As I am on "second wind" I'll just post a couple of comments about what you can actually expect if you are acutely ill here. If I need to see a general practioner I can get an appointment in 48 hours, if urgent I can go to the surgery and wait a couple of hours max to get an emergency slot. Out of surgery hours I can either go to a local centre or call out a doctor for a home visit  from the locum service (how many American doctors do that?) I live a half hour bus ride from two hospital minor injuries units run by GPs and nurse-practioners. On each of the two times I have had to use them I was seen within about 10 minutes of booking in at recption. Ambulance service is free and most crews now are fully trained paramedics who can stabilise patients instead of doing a "scoop and run". You can also get free advice from trained nurses on a local rate telephone call system. They either give self-help advice or refer you to a doctor or call an ambulace for you. Called "NHS Direct", they also have a web site that duplicates much of the "decision tree" expert systems that they use for the advice.

My local doctors' surgery has clinic sessions for dieticians, psychogical counselling, osteopathy, baby checkups and innoculation. It also does minor surgery (like removing a skin tag that my shirt collar kept knocking and a couple that were just annoying). I get annual flu injections as I am considered "high risk" because alergies can very infrequently give me a mild asthma. One of the doctors does acupuncture treatments and they can refer you to subsidised exercise sessions in the local swimming pool/gym. Non-urgent hospital treatment can mean waiting but the times are coming down. The main difference in quality is the "hotel accommodation" as there are still multi-bed wards - though these are now often arranged as 6-8 bed "bays" in the newer hospitals. Some operations are being carried out in private hospitals to reduce waiting times. These are fairly widely available as the better off take out private insurance to get better "hotel facilities" like  individual rooms or to be able to specify the date for a treatment. If you have an acute illness like cancer, a hospital will admit you for treatment virtually immediately.

All is certainly not roses. There are ridiculous financial problems resulting hospitals having to make staff redundant because of changes to their funding. Bed occupancy is so high that the risk of catching infections like MRSA are increased. Many have had to "contract out" services like cleaning and laundry to private companies who can provide inferior servies to the old in-house systems. At the moment there are some areas where quick access to sexually transmitted disease clinics can be difficult - meaningeitherr ou have to shop around to find one that has a limited "walk in" system or making an appointment. This particular problem seems to result from a combination of the underfunding of a "cinderella" service and an increase in demand from patients wanting a sexual health check-up as a result of publicity.

You should also realise that the service is organised semi-locally into "health care trusts" covering say a county or couple of London Boroughs. Drugs are both licensed for use (ie declared safe like FDA approval) and new ones are approved for use as cost-effective by a central body called N.I.H.C.E. (pronouced nice as the H was added later) Their decisions can cause problems - an example being their refusal to approve inhaled insulin for general use. The local Trusts can refuse to pay for treatments not passed by NIHCE - a current one is a treatment for early breast cancer which is only effective in certain cases and is marginally more effective than existing therapies.

A large part of the financial overspend (actually a measly 1% of the whole budget if you take the country as a whole) is down to the effect of considerable improvements in nurses' pay and the pay and conditions of doctors. These are now about the highest in Europe and a lot of doctors have come from other EU countries to work here. This has recently caused a scandal as trainee doctors from non-EU countries who qualify are having to apply for work visas that they might not automatically get.

If there are problems, a lot  can be traced back to the government's constant re-organisation of the structures and slavish aherence to targets like reducing waiting times without reference to clinical urgency.

If you look at the cost to the individual, it works out at about 16% of pay, split between employer and employee but that also includes payments for a basic retirement pension. Obviously the young, unemployed and those retired over 60/65 (the retirement age for women and men) do not make these payments. (The difference between these contributions and the actual costs are made up from general taxation) Drug costs are a flat £6.75 (around $12) per drug on a NHS prescription, free for the young, elderly and those on very low incomes. Pharmacies can also sell a number of drugs over the counter and dispense some items like the "morning after pill" without having to get a doctor's prescription.

While the system may not be perfect, it certainly offers a far higher proportion of the population virtual immediate access to advice and urgent treatment than in the USA. Of course there are differences. You might not get an MRI or CAT scan if a standard x-ray will provide an equally good diagnosis. On the other hand the Accident and Emergency Departments (Emergency rooms) are not clogged with the poor getting treatment for chronic illnesses. Apart from those in high risk groups, women do not get breast x-rays every year. (Rather more scandalously men do not get regular testing for prostate cancer. They are also far less likely to have very early operations for it, which may not be so bad if you consider most are very slow growing and quite frankly a  70 year old will die of other things before a newly diagnosed prostate cancer will kill them, plus they do not have to live with the common side-effects. The recommended practice now is not to give drugs for mild to moderate depression in the first instance. Self-help like exercise is likely to be suggested, then talking therapies offered and only if these do not work are drugs recommended. This NIHCE recommendation is fairly recent so the effects have not fully worked through the system yet. One important difference in the approach is that young people should not be given drugs except in very severe cases and then only certain very safe ones should be given. You may know that some of the anti-depressants have potentially fatal side-effects as they can produce inappropriate violent behaviour to either self harm or attack others.