Many Americans look across the pond with envy at the fact that the UK has universal healthcare, while viewing the US system as greedy and unforgiving.
But those who have actually moved to Britain and have first-hand experience of the National Health Service (NHS) paint a very different picture.
DailyMail.com spoke to American expats who felt “terrified” about missing out on major screenings due to abysmally long wait times.
Many revealed that they were surprised by the fact that “free” healthcare was not actually free and that they were surprised by the high taxes and additional fees that foreigners demanded.
However, others told DailyMail.com that it made them feel more financially secure and less anxious about seeking care.
It comes as the NHS faces dismal approval ratings from UK citizens, with less than a quarter of people saying they are satisfied with care.
The main complaint among Britons is waiting times, which have soared to record levels after the pandemic.
Andrea Jones, who lived in London for eight years, learned this firsthand.
The professional singer, 38, originally from California, injured her vocal cords and was told she would have to wait six months to receive physical therapy.
Without it he would not have been able to earn money, so he had to pay for private care out of his own pocket.
“I basically had to pay someone myself because I didn’t have time to wait,” he told DailyMail.com.
Physiotherapy is not the only service facing long waiting times.
It takes approximately four months to see a dentist.
And for elective surgeries such as knee or hip replacement, British patients can wait up to four months on average, and up to two years, while the average waiting time in the US is a few weeks.
Besides, recent NHS data showed that one in five patients waited up to six weeks after being referred for “urgent” scans to detect cancer.
Nicole, a mother of three who has lived in several different countries, said she had trouble getting a mammogram under UK screening guidelines, despite having a family history. She called the lack of preventive care “scary.”
Despite this, Ms Jones said that while each system has advantages and disadvantages, she misses knowing she could always be covered by the NHS.
“There was that security of knowing I could access care and pay for it,” she said.
A TikToker called Sean, who moved from the US to the UK in 2017, posted a TikTok in late 2022 saying that despite misconceptions from other Americans and Brits, the NHS is still expensive, especially for foreigners.
‘The NHS is not free. “It’s actually very expensive,” he stated. “When I say the NHS is expensive, it’s expensive for the quality of service it provides.”
Sean, who moved from the US to the UK in 2017, said NHS care “is expensive for the quality of service you get”, especially when additional fees are racked up for foreigners.
Total U.S. health care spending, which includes what the government, insurance companies and individuals pay, surpassed $4.3 trillion in 2021, nearly a fifth of the country’s annual GDP.
Sean, who moved from the US to the UK in 2017, said one of the biggest misconceptions among Americans is that the NHS is truly “free”.
He noted that most Americans don’t know that the NHS is paid for through taxes.
For example, someone earning £50,000 ($62,000) could be expected to pay between eight and 10 per cent (between £4,000 and £5,000 ($5,000 to $6,200), although the exact rate varies.
While in the United States, health insurance is not tax-based and is instead paid for by the individual, their employer, or a state program such as Medicaid.
‘The NHS is not free. “It’s actually very expensive,” Sean said in a 2022 TikTok video. “When I say the NHS is expensive, it’s expensive for the quality of service it provides.”
Additionally, the UK has a smaller range of prescription medications than the US, meaning patients sometimes get cheaper, less effective versions.
This is because the NHS negotiates prices with pharmaceutical companies and maintains a tighter budget, meaning fewer drugs are approved and made available to the public.
For example, Ms. Jones noted that while she was able to find a medication that worked for her ADHD, she would have had fewer options in the UK than in the US if her medication had needed to be changed.
However, expats also had several advantages over UK healthcare. Ms Jones, for her part, said the NHS allowed her the luxury of seeing specialists that American insurance would not otherwise be able to pay for out of pocket.
“I was excited to have health care that I essentially didn’t have to pay for,” she said. “I had a lot of things that I hadn’t taken care of properly that I was able to take care of when I got there.”
Mrs Jones estimates she had to pay an extra £1,000 ($1,200) as part of her visa, which was extended over two and a half years.
She noted that her primary care doctor in the United Kingdom was the first provider she saw who referred her for testing and surgery to diagnose endometriosis, a condition in which tissue similar to the lining of the uterus grows in other places near the abdomen and pelvis. .
This results in painful and heavy periods, as well as fertility problems.
“If I had to do that operation (in the United States) as a freelancer, I wouldn’t have been able to afford it,” she said. “In the US, I visited a specialist but was never offered the procedure to diagnose endometriosis.”
Nicole, a mother of three from the US, said she had several positive experiences with the healthcare system.
One example he gave was an ambulance ride so his son would be fully covered and give him peace of mind.
However, she was “terrified” by the lack of preventive screenings for diseases such as cancer.
“As a woman, for me, preventative healthcare is the most important thing, and in the UK you can’t have a breast exam until you’re between 50 and 53,” she said.
Nicole said she wanted to get a mammogram at age 42 because her grandmother died of breast cancer. However, despite having private insurance, she was not allowed to be tested.
“To me, the fact that there is little preventive care is really scary,” she said. “I’m grateful, but I’m just worried about the preventative care part of the NHS and why it’s so lacking.”
Breast cancer screening recommendations in the United States also generally begin at age 50, although last month the U.S. Preventive Services Task Force (USPSTF) suggested lowering that age to 40.
On average, cancer is diagnosed earlier in the US, with national figures suggesting 66 years in the US and 70 years in the UK.
Experts suggest this could be because people in the United States are screened for certain cancers at younger ages. For breast cancer, screening in the US begins at age 40, while UK guidelines begin at age 50.
And colorectal cancer screening, which is on the rise in both the United States and the United Kingdom, begins at age 45 for Americans and age 60 for Britons.
But American reveals why living in the UK is still better than the US
Olivia Carney, originally from North Carolina, shared her experience living in the UK and using the NHS.
Despite the NHS’s wake-up call for many Americans, one expat praised the UK system.
Olivia Carney, who moved to the UK from North Carolina last year, said on TikTok: “Overall, I prefer the UK to the US,” she said.
‘The main thing I would say here is that I prefer healthcare. I think that’s a fact.”
“By now everyone should know that American healthcare is crazy.” He noted that while he had insurance through his employer in the US, it cost him $600 per month.
“That doesn’t cover everything I went to the doctor about, either,” he said.
“Being here, using the NHS, I paid a healthcare surcharge to get in and I pay tax on top of that.”
‘I understand that I haven’t contributed my entire life like all other UK citizens, but I don’t use it for free. I’ve paid for it, but I don’t get a bill every time I go.’
Carney also praised the UK for feeling safer than the US, particularly in terms of gun violence, and for having fewer food additives.