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Con: Long waits, outdated medicine and rationing make British system one import we don’t need

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Merrill Matthews
August 9, 2008
EDITOR’S NOTE: The writer is addressing the question, Is Britain’s government-run national health service a good role model for the United States?

The slow-boiling national debate over health care naturally leads people to look at England, Canada and other government-run systems as potential role models for sweeping reform in the United States.


Activist filmmaker Michael Moore is by far their most visible advocate. The millions who saw his documentary “Sicko” came away with the impression that England is a health-care utopia. They were told that doctors in such single-payer systems made good salaries, had nice homes and drove expensive cars. Their patients, of course, were very satisfied.


But anyone who reads the British press over a period of time will develop a more balanced view—in reality England’s National Health Service is known for its long waiting lines, angry patients, rationed and often sub-quality care.


Consider some recent news stories reported by leading British newspapers:


FROM LONDON’S DAILY MAIL: Twice Katie asked for a Pap smear test but was told she was “too young” to need one. Now 24, she is dying from cervical cancer, one of many young women who have fallen victim to a scandalous change in health policy.


FROM THE YORKSHIRE POST: A man with terminal cancer has been refused a drug by the NHS that could extend his life—despite offering to pay part of the cost himself. … David Swain’s offer to meet the monthly 2,000 pounds cost of Erbitux was refused, he said, because the National Institute for Health and Clinical Excellence ruled it was too expensive.


FROM THE TIMES OF LONDON: Health service dentists have been forced to go on holiday or spend time on the golf course this month despite millions of patients being denied dental care. … Many have fulfilled their annual work quotas allotted by the National Health Service and have been turning patients away because they are not paid to do extra work. This is despite the fact that more than 7 million people in Britain are unable to find an NHS dentist.


Does that sound like your idea of a great health care system? The British press—as well as the media in other countries with socialized medicine—regularly runs stories like these about patients who are denied treatment because they are too old or too young or too sick or just too costly.


Indeed, The Times of London ran a story in 2006 asserting: “Patients are being denied appointments with consultants in a systematic attempt to ration care and save the NHS money, The Times has learnt.”


In single-payer systems such as Britain’s, taxpayers pay higher taxes for universal health coverage and the government pays most of their medical bills. But the fact is that every government-run health-care system struggles to make ends meet. Money for health care in those systems has to compete with money for other government programs such as education, defense and pension programs.


That’s why other countries spend less than the United States on health care. It’s not that their systems are better or more efficient; it’s because politicians control the funds and have to make trade-offs. That often means the more expensive treatments, the marginal members of society, and even preventive care and screening can get axed.


Yes, everyone in those countries is “insured”—the apparent goal in the current health-care reform debate—but that doesn’t count for much if patients can’t get quality care in timely manner.


American health-care reformers often claim or imply that the U.S. system is terrible, while countries such as England provide quality care for everyone, and for less money. That’s a blatantly distorted assessment rather than a balanced one.


While U.S. health-care leads the world, it can and it must improve. But copying government-controlled systems elsewhere isn’t the solution. They have egregious problems that make ours pale by comparison. As the current debate heats up, we should concentrate on finding solutions to our flaws without importing their problems.


Merrill Matthews is executive director of the Council for Affordable Health Insurance (www.cahi.org), an advocacy association of insurance carriers. Readers may write to him at CAHI, 127 S. Peyton St., Suite 210, Alexandria, VA 22314 or e-mail him at mmatthews@cahi.org.

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