The relationship between Americans and the British and how they view each other is complicated and interesting. For obvious reasons Americans feel they share a common heritage with the British more so than people from other countries. But I know from my days as a student in the UK, there is a mildly contemptuous attitude by many Brits to Americans and all things American. Americans are viewed as brash, materialistic and superficial. Americans, on the other hand, despite their common heritage and fascination with the royal family, British pomp and ceremony and some movies and television programs, view the British like they view much of the world – they are inconsequential and irrelevant to their lives!

It is an attitude that infuriates much of the world and is born out of a sense of self-sufficiency and raw economic and military power as well as being on the cutting edge of all of the major innovations in the past century. It is one of the reasons why the level of indebtedness to the Chinese is so bothersome to the average American.

I recently read an interesting article about British outrage at the criticism of the NHS by some in the US in their opposition to Obama’s healthcare reforms and how adopting a single payer system tantamount to socialized medicine was viewed as anathema. Opponents of healthcare reform in the US claimed that a single payer system would result in a system as “inferior” as the healthcare system in the UK in place of the generally excellent healthcare that most Americans enjoy in the US. Brits were infuriated by what they deemed as unwarranted criticism of the NHS which offers virtually free care to people.

The spectre of something akin to Britain’s system of socialized medicine being forced down the throats of Americans as a result of Obamacare has been a powerful argument against single payer financing. There was a widespread view among Brits who commented on the article that those critical of the British health care system were the fringe element within the right-wing. Nothing could be further from the truth …. while the right may be the most vocal the vast majority of Americans of all political persuasions are generally opposed to socialized medicine or anything akin to the British system. Incidentally, the version of healthcare reform that was passed and is now awaiting a ruling as to its constitutionality by the Supreme Court, bears no resemblance to Britain’s NHS. The version that was passed essentially sought to mandate coverage to the uninsured/under-insured through private insurance companies. Even the “public option” which would have made the federal government a competitor to insurance companies could not pass Congress.

The American healthcare delivery and financing system is by no means perfect but the reality is that most Americans who have healthcare insurance are very pleased with the care they receive and the ready access they have to healthcare. The problem is with those who don’t have insurance coverage or adequate coverage available and they represent about 15% of the population – this is a yawning gap and most Americans agree that a solution needs to be found for the uninsured or under-insured but they are opposed to legislation that would impact the coverage and care received by those who are currently insured. Above all, they do not want a system of socialized medicine such as exists in the UK that limits choice and effectively rations care.

For those who are in any doubt that rationing of care is occurring in the UK, this excerpt from an article in the well-regarded “Independent” newspaper will be an eye-opener. Examples of the rationing cited in the article include:

* Hip and knee replacements only being allowed where patients are in severe pain. Overweight patients will be made to lose weight before being considered for an operation.

* Cataract operations being withheld from patients until their sight problems “substantially” affect their ability to work.

* Patients with varicose veins only being operated on if they are suffering “chronic continuous pain”, ulceration or bleeding.

* Tonsillectomy (removing tonsils) only to be carried out in children if they have had seven bouts of tonsillitis in the previous year.

* Grommets to improve hearing in children only being inserted in “exceptional circumstances” and after monitoring for six months.

* Funding has also been cut in some areas for IVF treatment on the NHS.

Approximately 15% of the British population has private medical insurance in conjunction with NHS – it gives them an option to go private if they are not satisfied with the coverage and promptness of service offered through the NHS. In fact, surveys shown that private medical insurance is one of the most sought after benefits by employees in the UK with 40% of employees expressing a preference for such a benefit – second only to the benefit of a pension. If the quality and coverage of services under the NHS were as great as the proponents and supporters claim, it seems hardly likely that it would be such a sought after benefit.

Also, the critics of Obamacare who claimed that it would result in death panels have cited the UK as being a prototype for what could happen in the US. Those claims are far-fetched and amount to scare-mongering but that is not to say that budgetary pressures may not result in the kind of choices that are high-lighted in this article in the Telegraph that is headlined “Sentenced to Death on the NHS”.

I am always wary of anecdotal evidence when it comes to the evaluation of the quality of health care in any country. I lived in the UK in my teens and early twenties and I certainly did not have any complaints about the NHS at the time – though, to keep things in context, I was hardly in need of care beyond the most minor ailments at the time. I do know that, in 2006, when I went to visit my cousin who was in one of the best stroke units in London the staffing at the unit was nothing short of appalling – there was one nurse taking care of 16 stroke patients. She was very apologetic that she could not give him the attention he needed because of lack of staff. A physician friend of my cousin who was visiting him when we were there, said that budgetary cutbacks in the NHS had created a crisis atmosphere and there was nothing that could be done and that the situation at the stroke unit was prevalent elsewhere! Such staffing levels in the US would be illegal under the laws of most states even in regular inpatient units let alone a stroke unit!

For those who think that a single payer system as exists in the UK is what is needed in the US, perhaps this anecdotal account will give one pause. It is from an American who has lived in the UK for several years. Leaving aside the subjective comments, just the process would drive the average American up the wall. Some of what she relates is nothing short of stunning. An excerpt from her account:

“That’s where I stayed until Sunday, unable to lift my head from the pillow longer than it took to answer a call of nature or vomit. And I vomited a lot. I noticed other symptoms: bloody urine, constant temperature and a nagging headache, itchy skin as well.

Did I ring a doctor? No. Why?

Well, because here’s how it works under the National Health System: You get sick, and you ring the surgery to which you are assigned. A receptionist takes your telephone number and says a triage nurse will ring you back. Never mind the actual doctor with whom you’re registered, if they NHS can diagnose over the telephone, it’s that much less work for them to do.

Two hours later, if you’re lucky, the triage nurse will ring you, listen to what you say your symptoms are, and decide if you need to be seen that day. You’ll either get assigned to see a nurse, or whatever doctor happens to be on duty. Making an actual appointment to see, you know, like the doctor whose list you’re on, is more than a joke. You’ll be given an appointment some two months in advance. I’d stand a better chance of an audience with the Queen.”

Consider this account in the Telegraph a reputable newspaper – with waiting times that are unimaginable in the US for someone who has health insurance. An excerpt about a patient’s experience:

“when the results came through two days later, however, he was informed that he had high levels of calcium deposits in his coronary arteries and that he should immediately consult his GP, who sent him for an exercise ECG on the NHS. The test had to be stopped within minutes because of abnormal heart readings.

Derek, who lives in Ilford in Essex, was prescribed beta-blockers and told to have an angiogram. As the NHS waiting list was six months, he paid £1,350 to have one privately, which was the wisest decision he has ever made. The results showed that one artery was 90pc blocked, two others were 50pc to 60pc blocked and a fourth was partially blocked.

He said: “They told me I could drop dead at any time and, as the triple heart bypass operation I needed involved a six-month waiting list, I opted for a £13,500 private self-pay package. By the time they had finished the operation, they had decided I actually needed a quadruple bypass.”

If these accounts are accurate, all I can say is that Brits who are satisfied with the NHS as it exists would just love the health care system in the US – assuming, of course, that they had insurance!

As I said at the outset, the US health care system is nowhere near perfect but I know for sure that going to a system of socialized medicine as exists in the UK would not be a panacea for the challenges facing the US in the health care arena.

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5 Responses to “Blimey! Is this really what we want in the US?”

  1. David from Essex says:

    The creation of the NHS was a disastrous mistake and marked a historic wrong turn for Britain. It’s not the “envy of the world”, as its supporters (ludicrously) claim which is why no industrialised nation in recent history has ever adopted it as a model for their own health care system.

    The NHS is abysmal, self-serving and just like British Rail prior to privatisation, antipathetic towards its customers. It is institutionally unionised – to the detriment of the patient & taxpayer. Billions upon wasted billions are funded to keep this archaic system going.

    We need a Thatcher to undo this fiasco and instead we have a Heath.

  2. Ian says:

    Having to choose between the US and UK systems is a false binary choice.

    There are incremental improvements that can be made to both systems (although I am not sure the NHS can get better without being scrapped, due to ideological insanity).

  3. Evelyn M says:

    Whatever one may say about the inadequacies of the NHS and, yes, it is admittedly broken, the one thing that must be acknowledged is that the NHS provides care for every citizen.

    The same thing cannot be said about the US where tens of millions of citizens have to fend for themselves when it comes to payment for health care services.

  4. linda ryder says:

    There is an obvious misunderstanding, between NHS Direct and a GP surgery. NHS Direct have RNs to advice, wehether you should go to the ED or wait for a phone consultation with your Doctor (I note that some Insurance companies are setting up a similar system in the US). British citizens do not loose their homes, because, they are seriously ill. That certainly is the experience of those on the lower payscales over here, if they can get Insurance. The elderly have to top up their medicare, to ensure they do not find themselves on the streets, if they require in-patient treatments. What costs over $4000, here costs $400 in the UK, need I keep going. I am sure the Doctors and Nurses, performing at the olympics, to demonstrate pride in the NHS, which by the way was started c/O Winston Churchill (Right Wing), should help you to recognise that Newspaper headlines are 20 times more horrific in regard to Healthcare over here, irrelevant of how reputible the newspaper is.

  5. David Henderson says:

    Speaking from personal experience having lived, with my family, in the UK for over two years and having used the NHS system, it does work well for run of the mill conditions like colds and flus, but if there is a more complicated issue, that’s where your luck runs out.

    Specialist care was difficult to access and the specialists we saw were downright arrogant and didn’t listen or seem to care what you thought…..there were other patients waiting.

    Just about every British family we knew had horror stories of being misdiagnosed by NHS doctors who cut corners with sometimes deadly consequences. We used a hospital emergency room on one occasion with my injured daughter and it was the dingiest, dirtiest, most depressing hospital and emergency room I’ve ever been in and sub-standard in every respect. It would have been state-of-the-art decades ago. We waited for 5 hours to get an x-ray and then speedily departed.

    Every British family we knew, EVERY single one, that could afford private health care insurance purchased it – not exactly a ringing endorsement of the NHS system.

    The US will rue the day it goes to anything akin to a British NHS, single-payer health care system…it is ridiculously expensive, inefficient and ineffective. Like all government programs it is near impossible to restructure because there are vested interests who don’t want to make changes.

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