US vs UK healthcare

FT journalists Aimee Keane in New York and Hannah Murphy in London compare healthcare systems in the two cities. Their article compares the experiences of one man in each city, aged 28 and 27 respectively, who fall ill and are diagnosed with multiple sclerosis (MS).

Each system has flaws. An important distinction is costs – and who bears them. The New York patient was fortunate to have private insurance through his employer. His diagnosis was speedy (one day), but he had to pay the first $2,000 of the $14,367 bill for a single day of care. The British patient, with access to universal healthcare (NHS), had to wait two months for a diagnosis, but paid nothing out-of-pocket.

In the US, access to affordable medical care is a critical factor. According to the National Multiple Sclerosis Society in the US, 70 per cent of MS patients report “some difficulty” paying for healthcare and 16.4 per cent report “a lot of difficulty”.

The US healthcare system is run largely by the private sector. For those who do not qualify for the government assistance programs designed to help low-income families and the retired, access depends on insurance plans offered by an employer or on Healthcare.gov, the online insurance marketplace created through the Affordable Care Act of 2010, otherwise known as “Obamacare”.

The Milliman Medical Index, which measures the out-of-pocket cost of healthcare for a typical American family of four, on an average employer-sponsored plan, came up with a figure of $24,671 for 2015. According to Milliman, the actuary that publishes the index, this number has almost tripled since it began tracking these costs in 2001, an increase attributed in part to a spike in prescription drug costs in the US over the past few years.

Aimee Keane and Hannah Murphy, “Managing multiple sclerosis: a transatlantic tale of healthcare in US v UK“, Financial Times, 16 May 2016 (metered paywall).

Keane and Murphy fail to mention that UK residents can use private hospital and clinics, and purchase private insurance, if they desire. Speedy attention is available in the UK – at a price. The UK healthcare system is analogous to the two-tier system in effect almost everywhere for primary and secondary education: ‘free’ government schools operating as an alternative to private schools that charge tuition.

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