# Emergency care in London, Paris,Switzerland and Italy



## Teddie2 (Sep 10, 2011)

OK I am not being pessimistic here but I cannot tell you how many vacations my H and i have been on where one or the other has been sick --I wound up in the emergency room on at least 3 occasions while on vacation and I have had kidney stones which can appear out of no where...no warning and I need an ER right away when that happens,
Knowing all this causes me to plan plan plan as much as I can so I see all the docs before I go, take all meds with me and extra prescriptions (though not sure how helpful they will be in another country) 
I plan to call my health insurance before I go to find out what they will or will not cover,,, 
What I want to know is .. had anyone ever had to go to the doc or ER while in any of the countries mentioned and if so did you have to pay alot --what was the experience like --is there anything else I should be doing. Rick Steves gives a lot of good advice but I am a bit nervous renting someplace say for example in the middle of a little town in Tuscany where who knows how far the nearest ER is and I don't speak the language.
My H and I are not that old but I guess as we are getting a bit older I think of these things...we are both active and in good health..but just covering my bases here... I have also had about 10 root canals and they just come on all of a sudden as well...not sure where I would find an endodontist in Sienna


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## DeniseM (Sep 10, 2011)

For International Health Care, you will probably have to buy travel insurance.  Most US Insurance companies are not contracted with providers in other countries.


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## Passepartout (Sep 10, 2011)

We generally take out www.travelguard.com and have never needed it. We buy it because we have at least one 95-y.o. parent at home that if or when he should expire, or require our personal care, we can get back and it's covered. DW and I are both in mid 60's and though in good shape, anything can happen.  There have been TUGgers, though who have been hospitalized and air-repatriated at great expense and the travel insurance has paid off. Your at-home health insurance is not worth much overseas, but there is medical care everywhere you are going, and at much lower cost than what we pay in the USA. 

Travel insurance is all about peace of mind.

Jim


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## MULTIZ321 (Sep 10, 2011)

Teddie2,

Check out International Association for Medical Assistance for Travelers (IAMAT.org)

You can become a member for free and use their site to find English speaking Physicians when traveling. Can also get medical insurance through them.


Richard


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## Teddie2 (Sep 10, 2011)

awesome thank you both I will check into both suggestions....you are right its all about peace of mind..


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## Carolinian (Sep 11, 2011)

I have had experience with the medical systems of both the UK and Switzerland, although both were appointments arranged ahead of time.  I found the service to be very high quality and reasonably priced.  The UK experience was with a private hospital, not one run by the NHS, and that is a very key distinction.  If you have a problem in the UK, avoid the NHS and go to a private hospital.  A former employee of mine got her master's degree in the UK and says she much prefers post-Soviet health care with all of its warts to the Briitsh NHS.  Her favorite comment on the NHS is that if you are going to have a heart attack you had better plan it 6 months in advance and make an appointment, or they won't see you.  Private hospitals are very different, as you can make appointments very easily and on short notice.  The doctors in both the UK and Swiss experiences were also high quality, both medical school professors.

In the British situation, it was for a second opinion on a diagnosis of a rather serious conditiion for my daughter in law.  It turned out that the local doctors here had not run all the tests, and she actually had a less serious and easily correctable conditiion.  We were very pleased with the care at the UK private hospital.

In Switzerland, it was actually a third opinion for me, with widely varying treatment options from a doctor here and one in a neighboring country.  The Swiss doctor did much more thorough testing than either of the other two, and concurred with the opinion of the doctor in the neighboring country which involved non-surgical treatment, which took care of the problem.

As to cost, the Swiss billed me just under 100 francs for physician and tests combined, which included ultrasound.  I felt that was a bargain.  The British billing was more substantial but was less than it would have cost in the US.  My daugher in law's insurance did not cover the UK doctor visit.  The medical insurance provided by my employer covers me internationally, including air medivac if necessary, but the cost was so low in Switzerland, I did not even bother with the paperwork to get my money back.

My only ER experiece in Europe was in Latvia, and I found it much more efficient and less costly than the US.  I had a substance sprayed in my eyes in an unsuccesful robbery attempt, and the internet cafe I ran to called an ambulance which took me to the ER in Riga.  Unlike US ER's, it was not jammed with deadbeats trying to get free medical care.  I was seen within 5 minutes by a emergency medicine physician who identified the substance as pepper mace which should do no permanent harm. He sent me on to an eye doctor who was on duty (midnight) who gave more detailed examination and irrigated my eyes.  I then went to check out, and they insisted on immediate payment.  They did not process insurance.  If I needed to go to an ATM or back to my hotel they would provide a staff member to go with me to get the money.  I asked how much it was and was given a bill which worked out to about US$30 for everything, including the ambulance ride.  I had that much in my pocket so I paid them on the spot.  That is a tiny fraction of what the same would have cost in the US.


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## Margariet (Sep 11, 2011)

You just need to look into your health insurance and travel insurance papers. The health care in the countries you will travel to is very modern and professional. Don't worry! You will find newer and more advanced techniques and procedures than you might expect. But not cheap, like nothing in Europe for you at the moment. But I'm sure that a good insurance does cover you well.


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## Teddie2 (Sep 11, 2011)

Well we will check into the suggested insurance and call our own although I am sure they do not cover us out of the country. 
US heath care is very expensive you are correct... I think I am less concerned about England and more about Italy and France  becasuse of the language -we do have my sister in law's friend as a contact in Paris in the event we have a serious emergency but if we cannot explain symptoms etc and there is no one speaking English well that could be a problem.. I am also more concerned about a small town in Tuscany than London or Paris-  Is there and equivalent to our 911 that you call if you have an emergency?  Here wherever you are if there is an emegency call 911 for an ambulance... not sure what they do in each of these cities and again in the middle of the countryside
The cost is a separate issue and we need to check into the insurance.


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## Passepartout (Sep 11, 2011)

Teddie2, 
You will find that there are plenty of English speakers everywhere in Europe. It is and has been taught in the schools in Western Europe for decades. Many people- especially in the countryside where fewer tourists go- will want to practice their English on you. 

If you choose TravelGuard, it comes with a phone number to call and they will direct you to a doctor or hospital wherever you are. 

I think you are investing too much worry in this. You aren't going to a third world country. If you run out of shampoo or toothpaste there, go to a store. Europeans wash their hair and brush their teeth too. Some of the joy of going to another culture is to see how they handle the day-to-day situations that arise. You will find far more similarities than differences.

Relax and have a fun trip. 

Jim


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## x3 skier (Sep 11, 2011)

*No problem with english*

When my wife came down with Pneumonia in Germany, they put her in the intensive care unit since they was where most of the English speaking staff were located. She really did not need it but the Germans being known for their efficiency decided it would be best for communication purposes rather than the regular rooms at the "Krankenhaus". 

Our insurance covered everything but I had to pay 500 euros to ransom her from the Hospital after her three day stay and get reimbursed later.

Many hospitals in Europe have a large number of the staff who have trained in England or the States so there is seldom a problem with even the most technical medical terms.

Cheers


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## Teddie2 (Sep 11, 2011)

Passepartout said:


> Teddie2,
> You will find that there are plenty of English speakers everywhere in Europe. It is and has been taught in the schools in Western Europe for decades. Many people- especially in the countryside where fewer tourists go- will want to practice their English on you.
> 
> If you choose TravelGuard, it comes with a phone number to call and they will direct you to a doctor or hospital wherever you are.
> ...




I am very aware that I am not going to a third world country..My H and I have had several emergencies while on vacations elsewhere and thus my preparation. I also had a cousin whose fiance died in a medical emergency while in Europe.  I just like to go somewhere informed..we are going to be away for 24 days and one never knows what might happen.   If you have ever had kidney stones you would know the worry about wanting to know what to do if.
I know what I do here if I need help so just want to know what to do in case. I also do not assume that everyone speaks english everywhere--so being prepared with important phrases written down somewhere... medication list etc..will take any anxiety about the what if. 

TravelGuard is something that I plan to check into and thank you for the suggestion and well wishes.


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## Margariet (Sep 11, 2011)

Passepartout said:


> Teddie2,
> You will find that there are plenty of English speakers everywhere in Europe. It is and has been taught in the schools in Western Europe for decades. Many people- especially in the countryside where fewer tourists go- will want to practice their English on you.
> 
> If you choose TravelGuard, it comes with a phone number to call and they will direct you to a doctor or hospital wherever you are.
> ...



   Yes Jim, you are so right! I washed my hair this morning (I wash it every day) and brush my teeth twice a day, my husband three times.  

Oh dear, I didn't know people would be so upset to visit Europe!   Please, don't worry but enjoy! We Europeans are used to speak and listen to so many languages. Nowadays we all speak English with all sorts of accents.  

Dial 112 when you are in need. It's the alarm number for Europe. You will get connected immediately and you can speak your own language.


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## Teddie2 (Sep 11, 2011)

Margariet said:


> Yes Jim, you are so right! I washed my hair this morning (I wash it every day) and brush my teeth twice a day, my husband three times.
> 
> Oh dear, I didn't know people would be so upset to visit Europe!   Please, don't worry but enjoy! We Europeans are used to speak and listen to so many languages. Nowadays we all speak English with all sorts of accents.
> 
> Dial 112 when you are in need. It's the alarm number for Europe. You will get connected immediately and you can speak your own language.



Perfect that was all I needed to know


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## radmoo (Sep 11, 2011)

On our recent trip to London, hubby needed to secure some additional insulin.  A prescription from EU physician was required.  DIL made appt for us at NHS clinic (we made appt in the am and ret'd in the pm). Doctor wrote scrip for hubby and we were off to Boots to have it filled. Yes, we did have to fork over 60 Euro at the clinic and an addt'l 40 at Boots.  But when I returned to work , I put in claims to United Healtchare and Medco and was reimbursed all but $35 visit co-pay and $30 drug co-pay.  I subsequently submitted those charges for FSA reimbursement.


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## sfwilshire (Sep 12, 2011)

DeniseM said:


> For International Health Care, you will probably have to buy travel insurance.  Most US Insurance companies are not contracted with providers in other countries.



My FEHB Blue Cross covered us in England, Scotland and Wales. Thankfully, we didn't need to use it, but I had printed out all the particulars in advance just in case.

Sheila


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## GeraldineT (Sep 12, 2011)

You will have to pay out of pocket and then some reimbursed to you.  May not be all you paid but travel insurance is not 100% either.  Check with your insurance company to see what the coverage is.  I know mine is the same as using an out of network provider.  Also keep the phone numbers to the US Embassys in the countries where you are traveling.  Your tax dollars pay a great deal of money for this and they are more than helpful and have arrangements with doctors, dentists and hospitals.


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## Carolinian (Sep 12, 2011)

GeraldineT said:


> You will have to pay out of pocket and then some reimbursed to you.  May not be all you paid but travel insurance is not 100% either.  Check with your insurance company to see what the coverage is.  I know mine is the same as using an out of network provider.  Also keep the phone numbers to the US Embassys in the countries where you are traveling.  Your tax dollars pay a great deal of money for this and they are more than helpful and have arrangements with doctors, dentists and hospitals.



Good point.  US Embassies keep lists of English speaking doctors in the country.


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## JudyH (Sep 13, 2011)

Although you have not asked about the Caribbean, we found out the hard way that there are public hospitals and private hospitals.  If anything ever happens, insist on going to a private hospital, especially in Jamaica.  I feel so sorry for those who are forced to undure the facilites at the public hospital, which resembled a decaying school.  The staff was kind, trained, but clearly stretched beyond their means.  Finally, after hours, one of the docs put us in a cab and sent us to his private facility.


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## Teddie2 (Sep 13, 2011)

we are going to Europe not Caribbean but yes we have heard that before about private vrs public..someone mentioned that as an issue in London


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## Carolinian (Sep 14, 2011)

Teddie2 said:


> we are going to Europe not Caribbean but yes we have heard that before about private vrs public..someone mentioned that as an issue in London



It would be an issue in the UK, but not in Switzerland.  I am not familiar with the medical system in Italy.


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## Pompey Family (Sep 14, 2011)

The NHS doesn't deserve the criticism that it receives.  In terms of medical care NHS and Private are comparable.  What Private offers above the NHS is more in terms of facilities.  With Private you will have your own room and bathroom etc whereas this is less likely with the NHS.

I've experienced both levels of care and in relation to the medical side of things there is little difference, things are just more comfortable in private but that's because you're paying through the nose for it.

Personally, I'm happy with the NHS and despite its faults it's still a fantastic institution.


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## persia (Sep 14, 2011)

It's the same with Medicare in Australia, you just get a bit more choice with private insurance.  The nice thing is that when I am in the UK NHS covers me because of a reciprocity agreement between Medicare and NHS.  It would be nice if all countries had reciprocal agreements.



Pompey Family said:


> The NHS doesn't deserve the criticism that it receives.  In terms of medical care NHS and Private are comparable.  What Private offers above the NHS is more in terms of facilities.  With Private you will have your own room and bathroom etc whereas this is less likely with the NHS.
> 
> I've experienced both levels of care and in relation to the medical side of things there is little difference, things are just more comfortable in private but that's because you're paying through the nose for it.
> 
> Personally, I'm happy with the NHS and despite its faults it's still a fantastic institution.


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## MomoD (Sep 14, 2011)

*Uk Nhs*



Carolinian said:


> I have had experience with the medical systems of both the UK and Switzerland, although both were appointments arranged ahead of time.  I found the service to be very high quality and reasonably priced.  The UK experience was with a private hospital, not one run by the NHS, and that is a very key distinction.  If you have a problem in the UK, avoid the NHS and go to a private hospital.  A former employee of mine got her master's degree in the UK and says she much prefers post-Soviet health care with all of its warts to the Briitsh NHS.  Her favorite comment on the NHS is that if you are going to have a heart attack you had better plan it 6 months in advance and make an appointment, or they won't see you.  Private hospitals are very different, as you can make appointments very easily and on short notice.  The doctors in both the UK and Swiss experiences were also high quality, both medical school professors.
> 
> In the British situation, it was for a second opinion on a diagnosis of a rather serious conditiion for my daughter in law.  It turned out that the local doctors here had not run all the tests, and she actually had a less serious and easily correctable conditiion.  We were very pleased with the care at the UK private hospital.
> 
> ...



I'm not sure where you got your information from about the NHS in the UK, Not sure where your former emplyee lived whilst here, but I can assure you 100% if you have a heart attack or any other serious condition you are seen IMEDIATELY by a doctor at any of our hospitals. No serious medical condition in this country is ever left for 6 months, a gross and very unfair description. I had a friend vist from the US who did'nt feel very well, I took her to our local hospital to see a doctor who diagnosed Lime's disease (something we only have in Scotland), he explained that as she was leaving the very next day she should see her own doctor when she returned home. All this FREE OF CHARGE, and with a real qualified doctor. When you visit the UK you will be given one free visit to the hospital, any other follow up visit will be charge for, however, if you have a friend or relation in the UK you may visit their doctor as many times as necessary without ANY charge whatsoever.

Hope this clears up some mis-information.

Maureen


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## Carolinian (Sep 14, 2011)

Some of the best articles on the flaws of the NHS were written in the context of the Obamacare fight in the US citing varioius statistics.  One of the best was written by a prominent UK journalist which quoted official reports of absolutely awful conditions in some of the NHS hospitals.  Because of that political context, I cannot link to them here, unfortunately.  I have also personally read a series of horror stories directly out of the UK press on the NHS in the Daily Telegraph while I have been travelling in the UK.  Waiting lists are a big complaint but so are conditions of some of the facilities.  All of that just backs up what one of my former employees said about her experiences with the NHS while she was getting her master's degree in the UK and her opinion that medical care in the hospitals of post-Soviet states, even with all its warts, was still better than that of the UK NHS, not that she was that fond of post-Soviet care, either.

I have read and heard enough about the NHS that I made sure my DIL went to a private facility instead.

It is not just the UK, but there is a huge difference here in eastern Europe between the level of care at public hospitals and private hospitals.  In my own case, I had a local doctor who was extremely keen to do an unnecessary operation that would have put some money in his pocket and may have had some negative results in future years.  The Swiss specialist I saw prescribed a non-surgical treatment that has resolved the condition.  That was before we really had a private hospital here.  Now we do, and from what I hear, the level of care is far superior to the public hospitals.





Pompey Family said:


> The NHS doesn't deserve the criticism that it receives.  In terms of medical care NHS and Private are comparable.  What Private offers above the NHS is more in terms of facilities.  With Private you will have your own room and bathroom etc whereas this is less likely with the NHS.
> 
> I've experienced both levels of care and in relation to the medical side of things there is little difference, things are just more comfortable in private but that's because you're paying through the nose for it.
> 
> Personally, I'm happy with the NHS and despite its faults it's still a fantastic institution.


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## Carolinian (Sep 14, 2011)

My former employee never had a heart attack herself, but had other medical issues where she found immense problems with waiting lists.  With her journalist background, I think she used the heart attack scenario mainly to make her point about waiting lists in general.

While I don't think I have seen any stastics or read any articles concerning heart attack care in the NHS, I have read quite a few about cancer care, where waiting lists too often cause the condition to worsen before a patient makes it up the list for surgery.  That results in significantly higher death rates from many cancers in the NHS compared to the US.

Frankly, the articles I read while travelling in the UK in the Daily Telegraph of London, one of the major British newspapers about filthy conditions in a number of HNS hospitals would be enough to cause me to try to avoid any of them.  Granted they may only be a minority, but I would not want to chance dealing with the conditions described in those articles.




MomoD said:


> I'm not sure where you got your information from about the NHS in the UK, Not sure where your former emplyee lived whilst here, but I can assure you 100% if you have a heart attack or any other serious condition you are seen IMEDIATELY by a doctor at any of our hospitals. No serious medical condition in this country is ever left for 6 months, a gross and very unfair description. I had a friend vist from the US who did'nt feel very well, I took her to our local hospital to see a doctor who diagnosed Lime's disease (something we only have in Scotland), he explained that as she was leaving the very next day she should see her own doctor when she returned home. All this FREE OF CHARGE, and with a real qualified doctor. When you visit the UK you will be given one free visit to the hospital, any other follow up visit will be charge for, however, if you have a friend or relation in the UK you may visit their doctor as many times as necessary without ANY charge whatsoever.
> 
> Hope this clears up some mis-information.
> 
> Maureen


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## MomoD (Sep 14, 2011)

The freedom of speach means exactly that, you are entitled to your opion as are all of us.
I'm not sure that anyone having a heart attack would make any list alive!! 
I think the term OBAMACARE says it all with regard to any negative information regarding the NHS system, a lot ot people were looking for negative comments, I wonder why?
The thing about statistics are they can be manipulated, so I don't not beleive everything I read in the press.
If you have used the NHS and found it lacking, I am sorry for your disappointment, if not and only have newspapers, maybe you should wait until you have tried it first before trashing it. 
I am 100% certain that not all hospitals within the US would pass muster, but that would'nt stop me going if I really needed a doctors help.

[/Quote]While I don't think I have seen any stastics or read any articles concerning heart attack care in the NHS, I have read quite a few about cancer care, where waiting lists too often cause the condition to worsen before a patient makes it up the list for surgery.  That results in significantly higher death rates from many cancers in the NHS compared to the US.

Frankly, the articles I read while travelling in the UK in the Daily Telegraph of London, one of the major British newspapers about filthy conditions in a number of HNS hospitals would be enough to cause me to try to avoid any of them.  Granted they may only be a minority, but I would not want to chance dealing with the conditions described in those articles.[/QUOTE]


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## colamedia (Sep 15, 2011)

If you're going any great distance, travel insurance is highly recommended.  It isn't just health care, it also covers things like delayed/lost luggage, repatriation home after some major event, accommodation costs for travelling companions if they need to wait for you to be fit to travel, it covers any missed events, or change of plans due to other scheduling changes outside your control, missed flights, etc. There is always some international toll free number to call and they can get interpreters for you if you are somewhere that doesn't speak your language. It's insurance for your possessions, if you leave something on a seat or something gets stolen or goes missing from your room, all of that is usually covered. Sometimes it will cover a lot of the optional or even compulsory additional insureance required when you hire a car.  It's a lot more than just international health care.
If you buy your plane ticket with a credit card, quite a few of them include basic travel insurance for the length of the trip.

I know most people don't bother with travel insurance for domestic travel, but it can make a huge difference if something does go wrong. I usually just use the credit card travel insurance for domestic travel, and get a real policy for international travel.  



As for the NHS vs any other medical system, there are horror stories in every medical system. The local socio-economic level does get reflected in the local NHS system, as it does in almost every country - well equipped hospitals tend to be equipped well when the local community is judged worth providing that level of service to.  Even so the lowest quality NHS care is probably a huge step up from what you can find in some areas of Washington DC, just as some of the healthcare in Washington DC at the other end of the scale is probably quite a step up from the average NHS level of care.


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## Pompey Family (Sep 15, 2011)

Carolinian said:


> Frankly, the articles I read while travelling in the UK in the Daily Telegraph of London, one of the major British newspapers about filthy conditions in a number of HNS hospitals would be enough to cause me to try to avoid any of them.  Granted they may only be a minority, but I would not want to chance dealing with the conditions described in those articles.



My advice would be to base comments on personal experience certainly not what you read in the paper.  The Telegraph is just as guilty of sensationalism as the rest of the tabloids.

Hospitals aren't filthy, there are no waiting lists for emergencies and best of all....it's free.


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## x3 skier (Sep 15, 2011)

As this thread has now sort of evolved into a discussion on the merits of various ways of financing Health Care and the results thereof, I hope Teddie2 got enough info on her original question.

Cheers


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## Teddie2 (Sep 17, 2011)

Thank you all yes I did and then some


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## pwrshift (Sep 20, 2011)

If you're concerned about health problems you might also consider MedJet Assist.  I've been a member for a number of years and never had to use it, but it gives me peace of mind in case I might need special air transportation from a hospital anywhere in the world to another hospital of my choice.  Savings if you belong to AARP.

http://www.1earthtravelprotection.com/PDFs/Medjet Assist.pdf

Brian


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## Carolinian (Sep 22, 2011)

Pompey Family said:


> My advice would be to base comments on personal experience certainly not what you read in the paper.  The Telegraph is just as guilty of sensationalism as the rest of the tabloids.
> 
> Hospitals aren't filthy, there are no waiting lists for emergencies and best of all....it's free.



The Daily Telegraph is NOT a tabloid.  It is the largest circulation broadsheet newspaper in the UK.  Not all hospitals are filthy, but some are, and that is the rub.  If you are in an area that has not had a problem, more power to you.  But other challenges at the NHS also degrade the standard of care, such as this one:

http://www.telegraph.co.uk/health/healthnews/8780363/NHS-hospitals-crippled-by-PFI-scheme.html


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## Carolinian (Sep 22, 2011)

Pompey Family said:


> My advice would be to base comments on personal experience certainly not what you read in the paper.  The Telegraph is just as guilty of sensationalism as the rest of the tabloids.
> 
> Hospitals aren't filthy, there are no waiting lists for emergencies and best of all....it's free.



Here is one article from a prominent UK journalist that was published in the US:

*Britain's National Healthcare Looks Like Medieval Medicine*
by  James Delingpole 03/24/2009 

 Victims left for hours covered in blood, denied pain relief; elderly cancer patients lying in their own filth; dirty, chaotic wards akin  to "war zones"; a shortage of basic equipment, including trolleys and thermometers; shouting nurses; ill-trained, badly supervised medics;  disease outbreaks; starvation and dehydration; mounting piles of dead…

Scenes from a hospital in war torn Chechnya, perhaps? Mugabe's Zimbabwe? Romania in the days of Ceaucescu? The aftermath of Antietam? The Middle Ages?

Why, no. This was an English hospital the day before yesterday. And the day after tomorrow [political comments deleted]

All too often when I tell my U.S. friends just how dire the state of our nationalized health care system is in Britain, they assume I must be exaggerating for effect. "But we've English friends who tell us that it's the Envy of The World," some of them say (of which more later). "Come on, it can't be that bad. At least it's fair, and at least it's for free," say others.

Then consider, my friends, Exhibit A. The foul sub-third-world conditions I've just described came not from my overactive imagination but from a newly-published official report into the parlous state of affairs at two state-run hospitals in the central English district of Mid Staffordshire.

According to the report by the Healthcare Commission, standards of care were so "appalling" that between 2005 and 2008 as many as 1,200 patients may have died unnecessarily.

You should see the photo shrine the victim's families have erected on one of the walls inside the hospital -- like a mini-9/11 memorial; it's a heartbreaking sight. There are pictures of the loved ones while they were still smiling and healthy, their dates written underneath. And there are printed sheets detailing some of the myriad ways they suffered and died:

•"Medication not monitored for side effects."


•"Staff shouting, squealing and laughing throughout the night disturbing patients"


• "Patients not helped to the toilet, told to use a bed pan -- staff too busy."


• "Patients not fed or given fluids -- food trays just left on the table out of reach."

It has been described by the National Health Service's medical director as a "gross and terrible breach of trust" of patients, though why he should be so shocked is anybody's guess. It's not as though this sort of thing hasn't happened in Britain's magnificent "free" healthcare system many, many times before.

This, remember, is the "service" so poor that 55 per cent of senior doctors take out private medical insurance so they don't have to use it; the one where one in 300 hospital deaths is the result of a patient contracting an infection completely unrelated to the one they came in to have treated; where the cancer survival rates are the worst in the civilized world; where more patients die in hospital in a year -- 40,000 -- than were killed in the 2006 Iraqi civil war.

[political comments deleted]

It's at this point that I ought to anticipate some of the comments which will appear at the bottom of this piece from one or two rose-tinted British readers. "Come off it," they'll protest. "It may be a basic service but at least it offers free healthcare at the point of  
need, unlike in fascist America where if you haven't got insurance they leave you to die on the street…." or "How dare you insult our hardworking nurses" or "If it hadn't been for the wondrous NHS my beautiful, blue eyed child…" etc.

Yeah, yeah, all right so the NHS doesn't actually manage to murder every patient which crosses its threshold. Sure, its doctors and nurses can be nurturing and caring, but -- duh -- that's why they joined the medical profession rather than becoming, say, serial killers or  
professional torturers in the service of Kim Jong Il​. 

But I should warn American readers to take the surprisingly widespread British affection towards the NHS with a hefty pinch of salt. It’s a legacy of wartime rationing, I suspect.  [political comments deleted].

.


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## CarolF (Sep 22, 2011)

*Everything has changed now*



Teddie2 said:


> OK I am not being pessimistic here but I cannot tell you how many vacations my H and i have been on where one or the other has been sick --I wound up in the emergency room on at least 3 occasions while on vacation and I have had kidney stones which can appear out of no where...no warning and I need an ER right away when that happens,
> Knowing all this causes me to plan plan plan as much as I can so I see all the docs before I go, take all meds with me and extra prescriptions (though not sure how helpful they will be in another country)
> I plan to call my health insurance before I go to find out what they will or will not cover,,,
> What I want to know is .. had anyone ever had to go to the doc or ER while in any of the countries mentioned and if so did you have to pay alot --what was the experience like --is there anything else I should be doing. Rick Steves gives a lot of good advice but I am a bit nervous renting someplace say for example in the middle of a little town in Tuscany where who knows how far the nearest ER is and I don't speak the language.
> My H and I are not that old but I guess as we are getting a bit older I think of these things...we are both active and in good health..but just covering my bases here... I have also had about 10 root canals and they just come on all of a sudden as well...not sure where I would find an endodontist in Sienna



Great idea to plan for any health emergencies. Sadly the European debt crisis has started to affect consumers.  A friend recently needed an endodontist in Turkey and found an excellent one but he would only accept payment in Euro and cash before commencing treatment (no credit card/cheque and said "the US$ is not worth anything to me").  Then there is the problem with hospitals not paying their bills and drug companies stopping deliveries (Roche stopped deliveries to Greek hospitals and there was also discussion that they may take similar steps elsewhere - see link below).  

I would continue to do more research for your stay in Italy (given their financial difficulties).  Search for recommendations for appropriate medical practitioners/hospitals should they be needed, and you could then follow up what methods of payment would be acceptable/preferable.  As you said, it's always good to cover your bases, a bit of research and planning now can put your mind at ease whilst you are away.  


http://online.wsj.com/article/SB100...1877220786.html?KEYWORDS=roche+greek+hospital


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## Pompey Family (Sep 22, 2011)

Carolinian said:


> The Daily Telegraph is NOT a tabloid.  It is the largest circulation broadsheet newspaper in the UK.  [/url]


I didn't say it was a tabloid, I said it was just as bad as the rest of the tabloids.  Simply because it's the largest circulation broadsheet in the UK doesn't mean that what it prints is the 'gospel'.  In actual fact it has gone steadily downhill in recent years and a few looks at the website will confirm its general downward spiral into sensationalism and tabloidesque journalism and is now comparable to the Daily Mail.  In my opinion one of the best newspapers is The Independant.

The extract from the paper you posted below your other message just highlighted the sensationalism that it has plunged to.  To anyone who has never experienced a UK hospital would be rightly appalled and shocked to read the description written however it is simply not representative of any hospital I know and I struggle to think of any hospital in the UK that resembles the one described in the article.  Artistic licence at its worst I'm afraid.


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## Carolinian (Sep 22, 2011)

The article quoted was not from _The Daily Telegraph_ but was published in a US publication, _Human Events_

The _Daily Telegraph_ articles I read on a trip to the UK about a year after this article was pubished involved different hospitals in a different part of England, was written in a very different style, but recited facts that were quite similar to this op-ed piece, backed up again by official reports.



Pompey Family said:


> I didn't say it was a tabloid, I said it was just as bad as the rest of the tabloids.  Simply because it's the largest circulation broadsheet in the UK doesn't mean that what it prints is the 'gospel'.  In actual fact it has gone steadily downhill in recent years and a few looks at the website will confirm its general downward spiral into sensationalism and tabloidesque journalism and is now comparable to the Daily Mail.  In my opinion one of the best newspapers is The Independant.
> 
> The extract from the paper you posted below your other message just highlighted the sensationalism that it has plunged to.  To anyone who has never experienced a UK hospital would be rightly appalled and shocked to read the description written however it is simply not representative of any hospital I know and I struggle to think of any hospital in the UK that resembles the one described in the article.  Artistic licence at its worst I'm afraid.


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## sml2181 (Sep 22, 2011)

I think it is always a good idea to investigate your options before leaving home. I always check things mentioned by the op - including when I travel to the US. 

My friends think I am weird, but having had the experience once, of needing a hospital very badly because you suspect your child is in a coma, while everyone thinks he is just asleep, and you do not know where the nearest hospital is, let alone how to get there and nobody does speak any of the languages you speak - you really want to make sure about all your options before leaving home. 
(Son is doing fine btw but he really was in a coma, just out of te blue he appeared to have an epidural haematoma)

So - I would always recommend to

- check your insurance (what is covered, and where)
- Ask insurance about the nearest hospital, or at least a doctor - and write down phone numbers, which most of them can provide
- make sure you have not maxed out your credit card
- make sure you have some cash, at least to cover some upfront costs
(Someone I know (American lady who has lived in Europe for ages) had to pay $5,000 in the US this last summer due to some unexpected treatment, her cc was maxed out and she didn't have enough cash in her bank account - she just assumed that the hospital was going to charge her insurance, but this hospital invoiced her, instead of her insurance. She was lucky because her parents were there and could help her out.)

- make sure you can access ATM's in foreign countries; at least to cover some costs
- make sure you have access to a phone or something else for communication
- make sure you do know where the embassies and consulates are, and have their phone numbers at hand 
- I think for Americans it would be wise to have an AAA emergency number or something like that (I think AAA has a helpdesk for people traveling abroad?)
- We always prefer to have a rental car, but if that is not an option, make sure you can pay for taxi costs, or other transportation costs

Maybe it looks like a lot of work and maybe it is completely crazy to some, but usually, one phone call to my insurance or the Dutch version of the AAA, depending on what I need to know, does the trick. And if not - I think it is worth the relatively small amount of effort.


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## Teddie2 (Sep 22, 2011)

sml2181 said:


> I think it is always a good idea to investigate your options before leaving home. I always check things mentioned by the op - including when I travel to the US.
> 
> My friends think I am weird, but having had the experience once, of needing a hospital very badly because you suspect your child is in a coma, while everyone thinks he is just asleep, and you do not know where the nearest hospital is, let alone how to get there and nobody does speak any of the languages you speak - you really want to make sure about all your options before leaving home.
> (Son is doing fine btw but he really was in a coma, just out of te blue he appeared to have an epidural haematoma)
> ...



Thank you all for your suggestions... you have given us many things to check out and some we have already and taken advantage of....TUggers Rock!!:whoopie:


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## MALC9990 (Sep 24, 2011)

Carolinian said:


> My former employee never had a heart attack herself, but had other medical issues where she found immense problems with waiting lists.  With her journalist background, I think she used the heart attack scenario mainly to make her point about waiting lists in general.
> 
> While I don't think I have seen any stastics or read any articles concerning heart attack care in the NHS, I have read quite a few about cancer care, where waiting lists too often cause the condition to worsen before a patient makes it up the list for surgery.  That results in significantly higher death rates from many cancers in the NHS compared to the US.
> 
> Frankly, the articles I read while travelling in the UK in the Daily Telegraph of London, one of the major British newspapers about filthy conditions in a number of HNS hospitals would be enough to cause me to try to avoid any of them.  Granted they may only be a minority, but I would not want to chance dealing with the conditions described in those articles.



One wonders why you ever thought it safe to leave the USA.


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## MALC9990 (Sep 24, 2011)

Carolinian said:


> The Daily Telegraph is NOT a tabloid.  It is the largest circulation broadsheet newspaper in the UK.  Not all hospitals are filthy, but some are, and that is the rub.  If you are in an area that has not had a problem, more power to you.  But other challenges at the NHS also degrade the standard of care, such as this one:
> 
> http://www.telegraph.co.uk/health/healthnews/8780363/NHS-hospitals-crippled-by-PFI-scheme.html



Yeah and every hospital in the USA is a brilliant facility with fantastic medical services that you will not be hassled for your credit card before you get treated. No one dies in hospital in the USA ????

The Daily Telegraph is a right wing newspaper that derides everything that is not driven by money !


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## Carolinian (Sep 25, 2011)

MALC9990 said:


> One wonders why you ever thought it safe to leave the USA.



I have no health care concerns in eastern Europe. My employer provided health coverage can get me into the superior private facilities here and even includes air medevac coverage if necessary.  In the UK, it would get me into the excellent private health care facilities.

As to my former employee, she was young enough that I am sure that whatever she was confronted with waiting lists on at the NHS, it was not a heart attack. With her background in journalism, that was likely used for emphasis on her opinion of the NHS and its waiting lists.  Since she left us, she is back in journalism, now as news director for one of the largest broadcast networks in this country.


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## Carolinian (Sep 25, 2011)

MALC9990 said:


> Yeah and every hospital in the USA is a brilliant facility with fantastic medical services that you will not be hassled for your credit card before you get treated. No one dies in hospital in the USA ????



One out of every 300 deaths are NOT from an infection unrelated to what they went to the hospital for as they are in the NHS.

One in 6 is not misdiagnosed as they are at the NHS according to the official reports.


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## cwtkm3 (Sep 25, 2011)

*Our awful NHS!*

I am an urgent care centre emergency nurse practitioner and can assure all visitors to the UK that any emergency eg heart attack, stroke, acute abdominal pain etc etc will be dealt with immediately.  

Our ERs do a fantastic job under immense pressure.  Many of the patients in there don't need to be as they don't have an accident or an emergency. 

Like anything in life you get what you pay for so for those fortunate enough to be able to afford health care you'll get to see the specialist; after all he/she wants your cash.

My mother died 2 years ago in an American hospital having lived in the USA for 27 years.  When she took ill my father failed to recognise the seriousness of her situation.  No Doctor would do a home visit (unlike my own workplace where both Doctors and Nurses do home visits to the ill and needy).  My father was told to call 911 but unfortunately he didn't as was concerned re- a huge bill should it not have been deemed necessary. My mother lost her life and I can 100% hand on heart say that if she had been in the UK she would still be alive today.

I am not making this up - I swear a home visit by one of our General Practitioners (family Doctors) would have saved her life.

Her care over the years in the USA was shambolic.  I meet many Americans at my workplace who have plenty of bad things to say about the wonderful American healthcare system.

So Carolinian don't condem our NHS on tittle tattle and what you read in the press.  Mid-Staffs was a horrible situation but not all of our hospitals are like this.  Our country is over populated (many of your Eastern European "friends" love to live here and enjoy our "free" healthcare) and copes extremely well under pressure.


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## Teddie2 (Sep 25, 2011)

cwtkm3 said:


> I am an urgent care centre emergency nurse practitioner and can assure all visitors to the UK that any emergency eg heart attack, stroke, acute abdominal pain etc etc will be dealt with immediately.
> 
> Our ERs do a fantastic job under immense pressure.  Many of the patients in there don't need to be as they don't have an accident or an emergency.
> 
> ...




I feel as if my post has started a mini international war just for asking for some simple advice.
Every health care system has is flaws and you are right US is no different -it is expensive and many cannot afford it...it is in a crisis of sorts... but its what I know and since I will be in several places that I don;t know I was just trying to be prepared... life happens and like it or not people do get sick-- I wish it had not happened to me so many times --thank goodness not life threatening but necessary regardless---
I am sure no matter where I am if I should need help I will get it.
Thank you for all th advice and the entertaining banter...peace


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## MALC9990 (Sep 27, 2011)

Carolinian said:


> I have no health care concerns in eastern Europe. My employer provided health coverage can get me into the superior private facilities here and even includes air medevac coverage if necessary.  In the UK, it would get me into the excellent private health care facilities.
> 
> As to my former employee, she was young enough that I am sure that whatever she was confronted with waiting lists on at the NHS, it was not a heart attack. With her background in journalism, that was likely used for emphasis on her opinion of the NHS and its waiting lists.  Since she left us, she is back in journalism, now as news director for one of the largest broadcast networks in this country.



Indeed it would. Your Employer Provided health Care Insurance would get you excellent private treatment in the UK - but most likely initially from an NHS source. Your pots alluded to "rationing" in the NHS for treatment. Whaqt is it but rationing in your Eastern European country where 99% of the local populace are unable to afford the "superior" private facilities that your Employer provided Insurance provides to you. So rationing by another route - one which provides superior treatment to those that can pay rather than rationing of treatment to those in most need. Ethically I think I prefer the later. Having  said that no one should iundertake foreign travel without adequate travel insurance including medical insurance. i certainly would not go to the USA without at least $2 million in cover and would not set foot east of Dover without my EHIC (European Health Insurance card) and adequate travel insurance for medical cover.

Is the NHS perfect - by no measure can anyone say it is. Is healthcare in the USA excellent - yes if you can afford it or have Employer provided healthcare insurance - something a growing unemployed base in the USA is losing. Are millions of people in the UK excluded from proper healthcare because they cannot afford insurance or choose not to have private health insurance - NO they are not they get the treatment FREE at the point of use.

To the OP I would say this - take out adequate travel insurance that provides the required level of medical insurance in case you need it. I would never travel to the USA or any other country in the world without it.

If you are unfortunate enough to be taken ill in the UK then the first point of contact to get help would be NHS Direct http://www.nhsdirect.nhs.uk/

There  are also Walk In Medical centres available across the UK. 

http://www.nhs.uk/NHSEngland/AboutN...gentcareservices/Pages/Walk-incentresFAQ.aspx

You will be safe using medical services in the UK should you need them but travel insurance is essential wherever you go in the world.


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## colamedia (Sep 28, 2011)

Carolinian said:


> > Originally Posted by MALC9990
> > _No one dies in hospital in the USA ????_
> 
> 
> ...


You are quite correct, the US numbers don't match the NHS numbers - they are WORSE - intraogenic deaths account for at leat 2% of deaths in hospitals, almost half of those from unrealted to admission infections obtained in hospitals, which is a lot more than 0.33% under the NHS.  (2000 numbers and the more recent figures are higher).  

The misdiagnosis of serious medical conditions in the US is one in 5, worse than the NHS figure you quoted (that 1 in 5 has not changed since the 1930s according to the NY times)

Basically going to hospitally is the 3rd largest killer in the US, behind cardio-vascular disease and cancer.

The NHS isn't perfect, standards vary across the system, that pretty much applies to any 'system', and there is no way of knowing if you'll find a low standard or high standard until you actually check the individual standards.  Private healthcare is usually of a higher standard than public healthcare, that doesn't just apply to UK, or US, it's anywhere else in the world where there is a public and a private system. The HUGE difference is the cost of healthcare in US compared to the rest of the world.


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## tlwmkw (Sep 28, 2011)

Not trying to fuel this fire any further but one thing to remember is that the consultant doctors that you see in the private hospitals, & on Harley Street, in England are the same ones you see in the NHS hospitals.  They can do both within the system and it is not frowned on.  The differences are actually more cosmetic than anything else.  Often the consultants will see a patient in an NHS clinic and then say "You can have surgery in 6 months with the NHS if you wait on the list but if you want I can do it tomorrow at the private hospital around the corner".

Now in Eastern Europe it is very different.  I know someone who was physician there (in Russia) and he tells horror stories about how things are done in the public hospitals.  If you have money in Russia you leave and travel to Switzerland or Germany for health care.

Having lived in Europe and the US I would personally say you will probably get better and cheaper care there than in the US.  Even without the insurance you will probably not be bankrupted in Europe.  I would still get the insurance though.  Just my opinion.

tlwmkw


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