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British National Health Service a Model for Reform?


A 2007 health care survey by the Commonwealth Fund found that the United States, with the most expensive health system in the world, is outperformed by other developed countries on measures of quality of care, access to care, and health outcomes.  And, although the other countries reviewed had varying types of health care systems, most provided a publicly financed system, with universal coverage for their citizens. It is that kind of a national health care system that the US should use as a role model for reform of the US health care system.

America’s health care crisis grows more serious year by year.  47 million Americans, nearly 20% of the US population, are without any health insurance coverage, and that number grows as more and more workers and retirees with job related health care coverage watch it disappear in a shrinking economy.   It is now estimated that there could be as many as 25 million Americans who are underinsured, only a serious illness or medical emergency away from financial ruin.

In “Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care”, the Commonwealth Fund focused on interviews with physicians and patients in Australia, Britain, Canada, Germany, New Zealand and the United States who were asked to speak about their experiences and views on their health systems.  The US ranked last in most areas, including access to health care, patient safety, timeliness of care, efficiency and equity.  Americans also were last in terms of whether they had a regular physician.

In another study of why health costs in the United States are so much higher than in eight other countries of the OECD (the Organization for Economic Cooperation and Development) - Australia, Britain, Canada, France, Germany, Japan, the Netherlands, and New Zealand – it was found that, even though the US spends the most on publicly and privately financed health insurance, its citizens had the most potential years of life lost due to circulatory and respiratory diseases as well as diabetes.

The number of uninsured Americans is rising while the number of U.S. companies offering a health care benefit to employees is falling.  Health care premiums have risen 78% in the last six years but wages have risen only 19%.  The financial health of the American middle class deteriorates every month because of health care costs.

The public-private programs that have been established in the US – Medicare, Medicaid, and the SCHIP program – have proven to be successes, making vast improvements in health outcomes for seniors, low income families and children.  That doesn’t mean they are without flaws, but they have proven to be efficient deliverers of health care service to the populations they cover.

A guaranteed American health care plan would cover every American citizen with health care services financed publicly and implemented privately.  An American health care program would create a national risk pool including every American, driving the risk down to the lowest possible point.  Under an American health plan, there would be no interference with the delivery of health care services by the private sector, while public financing would provide financial support to drive the system to achieve maximum efficiencies and lower costs. 

Such a health care system works in many of the industrialized nations of the world including Great Britain; it will work for the United States as well.

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