Do You Have Insurance?

The first thing they ask you in America is not what’s wrong.

It’s: “Do you have insurance?” The first few times I heard it, it honestly felt strange.

As a Brit who had grown up with the NHS, I wasn’t used to healthcare beginning with paperwork and policy numbers. In the UK, you walk into your local doctor’s surgery, give your name, maybe your date of birth, sometimes your address, and then you sit down and wait to be called.

No forms. No discussions about money. No “checking coverage.” Just healthcare.

When I moved to the United States, especially when taking my son to appointments, the difference was immediate.

Before you are checked in, there are forms to sign, insurance cards to hand over, systems to process. It feels administrative before it feels medical. But then something else struck me too. The waiting rooms.

Back home in the part of England where I lived, most doctor’s surgeries felt tired. The buildings were often run down, the noticeboards overflowing with posters that nobody really read anymore, and the waiting rooms were usually full. You rarely visited the doctor without sitting alongside another twenty people waiting for their name to be called.

In Florida, it felt completely different. At my doctor’s office, there are only three chairs in the waiting room. Sometimes I don’t see another patient at all. The rooms feel modern, clean, quiet and calm. Maybe that differs elsewhere in America, but it was one of the first things I noticed.

Then there’s the appointments themselves. In the UK, appointments often feel fast because they have to be. Doctors are under enormous pressure, and the system is stretched thin. You go in, explain the issue, receive your prescription and head next door to the pharmacy. Usually within ten minutes your medication is in your hand and you’re heading home.

In Florida, it almost feels reversed. The appointments are slower, more detailed and less rushed. Nurses usually see you first to check your blood pressure, weight, temperature and other observations before the doctor arrives. You often leave with printed paperwork explaining everything you discussed, and there is time spent updating records while you wait.

But then comes the pharmacy experience. Unlike the UK, where the prescription is often filled immediately nearby, in Florida the prescription is electronically sent elsewhere and, in my experience, it is almost never ready when you arrive. You’re usually told to come back in an hour, which sounds simple until you remember that nothing in Florida is particularly close to anything else.

It’s a small frustration, but one that stands out when you’ve experienced both systems.

The differences continue when you need specialist care. In the US, you often have choice. You can research specialists, read reviews, ask for recommendations and decide who you want to see. In the UK, the NHS generally decides for you. The trade-off, of course, is cost. You may wait far longer, but you are not usually worrying about whether you can afford the appointment itself.

And that, really, is the heart of it all. Both systems have strengths. Both systems have flaws.

America often delivers a more personalised, efficient and comfortable healthcare experience — if you can afford it.

The UK provides universal access regardless of income — but the pressure on the system is visible everywhere.

As a parent, I honestly cannot imagine what it must feel like to worry about whether you can afford medicine for your child. That is where the American system feels deeply unfair to me.

At the same time, the NHS is carrying burdens that are becoming impossible to ignore. Stories about corridor care, waiting lists and overwhelmed hospitals dominate headlines for a reason.

Neither system has fully solved healthcare. Maybe no country truly has. But if I were designing a healthcare system from scratch, I think I’d start here:

Children and the elderly should never have to worry about the cost of healthcare. No paying for medicine. No paying for appointments. No paying for treatment.

For everyone else who is able to work and contribute, perhaps there is a middle ground somewhere between the two systems — one that protects people without overwhelming the system itself.

Because healthcare should never feel like a luxury. But it also should not feel impossible to access. So perhaps the real question is not: “Which system is better?” Maybe it’s: “What could both countries learn from each other?”

I don’t write this as a politician, healthcare executive or policy expert. I write it simply as a British mother now raising a child in America, trying to navigate two healthcare systems that are both impressive, frustrating and deeply human in very different ways.