"Two Essential Truths"
"There are, I think, two essential truths in international health policy," writes Alex Massie. "No-one sees fit to copy the [U.K.'s] National Health Service and no-one sees fit to copy the American system." That sounds about right to me. The NHS and the American system are both outliers. The American system biases doctors toward overtreatment by paying them for everything intervention they try. The British system does the opposite by paying them a lump sum for each patient, and every treatment comes out of that total. The effects are predictable: The American system is extremely expensive. But the British system is extremely cheap. Uncommonly cheap. Weirdly cheap. About 41 cents for every dollar we spend per capita cheap.
That makes the British system, to the mind of most people, too cheap. The American system, of course, is far too expensive. The British system might be a better deal than our system is, but there's no reason we have to buy the thing on sale. Which is why other countries refuse to imitate either our model or the British model and generally go for a more hybrid system.
Anyway, Massie actually lives amid the NHS and goes on to explain some of the differences:
The relevance of the NHS to American health care plans seems pretty limited anyway since, as best I can tell (though I try not to pay too much attention to these things) Obama doesn't actually plan on copying the NHS.
Fundamentally, however, the difference between the systems is psychological. In Britain you worry what will happen when you fall ill; many Americans worry about what will happen if you fall ill. Will your insurance cover you? Often (but not always), yes it will and the best American care probably is better than the best British care, but there's a greater psychological security to the British system. That's probably worth something too. In other words, many Americans find themselves fretting about healthcare even when they're perfectly healthy. That's a psychological burden people in this country (and many others), don't have to worry about.
For more on the differences between the world's many health-care systems, go here.
August 11, 2009; 12:11 PM ET
Categories: Health of Nations
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