Trump said he wants to replace Obamacare with something ‘better’ — here’s what he could learn from the British

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Erin Brodwin / Business Insider

In his first major address to Congress, Trump urged Congress to repeal the Affordable Care Act and replace it with something simpler, less expensive, and more efficient.

I recently moved from New York City, where I’d used Obamacare, to London, where I enrolled in the National Health Service, Britain’s public health care system.

The transition has taught me a great deal about the differences between the two systems, and has highlighted some areas for improvement that American leaders could focus on back home.


I arrived and started working in Britain in September 2016. Before moving, I’d gotten private insurance in New York through my employer. Prior to that, I’d used the government insurance program Medicaid.

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Business Insider / Erin Brodwin

Once I got settled in London, I needed to sort out my health care, so I started my search as any newbie would — with Google. I typed in “find a doctor in the UK” and there, under two sponsored ads, was a link to The National Health Service (NHS), Britain’s public system of “socialized medicine.”

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Google

On the NHS website, I was asked to enter my post code (the equivalent of a zip code in the US).

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NHS

Source: NHS


After doing so, I got a list of results for doctor’s offices within about a half-mile of Business Insider’s UK office. Nothing too surprising here, until I looked at one column…

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NHS

… Ratings! I could see how each doctor’s office near me had performed according to patients who’d evaluated their experience.

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NHS

The other columns were helpful too — they told me things like how many patients were currently registered with the doctor and whether or not an office was accepting new patients.

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NHS

Once I’d selected an office, I was taken to a screen where I could see its hours, a list of doctors, and its contact information. Clicking the link for the “registration form” took me to the UK-wide new patient paperwork.

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NHS

It was a single-page PDF, so all I had to do was print it off, fill it out, and bring it to the doctor’s office. As an American, I’m accustomed to filling out a magazine’s worth of paperwork, so I was sure I’d missed something.

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NHS

But when I showed up at the doctor’s office, the receptionist smiled and took my form. “You’ll be registered in our system in 24 hours,” she said.

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Flickr/George Redgrave

Shortly after that, I realized my prescription for the antidepressants I’ve been taking for 10 years was running out. In the US, I needed a psychiatrist who accepted my insurance (and agreed to see me regularly) to refill it. This had been frustrating in New York, where it took me months to find someone.

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Thomson Reuters

At times, it felt as though I was trying to treat a made-up condition. If I’d had a broken arm, surely I would have been able to find a doctor to fix it, I often found myself thinking.

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Flickr / Sandor Weisz

I thought about my months-long search to find a psychiatrist in New York. I’d spent weeks poring over databases until, finally, a doctor who accepted my insurance AND was taking new patients called me back. It felt like a miracle.

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Erin Brodwin

While I was talking this over with a friend, she told me that in the UK, I’d probably be able to get my antidepressants from a general practitioner (GP). Roughly 60% of Americans with depression get their drugs this way, but I’d always been referred to specialists. That meant I’d needed to see a therapist weekly and a psychiatrist monthly for my prescription. In London, I’d already found a therapist. All I needed was the prescription.

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Flickr / Orbis – Giving the gift of sight

Source: Yale Journal of Psychiatry and Medicine, 2013


I called the doctor’s office the next day and said I needed to book an appointment to renew my prescription. The GP called me three hours later, and we talked about my history and treatment for about 15 minutes. My prescription was ready that evening.

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Unsplash/Freestocks.org

I was elated. No endless searches or pointless appointments. No paperwork to convince my insurance company to help pay for the cost of my treatment when I found out that my psychiatrist was “out of network.” And practically no waiting. To celebrate, I had a piece of cake. Yes, really.

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Erin Brodwin

The next day, I headed to the nearest chemist (pharmacy) and picked up my prescription. The best part so far? It was incredibly cheap — less than the equivalent of $8 for a 90-day supply.

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Flickr/Geoff Holland

Source: Lloyd’s Pharmacy Fluoxetine 20mg Capsules


I’ve been pretty been blown away by how seamless the entire health care process in London has been — from finding a doctor to booking appointments and getting a prescription. Everything feels so much easier.

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Erin Brodwin

To be fair, the British system has its drawbacks. For example, US emergency rooms are generally faster at treating patients than those in the UK. In the US, 95% of ER patients are seen within three hours, whereas 84% of UK ER patients are seen within four hours. Plus, wait times for specialty procedures can be longer in the UK.

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CDC

Sources: Centers for Disease Control and Prevention, 2012; Business Insider UK, 2015; The Guardian, 2014


On the whole, I prefer my experience in the UK. My health care is basically free — it’s included in my taxes, which for most Brits are very similar to the rates Americans pay under Obamacare (and there are no insurance premiums). Plus, there’s essentially no paperwork, and the wait times for most procedures are minuscule. Most importantly, though, I can get the antidepressants I’ve been taking for 10 years from my GP, which at least to me, made it feel like depression here is treated as it should be — like a valid illness, rather than a made-up one.

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Erin Brodwin

Sources: Which? Tax rates, amounts, and allowances; Business Insider UK, 2015; The Guardian, 2014