The American health care system sucks. We pay more for health care than any country in the world and we only get average results. And tens of millions of Americans have no health insurance. Our latest attempt to address this situation, Obamacare, is a mind-numbing kluge of laws and policies that is off to a very rough start. And even if Obamacare ends up working, it will only fix part of the problem.
The problem, as a ground-breaking article by Steve Brill made clear, is that America’s health care providers and insurers treat people differently. If you’re lucky enough to be included in a big insurance plan provided by a huge entity with a lot of negotiating leverage (such as the federal government), you pay low rates and low prices. If you’re unfortunate enough to be in a high-risk group or not to be included in any plan, you pay sky-high prices. Or you get all your “health care” from the emergency room and, thus, lay the costs off on everyone else that way.
The answer, as Brill’s article also made clear, is a fully national health insurance system, in which all Americans are covered in the same massive group and for-profit insurers and health care providers can’t pick and choose who to cover and how much to charge them. This system would effectively extend the current Medicare and Medicaid system to the whole population, and, in so doing, make it even more efficient.
As in some other countries with national health insurance, Americans insured under this system would also be free to buy additional health care services, including additional private insurance. The system, in other words, wouldn’t limit anyone’s ability to pay for “premium” health care services if they chose to.
But a lot of Americans still hate that idea. They have been told since birth that “national health care” is a disgrace. They have been brainwashed so thoroughly by America’s vastly profitable medical industrial complex that their resistance to reality and change has become a religion.
Anti-change advocates don’t assess facts. They just claim, absurdly, that America currently has “the finest health care system in the world” and then cite horror stories about sick people dying in streets because they have to wait so long to get the (terrible) health care services available to them under “socialist” health care. (This horror story, naturally, is presented as the polar opposite of our current system, In fact, in many ways, it’s similar. Today, in America, many people without health insurance spend their lives waiting until they get so sick that they can go wait in emergency rooms. And then our often wildly profitable hospitals pay for their care by, effectively, sending their bills to everyone else.)
Anyway, any American who is skeptical about national health insurance but has an open mind should read this testimonial from another American who is currently living in a country with national health insurance—Britain. An American expat, Dawn Rutherford Marchant, lives in the UK with her family. She was recently asked on Quora to describe her life there. Amid this description (full answer here), she had the following to say about Britain’s national health care system:
A massive advantage of living here is the National Health Service. If an American could understand it, they would be amazed by its magnificence.
In this past week I have seen an ENT consultant surgeon and have had surgery scheduled in a few weeks’ time. There was no direct cost to me.
Tonight my GP (family doctor) rang at 8pm to check in on another health issue. She is chasing a consultant to authorise a new medication and will ring me back next week. This did not cost me a penny.
So, three doctors and one medical procedure without a form to fill in or a bill to pay. Pretty damn impressive stuff—yes, I know it is in our taxes but the system works well. It is ‘from birth to grave’ care all woven together into one service—ambulance to GP to hospital to nursing care. There are all kinds of synergies created by such a system. It is to be deeply respected, emulated, and not feared.
The British National Health Service was created shortly after World War II, when everyone began to realize what a mess the system of private and municipal insurance was. It was a political challenge to get it passed—not surprisingly, those doing well under the status quo pushed back—but it passed. The NHS now costs the UK less than half as much per person as the U.S. system does. It is paid for with an 11 percent tax. The contributions equate to about $3,000 a year per person.
In addition to the National Health Service, the UK also has private insurers, which about 10 percent of the population choose to use. In other words, the British system has all the benefits we say we love so much—the ability to pay more for premium health care if we want it—and it also covers the basics for everyone in the country at half of our per-capita costs. Not bad!