A tale of 2 sickbeds: Health care in U.K. vs. U.S.
By Brinley Bruton
September 2008

A journalist's treatment for same condition in two countries is worlds apart

LONDON - A few weeks ago I found myself curled up in a hospital here in London, my feverish body shaking violently back and forth. The pain in my side and back made it hard to straighten my torso, and I’d thrown up in a friend’s car on the way to the hospital.

The hospital couldn’t find an extra hospital bed, so I spent my first night hooked up to an IV on a gurney in the middle of a row of men and women, my sweaty skin sticking to the plastic. A shriveled woman in the bed to my right issued loud and largely unintelligible commands to nobody in particular. A steady flow of patients visited the bathroom right in front of my bed. A shouting match broke out between some of the nurses and nurses aides until a man at the other end of the room yelled, “Could you please take it outside? I’m trying to rest.”

Sometime in the midst of this I was diagnosed with pyelonephritis, a severe urinary tract infection that had spread to a kidney, and ended up in the hospital for three nights. I had already been on two courses of antibiotics, but that hadn’t cleared up the initial infection. Finding myself sick and alone thousands of miles away from my mom was bad enough, but scarier still was just how familiar the illness felt.

I’d been sick with the same thing almost 10 years ago when I was in my 20s and still living in the United States, where I’m from. In both cases, my side and back hurt and fever shot up. And each time, I recovered after serious doses of antibiotics and lots of bed rest. But apart from that, my experiences were a world apart.

The biggest difference: Money. Getting sick in New York City decimated my bank account. In London, I didn’t pay a penny. I should note, however, that a full 9 percent of my gross pay goes towards the equivalent of a health tax. (For comparison’s sake, according to the Commonwealth Fund, in 2007 about half of working-age Americans spent 5 percent or more of their income on out-of-pocket medical costs and premiums.)

And while I recovered fully in both cases, the care I received felt quite different. In New York, I never feared that I would be overlooked. At my doctor’s office in upscale Gramercy Park, he and his nurses took their time seeing me, and were always at pains to reassure me. On my first visit, the receptionist let me sit in an empty consulting room so that I wouldn’t have to weep in the waiting room. She checked in on me and brought me water.

But unlike the personal care I received in the U.S., in London, I felt like I was on a vast and often creaking conveyor belt, and there was a big risk of falling through the cracks. British care is socialized - and feels that way.

Affordable, but at what cost?
Amid the fever and pain, and the crushing boredom of my London hospital beds (I spent each of my three nights in different wards of the huge Royal Free Hospital), I couldn’t help but compare my two experiences and think about the presidential campaign happening back home and the growing impetus for health care reform in the United States.

Would the elderly woman in my ward in London who repeatedly pleaded “Can someone help me please?” after being left on her dirty bedpan for almost an hour, recommend a version of the National Health Service to Americans? What would British patients who are denied certain drugs because of funding constraints or because they’re deemed too experimental say about it?

And how about Professor Paul Goddard, one of the England’s senior doctors, who said recently that thousands of hospital patients are “starving” because over-burdened nurses don’t have time to feed them?

I saw what he was talking about. In the third ward, I spent a day next to an ancient-looking woman who refused to touch her food. A few times the harried nurse tried unsuccessfully to get her to eat. Mostly my neighbor sat with her eyes closed, her chin resting on her chest.

Being mouthy and mobile, I felt confident that I could cajole the hospital workers into paying attention to me. As it turned out, I had to be very, very patient. Nurses paced the corridors all the time and we could call them from our beds, but doctors were a bit harder to come by - unless there was a real emergency everyone had to wait their turn. And about twice a day a pack of lean and well-dressed physicians clutching clipboards would lope into the ward, pull the flimsy green curtains around our beds and ask us to share intimate information within earshot of the other patients. Being shameless and forthright, I got along OK - I pressed the doctors for answers and they sent me for a battery of tests to make sure that there wasn’t anything else wrong with me.

But I wasn’t so confident for some of my companions. One of my three roommates in the second ward was a woman who said she had a dislodged stent in her chest and was waiting for urgent heart surgery. She gasped for breath when hobbling across the room to the bathroom, and rarely spoke to the doctors except to say “thank you.” She confessed to me through tears that she had tried to kill herself a few weeks earlier. At one point the nurses left her in a corner in a wheelchair for about two hours as they looked for a bed for her on the cardiac ward.

Going broke to pay for clean bill of health
Complaints about health care straddle both sides of the Atlantic, of course.
With both Republican John McCain and Democrat Barack Obama devoting time to the issue of reform, politicians in the United States are responding to the feeling that something fundamental has to change when it comes to taking care of Americans’ health.

That’s because “the system is breaking down,” says Jacob Hacker, a professor of political science at the University of California, Berkeley, whose work on health care reform influenced Obama and his former rival in the Democratic primary, Hillary Clinton.

“We have people who are facing financial ruin even if they have medical insurance,” says Hacker, the author of "The Great Risk Shift: The Assault on American Jobs, Families, Health Care and Retirement - And How You Can Fight Back.”