English healthcare system question

It was my understanding that England had a gov’t run healthcare system that would prevent medical problems from becoming a major debt for its citizens. If that is the case how does this happen.

Burr has since been diagnosed with Multiple sclerosis, the treatment of which left him deeply in debt. Iron Maiden staged a series of charity concerts and were involved in the founding of the Clive Burr MS Trust Fund. Burr now uses a wheelchair because of the MS.

I do not know, but the account of his musical career would suggest that he has spent quite a lot of time of time touring, and probably resident, in America. He seems to have been a member of several U.S. based bands. If he needed major medical treatment while in the U.S., and did not have U.S. insurance, he could have racked up major medical debts very quickly.

The British NHS will treat British citizens in Britain for free, and generally have some sort of reciprocal arrangement with the other countries with sane healthcare systems (i.e., the rest of the developed world and much of the developing one) so that British citizens will get free or treatment if they are taken ill in those countries too. However, they are not going to pay the sort of costs that can be incurred by someone who gets sick without good private insurance in the U.S.A. They are not crazy.

I am a British citizen living in the U.S.A. myself, and I have just lost my healthcare insurance. Although my family and life is now in America, I am very seriously contemplating returning to Britain just for that reason.


He went wild and crazy with paying for lots of unusual alternative therapies not covered by the NHS (bear in mind that homeopathy sometimes is, so it really would have to be quackery);

He doesn’t live in the UK, or, like njitt says, incurred medical bills outside the UK in countries not covered by reciprocal agreements;

Or he’s broke because his illness has made it difficult for him to work and he racked up debts while he was still working that he’s now finding it difficult to pay off. He would be entitled to state benefits, but they’re quite meagre.

Organisations like the Clive Burr one are either about paying for research, raising awareness or offering ‘extras’ to sufferers and their families; what little I can see online about this charity indicates that it’s the latter. Typically the help on offer would be grants for things like a mobility scooter or a specially adapted computer, help with extra respite care above what the government offers, a helpline or support group, even occasionally days out and holidays. They don’t have anything to do with medical treatment, though of course they do (or at least they try to) help the health of their members.

Well, half a sentence on Wikipedia doesn’t really mean anything. I’ve googled, and the only other references I can find are copies of that Wikipedia piece of non-information.

Assuming that he’s actually in debt, and assuming that that debt is for medical treatment and not other reasons:

He won’t have had to pay for medical treatment in Britain. As people have pointed out, he spends a lot of time in the US; if he had medical treatment there, then he could well owe large sums of money.

There is an approved list of treatments which are paid for on the NHS, if you want to try a new experimental treatment, the NHS is not obliged to get it for you.

There’s been a few cases that have had a fair amount of publicity where someone has heard of a new cancer treatment, discovered it was not available, or at least not in their area, and paid for it themselves, generally published in the Daily Mail. It mainly seems to happen for terminal conditions where people are desperate to try anything.

There is an NHS panel which decides yearly what new treatments they will take on, and which old ineffective treatments are no longer cost efficient to supply. They don’t have an infinite budget after all…

And lest anyone believe that that means we cut corners and penny pinch: IME new and expensive treatments are usually approved. The difficulty comes with those treatments that cost more by several orders of magnitude and have near negligable benefits.

It’s the kind of decision that you really don’t want to make but in some cases we’re talking drugs that cost tens of thousands of dollars and only increase (painful) life expectancy by a week or two in a minority of patients.

What should the rule be? And if we’re gonna say any drug should be available, what’s stopping pharmas charging a kajillion dollars? (actually, what stops this happening in the US system?)

From previous discussions on here, it does happen in the US - insurance companies won’t approve every single drug of negligible effectiveness either.

One possible route is that he opted for private treatment in the UK. He may have been told there was a lengthy waiting list for treatment on the NHS and opted to pay for quicker treatment from a private hospital. I believe the NHS pays for part of the treatment in this case.

It doesn’t actually say where he sought treatment. The only thing it says is that “Clive Aid has since continued to raise awareness and funds for various Cancer and Multiple Sclerosis (MS) programs around the world” - i.e. not only in the UK. The Clive Aid site isn’t available at the moment, but there’s a blog entry that says it bought him a new wheelchair. You often hear about people raising money for such things themselves or with the assistance of charities, while the NHS provides their actual medical care; as Filbertsaid, they don’t have an infinite budget.

Unless there’s been a change, the NHS also covers anyone travelling through Britain, citizen or not. My experience was back in 1998, my wife broke her ankle in London and it was all covered by National Health.

This old blog post indicates that donations were used to perform extensive disability-related renovations to Burr’s home and to provide for continuing care.

My aunt recently broke her wrist in London the day she was supposed to return to Chicago. She has been dealing with the British hospital and her insurance to try and figure out who is going to pay for it but it’s clear that they are billing her for the treatment.

This is not supposed to be true. ‘Health Tourism’ is an issue for the Daily Mail types, and, to be fair, the NHS is not good at making non-nationals pay. That said, in general, they treat first and bill second. Further, for something as quick and routine as a broken ankle, it may not have been worth pursuing payment.

They will bill the insurance company, but, as is fairly often complained about in the news, not really bother chasing individuals for the money. I’d be curious about how much they’re asking for and how it compares to the average costs in US hospitals.

Hospitals will also bill the insurance company for at least some aspects of medical treatment if the driver was in a car crash, but the (UK) driver won’t be held personally responsible for the costs.

Treatment is free for those ordinarily resident in the UK.
Ex-pats who live elsewhere are NOT entitled to it although they may feel otherwise.

Emergency care (solely in an A&E department) is free to all, surgery and inpatient stays are charged to non residents.

So a broken ankle x-rayed and treated by a plaster cast in A&E would be free, a broken ankle that requires plates and screws and a week in hospital would not be.

Interestingly, compulsory inpatient psychiatric care, family planning and treatment for certain infectious diseases (TB is one) are free to all.


A friend of mine was telling me about having broken his wrist while visiting some European country. The doctors there examined and xrayed him, admitted him to the hospital for some orthopedic surgery, and put on a cast. When it was all over, they apologetically handed him a bill for (approximately the equivalent of) $750 for their services, explaining that they were obliged to with American patients. He then went home and had a follow-up appointment with an American orthopedist, who spent five minutes prodding his wrist and then told him he was healing up nicely. The orthopedist then sent him a bill – for $750.


That reminded me of when I had food poisoning overseas in Asia. We went to a doctor and he examined me for 5 minutes and his staff gave me two medications in plastic baggies (prolly an emetic and antibiotics?) The whole bill came to four dollars.