I'm an American living in the UK... here's why universal healthcare is not all roses

Many Americans look across the pond with envy at the fact the UK has universal healthcare - while viewing the US system as greedy and unforgiving. 

But those who have actually moved to Britain and have first-hand experience of the National Health Service (NHS) paint a very different picture.

DailyMail.com spoke to US expats who felt 'terrified' about missing important screenings due to abysmally long wait times. 

Many revealed they were shocked by 'free' healthcare not actually being free and were blindsided by high taxes and extra fees required by foreigners. 

However, others told DailyMail.com it made them feel more financially secure and less anxious about seeking care. 

It comes as the NHS faces grim approval ratings from UK citizens, with less than a quarter of people claiming they are satisfied with the care. 

The chief complaint among Britons is wait times, which have soared to record highs following the pandemic. 

Andrea Jones - who lived in London for eight years - learned this first-hand.

The professional singer, 38, originally from California, injured her vocal cords and was told she'd have to wait six months for physical therapy.

She would not have been able to make money without, so she had to pay for private care out of her own pocket. 

'I basically had to pay for someone on my own because I didn't have the time to wait,' she told DailyMail.com. 

Physical therapy isn't the only service facing long wait times. 

It takes roughly four months to see a dentist.

And for elective surgeries like knee or hip replacement, British patients can expect to wait as long as four months on average, and up to two years - whereas the average wait time in the US in a few weeks. 

Additionally, recent NHS data showed one in five patients waited as long as six week after being referred for 'urgent' scans to detect cancer.  

Despite this, Ms Jones noted while there are pros and cons to each system, she misses knowing she could always be covered under the NHS. 

'There was that security of knowing I could access care and afford it,' she said. 

A TikToker named Sean, who moved from the US to the UK in 2017, posted a TikTok in late 2022 where he said despite misconceptions from other Americans and Brits, the NHS is still costly, especially for foreigners. 

'The NHS is not free. It's actually very expensive,' he said. 'When I say the NHS is expensive, it's expensive for the quality of service that you get.'

Sean, who moved from the US to the UK in 2017, said one of the main misconceptions among Americans is that the NHS is truly 'free.' 

He noted most Americans are not aware the NHS is paid for through taxes.

Someone making £50,000 ($62,000), for example, could be expected to pay eight to 10 percent - £4,000 to £5,000 ($5,000 to $6,200) - though the exact rate varies.

Whereas in the US, health insurance is not based on taxes and is instead either paid for by the individual, their employer, or a state-run program like Medicaid. 

'The NHS is not free. It's actually very expensive,' Sean said in a 2022 TikTok video. 'When I say the NHS is expensive, it's expensive for the quality of service that you get.'

Additionally, the UK has a smaller variety of prescription drugs than the US, meaning patients sometimes get cheaper and less effective versions.

This is because the NHS negotiates with drug companies on prices and keeps a stricter budget, which means fewer drugs get approved and become available to the public. 

For example, Mrs Jones noted while she was able to find a drug that worked for her ADHD, she would have had fewer options in the UK than the US had her medication needed to be switched.  

However, expats also had several pros about the UK healthcare. Ms Jones, for one, said that the NHS allowed her to more comfortably afford to see specialists that she otherwise could not afford paying for US insurance out-of-pocket. 

'I was just excited to have healthcare that I didn't have to pay for essentially,' she said. 'I had a lot of stuff that I hadn't really properly taken care of that I was able to take care of when I got there.'

Ms Jones estimates that she had to pay an extra £1,000 ($1,200) as part of her visa, which was spread out over two and a half years. 

She noted that her GP in the UK was the first provider she had seen who referred her for tests and surgery to diagnosis endometriosis, a condition in which tissue similar to the lining of the uterus grows in other places near the abdomen and pelvis. 

This results in painful and heavy periods, as well as fertility issues. 

'If I had to have that operation [in the US] as a freelancer, I wouldn't have been able to afford it,' she said. 'In the US, I saw a specialist but was never offered the procedure to diagnosis endometriosis.' 

Nicole, a mother-of-three from the US, noted that she had several positive experiences with the healthcare system. 

One example she gave was an ambulance ride for her son being fully covered and bringing peace of mind. 

However, she was 'terrified' by the lack of preventative screening for conditions like cancer. 

'As a woman, for me, preventative health care is the most important thing, and in the UK, you cannot get breast screening until between the ages of 50 to 53,' she said. 

Nicole said she wanted to get a mammogram at age 42 because her grandmother died of breast cancer. However, despite having private insurance, she was not allowed to get screened. 

'To me, the fact that there's little preventive care is really scary,' she said. 'I am thankful, but I'm just concerned with the preventative care side of the NHS and why it lacks so much.' 

US breast cancer screening recommendations have also generally started at age 50, though the US Preventive Services Task Force (USPSTF) last month suggested lowering that age to 40. 

On average, cancer is diagnosed earlier in the US, with national figures suggesting age 66 in the US and age 70 in the UK. 

Experts suggest this could be due to the US screening for certain cancers at earlier ages. For breast cancer, US screening starts at age 40, while the UK guidelines begin at age 50. 

And screening for colorectal cancer, which is on the rise in both the US and UK, starts at age 45 for Americans and age 60 for Britons.