Question About NHS

[Poniesrfun]

I started to ask this in another post but didn’t want to hijack the thread.

I’m always taken aback a bit when I read posts here as I can’t imagine my primary doctor (actually nurse practitioner) not running my thyroid tests as needed - including free T3 and T4, Reverse T3, etc., having to pay out of pocket for them or her not being able to order the meds I need for me to pick up at the local pharmacy - including NDT and T3. OTOH, I do pay over $400US a month for “insurance” (Medicare + private secondary). While many endos here do stick with TSH and levothyroxine only, our GP’s aren’t restricted from ordering tests and meds.

I presume you pay a substantial portion to NHS via taxes so it isn’t really “free”. But can you purchase “supplemental insurance” for private services outside of NHS? Or is it strictly out of pocket? In the US, after age 65 Medicare basic is “free” (we’ve paid in all our working lives via payroll taxes) but many hospital,imaging and lab services are not covered less you purchase “Part B” or a privately administered “advantage plan”. Meds may or may not be covered requiring an additional purchased plan to cover them. If you were lucky, you may have gotten retirement benefits which allowed you to continue a medical insurance plan that covered most everything - for a hefty fee. So you might be required to buy in to three or four plans to have your medical costs covered. Some plans allow you to “doctor shop”, some don’t. Under age 65 you’re at the mercy of whatever “insurance” plan you can or can not afford.

The reason I ask is that some of the “standard” support we give folks on the US ThyCa forum is sometimes difficult for U.K. (and to a lesser extent, Canadian) patients. I do try to suggest U.K. patients join here for the specific quality information you provide - while we’re very cancer focused the challenges of trying to help someone who is navigating an unfamiliar health care system can be challenging.

Thank you.

Patti in AZ

[SlowDragon Administrator]

Here in the UK one big problem with insurance, unless taken out early in life before you get ill, is it generally doesn't cover any pre-existing conditions

[Angel_of_the_North]

The NHS is great if you have a broken leg or a stroke, but not much good on chronic illness. The lab decides (probably on a cost basis) what tests need to be run regardless of what the GP asks for, so it is very rare to get antibodies or free t3 tested. The NHS has no money for patients, only for "quality checking" and managers, and only thyroxine is allowed to be prescribed by a GP. You need to get an endo referral for T3 and, as it costs so much and, as you probably won't die without it, very few endos will prescribe. NDT is "banned" on the NHS, so you'd have to pay privately. In most cases, insurance will only pay for what you can get on the NHS, but you get it faster and in a posher hospital, and it doesn't cover conditions that you already have when taking out the insurance.

We pay for the NHS out of our taxes whether we use it or not.

[Hidden]

Since the NHS structure changed in 2013, many GPs are leaving NHS, which is now run by Clinical Commissioning Groups under the auspices of NHS England.

Everything is down to money. We are told how much patients are costing the NHS, but there is no information how much the CCGs and NHS England is costing the tax- payer.

Have you a link for the US ThyCa forum you mention?

I prefer to use drugs.com/ and rxisk.org/ (RxISK is owned and operated by Data Based Medicine Americas Ltd. (DBM), based in Toronto, Canada, which is run by a group of high-profile medical experts with international reputations in early drug-side-effect detection and risk mitigation, pharmacovigilance, and patient-centred care.) There are very informative blogs here as well.

I also use canada.ca/en/health-canada/...

These links for me, are the best for Prescription Drug information drug interactions, and much more.

In the UK the amount of National Insurance(NI) you pay depends on your employment status and how much you earn. If you are employed, you pay Class I NI

N.I. is extremely complex and it is advisable to look on gov.uk/national-insurance/h... for an insight as to “what goes on”. It does explain everything.

We also have numerous Private Health companies. Some companies offer Private Health Insurance as a “perk” on top of the salary. If you are “ultra wealthy” you can pay for your own Private health Insurance on top of the NI I!

Hope this info. helps.

[Poniesrfun]

Thank you - the system is quite a bit more complex than I had thought. Of course the wealthy will always have access to whatever health care they feel they need even when others are denied necessary care. And “insurance”, as in the current battles in the US, don’t necessarily equate to access to health care. They are about profits for investors, doctors trying to defend their turf (from nurse practitioners) and politics. Patients are at the bottom of the barrel.

The forum is inspire.com/groups/thyca-th.... We “try” to not give “medical advice” or at least couch it in terms of our own experience, and are focused solely on cancer and it’s after effects and treatment. So I appreciate what I have learned here about non-cancer related thyroid issues.

Patti in AZ