This story has moved. You now can read it at AAFP News Now, the Academy news publication that launched April 4, 2005.
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I read with interest the article "New President Calls for Fairness, Decency, Respect for All Patients" in the November FP Report, in which AAFP President Mary Frank, M.D., expresses her dismay with the poor access to health care for some Americans. I am a U.S.-trained physician (an FAAFP) currently working in Great Britain as a general practitioner. Of course the British National Health Service is the bogeyman (along with Canada's system) for those in the U.S. medical system -- both doctors and insurance companies -- but I have observed and studied how it works, and it has a great deal to offer us.
It was quite a paradigm shift/epiphany for me, when I first lectured about the American system to British GPs, to realize how appalling the American system is to them (and to me, but one can never smell the foul stench of the atmosphere one has lived in for years until an outsider points it out). They recognize and complain about the NHS' inadequate funding and delays in nonemergent care (and, sadly, sometimes brief delays in emergent care) but cannot fathom the cruelty of denying all but emergent care to 44 million people too poor or too proud or too foolish or just too unlucky to not have health insurance that pays for their health care needs.
I see now our system as a cruel, negative lottery for the uninsured: They gamble that they will pay no penalty (and save, could they possibly have paid in any case, the costs of buying insurance), but if they are unfortunate enough to have a severe illness or injury, they may suddenly owe thousands if not millions in hospital and medical bills.
Jennifer Marsden, M.D.
Andover, England
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