I lived in Scotland for a decade or so. On the surface, the provision of healthcare seemed good, and the media constantly tells you it is, but it tended to fall apart once you needed it for anything serious.

I heard of the experiences from countless others and, sadly, encountered it myself. As the patient, even though you are paying for the service through high taxes, you are not seen as the customer. This leads to a certain sense, when you do need a medical service, that they are doing you a favor, that you are somehow the recipient of charity and should be grateful for what you get.

Decisions about what medicines or treatments are available are often political, with certain high-profile conditions sucking up scarce resources at the expense of others. The focus is very much on managing public opinion.

There are many situations in which cost considerations have a horrific impact on lives. For instance, if there is a medicine which can prevent you losing your sight, but it is expensive, you will be offered it only for your second eye after you have lost sight in your first - the reasoning being that it is only worth spending that much money to prevent total blindness, but sight in one eye is enough.

If you think that your high taxes mean that your healthcare needs are covered, think again.

There is also a deep-rooted coverup culture that circles the wagons around bad doctors and poor processes. In my case, a ridiculous misdiagnosis had a real impact on my life for over a year. The other healthcare professional only came clean about it after the lead doctor had retired.

Again, you are not seen as the customer, as the one paying all their wages, so, you should just shut up and be grateful for what you get.

I often laugh when I hear inexperienced American talk about how much better the health system is in the UK. Sure, health insurance is expensive, but the actual healthcare is leagues ahead of anything available via any sort of national health service. Being recognized as the customer, with real rights, is of pivotal importance in receiving the care you need, when you need it.

In fact, you often come across UK citizens with a rose-tinted view of the National Health Service, but such opinions tend to change rapidly once you actually need something more than an occasional General Practitioners appointment. The whole thing is a cruel joke.