Meds Across Borders
When you live in a country where the health care system is in trouble or hard to access, what do you do while you’re abroad?
In the UK more than one person in every 10 (I think it’s close to 1 in 7 now) is on a waiting list for health care. The length of time people have to wait for even urgent types of care can be startlingly long. If the need is not urgent, the wait can be years long. But I could also ask my question if I still lived in the USA where the cost of health care is remarkably high.
These days, whenever we are in other countries we look for ways to help ourselves avoid needing to see a doctor after we go home.
A surgeon I know went to a Third World country for a few weeks. It was a charitable endeavor by a group of medical people. They work hard on such trips, delivering specialized medical care to people who otherwise would not get it. Pharmaceuticals were readily available at absurdly low prices, so they stocked up on whatever they would need at home. As doctors, they can get whatever they need where they live, but it costs much more… and these days shortages of specific drugs keep popping up. What is easy to find in one country can be unavailable for weeks or months in another.
This is as true for veterinary medicine as it is for human medicine. The surgeon has horses. Other doctors have smaller pets. They stocked up on meds for their animals too.
What they got fits under the umbrella of personal use. They didn’t get extra meds to sell or hand out. Nothing they got was narcotic. They stayed within the rules.
Governments in countries where health care costs are high tend to get upset when people do this. They say medications can only be trusted to be properly made in their high-cost nations. Sometimes they have a point. (Once I got a med in Mexico that had effects indicating some contamination from a previous batch of something else in equipment that didn’t get fully cleaned. But only once. Let’s just say that was a very low incidence of such trouble.) Often the real main issue is that they don’t want their pharmaceutical industry to have to compete with supplies from a country where prices are lower.
People in the USA frequently bring medications back from Canada or Mexico. Prices are lower outside the USA, and drugs that require a prescription in the States are often available over the counter elsewhere. In Canada in particular, there’s little reason to worry about the quality of manufacture or counterfeits or contamination. It’s trickier in Mexico, but navigable.
What about me during my visit to Texas?
This time I focused heavily on things that don’t come back in a box or a bottle.
My mother’s dentist runs a HEPA filter in each treatment room. His staff wear face masks (usually respirators). The dental practice I’ve always gone to in the UK no longer opens windows, has no ventilation system, doesn’t have air filters, no longer allows any fallow time between patients in a treatment room, no longer requires face masks—although staff will wear a baggy blue if I request it. Last year I allowed a few months to pass after the NHS issued new guidance about ventilation and air filtration in health care facilities. Then I asked what the practice was doing to comply. They were mystified. What guidelines? Why would anyone want to ventilate or filter the air?
To be fair, the doctor’s office and even the local hospital behave similarly. The last time I saw a doctor, she had a HEPA filter on her desk. It was turned off.
My mother’s dentist isn’t taking new patients, but bent the rules months ago to schedule me in for a long-overdue cleaning and checkup. We timed it so that if I picked up any airborne germs on my flight over, we would know before my appointment. I tested before going in. They didn’t ask me to, but it seemed like common courtesy.
Now that I’m back in the UK, I’m following up on a rumor of a dental practice with good infection control protocols against airborne diseases. My wife needs safe dental care too. Fingers are crossed for the rumor to be correct.
I also got boosted with Novavax. At the time COVID vaccinations were no longer available in the UK in any way. The NHS wasn’t administering them any more and getting them privately was forbidden.
A few hours after I got my shot, UK government announced that Novavax will be made available, but only privately at £45 per jab. Health care isn’t supposed to be delivered this way in the UK. Going private is supposed to be extra, not for necessary care.
I wanted to get vaccinated against RSV, but it’s very expensive in both countries, $325.99 in the States or £350 (about $440-$450, privately only, NHS doesn’t offer it) in the UK. That shot only lasts a couple of years. I wear my FFP3 mask for nearly every indoor potential exposure and sometimes outdoors. What are the odds of getting RSV in light of my habits? Very low.
Turning away from RSV, could I get some other vaccination that would be more useful at a lower price?
Looking through my vaccination cards, I realized I was due for a tetanus booster last autumn. It’s a ten year vaccination. The last time I was due for one, the NHS called me in to get it. This time, the NHS is swamped. The shot isn’t anywhere near the high price of vaccination against RSV, and it’s a must. Tetanus is endemic in the UK’s soil. In some regions, especially potent strains are common. Years ago a colleague got pricked by a thorn when not up to date on tetanus boosters. She was rushed to A&E and given a booster as an emergency.
My wife and I putter in the garden during the growing seasons. That’s potential exposure.
I could press the NHS to give me a booster for no charge. Instead, I chose to pay a little to get it in the States and not add myself to NHS waiting lists. Tetanus, diptheria and pertussis all in one—from past experience I know pertussis would kick my butt, so protection against it is a bonus.
None of this is new. When AIDS exploded onto the scene, gay men often went to Panama for health care. It was USA-trained, USA-style medical attention at a fraction of USA prices. More importantly, it could be paid for in cash and never get into records in the States. This prevented health insurance premiums zooming out of reach (or coverage cancellation), landlords finding out and evicting, employers finding out and firing, family finding out and disowning…
Health care is struggling in many parts of the world, but not always in the same ways. If you have to travel to another country, it can be worth your while to find out what they’ve got that is currently not easy to come by at home and that you can legitimately bring back with you.
Well stated!
It's a shame that health care in both countries is so problematic.