by Mark Angelides
As the disastrous Obamacare expensively crashes, and the new Health Care Act comes into play (probably just as expensively), many Americans are wondering why the US has not gone “Full-Brit” and created a National Health Service (NHS). A full health care system, paid for through general taxation, and free at the point of use for all Americans, would not only work out cheaper, but it would cut the price of drugs provided by Big Pharma overnight.
There are several good reasons to stay with an insurance based system (choice in care, less tax proportion on the young), but the inherent problems of the system are too great to be overcome. The main issue being that almost no one gets the actual provisions they really need. An elderly and/or sick person will be sold only the provisions that are legally required, whereas a young healthy person will be oversubscribed to a range of provisions that they will likely never use. The Insurance companies thus manage their profits based on either over or under providing. Insurance companies also have far too many ties to pharmaceutical companies and make cozy arrangements that benefit their bottom lines at the expense of you.
This is not to suggest that creating a US NHS would be without problems. Several key side-policies would need to be implemented to make it work.
- Doctors: The cost of medical training is so high, that hardly any doctors could afford not to go into private practice. But if the cost of medical school were subsidized for doctors willing to work (for example) 6 years at an NHS hospital after graduation, odds are it would encourage more students to join the medical profession and keep the NHS hospitals fully staffed.
- Choice: As in the UK, the option of Private health care is still available, but it is surprisingly cheap. Because another option is available, Private Health Insurers need to be competitive to tempt people away from the NHS. People can choose their own specialists, meals etc… but the cost is not overly prohibitive.
- Full immigration control: Whilst the US borders are so porous, a National Health Service would soon become an International Health Service with people coming and going based on their medical needs. In the UK, health tourism costs the NHS an estimated £2 billion per year (although the real figure is likely much higher), and although that only seems a small amount out of the £116 billion yearly budget, it is still a strain on resources that the British taxpayer could well do without.
A National Health Service may not be the greatest option for the US, but it is the best option so far. Insurance has been shown to fail many people (especially when it comes to actually paying out), Obamacare has left people on low incomes being fined money they can never pay back for failing to pay premiums they can ill afford. And whilst some may argue that it is up to the individual to take care of their health bills, coming from general taxation, they would be. What does the US have to lose by trying it?
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