Second Life: National Health Service (UK): (Photo credit: rosefirerising)
At the outset of this post, I want to share that seeing the word carcimoma on a pathology report is extremely unsettling. Even if it's more likely to be an adenoma and even if you know it would be curable anyway, the limbic system does its little freakout. Carcinoma is a big scary word--and fear is bad for your immune system. So after seeing that scary word, naturally you want to get your surgery as soon as possible--or that's how I felt.
Another pertinent point here is that I'm from the UK and so I view healthcare as a right, not as a privilege. I was in for a rude awakening. In the UK it's simple. You get the pathology report and your doctor refers you to a London teaching hospital for specialist surgery and you don't pay for anything.The beauty of universal coverage came home to me when I did my Accident and Emergency rotation at Barts Hospital. On several occasions, the police brought in an old tramp (hoboe) who was in a bad way. We would admit them to the wards, where they would be cared for by the finest doctors, nursed back to health and discharged to transitional housing. I was soon to find out that as an uninsured American citizen, I had fewer rights than an English tramp.
My friend Renu had given me a list of thyroid surgeons in Colorado--none in Boulder and a couple in Denver at University hospital. So began a tortuous process of trying to get seen by one of these surgeons on CICP (indigent care). We jumped through various hoops trying to get information. My sister-in-law even drove to university hospital to get find out the facts. But the situation remained confusing until I called GITES Center, the specialist surgery centre, myself. The answer was crystal clear. They would not accept me on CICP "unless it was life-threatening" as evaluated by their centre. I could not get a payment plan, nor any form of charity from the government-funded hospital. The surgery would cost tens of thousand of dollars and basically, " Show us the money and we'll do the surgery."
I was so astounded that I simply thanked the receptionist politely, by name, for providing the information, hung up the phone and had a meltdown. I felt oppressed, for I was being denied the right to care that had been mine for my earliest youth. The surgery was supposed to be done within three months of the biopsy and I had lost several weeks getting nowhere at all. So began my search in the medical tourism direction. That too was quite difficult; at lot of web searching and going down blind alleys. How could I check the thyroid surgery credentials of a doctor in India or Mexico? Would my emails even get a response? Often not. But my web searches revealed to me that medical costs for a private patient in the UK would be about 15% of the US costs.
The next red herring was provided by my beloved mother, who told me I could be treated free on the NHS (National Health Service). By visiting her GP's website, I learned that you have to be 'ordinarily resident' in the UK to be treated free. That means you have to prove that you will be living there for at least six months. If you can prove that, everything covered by the NHS is free from day one. However, with the 85% difference in costs, it made sense to be treated as a paying patient at one of the big London teaching hospital NHS trusts.
At this point I still don't have a surgery date, but on August 8th I'll be meeting with Mr Fausto Palazzo http://www.londonendocrinecentre.co.uk/fpbio.php at Imperial Centre for Endocrinology. He is one of the best thyroid surgeons in the UK if not in the world. The procedure will still be expensive but, of a different order of magnitude to US costs. I learned that our healthcare system here in the US is broken, that I have less healthcare rights than an English tramp, but also that every problem has a solution if you are determined and keep going.