Ask HN: Who has moved from the U.S. to Europe?

> brink of civil war

I think that might be overstated.

> NHS is absolutely amazing

I've read and heard that for a non-emergency appointments, the wait could sometimes be months. Is that also overstated?

The wait is really months.

Also the quality of the NHS is pretty bad. The NHS being great is the usual state-backed propaganda you can hear in a lot of other European countries to justify spending all that tax money on healthcare.

Just from my personal experience: They skipped some safety measures they were supposed to follow during a birth delivery, they dealt terribly with one of my newborns after birth, they recommended removing 4 teeth of a 2 year old (we went private and all his teeth are fine and have been properly cleaned), they said that what we thought was a cavity was just a "discolouration" (it was a cavity, we dealt with it privately).

Luckily most decent employers pay private insurance (BUPA is very popular).

> I've read and heard that for a non-emergency appointments, the wait could sometimes be months. Is that also overstated?

Depends on where you are. I lived in the UK until last August and am now in the US. When I lived in London and Oxford I found the wait times to be very quick - in Oxford I could get non-emergency appointments the same day, possibly due to the high number of GPs and University hospitals. In London it was same week for everything I ever had an issue with. I believe in the less well-off areas, especially in the North of the country, there are areas with far lower staff numbers so the waiting time inflates. Worst-case scenarios in worst-case areas do have multiple-month waiting times nowadays.

I moved to UK from Europe and I wouldn’t really say NHS is convenient. It is universal healthcare and you are not facing a bankruptcy most of the time in case of a health condition. Preventative and diagnosis treatments are so slow. In case I need to see a GP, i must try reaching them at 8ish in the morning otherwise they will simply ignore you and tell, call tomorrow.

> Also the quality of the NHS is pretty bad. The NHS being great is the usual state backed propaganda you can hear in a lot of other European countries.

Not really. The NHS itself and the various NHS trusts have been continuously drained of funding over the past few decades. The NHS runs on a shoestring.

If you want things to improve, Tory cuts need to be rolled back.

The wait for non emergency treatment on the NHS can certainly be long, and COVID has made that worse. But if you're a software developer you can afford to buy or be provided decent private cover to buy your way round the queue - and since the NHS is there to cover all the difficult cases, the private insurance is much cheaper and far less likely to engage in scammy billing.

Private health insurance is a bit of a scam for anything serious in the UK though - they don't have the ability to do anything out of the ordinary or complex and send you to the NHS hospitals when they are out of their depth.

The problem is that you have to go through a GP first, which has a budget and tends to be very conservative. Many GPS will try some silly experiments for months before writing a referral. But once you get a referral it’s reasonably quick. Many companies now offer health insurance with private GPs, which tend to be less unreasonable re: referrals.

Said that it is much worse than Germany or France. To this day I don’t understand the British obsession for a healthcare system that would be acceptable in a middle income country (say Russia or Mexico), but that’s clearly not what you’d expect in a developed country.

Are you able to make an appointment for a specific date or you actually have to call everyday to see if there are open slots?

> I think that might be overstated.

You think correctly, this is sensationalist nonsense. Maybe a group of 0.05% of the population are in a bubble thinking their riots about stuff will constitute a civil war but by no means is there any sizable group wanting to protest aggressively.

It's a pretty similar system in Germany and Sweden at least though (I haven't lived in France).

I moved from the UK to Germany right when I had to have surgery and the wait time was identical (scans were much quicker though as I lived right next to a student hospital).

The only year in which the NHS budget was cut in real terms was 97 or 98. Otherwise it has increased in real terms since 1980. Since 99, the NHS budget almost doubled.

It is increasing right now, the current plan (2018-2024) increases the budget by 3.4% in real terms every year.

Is it? Unless I'm reading the following wrong:

https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/nhs-...

It isn’t similar. As you mentioned, it’s much quicker to get a scan in Germany (or Italy or France), which is specular to saying it’s very hard to get referred for a scan in the UK.

Seeing specialists through the NHS is very hard. I’m giving you some examples from my past year:

- in the UK women deliver babies without being visited by a gynaecologist a single time, my partner had to pay for that.

- The NHS don’t provide paediatricians. We have to go to a private doctor.

- Getting a referral for an allergologist was taking ages, we had to take the baby to a private doctor.

All this cost in excess of 5000£. My insurance paid or will pay back that money, so it’s not a problem for me, but not everybody is insured here.

I would have spent 0€ in Germany or France for the same level of service.

I like the NHS but it is a massive cash hole. I don't believe it could ever be fixed with more money - it's already the seventh largest employer in the world in a fairly small country. The issue is in its red-tape, middle-management inflation, and odd mix of both centralization and decentralization in regards to how the trusts are split up. I have a friend who runs a nursing ward in a major university hospital and they have something like four different data entry tools to get patients information because different GPs use different tools in and out of a specific trust. Communication runs over different tools. I once worked on a project for the NHS to do with flexible scheduling using agencies to bump admin/nursing teams when needed which consisted of a csv file, without a header or documentation, appearing in a folder that would then be consumed and with some guess work actioned. This isn't a crazy example of how the NHS works, I've seen worse, but the idea that an entire hospital functioned from this undocumented unknown csv file just made my mind blow.

I believe they release slots every morning. So it’s not possible to book for the next day. They always tell me call the next morning when I call around 9:30