeah. Hold on. Uh, I'll go back cuz other people might be confused. So, I didn't really have to choose so intricately. Number two has been finding the right doctors. Your choice in doctors. In the UK, your GP pretty much does everything. They see kids, they see adults, they see asthmatics, they see people with GP, not general practitioner, mental health conditions. That doctor has the power to treat all of those things. to prescribe you anti-depressants, to prescribe you an inhaler, to treat a baby and an elderly person, and this is all I ever knew. So, I had an endocrinology team and I had my GP. That was pretty much
6:11 it. Every year, I'd go for an eye exam where they'd screen my eyes and take scans of my retinas and all that stuff to make sure there wasn't any degradation in my eyes due to diabetes. But that was pretty much it. here. I have spent so much time registering with different doctors. So much so to the point where I finally registered with the the GP or your primary care physician as they call it here and I I was like, "Okay, great. Uh I'm diabetic, so I need a my insulin prescription." And she just said, "Oh, no, no, no. Like, I don't prescribe insulin." Absolutely not. You have to go
6:56 to your endocrinologist for that. Yeah. So, I did have an appointment with my endocrinologist, but because he was, you know, a good endocrinologist that had a waiting list, I couldn't see him for like 3 months. Oh, wow. Oh my god. I was like, "What do I do?" And I was also so shocked that the primary care couldn't prescribe insulin. It was totally totally categorically unwilling. So, that has been a big shock to me. And it's a little bit of a disaster, too, because what happened with me is I went to uh I guess he was a cardiologist. Yeah. And he prescribed me something that took me off of the uh medication that I was on before from your primary
7:44 care doctor, right? And because my primary care doctor sent me here because this was such an urgent matter and I was like, "Okay." And so we end up just keeping that medicine until we came here to Spain and realized you didn't need that medicine and shouldn't have been taking that medicine, right? And yeah, but we didn't want to go back and spend more money to find out what we should do and and that maybe you need to re-evaluate your insurance. We just said at that point, we just said, "Let's just get to Spain." Yeah. Have have those doctors help you because we were sick of having to go to different doctors. And she's right. I when the boys were our boys were young, um our oldest kept breaking things. He would do parkour and he would do all these crazy things and
8:29 it was you couldn't just see it took forever. Yeah. And I remember back then it was hard for me to get off work and but I had to keep going to different doctors uh because each doctor did something different and it's just a waste of time and Yeah. Uh it's just a way to probably generate more money and Yeah. And now here our son of course like we we thought he broke his ankle but he just really sprained again. Yeah he was skating within I don't know hour and a half two hours he went in we he he saw the doctor we had x-rays went then didn't saw the doctor they put a cast on it did like everything and didn't cost us anything except what we're paying for our insurance which is a nominal amount like 200 and something dollars for four people for four people here in Spain.
9:15 So, you know, we have to get private insurance because I don't know. We just Well, we still have access to you and I have access to the public insurance because I'm paying taxes. Yeah. Yeah. Zoom to me in that in order to get the treatment that I need, I have to go to all these different doctors. And every doctor has somewhat of a different system. So, you know, you go in, you fill out the paperwork, you go through all the initial questions, and then they want their own blood work, which all costs money, money, money. And yeah, at the end of all these appointments, money, please. You got to Yeah. Because you can't just go to a specialist, they
10:01 call those what she's talking about. In order to see a specialist, depending on the type of insurance you have, you have to go to your primary care physician. Yeah. Yeah. And then your primary care physician has to be the one that agrees that you have XYZ wrong with you, right? And then they send you somewhere else. So then you got to go to that specialist and schedule an appointment which could take time and you finally got to get in there and next thing you know it's 2, three, four weeks later. That's just part of the system. And hopefully you don't have to go to multiple specialists because then you got to go. It's just that's another uh when you're self-employed you do have to decide between we call it HMO or a PO. It's a health maintenance organization or um uh I forgot it was called provider. Yeah. PI personal provider organization or something or Yeah. So
10:46 you that's another choice you have to make. The HMO is cheaper but that with the HMO is what Greg was saying. You have to go to your primary care doctor and they have to refer you even though you know you have a heart issue or whatever it is but they have to refer you. So you have to waste that time to for them to otherwise the insurance won't pay it. Right. And but this is an example of what she's saying that she believes that the type of health care you get depends on your wealth, right? Because a PO is more expensive as a personal provider organization, I think it's called, but that's more expensive. So the people with money get the better. Exactly. And that way they don't have to go and see their primary care physician. They can go straight to their specialist. Exactly. So yeah, America is a lot of halves and halves not. Mhm. got have the money to pay for the insurance and then you got to have the money to
11:33 take time off work to go see these various different doctors because they're different places. The transport to get there or the transit time to get there is different. It just demands so much of a person and you have to be so organized and on top of it which I always thought like in the UK if you're your own advocate you can get the care you need and I still believe that. Mhm. But you would always be getting that through your general practitioner for the most part. Whereas in the US, I feel equally, if not more, the need to advocate for myself because you're choosing doctors from a directory of a thousand different options, which sounds
12:18 great, and there is a plus to that, but it's also incredibly complicated and confusing and time consuming to look up all the reviews and make sure you're choosing a doctor that is going to be good for you. The other thing I think is a very like dividing factor that I've seen is the amount of time you need to be able to devote. Yes. But also like savvy smart nature you need to have to know that for example I can go to this pharmacy and I can get a better rate there my insurance what's best with this pharmacy or sometimes I should use my insurance for this prescription but other times I should use like a coupon or a good RX that that is actually going to make that more cost effective. You need to be constantly on the alert and
13:04 bobbing and weaving through these different options to be that is 100% true. Yeah, that's how I got our prescriptions. I used I didn't use insurance because uh there's an app called Good RX that uh it was cheaper through Good RX, but sometimes it was through this I had to go through Walmart. Sometimes I had to go through this grocery store pharmacy. Sometimes it was better over here. And it is a lot of bobbing. She's exactly right. Yeah, it's a lot of bobbing and weaving. Mhm. Be savvy to make sure you are getting the best deal, which like I'll be honest with you, deal and healthcare. Yeah, it's great. These are just concepts that in my adult life have not been alive in
13:49 my mind. And I know I'm very very very very very very lucky to say that, but I feel like you need to be pretty darn educated and have the confidence to call places up and to use coupons that you might not be sure are going to work or advocate for yourself when you know it's right through the insurance, but the person providing isn't providing the same thing that you were told you were going to get. These are these are all things that the consumer here really needs to have if you're going to get the most bang for your buck, I guess. Which don't we all want that? That's just crazy. Yeah, we'd all like that. Yeah. I mean, I guess it's just the way it is. Like, you just
14:36 I guess I'm saying it's crazy. You even got to think of like how do I get the best bang for my buck? It just It just wouldn't be nice if if you got sick, you just got it taken care of. Yeah, it feels like that. We I'm so grateful and thankful that we don't have to experience that anymore. Right. Like I don't worry about it anymore. Right. Right. Yep. Especially when you're dealing with a chronic condition that you have many different medications that you have to keep renewing every single month. You want to make sure you're doing like the smartest thing possible. So, we relocated about a year ago and because of this being a whole new system to me, I am only just getting to grips with things and getting in place a structure
15:24 of how I'm going to get my medications every month. And I really don't mean to sound like I'm complaining or bashing the American health care system, but this is just what I've experienced and a genuine comparison to what I experienced on the NHS in the UK for the last 15 years. And I should say is an addendum to the it's free in the UK. The NHS is a taxed system. So I believe it is about 20% of the people's income tax goes toward the NHS. Don't quote me on it, but I believe that's a general gist. So you are paying for it in a certain sense. Absolutely. But it's in alignment in terms of the percentage to your own
16:11 personal income taxes. And a lot of people have a big problem about that because then the more wealthy are funding it more so than the less wealthy. And I hear that but from and that's exactly why it won't work in America, right? Because that's such a that's a problem. And yeah, there's so right now in that country, they're trying so hard to give more tax deductions. Yeah. To the wealthy. In fact, there was just a bill passed where it's going to be taking away a lot of Medicare, Medicare, Medicaid. Obviously, it depends on triggers and all these other things, but ultimately at the end of the day, some of the people who voted for the administrator administration that's in there now are going to be without health insurance. Yep. But the wealthy will get they'll
16:59 get tax breaks, so it'll be good. Yeah. More wealthy are funding it more so than the less wealthy. and I hear that. But from an ethical and moral perspective, I personally find that to be a more suitable way to care for a public. And if I'm paying more than people that are less fortunate financially, I'm really okay with that. But I understand that that can be a very divisive subject. And and I get it. But I'm so certain of where I stand on that front that I'm happy to say it. And if you want to come at me in the comments, that's fine. Moving to the US, and I always knew this, and it was a factor I had to get to grips with when we decided to move, and it's so much more complicated than I
17:44 could ever have understood, watching us bloggers and whatnot talk about it. Mhm. You can hear people talk about this, but it's not till you're really in the thick of it that like you realize just how complicated and overwhelming it is. This isn't meant to be a bash on the US system. The quality of care that I've found has been excellent. It's just the way the route to get to that care and what you need to have to have access to that care bothers me a lot and I'm lucky because I have the capability to do what I need to do and pay for what I need to pay to get access to what I need to not
18:31 only survive but like thrive and live a healthy life. So, I fully stand up and appreciate that as well. Like I say, always, I wish you great blood sugar, straight CGM lines if you can have access to a CGM. Uh, but most of all, I wish you a happy, healthy mind with it all. Thank you so much for watching and I will see you next time. Yeah, that mean that's really scary. I don't know. It sounds like she was living in the UK and decided they all decided probably as a family to move to the United States. Um, is that what it sounded like to That's what it sounds like. Um, yeah, that's tough. Especially when you have, it seems like they have the means to be okay in the United States. But if you don't have the means, then I feel like
19:18 I wouldn't go back. Yeah. Yeah. At all. I mean, even even if you have the means, it's just not fair. I mean, I don't I don't know, but yeah, I know what you're saying. But all right, let's see what the people got to say. 10% national insurance which contributes to the NHS 22% income tax comes from your salary in the UK. All right. My great aunt was one of the first test patients for insulin when it was manufactured with pigs in the UK. I earn about 70,000 euros no pounds. Earn about 70,000 a year and pay about 20,000 in national insurance and tax. I can't imagine a world where people are denied care for something like diabetes because of their ability to pay,
20:04 especially where the treatment is now so cheap to synthesize and 70 plus years old. I've been to the US a many something. Oh, no. All right. As a type 1 diabetic here on the UK, I do not have to pay for my prescriptions and therefore get my insulin pins and needles, etc. free of any charges each month. Something I'm incredibly grateful for. And in America, it used to be $35 a $35 cap on insulin and then the election happened and that cap changed. I know I was talking to people that were paying $35 and that's
20:52 mostly had to pay. Now they had to decide do they take one pill or two because they don't want to run out of medicine because they can't afford it. Mhm. People I mean you hear a lot of stories where they have to they take it every other day. Yeah. Mhm. Because they can't afford to take it every day. All right. Man, she did a really good job. That was a great video. She's diabetic. So again, we will definitely include a link for her. So, go ahead and go and show her some love. And as always, thank you for stopping by and we will see you on the next video. Peace. [Music]
