Britain's National Health Service and the "Appreciation of Life"

In 1990, my family became uninvited guests of the British National Health Service. It wasn't our plan. My husband, Denis Leary, and I were young, broke and I was 6 months pregnant.
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I don't think that Britain asked to be involved in our national debate over healthcare reform, but comments from certain members of congress, such as Republican Paul Broun of Georgia who claims that the UK and Canada "don't have the appreciation of life as we do in our society, evidently," have put some Brits on the defensive about their National Health Service. I don't know what personal experience Congressman Broun has with the NHS, but I'd like to share ours.

In March of 1990, my family became uninvited guests of the NHS. It wasn't our plan. My husband, Denis Leary, and I were young, broke and I was 6 months pregnant. We had been flown to London by the BBC because Denis, then an unknown comic, had been hired to appear on a television variety show called London Underground. We were supposed to stay for two nights but -- and I wish there was a daintier way to say this -- my water broke as we strolled down Oxford Street, the day after we arrived.

Denis and I took a taxi to University College Hospital in central London and were immediately seen by an obstetrician and admitted. I was given an ultrasound and an amniocentesis test and it was confirmed that I was pregnant with a 26-week-old fetus. The doctor informed us that our baby's chances of survival were less than 50%, if he were to be born during the next few days. I would like Sarah Palin to rest assured that there was no "death panel" to determine whether or not our son was worth saving. On the contrary, I was placed in the maternity ward and received outstanding medical care from UCH's highly qualified and compassionate medical staff. I was given a series of injections of a steroid that had not yet been approved in the United States, but that helped my baby's lungs produce surfactant -- a substance that normally doesn't develop in human lungs until 32 weeks gestation. Because of these injections, my son, who was born at 28 weeks gestation, breathed on his own from birth, and was never placed on a ventilator.

As non-citizens, we were not entitled to receive free services from the NHS, but nobody delayed our admission or emergency medical care to ask how we intended to pay. We had health insurance, but the doctors and nurses actually seemed slightly embarrassed when we brought this up and it was several weeks into my stay at the hospital before an administrator approached me to inquire about the insurance. He assured me that I would receive the same standard of care whether I was insured or not, but if I had insurance, they would like to be reimbursed, if that was possible. Of course we were happy to supply our insurance information and our carrier was more than happy to pay up (you'll see why in a minute).

I was in the hospital for two weeks before delivering, had multiple ultrasounds, the amniocentesis, blood tests, medications and ultimately a caesarian delivery. Our son was in the neonatal intensive care unit for two months, the first weeks in a level one unit where he had 24-hour, one-on-one nursing care. After I recovered from my surgery, I was provided a room in the University College's student dormitory for a very minimal fee. I was given a hospital breast pump and was encouraged, daily, by the midwives and nurses, to keep my milk supply up.

After our son's discharge from the hospital, he still wasn't healthy enough to travel by plane so we had a health professional come to our temporary home -- as they do to every home in Britain after a baby is born -- to see how we were doing. The "health visitor" taught me an infant message technique that she had learned at a seminar in Sweden that was known to improve the muscle development of preterm babies. She taught me how to hold our tiny baby in a way that soothed his colicky belly. She answered my frantic, new-mother questions. She hugged me, because I was a little teary, and so far from home. She gave me her card and told me to call her anytime. She told me where to take our baby for his first vaccinations. Later, she called me to check that our son had received them.

Our bill? 10,000 British pounds. At some point we compared medical bills with an American couple that had had a 28-week preemie at around the same time. Their bill was in the hundreds of thousands of dollars.

But more to the point than the cost of the care, was the value that was placed on our tiny son's life from the moment we walked, dazed and panic-stricken through the doors of University College Hospital. The goal of every person who attended to us, every moment that we were there, was to save this baby and offer him the best medicine had to offer. In some cases, such as with the steroid injections, this was better medicine than would have been available to us in the United States.

I spent many weeks in the neonatal unit and saw many sad cases. Babies with severe birth defects. Babies who were born at 24 weeks gestatation, or even earlier. Some of these babies had been in the NICU for months and months. There was no "death panel" deciding the fate of these most vulnerable lives. No life was considered unworthy of the outstanding care that was being provided. I learned, during our time in the UK, that the British are very proud of the NHS and for good reason. How embarrassing, now, to have to watch our provincial leaders, in the government and the media, try to frighten American voters by making uninformed, extremely negative references to a healthcare system, that, in my experience, far outshines our own.

Ann Leary is the author of the memoir, An Innocent, A Broad, (Morrow, 2004) which details her experiences with the NHS, as well as the novel Outtakes From a Marriage, (Shaye Areheart, 2008).

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