It does not matter which side of the health care debate you are on, truth has long been subjugated by politics and posturing. It seems that the latest scare tactics for those opposed to any change is to darkly warn that the U.S. will become like the U.K. That intellectual giant, Sarah Palin, went so far as describe the U.K. National Health Service as "evil" evoking Darth Vadar like images of anyone over 55 being left to rot rather than waste valuable resources. I cannot compete in the supposed facts being thrown about but what I can offer is some personal experience having lived for 30 years under the evil system and that past 18 years in the land of the free but chronically under-insured.
- Both my parents lived (and died) under the British system and I cannot fault the system for the care they received. Yes the waiting lists were long for knee and hip replacements (much shorter now) but the quality of care was perfectly acceptable and the medical staff the equal (from my dumb consumer perspective) to that found in the U.S.
-Basic medical care through the General Practitioner channel was much more effective in the U.K. Doctors will still visit homes and access was easy. In the U.S. everything seems to require a referral to a specialist. Notwithstanding I have generally received great health care in the U.S. and it used to offer value for money - not anymore.
- The U.S. system seems test and drug happy - no one feels like they have received effective treatment unless at least one MRI is ordered and two prescriptions written. Tests are much less frequent in the U.K. Of course this is not always a good thing but the again you don't get a $3,000 MRI bill confirming what the cheap X-ray already showed.
- From a personal perspective I pay around four times more in the U.S. for family health care than the equivalent tax burden would be in the U.K. When I moved to the U.S. in 1991 it was around twice as much but the lower U.S. tax rates more than made up for the difference. However, my total tax burden in the U.S. is now close to what it would be in the U.K. (even with the Bush tax cuts) so the extra U.S. cost is a reduction in income and hence spending power. No doubt this is going to get worse as I pay for my share of Chevrolet, AIG, and a few thousand Las Vegas condos further hampering any consumer-led economic recovery.
- The one fact that seems tough to avoid is that the U.S. spends almost double the amount of GDP (17%) on health care than the U.K. but fails to cover 47 million people.
To my simple mind there are only two things I care about:
1. The U.S. needs to offer universal health care to its people in the same way everyone has the right to education and national defense.
2. Current health care costs are so far out of whack that radical redesign of the process is needed. How can the U.S. spend more of GDP and cover less of its people than any other developed nation in the world? An effective system should cover everyone at a total cost of around 10-11% of GDP (40 percent less than today). This is the challenge American ingenuity and entrepreneurship should be tackling. Unfortunately it seems that our politicians are the ones tasked with doing it and they do not exhibit these character traits in abundance. So put the right people on the job and give them a share of the benefits.