At Least Most Brits Like Their Government Run Health Care

Fascinating pieces in today’s Financial Times that try to correct the misinformation being spread about the state of health care in the United Kingdom. The first piece notes that Brtis of all stripes–conservative and liberal–are coming together to defend their system:

The fractious British political classes have united in defence of the UK’s healthcare system after it has become a byword for the failings of universal, state-funded provision among the US Republican right.

Gordon Brown, prime minister, and David Cameron, leader of the Conservative opposition party, on Friday both declared their commitment to the National Health Service.

The US right has used the NHS as an example of the potential pitfalls facing President Barack Obama as he tries to push through a healthcare reform bill.

Some Republicans have ridiculed it as a bureaucratic and “Orwellian” system that often denies care to the elderly – with Sarah Palin, the former Republican presidential candidate, decrying it as “evil”.

But in Britain, where since 1948 all citizens have enjoyed free healthcare from birth to death, the attacks are widely seen as wrong and insulting.

Such is the strength of public support for the NHS in the UK, that the two main political parties have agreed to ring-fence its expenditure in the coming years – in spite of cuts to almost all other departmental budgets.

Mr Cameron, who leads the Conservative party, once headed by Margaret Thatcher, on Friday described the NHS as one of the UK’s “great national institutions” and said the service was his “number one priority”.

Nicholas Timmins also weighs in:

This is a debate being driven by blind prejudice on both sides. For a start, what Mr Obama is proposing is not a British NHS. There is no proposal that a government backed insurer would run hospitals, as is still largely the case in the UK.

Second, half of the mighty 17 per cent of gross doemstic product that the US spends on health care – roughly double the level in the UK – is already funded by tax dollars through Medicare, Medicaid and the Veterans Health Administration, which incidentally does run medical facilities and provides some of the best health care in the US.

Third some of the charges levelled against the NHS are plumb wrong. That Teddy Kennedy would not get treatment for his brain tumour in the UK. That the NHS indulges in forced euthanasia. That people over the age of 59 do not get coronary artery by-passes.

Some are true. The UK does have a lower dialysis rate for kidney disease than the US. Some of its cancer survival figures look appreciably worse and quite probably are worse: “probably” for a bunch of reasons, which include comparability of the data and the fact that five-year survival figures are by definition what was happening then, not what is happening now.

The NHS does indeed have waiting lists for non-emergency surgery, although after a doubling in spending in real terms over the past decade they are much shorter than they were. And, in contrast to the impression of “socialised medicine” held by some in the US, people can by-pass those queues by going private. About 10 per cent of the population has some sort of private insurance, paid for indivdually or by their employers. The proportion has barely shifted over a decade, implying at least some sort of satisfaction among Brits at what they get.

In response to the worst of the UK performance, Brits can also pluck selective statistics from the US showing it has much poorer overall results for diabetes and a bunch of other chronic conditions where Britain’s primary care physicians treat patients well in the community, reducing complications and avoding costly hospital care.

Both pieces are worthy of your consideration.

Then there was the chat I had yesterday with an old friend, a Republican who had a senior job at the VA during the Bush Administration who also is a veteran himself. He related how horrific some of the problems are with the U.S. Government run hospitals. One of the biggest problems are the surly bureaucrats who staff the VA. More than 275,000 employees to be precise. So what to do? Let’s push this as a standard–everyone who works at the VA must get their health care (and that of their family) from the VA.

And how about this? Eliminate all government-provided health care for every member of Congress. Let’s dispense with the cushy pensions as well. If Senators and Representatives had to live like most American they might better understand why some folks in the hinterland are angry.

I am not arguing that we should adopt a British-style system. And we still have the problem that Obama has not advanced or proposed a specific plan. To make matters worse, the House bill is a mess, reflects the meddling of special interest groups and lacks a coherent vision. Let’s focus on the facts and the substance.