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**JUNE 7, 2023**
Kuttner on TAP
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**** A Visit to Hallowed Ground
Despite efforts by British Conservative governments to strangle it, the
National Health Service remains a jewel of fair and efficient socialized
medicine.
LONDON - This was going to be a post about the Labour Party's
program and chances in the next British general election. That will have
to wait a few days.
Yesterday, I had some odd health symptoms that suggested a visit to a
doctor. This being Britain, off I went to the walk-in clinic of the
nearest hospital of the National Health Service. What happened next is
enough to make an American progressive weep.
I arrived at St Thomas' Hospital, one of London's busiest, at 10
a.m. By 10:20, I had been through a courteous triage process, filled out
a basic form, and was scheduled with a GP. The doctor saw me at 11:00,
took a history, examined me, performed a couple of tests right in his
office, assured me that this was not serious, and shook my hand.
"Do I need to check out?" I asked.
"No, you are free to go," he said. Less than 90 minutes after arriving,
I was on my way.
Bill: zero.
At home, I would have waited hours; the ER charge alone would have been
at least $1,000, plus separate line items for the doctor's fee, the
tests, and more. Insurance would have paid, but the inflated bills add
costs to the system. (Had I needed treatment in London, I would have
been billed, but at rates reflecting true costs.)
The author at St Thomas' Hospital, London
The NHS, founded right after World War II by the great postwar Labour
government of Clement Attlee, remains a model for the world. The Tories,
who have been in power since 2010, are doing their best to starve it.
The waiting list for elective services has about doubled since 2012
<[link removed]>;
doctors and nurses are overworked and underpaid.
But the system still gives priority to prevention and basic acute care.
Even a besieged NHS is far better, fairer, and more cost-effective than
our system. Britain is a poorer country than the U.S. but has an average
life expectancy almost four years longer (80.9 years to America's
77.3).
Because the NHS is true social medicine with salaried doctors and
nurses, the money and time wasted in the U.S. on parasite middlemen,
coding and billing, rapacious insurance companies, hospital
profit-maximization strategies, and excess lucrative procedures, is
simply not a problem or a drain in Britain. All the money goes to
patient care.
Sitting in the pleasant St Thomas' waiting room, I noticed that the
people there were from all social classes. Nearly everyone in Britain
uses the NHS. You can't get better care by paying privately. You can
jump the queue for elective procedures-but that's due to Tory
underfunding of the NHS, not because private services are superior.
In this fiscal year, the entire NHS costs 152 billion pounds
<[link removed]>, or
about $180 billion. That's close to two-thirds of all of Britain's
spending on health care. By contrast, the U.S. spends a staggering $4.4
trillion.
Relative to GDP, Britain spends about 12 percent and covers everyone. We
spend just under 20 percent, and tens of millions of Americans have no
coverage while tens of millions more are woefully underinsured and must
pay exorbitant sums or do without.
Alert readers may recall a similar piece about a medical experience I
had in France last year
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(My wife accuses me of feigning illnesses in order to write columns
comparing health systems, in policy travelogues.)
It took an electoral revolution in 1945 for Britain to get its cherished
NHS. All the marginal tweaks being debated to fix the broken American
health care system will change nothing fundamental. The cure is not
technical but political
**.** Only a comparable electoral revolution, with far more courageous
Democratic Party leaders, will get us what ordinary Brits have had for
three quarters of a century.
~ ROBERT KUTTNER
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