The Great Ormond Street Hospital in London

Alex Dunn.  Introduction by William Astore.

The New Year promises much misinformation about Obamacare as “socialism.”  Whatever else you can say of Obamacare, it’s not state-owned or state-provided.  Rather, it relies on private, for-profit insurance companies to provide health care coverage.  In short, health care in the USA remains a market-based commodity.  You get what you pay for, assuming you have the money or coverage to pay.

Anyone who’s dealt with medical bills in the US knows the baffling nature of the system.  The deductibles, the co-pays, often the need to obtain prior authorization from your insurance provider before your doctor can act—all this and much more make the system incredibly complex.  Even with private medical insurance, many Americans are driven to financial ruin by escalating medical bills.  Medical bills remain the number one cause of bankruptcy in the US, affecting nearly two million people a year.

Of course, there is another way: state-funded and state-provided health care, a single-payer system.  I lived it for twenty years in the US military.  I can’t say military health care was always topnotch, but it was often good and occasionally excellent.  Of course, I couldn’t choose my doctor, but I never received a bill when I needed an MRI or an examination.

It’s funny how Americans have no objection to socialized medicine in the US military (We love our troops, right?), yet otherwise we equate government-run health care with “death panels” and the end of America.

As puzzling as the American way of health care is to us, it’s even more puzzling to those who’ve experienced the peace of mind that comes with good health care provided by the state without the threat of personal bankruptcy and financial ruin.  But I’ll let Alex Dunn, with his vantage from across the pond, take it from here.  W.J. Astore

Healthcare in the UK: Great Care Instead of Nightmare

By Alex Dunn.

The European Union (EU) in general and the United Kingdom in particular is regarded by many commentators in the US as being a socialist experiment to be regarded with disdain and suspicion in equal measure. Republicans often cross the Atlantic to highlight examples of what they see as socialist witchcraft – exactly what they accuse Obama of practicing with Obamacare. When the topic is healthcare, the UK is a handy destination. The old colonial power can still pull on the bogeyman costume of red coat and musket, and the plummy accent is still enough to provoke the rebel spirit.

The British National Health Service (NHS) is presented by the Republicans as a perfect example of the catastrophic state interference that Obama has in mind for US healthcare. From this Briton’s perspective, such a twisted caricature is viewed with astonished amusement.

Twenty minutes of the 2012 Olympic opening ceremony in London celebrated the work of the Great Ormond Street Hospital and its children’s charity, giving global audiences an idea of where the NHS sits in British affections. If this segment went over US viewers’ heads, it was in good company. Another Olympic segment which thanked Tim Berners-Lee for inventing the World Wide Web had NBC commentators scratching their heads. They had no idea who he was. It was a bit like the BBC claiming not to have heard of Thomas Edison.

Why is the NHS held in such high regard in Britain? Consider the following example: should one suffer the misfortune to be knocked over by an automobile on a UK road, an ambulance will turn up, scrape the victim off the pavement and ferry him or her to an NHS hospital.  An overworked emergency room will then do its best to put the victim back together and dispatch them on their way as swiftly as possible.

It is true that during busy times when the British proclivity for excessive alcohol consumption results in startling numbers of accidents (weekend evenings), delays stretch to hours, but patients in mortal peril of expiration are shuffled up the list in priority against those suffering from UBIs (unidentified beer injuries).

If American readers think that this sound pretty much like the procedure at home, consider that at no time is our British victim asked for a credit card number or insurance details, nor will he be frisked for cash. Even more startling, our victim has no fear of medical bills and the debt collectors that thrive on them.

In the NHS, the sick are treated equally. A patient’s financial situation does not preclude him receiving any specialized treatment. Prescription drugs do incur a charge, but an administrative one, presently about $13 per item. Those needing expensive drugs only pay for the processing of the prescription.

In contrast, the cost of US medical care presents the ironic possibility of a patient needing to pay for dialysis by selling a kidney on eBay.

The NHS is not cheap at an annual $231 billion (just under 10% of GDP), but it helps that the UK does not have a panoply of “intelligence” agencies to fund. What about the British GCHQ I hear you ask? It turns out that GCHQ is to the NSA, what Tony Blair was to George W. Bush — a useful poodle to outsource leg work to. The only difference is that GCHQ at least has the sense to charge for their services.

Many Americans believe that an NHS model could never work in the US.  The cost of US ambulances alone should seriously endanger the possibility of following the UK model.  In 2012 British ambulances had to scoop up 42 fatal shooting victims.  The “scoopable” number killed by guns in the US in 2012? Around 30,000.  And rising.

The NHS healthcare system does undoubtedly result in delays for some procedures, outpatient treatment, and the like, but the tradeoff is more than worth it in the name of providing equitable healthcare for all Britons.

The NHS is not socialism, unless by “socialism” you mean an effective and durable strategy to deliver affordable and decent health care to the population of a major advanced industrial state without marginalizing those who cannot afford it.

So Republicans have no reason to fear: a US NHS is not coming. Your private, for-profit, health care providers have ensured that there’ll be no repeat British invasion.

Alex Dunn is a British ex-pat who currently lives in Luxembourg.