Does British Health Care Suck?
What’s Best For the USA?
My wife and I recently returned from a cruise to seven Caribbean ports. We took that opportunity to do an informal survey on health care. Starting with dinner on our second night, we sat down next to an obviously British couple, Colin and Sue, who were more than pleased to answer our questions about the UK. We knew little about the UK, never having studied it extensively in school or visited there. Now was our chance to get the real lowdown from two average well-educated Brits.
Not surprising, most of our questions to them concerned British healthcare. Most of their questions to us concerned American gun policies, which confounded them.
Here is a sample list of my questions: Are you satisfied with your health care system? Do you have to wait a long time to see a doctor or have an operation? Are you doctors good? Do they speak English? Why do Canadians and English come to the states and spend their own cash for medical treatment? Are drugs inexpensive and easy to get in the UK?
Our questions may have seemed a bit hostile to our Brit friends until I explained why we wanted to know. Lately it seems I have found myself debating Obama care on the Internet, but had no first hand information about “socialized” or UK health care. Colin and Sue were pleased to answer all our questions. True, much of it was anecdotal but, nevertheless, it was useful. We learned a lot and so did they.
I’ll start with the questions mentioned above. Yes, our Brit friends were very satisfied with the UK health care system and had very few minor complaints, but no desire to change the system. They had no complaints about the time they had to wait for treatment. Actually, the time was approximately the same as we Americans have to wait for a doctor’s appointment. Fast care was provided for in emergency situations. Brits are assigned a doctor at a clinic, and are referred on to a specialist if necessary, but have the choice to change if they insist. Americans seldom change their family doctor or the specialist who may be treating them. Americans usually take what they get without complaint. Americans have no idea how good their doctor is, and have never done research concerning their doctor’s qualifications.
It is true many British doctors are from Indian and Pakistan and carry heavy accents, but that’s often true in the USA as well. Brits seldom come to the states for private treatment because they have access to excellent public and private treatment in the UK and in Europe. Wealthy Canadians probably cross the border more often but they also have ready access to private care. Many Brits and Canadians have supplementary health policies, as do American Medicare patients. Over 90% of Brits favor taxing to pay for health care.
There are drawbacks to private health care in the USA. Insurance claim adjusters decide who is paid and who is not. They have quotas to meet. They can’t approve too many claims for fear of losing their jobs. They work on a commission; the more claims they deny, the more commission they make. A certain percentage of claims is rejected initially. A certain percentage of claim appeals are denied, and a certain percentage of secondary appeals are denied. Insurance companies know that most of those who appeal will become discouraged and give up, or eventually will die from lack of treatment. It is true that some bogus claims are weeded out, but the profit motive makes claim denial too profitable, too tempting to administer without careful oversite. Insurance companies already have too much power. They can choose your doctor, your treatment, your medications, they can deny, and they can delay. Nothing is more infuriating and frustrating as having the life of a loved one put in jepeorady or lost due to insurance denials and delays.
Drugs? Yes. They are less expensive in the UK and Canada than in the USA because the UK buys directly from the Pharmaceutical Companies at discounted prices. Americans routinely cross their northern and southern borders to buy drugs more cheaply.
Overall, we could see little difference between UK health care and American health care, except that all Brits have health care and millions of Americans have no health care. Also there is that huge discrepancy between drug prices. Quality and access seemed equivalent and our Brit friends had no complaints. They were shocked to hear so many Americans had no health care and our drug prices were so high.
At each Caribbean port we found an opportunity ask our tour guides about health care in their nation. The nations were either independent or administered by the UK, or Holland. In every case we were told the government paid for everything and there were no complaints. Access to private care was also available to those who could afford it. Foreign nationals are settling in Caribbean nations more frequently and routinely bring their national coverage with them.
The American military and Veterans Administration and Medicare provide excellent government run health care systems much cheaper and more efficient than private insurers. So do most police and fire departments and state and federal governments. When is the last time you heard have a congressperson or senator complain about their health care policy? All this seems to be good evidence that both universal and one-payer systems work well. So, why is the USA the only developed industrialized nation that does not provide health care to all its citizens? I don’t have a good answer, but here are a few bad answers.
The prevalent argument from the Right is, of course, a universal single payer system is too expensive. We cannot afford it. Private health insurance, on the other hand, would create competition and drive down the cost of health care. I don’t buy into the argument.
If everyone had to buy on the open market, the average health insurance shopper would get conned by insurance companies. They would be as inefficient at shopping around as they are buying life and car insurance. Comparative shopping often works but it takes time and smarts, which many good people don’t have. If intelligent shoppers really worked, everyone would own the same insurance, which would be the best and cheapest insurance, but they don’t. Everyone would own the best washing machine and dryer, but they don’t. Few American shop effectively even though consumer magazines lay out the facts for them. Advertising misleads, yes, even lies to the public. How many people subscribe to Consumer’s Reports magazine? Very few. A complicated purchase, such as a health insurance policy, is beyond the abilities of the average American. Just think of how many Americans were bamboozled by banks selling bogus mortgages to buyers who could not afford them. Clever advertising and slick expensive commercials routinely overwhelm the average buyer.
Major decisions concerning health care are too important to allow manipulation by slick advertising departments and agencies. If the federal government can make good health care decisions for the Congress and Senate, for our veterans, for all government employees, including our military, why not trust them to create and administer a single payer system that will be under the close scrutiny of elected officials or unbiased regulators? It makes good sense to me, and to most nations, and to most Americans. Doctors favor a single payer system 2:1. Surveys indicate a single payer system would have less red tape, have less bureaucracy, provide equal access for all, provide more bang for the buck, and higher quality care.
Steven Brill’s brilliant article in Time magazine, March 2013, sheds light on the short -comings of the American health care system as opposed to the UK system of “socialized” health care. His article gave me the shudders. Check it out.
Remember, 18 million Americans die each year because they did not have health insurance and 45 million Americans don’t have any insurance today. They and their children are suffering today. Most of the rest, do not have adequate insurance or are not covered between jobs. I am convinced that our present health care system, with revisions and waste cuts, would serve most Americans better than private insurance with huge managerial profits, and dictatorial control over patient treatment and costs. Private insurers will insure profits for themselves at the expense of the American public.