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The NHS is NOT rubbish. You cannot tar the whole system with such a broad brush. Granted, it isn't perfect, but it's better than not being able to pay for vital treatment. I'd already have been dead several times over without the NHS.

To give you some level of American perspective:

I lose health insurance when I graduate uni in a year (or possibly sooner as it may cut out when I turn 23 in September). To be honest, most of this year I've been on an alternate type of health insurance because I haven't been a full time student so don't have coverage under my parents insurance. Luckily, my one "absolutely have to take it" med is cheap. On the other hand, if I don't find a way to replace my health insurance when I graduate uni, I could then be denied health insurance, or denined coverage of any of the conditions I have now, when I find health insurance again. I've been lucky over the years to generally have had decent health insurance. I'm not looking forward to losing that. Also, it still doesn't cover everyone I might see (for example, my family has been paying $200 a week out of pocket for my shrink for a year)

I have friends who don't get to take some or all of their meds because they can't afford them. Certainly by this time next year, I don't know if I'll be able to afford any of the specialists I see.

Unlike most Americans, I have quite a few British friends so have a better understanding of the NHS. What I see is that the NHS has sacrificed things like timely referrals (in many places) for the affordability that private healthcare lacks. I have to admit that despite that, I would rather be in a place with higher taxes and universal health care, no matter how bad waiting times were, than everything being snappy, but not accessible to everyone. I know this may be largely based on my own fears and experiences, but at the moment it is true.

I once sat on a panel at my uni full of students with disabilities and someone asked what our concerns were about graduation. One of the biggest things we all said was fear of losing health insurance.

I have to wonder as well how much the economics factor in. I hear long waiting times for specialists and wonder if that means there's a doctor shortage. (Certainly here for some specialists it's still not unheard of or uncommon to have a 4-6 month wait) At that point I wonder what the difference is and whether it has to do with something like pay.

And now I shall stop rambling.

Chris: Not having access to, or even being denied, free vital treatment is in no way better than 'not being able to pay for vital treatment'.
Both situations are equally deplorable.
I respect the fact that your own experience of the NHS has been very different to mine. But I know I'm not alone in thinking the NHS is rubbish. Aside from family, friends and fellow patients, I know people within the medical profession even who agree. People who are suffering because of cutbacks and too many night shifts. People trying to do a good job without the resources in place. Managers baffled by new 'systems' which cost millions and achieve very little. People considering getting out or even 'selling out' and going into private practice because they can't stand not being able to deliver the standard of care they would like to see.
I would love to tell people that it's different, that free healthcare works. But sometimes it's hard to stay loyal to the NHS, if the NHS has actually caused you harm. And that's my subjective view, yes.
But this post was not based on my experience alone.
The UK doesn't fare much better than the U.S. when you look at global health stats.

Penelope: What you say about 'fears and experiences' is true. We are all likely to be influenced by what we, directly, have experienced - especially where something as emotive as healthcare provision is concerned. But it was Moore making a statement about something he has NOT experienced that riled me.
The NHS is not 'wonderful', and sadly it's not just my experience.
Re 'timely referrals' - it's an ironic observation as our Government is constantly trumpeting reducing waiting lists, and yet is still failing to deliver decent healthcare. The figures are often dubious, and sometimes it emerges that other areas of healthcare provision have suffered cutbacks to enable waiting list reduction in voter-friendly services.
You mention worrying about health cover on graduating, and people you know who can't afford all their medication. Both are appalling situations, as are many of the situations people face in the UK. And yes, I think from looking again at the ASRN's link above, it is true that the U.S. is facing a shortage of doctors.

The trouble with the NHS is that I think principally, there isn't a better way of organising healthcare within a society. However, there are much better ways of running a National Health Service than what we're doing currently. It's a baby and bathwater scenario.

However, whilst fatal mistakes and other avoidable tragedies do happen, at least we have a situation when nobody is going to die because they are too poor to go get that lump checked out - and where severely chronically ill people are often deeply impoverished and in debt just paying for essential meds.

There isn't any other fair way of doing it, other than through taxation, where you don't create hierarchies where rich and healthy, poor and sick, don't wind up coinciding - I mean, to a greater extent than they do here already.

Sara, who writes has written a fair amount about this; she has cancer and no insurance. And that's pretty bleak.

You make some good points re Michael Moore's understanding. In Canada, we also have universal health care-and Moore does seem to think its the ideal. Its not perfect, just like the NHS...however, it's dear to Canadians' hearts...and up to now, no politician who has tried to mess with it has succeeded.

Moore's big point in that film, I think, is the insured American...he who is one major illness from financial ruin. Yes, I have friends in the US who are privately insured, yes they get more timely health care than I especially in non-emergency cases...however, they pay dearly in insurance premiums and in co-pays each and every time they seek medical care. I am shocked at the co-pay costs quite frankly.

So I'll keep my system...the one where I might have to wait a bit longer-but the one with the freedom to seek any doctor I choose, the one where my dr and I select the course of treatment and the drugs to prescribe....unencumbered by an HMO as in the States....

"I wonder what is it like to be disabled in America, receiving healthcare you have to pay for, or worse, can't afford to pay for and go without. Then what happens? Do people have to stop taking medication if they haven't got the money? Do they have to make life-endangering decisions about what treatment they can or can't access?"

Yes, they do. See and for what is currently happening to one prominent American disability blogger and activist...

Goldfish: Part of my post deals with the grief I feel for what was once held up as a beacon of a health service. It’s now a shambles, and as I said to Chris above, many people I know in the profession are extremely disillusioned. They are, incidentally, the people who best understand what has happened to me. They see the result of bad decisions, poor funding, systems that fail patients, every day.
I'm glad I have an increasing grasp on the appalling situations facing people in the U.S. - people like Sara.
What I'm trying to get across is the fact that the level of mismanagement and sheer chaos within the NHS does cost lives. Poor screening programmes, postcode differences and waiting lists cause people to die of cancer over here, although it’s true to say cancer services are better funded than many, and it really hit home that Sara doesn't have access to the care people do have at least in parts of the UK.
And I hate, really hate, the irony that in my case they stuck me on a whole heap of drugs FIRST, rather than treat my condition. So yes, I don’t have a problem paying for drugs, like I would in the U.S. But they are drugs that do me harm. And so many people in my position, having fallen into the hands of extremely underfunded mental health services, have to wait years for treatment to repair the damage. And that’s damage done by the NHS.
Like I said, I wish it were different. It used to be better. Hierarchies are already being created, as I think you observed. People I know who have the money are going private for screening rather than wait, and wait, and possibly die. Stark, but true.

Cindy: Yes, I think Moore needs a wake-up call. I can understand in part why he’d be preoccupied with his country’s problems, as I’m obviously more likely to spark off about the NHS. And I do take on board points about the failings of the American system. In reacting to Moore’s lack of knowledge on the UK and Canadian health services, the resulting debate has alerted me even more to what people have to go through in the States.
His statement about the NHS, and from what I’ve read (we can’t see Sicko here yet) the misty-eyed idealism in the film with regards to Canadian and UK systems is irritating, to say the least.
Perhaps as debate continues in the U.S. he too will learn more about what it’s really like to live under supposedly ‘wonderful’ systems.
Sounds like from what you say, in Canada at least they’ve looked after your health service. They completely haven’t over here.

Shiva: Both those links are truly shocking. Really. I’m glad I have written this, as part of it has been to understand better what goes on in the U.S.

More details about the situation Shiva mentioned are at:

It's also worth reading the comment thread for this post because some Americans share their own various experiences (or the experiences of others) in dealing with the health system on this side of the Atlantic.

I also appreciate hearing more about the British system. I had read that some critics said Moore overidealized the UK and Canadian systems, but because I'm not familiar with them myself it's hard for me to visualize what that means, exactly, in pragmatic terms. Because even though health care in the UK, Canada etc have their own set of flaws, I'm sure they're generally of a different sort with different consequences for different populations than the ones who are affected the most over here.

another U.S. perspective:

I have not yet seen Sicko, but I imagine like most things in life, each person has their own experience with the health care system in the US. When I act diligently for my son, as his advocate, his health care is paid for first privately, and co-payed by the state..and is excellent, timely and thoughtful.
When I am not paying attention, when I forget to ask, or submit something or deal with the 'red tape', his care is costly and, as was the case more than once, filled with misdiagnoses.
There are many ways the uninsured, or under-insured can get health care basically for free. It just takes a lot of work, and when you are disabled physically or mentally, are here illegally, or speak a language other than English, the process can be overwhelming.
We have been in the position of having 'too much' for 'free' medical care, and not having enough to pay the premiums when we were between jobs. That was very, very hard, and nearly put us into financial ruin placing everything on credit, but with a lot of hard work..and getting back on employer subsidized insurance, we are fine now.
From my family in Canada, and friends in the UK it appears that many people privately insure on top of state-sponsored health care.. which seems to me that they are paying many times over. I wonder what the right answer really is.

I have a long term serious chronic illness and have had my share of troubles with the NHS. Long waiting lists, short staffed hospitals, bad experiences, overall which have contributed to long term irreversible damage. However I am still receiving treatment without having gone into debt or fear of not being able to afford it. I don't have to change or stop treatments midway through simply because my insurance runs out.

This is not the case for many of US based fellow members of my online support group. Those who do have insurance still have to pay large amounts, especially for the medication they take. To give you an idea, they pay as much as I do in rent! Those whose insurance runs out cannot renew it (unless you are super rich, my illness is uninsurable). Even if they are lucky enough to get on to some sort of help like Medicaid, some have then had to switch or stop the treatment they had been on, sometimes with disastrous results.

Although thankfully not in my support group, there have been cases where the patients have died by having to go without the medications and medical followups they needed. They had no insurance whatsoever and the only free care they were allowed was emergency care. By that time, it is simply too late.

Sarah, the more I hear about what goes on in the US the more it shocks me.
I find it hard to look at the NHS any more favourably though. As Goldfish observed, the the principle behind it cannot be bettered. But the provision of services is falling apart.
It's the hypocrisy of politicians that's the worst thing. People in the States and over here are dying because of lack of access to care and yet they still go on about how excellent services are.

jennyalice: Your experience sounds very stressful and way more complicated than it should be. What comes across from so many is that the added stress of red tape is hammering people who are already battling enough as it is. I think the answer can only lie in politicians stopping the soundbites and actually listening, then reforming policy or putting money where it needs to go.
But that sounds so naive. I get the feeling that both in the US and UK it'll take a lot of sorting out, over a long period of time.

Andrea: Thanks for the link, and yes, reading this thread does provide a sense of shared experience.
In the UK, and probably in Canada too, we experience different problems for differing reasons.
But suffering, and needless suffering at that, is what unites.

jennyalice mentions employer-subsidized insurance, which many Americans have, but it's worth remembering that even for those luckier people it massively limits their freedom of choice. I have friends who are in terrible jobs, bullied and harassed by managers, but cannot afford to complain because their health insurance is tied to their job. I've also heard that system described as 'like an umbrella that melts in the rain' - if you're sick for a long time and lose your job, you lose your insurance at exactly the point when you need it most.

seahorse, I agree that the NHS is terrible in many ways, and maybe what you're describing is grief at being betrayed by a system whose principles we believe in so strongly.

I am one of the American's who are insured. I just saw Michael Moore's movie on the weekend and wanted to see what others from the UK and Canada thought about it.

I am upper middle class and have insurance but we pay dearly for insurance and I pay out of pocket over $400.00 a month just for out of pocket expenses and that's not even the amount of the monthly insurance premium or if there are any Dr. visits. Those are just my perscription out of pocket expenses with the insurance co-pay. I sure would hate to see it if I didn't have insurance.
Well I wouldn't be able to take the meds I am taking which really are not that many as it's just that our country charges us close to double than it charges other countries.

I also have my sister and brother in law who owned a home right by us for 20 years. They had to sell their home and her husband who did well owning his own business had to go back to school so he could get a medical degree so they could get affordable insurance. They were paying over $1,000.00 a month just for insurance and $30,000.00 a year for co-pays of insurance. Who can afford that?

There is something wrong with a country when someone has to sell their home after 20 years in order to afford health insurance.

I hope that people from around the world can see the movie and see how corrupt our country/government is as far as health insurance goes. Something needs to be done and now!!!

The main comparison Moor makes in the film is that between the American system and the French system. Why doesn't the article mention this? There are problems with our NHS. But when choosing between America and the UK for a place to get ill? I know where I'd rather be and it aint the USA

Anybody who attempts to criticise US healthcare on the strength of SICKO or random 'factoids' in order to obtain a warm smug feeling of superiority over the US system is just wrong on so many levels. I don't understand why people are more than happy to question the inaccuracies of Moore's myopic analysis of national health systems of the UK and France through rose coloured spectacles, yet accept without question his rantings against the US system, or be blind to the heath care apartied suffered by ordinary Cubans.

For those who may be interested to see an alternative view of US healthcare, try this New York Times article:

I am a Brit in the US. I have been here for 5 years and so have experienced both systems and their failings as well as (in the case of the NHS) their triumphs.
Some seem to under the impression that it's the affording the care that is the issue, that if you can afford it you'll get the treatment you need. Well, you'll certainly get seen but getting what you need is another thing. If you have been misdiagnosed, badly treated or given the wrong drugs etc by the NHS then rest assured that exactly the same thing has happened to a US patient only they get a bill for their trouble.
Mistakes are made and it's the systems duty to improve and rectify such errors.
But you have to understand the restrictions placed on many US citizens, like what Doctors you can see, what prescription drugs the insurnace compnay will let you regardless of what your doctor says you need, etc. Then there are the errors and over charging in billing and being denied treatment all together. The NHS may be an ailing version of it's former self but I'll take it over this self serving mess any day!