An American Expat’s Guide to the NHS: honest thoughts

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Expats talk a lot about culture shock and the things that take getting used to when moving from the US to the UK.

The list is endless, but one of the more surprising differences for me was the NHS.

The NHS, or National Health Service, is national healthcare funded by the public.

For an American used to privatized healthcare, this was a whole new world.

There is a lot of rhetoric in America about how nationalized healthcare is a bad thing for XYZ reasons, but I’m not here to make a political argument, just to explain what my experience has been and the differences I’ve noticed.

doctor coat

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Pros of the NHS

1. Being able to show up to a doctor without fear of it costing me too much is AMAZING.

There’s no such thing as a “co-pay,” or extra money you need to spend to see a doctor or a specialist.

You just…go.

And get their help.

And that is a relief for a hypochondriac like me.

doctor doing surgery

2. Prescriptions are a set cost, no matter what it is. And it is currently about £9 per prescription.


I had a medication here a few years ago for 6 months that would have cost me THOUSANDS of dollars in the States, which is one of those weird things about America you realize once you move.

And it cost me less than 60 pounds for the 6 months.

Bless you, NHS!

3. Our local doctor is incredibly nice and helpful.

The waiting room is clean and I trust him just as much, if not more, than my doctor back home.

This of course varies place to place.

woman in hospital bed

4. In terms of getting an appointment with the GP (General Practitioner), it is easy enough at our local doctor to call up the morning of and snag an appointment.

You can also make appointments online for in the future.

Each appointment is scheduled to last 10 minutes, which is perfectly fine with me as I don’t need more than that to tell them what’s wrong and get their advice.

saline drip in hospital


1. I have never known our local office to run appointments on time.

One time I waited for an hour and was the first appointment of the day.

You generally expect to wait longer than just the 10 minute appointment time.

2. To see a specialist, you usually need to be referred by your GP.

And then you have to wait until they send you a letter or call you to schedule an appointment, which could be quite some time in the future depending on the issue.

This is really different for someone used to the American system where I would go straight to the specialist to get help without needing to go through someone else.

heart monitor in hospital

3. I was amazed to find out that private rooms (or even a shared room) at a hospital are not always a given.

When we went to visit a family member in the hospital a few years ago, he was in a room with like 10 other people!

I could not wrap my head around that.

You can pay in most instances to be ‘upgraded’ to a private room, but I think that if I did need to be in a hospital for a long time, I would prefer an American one (except for the crippling debt I’d come out with).

4. I feel like I need to self-advocate here quite a bit more than in the States.

So whereas my doctor at home would just prescribe a bunch of tests, I often need to push my doctor here to get certain things looked at.

It’s not because they don’t care, but in general I feel like British medical culture is “You’re probably fine, go home” instead of the American, “Well, it’s probably nothing, but here are 16 different test appointments so you’ll stop coming in about it.”

woman wearing nurse uniform

Overall Thoughts on the NHS as an American

For my daily life, I very much prefer the NHS.

Having the freedom to get medical help after having already paid the fees through my taxes before I even see them is fantastic.

Once I learned to self-advocate, I’ve gotten all the care and attention I needed here with no problem.

If I did come down with some horrible disease and had the money to, I would prefer go private here or I would go back to the States just to have access to more spacious facilities.

BUT, the thought that I always have the option to use the NHS and NOT go bankrupt after having come down with some horrible disease is a really, really comforting thought.

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