Medical Care in Great Britain and the United States

In Britain, there is a National Health Service (the NHS), which is paid for by taxes and national insurance, and in general people do not have to pay for medical treatment. Every person is registered with a doctor in their local area, known as a general practitioner or GP. This means that their name is on the GP's list, and they may make an appointment to see the doctor or may call the doctor out to visit them if they are sick. People do sometimes have to pay part of the cost of drugs that the doctor prescribes. GPs are trained in general medicine but are not specialists in any particular subject. If a patient needs to see a specialist doctor, they must first go to their GP and then the GP will make an appointment for the patient to see a specialist at a hospital or clinic.

Although everyone in Britain can have free treatment under the NHS, it is also possible to have treatment done privately, for which one has to pay. Some people have private health insurance to help them pay for private treat­ment. Under the NHS, people who need to go to the hospital (e.g. for an operation) may have to wait a long time on a waiting list for their treatment. If they pay for the treatment, they will probably get it more quickly.

Anyone who is very sick can call an ambulance and get taken to the hospital for free urgent medical treatment. Ambulances are a free service in Britain.

American hospitals are in general well-equipped and efficient, and doc­tors earn incomes far above the general average. For anyone who is sick, the cost of treatment is very high. There is a strong prejudice against "socialized medicine" (particularly among doctors), and there are only two federal health programs. Medicare provides nearly free treatment for the elderly, Medicaid for the poor – though, with an extremely complex system of admissible charges through Medicare, elderly people do not recover the full cost of some types of expensive treatment. Even so, the cost of Medicare to federal funds rose to seventy billion dollars in 1985, or more than two thousand dollars for each of the thirty million participants. Medicaid, for the poor, varies from one state to another because the states are heavily involved in it and some contribute more generously than others.

Working people and their families are normally insured through private plans against the cost of treatment and against possible loss of earnings if they are sick. The plans are often operated by deductions from one's salary. They too are enormously expensive, and the cost is rising. No single insurance sys­tem is absolutely comprehensive; some people have more than one policy and yet remain liable to bear some costs themselves. Among ordinary people anx­iety about the possibility of illness is accentuated by fears about its cost. These fears are reflected in some resentment against the medical profession, and this resentment is not alleviated by doctors' reluctance to visit patients in their homes. When people are sick, they usually go first to an internist. Unlike in Brit­ain, however, people sometimes go straight to a specialist, without seeing their general practitioner first. Children are usually taken to a pediatrician. As in Britain, if a patient needs to see a specialist, their general doctor will usually give them the name of one. Doctors do not go to people's homes when they are sick. People always make appointments to see the doctor in the doctor's office. In emergencies, people call an ambulance. Hospitals must treat all emergency patients, even if the patient does not have medical insurance. The government would then help pay for some of the cost of the medical care.

Comprehension

1. Answer the questions.

1. Do people in Great Britain have to pay for medical treatment?
2. What is the NHS?
3. What does being on the GPs list mean to a person?
4. Are GPs trained in any particular subject?
5. How can a person make an appointment with "a specialist doctor jn the UK / the US?
6. What are Medicaid and Medicare?
7. Why do people buy private health insurance in Great Britain / the US?
8. Can a patient call a doctor out to visit him in Great Britain / the US?
9. What happens to emergency patients without medical insurance in the US?

2. Circle T if the statement is true, and circle F if the statement is false.

1. There are special national health services both in Great Britain and the US. T / F
2. Unlike Britain, most people in the US have medical insurance. T / F
3. GPs in Great Britain make an appointment with a specialist doctor if a patient needs to see one. T / F
4. Americans do not call GPs out to visit them. T / F
5. People in Great Britain pay for the NHS only by taxes. T / F
6. Being on the GP's list means you can visit him any time you need to. T / F
7. Under the NHS, people have to pay the whole cost of the drugs the doctor prescribes. T / F
8. You don't have to pay for an ambulance in Great Britain. T / F

Text 3

The National Health Service

The text is taken from a British Council booklet for overseas students called "How to Live in Britain". It is important to know how to register yourself under the NHS and to know what treatment is free and what is not free.

Medical treatment, except for statutory charges towards the cost of med­icines, dental services and glasses, under the National Health Service is free to persons who are ordinarily resident in Britain.

As an overseas student residing in this country you may receive medical treat­ment under the National Health Service during your stay. (If you are here on a short-term basis this is generally limited to any necessary treatment for condi­tions occurring after your arrival in Britain but you may be permitted emergency treatment for conditions you were suffering from before arriving but only if treat­ment cannot await your return home.) As soon as you have found somewhere to live you should register with a doctor practicing under the National Health Service so that he can attend you if you get sick. If you need advice about registering ask the manager of the hostel, or your landlady, or the local National Health Service Family Practitioner Committee, whose address can be obtained from the local post office. If you live far away from your college it is better to register with a doctor near where you live. If your college has its own Student Health Service you could register at the college instead of with a local doctor.

If the doctor you contact has room on his list and is willing to accept you he will give you a card to complete which he will then forward to the National Health Service Family Practitioner Committee. They will send you a medical card bearing your registration number and the doctor's name and address. Keep this card in a safe place since you will be asked to produce it and give your registration number if you have treatment. There are statutory charges payable towards the cost of prescriptions, dental services and glasses. You will, for example, if you are 21 years old or over have to pay a proportionate part of the cost of dental treatment up to a maximum charge of £10 and, at present, the pharmacist will generally charge 20p for each item on the doctor's pre­scription for medicines and other necessary items. While vision testing is free, the charges for spectacles broadly cover their cost.

The National Health Service will provide you with advice and treatment for illnesses that occur or recur in aggravated form after your arrival in this country. If, as a student here on a short-term basis, you seek treatment for a condition (including pregnancy) which existed before your arrival, you will be regarded as a private patient and expected to pay all expenses. A bed in a hospital can cost over £100 a week and you may have to pay specialist fees. It is important for you to find out from the doctor or hospital providing the treatment whether they regard you as a private patient or are treating you under the National Health Service. There is no way in which fees paid as private patients can be refunded and if your situation is such that you may be treated under the National Health Service (as explained above) and you do not specifically want to be treated privately, you should make this clear at the start. It will be in your interest to have a complete medical check-up and X-ray before you leave home to ensure that you are in good health.

In Northern Ireland students at recognized places of study receive general medical and dental services under the National Health Service, but they usually have to pay hospital charges. In Northern Ireland also the families of married students are not eligible for health service benefits.

Comprehension

Answer the questions.

1. Do you pay the complete cost of medicines, dental services and glasses under the NHS?
2. Will an overseas student normally receive NHS treatment for an ill­ness that began before he came to Britain?
3. Where can you get the address of the local NHS Family Practitioner Committee?
4. Are doctors obliged to accept anyone who wants to be placed on their lists?
5. When you first go to the doctor, what must you do if you are accepted?
6. What will the doctor do?
7. What will the NHS Family Practitioner Committee do?
8. If the total cost of NHS dental treatment you receive is £12, how much must you pay?
9. If a doctor prescribes one bottle of tablets and some sleeping pills, how much will that normally cost?
10. Who do you pay for prescriptions?
11. Is vision testing free?
12. Are glasses free?
13. In what circumstances will an overseas student receive NHS advice and treatment for an illness that began before he came to Britain?
14. What will normally happen if an overseas student wants treatment in Britain for an illness he first began to suffer from in his own country?
15. Why is it particularly important to know whether you are being treated as a private patient or an NHS patient?
16. What should you do before coming to Britain?
17. In what two ways are students treated differently in Northern Ireland?

Text 4

Russian Medical Care

Americans have always judged other countries on the basis of American life. The press in the United States of America is no exception, and recently they have been analysing the dire situation that Russian hospitals find them­selves in at this present time. However, the press in the United States does tend to overexaggerate these problems, and they tend to shed a very dreary light upon the present state of Russian medicine.

To say that Russian medicine does not have any problems would be to falsify information. In actuality, Russian medicine does have many problems. For example, Russian hospitals are in the very difficult position of having absolutely no money. This much-needed capital is needed to pay doctors' sal­aries, to buy medicines, needles, etc. Without this money, Russian hospitals have to scramble to find ways of merely surviving in this quickly changing world.

How are many Russian hospitals able to survive? Many doctors are not paid for several months at a time. They continue to work merely because they cannot abandon the profession that they have chosen. Many of them argue that they chose to become doctors in order to help people, and they cannot leave it now just because of the mere fact that they are not getting paid.

However, medicine seems to be an even bigger problem. After all, how can a patient hope to be cured without the healing effects of medications that hospitals are supposed to supply? Medicines are very expensive, and Russian hospitals just cannot afford to supply them. Here again, a temporary answer has been reached. The patient must supply his or her own medicine. Howev­er, the stay in the hospital continues to be free. Thus patients are able to stay in hospital rooms for as long as they need to, as long as they are able to supply the medication that they need.

As for the facilities of Russian hospitals, they are in bad need of repair. Buildings are beginning to fall apart, and there is no money to repair them. This casts an eerie glow upon the Russian hospitals when half of the lights in the hospitals do not work. However, this is a much less serious problem than the previous ones, but nonetheless one that needs to be addressed.

The strength of Russian medicine seems to lie in the people who remain devoted to their given professions. The quality of care that doctors can give considering the circumstances that they are faced with is truly astounding. They are able to work and care for patients as well if not better than the doc­tors who have all the amenities that Western countries usually possess in their hospitals. Despite this lack of medicine, Russian doctors have obviously not forgotten their Hippocratic Oath, and continue to work to help people in the best way that they can.

In conclusion, it would be unfair to say that Russian medicine is in a horrible state. The fact is that it does need monetary help, but the level of competence of Russian medicine is on the same level as any other sophisti­cated country. If Russia were able to finance all of its hospitals and supply them with adequate medicines as well as pay their doctors salaries on time, Russian medicine would certainly be one of the best examples of modern health-care in the world.

Comprehension

1. Find factual mistakes.

Russian hospitals are in a dire situation these days as they are short of money. But many doctors continue to work because they can't find a differ­ent job. One of the most serious problems is absence of good medicine. The patients have to supply their own medication because hospitals are unwilling to provide them with expensive medicine.

A more serious problem is that of repairing the hospitals. But for the money Russian medicine would be one of the best examples of modern health care in the world.

2. Answer the questions.

1. According to the text, what are the problems of Russian medicine?
2. Why are Russian hospitals able to survive?
3. What does the strength of Russian medicine lie in?
4. Why would it be unfair to say that Russian medicine is in a horrible situation?

Text 5