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! <\/p>\n
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. <\/p>\n
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.<\/p>\n
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.<\/p>\n
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.<\/p>\n
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”<\/a> newspaper will be an eye-opener. Examples of the rationing cited in the article include:<\/p>\n * 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.<\/p>\n * Cataract operations being withheld from patients until their sight problems “substantially” affect their ability to work.<\/p>\n * Patients with varicose veins only being operated on if they are suffering “chronic continuous pain”, ulceration or bleeding.<\/p>\n * Tonsillectomy (removing tonsils) only to be carried out in children if they have had seven bouts of tonsillitis in the previous year.<\/p>\n * Grommets to improve hearing in children only being inserted in “exceptional circumstances” and after monitoring for six months.<\/p>\n * Funding has also been cut in some areas for IVF treatment on the NHS.<\/em><\/p>\n <\/p>\n 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.<\/p>\n 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<\/a> that is headlined “Sentenced to Death on the NHS”.<\/p>\n 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!<\/p>\n