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Monday

 

Managing MS: a transatlantic tale of healthcare in US v UK






















An MRI scan of a brain showing multiple sclerosis


Aimee Keane in New York and Hannah Murphy in London

Neema Mirchi woke up one Saturday morning in March of 2015 feeling groggy after a late night out with friends. His vision was blurry; something was wrong.

Four days later, a neurologist at Mount Sinai hospital in New York City would diagnose Mr Mirchi, then 28, with multiple sclerosis (MS), an autoimmune disease that attacks the protective covering of the central nervous system and disrupts communication between the body and brain.

MS awareness groups suggest that between 2.3-2.5m people live with the disease worldwide. Many with so called “relapse-remitting” forms of the condition are able to live normally with the help of disease-modifying treatments. Yet their ability to manage their symptoms depends greatly on the healthcare available to them.

Once diagnosed with the condition, Mr Mirchi would incur a litany of costly medical treatments in order to stabilise it.

In the US, access to affordable medical care is a critical factor. According to the National Multiple Sclerosis Society in the US, 70 per cent of MS patients report “some difficulty” paying for healthcare and 16.4 per cent report “a lot of difficulty”.

The US healthcare system is run largely by the private sector. For those who do not qualify for the government assistance programs designed to help low-income families and the retired, access depends on insurance plans offered by an employer or on Healthcare.gov, the online insurance marketplace created through the Affordable Care Act of 2010, otherwise known as “Obamacare”.

The Milliman Medical Index, which measures the out-of-pocket cost of healthcare for a typical American family of four, on an average employer-sponsored plan, came up with a figure of $24,671 for 2015. According to Milliman, the actuary that publishes the index, this number has almost tripled since it began tracking these costs in 2001, an increase attributed in part to a spike in prescription drug costs in the US over the past few years.

When Mr Mirchi decided to see a doctor, he was quickly ushered from an urgent care facility to the emergency room at Mount Sinai St Luke’s Hospital in midtown Manhattan. Nurses ran a series of blood tests, while the attending physician conducted an eye test and ordered an MRI scan.

The hospital’s MRI machine was broken and so he was immediately transferred to a Harlem hospital via ambulance to have the scan. “That’s when I knew this was really serious,” Mr Mirchi says.

A day later, he was sitting in the office of a neurologist hearing his diagnosis. Lesions had formed on his brain, causing inflammation of his eyes, and the blurry vision. “Leaving the hospital that day,” he says, “I was just miserable.”

He would later learn that the bill for this single day of care, including hospital and physician fees, lab tests and the ambulance, totalled $14,367. He knew he would be responsible for at least some of the bills as his employer-sponsored health plan required him to pay the first $2,000 of costs.

Despite that, Mr Mirchi considers himself lucky — the average annual cost for someone with MS in the US is $69,000, including healthcare fees, as well as ancillary costs like lost wages, according to the MS Society.

As a full-time employee, Mr Mirchi enjoys medical benefits, along with a generous holiday and work-from-home policy, allowing him to keep up with medical appointments. And although his speedy diagnosis came at a price, it is a luxury not available in many of the universal healthcare systems operated by other countries.

A few years earlier, in March 2013, Henry, a Londoner who did not want to reveal his surname, woke up with odd sensations down the left-hand side of his body. At first he dismissed the creeping numbness, but when his symptoms worsened in the days that followed, a friend drove him to the accident and emergency unit of a local hospital in west London. So started a two-month-long journey before Henry would receive his MS diagnosis.

“It was quite a drawn-out process and a frustrating one,” says the 27-year-old musician.

Unlike many MS sufferers, Henry did not have any visual impairments so staff at A&E concluded he had a vitamin B deficiency. They sent him for blood tests — which came back negative a few days later. “At this point, I’m walking with a stick, I’ve got very wobbly legs and no one knows what’s going on,” he says.

Story Source: The above story is based on materials provided by FTHEALTH
Note: Materials may be edited for content and length



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