Oxford University economist Simon Wren-Lewis explains why the British, despite complaints, remain attached to socialized medicine. Even Conservative politicians find they must support the National Health Service (NHS) or risk alienating voters.
What is perhaps not understood outside the UK is that the British regard the NHS as an institution on an equal par to our monarchy. Not beyond criticism, but seen as absolutely essential to national life. While many aspects of the 1945 post-war social transformation have been swept aside (nationalisation of utilities) or greatly modified, the idea that the health service should be free to all and paid for through taxation is sacrosanct. ….
The NHS embodies a principle that in critical matters involving health, all members of a society should be equal. Overall the UK is not a particularly equal society, and income and wealth inequalities have been growing, but this is one area where there is a strong national consensus that while additional income should mean that you contribute more to a health service, this does not entitle you to receive better treatment.
Do the British pay dearly for this attachment to equality in health provision? If you look at measures of quality or efficiency, the UK does reasonably well, but what does appear consistent is how badly the US performs in terms of efficiency. …. So what seems more likely is that it is the US aversion to government involvement in health provision that is a little delusional. Which of course brings us back to that certain US politician, who not only came up with a plan to try and improve the US health care system, but when the President took it up, he has been kind enough to let the President take all the credit.
Simon Wren-Lewis, “Why the National Health Service played a central part in the Olympic Ceremony“, Mainly Macro, 31 July 2012.
HT Mark Thoma
Government health care is free for all residents in the UK, but no-one is forced to consume it. Private alternatives exist for those who want a higher standard of care and are willing to pay. This socialized system is similar to education systems almost everywhere: government schools are free, and private tuition is available for those willing and able to pay fees.
It is not necessary to go so far as the UK to achieve universal health care. Canada, for example, has socialized health insurance (a single payer), but leaves provision of health care in private hands. Switzerland has achieved universal health care with private provision and private insurance, but this requires mandated purchase of insurance, subsidies for low-income families, and tight government regulation of insurance companies.
The United States is the only advanced country in the world that fails to provide universal health care for all residents. Medicare – government insurance primarily for older US residents – is nearly universal, and works quite well. Medicaid, available to those without access to Medicare, is means-tested and performs very badly. It is extremely difficult for Medicaid patients to find health care providers willing to accept them, because Medicaid rates of reimbursement for services are quite low. This is yet another example of a universal system (Medicare) providing more benefits for the poor than an alternative system (Medicaid) used exclusively by the poor.