Health Care Around the World: Great Britain
April 23, 2008 in Health Care Around the World, International Health Care Systems
Great Britain represents all that is good and bad with centralized, single-payer health care systems. Health care spending is fairly low (7.5% of GDP) and very equitable. Long wait lists for treatment, however are endemic and rationing pervades the system. Patients have little choice of provider and little access to specialists.
Percent Insured. ~100%
Funding. Great Britain has a single payer system funded by general revenues. With any centralized system, avoiding deficits is difficult. In 2006, Great Britain had a £700 million deficit despite the fact that health care spending increased by £43 billion over five years.
Private Insurance. 10% of Britons have private health insurance. Private health insurance replicates the coverage provided by the NHS, but gives patients access to higher quality care, and reduced waiting times.
Physician Compensation. Unlike in the case of other single payer systems such as Norway, most physicians and nurses are mostly government employees. In 2004, the NHS negotiated lower salaries for doctors in exchange for reduced work hours. Few physicians are available at night or on weekends. Because of low compensation, there is a significant shortage of specialists.
Physician Choice. Patients have very little physician choice. However, under the experimental London Patient Choice Project, patients waiting more than six months for treatment will be offered a choice of four different treatment providers.
Copayment/Deductibles. There are no deductibles and almost no copayments except for small copayments for prescription drugs, as well as for optical and dental care.
Waiting Times. Waiting lists are a huge problem in Great Britain. Some examples: 750,000 are on waiting lists for hospital admission; 40% of cancer patients are never able to see an oncologist; there is explicit rationing for services such as kidney dialysis, open heart surgery and care for the terminally ill. Further, minimum waiting times have been instituted to reduce costs. “A top-flight hospital like Suffolk Est PCT was ordered to impose a minimum waiting time of at least 122 days before patients could be treated or the hospital would lose a portion of its funding.”
Benefits Covered. The NHS system offers comprehensive coverage. Because of rationing, care might not be as easy to get as advertised. Terminally ill patients may be denied treatment. David Cameron has proposed that the NHS refuse treatment to smokers or the obese
(Bigmarkod Commentary) So if you don’t mind being one of the millions on a waiting list for government employee care, or don’t mind being denied care by some government bureaucrat, because you eat too much, smoke or have some other lifestyle they are trying to control, have no available specialists but do have minimum waiting times this will be great! I don’t need to be told or to tell people what is better…..people can make their own decisions….this is what is going on, you are all free to draw your own conclusions.
You think we’re headed for single-payer under Obama?
Then you’re clueless.
The author of the study quoted is a puppy. Citing stuff like this is simply lazy, sad, and misleading.
Oh yeah anon – listen to Obama’s words:
http://www.youtube.com/watch?v=fpAyan1fXCE
Obama says: “I am a proponent of single payer. But first we have to take back the White House, Senate & House.”
Now all the pieces are in place.
CTV said: “The author of the study quoted is a puppy. Citing stuff like this is simply lazy, sad, and misleading.”
What do you mean by saying that the author is a puppy?
YOUR comment is “simply lazy and sad.” It is not misleading because we can plainly see that you ignore the facts.
anonymous #3,
Nice try, but the comment you site is long before Obama became President, and inevitably learned how in control insurance companies, big pharma, etc. REALLY are.
And if YOU don’t realize that, you’re just as clueless as bigmarkod.
True Story!
last year my Aunt Eileen had a kneen replacement.
During her hospital stay she did not get her blood pressure meds, which would most likly cause a condition called re-bound hypertention (which i believed happended). She had three massive strokes in hospital.
I called her doctor asking about her care. Next day i was on a plane to N.Ireland for 4 days (I have babies at home). I went stright to the hospital.
1. She had not eatten for days due to disphasia, due to the stroke. They did not even bother to give her thinkened Liquids.
2. They were giving her asprin as the main med for the stroke (NO KIDDING!)
I was their for 4 days and during those days, i admitt i have more knowledge than most about medicine, but having to convinice a doctor to put her back on blood medication was beyond belief.
Really think about it!! Dogs don’t want to be treated at a VA hospital for a reason!
by the way, N.Ireland is tops in Europe for health care!! SCARY AH!
Think about the fact that the post office employees are now your Doctor’s.
Sorry post office!.
Health insurance companies are like oil companies, no real competition.
THATS THE KEY KIDS!
*The Dutch have a National System with 90 percent supplied by Private Insurance Companies. Right you are Ms. Quinn….they make it work at very affordable rates because of competition!
Since when a dentist carries the stethoscope?
The naysayers who don’t think the US can do better than Great Britain, Canada, France, etc. should move to one of those countries. Why not take a look at the Republican version of Universal Coverage in Massachusetts which George Romney started – have all the top hospitals there closed with Dr’s moving to other states?
NOT ALL UNIVERSAL HEALTH CARE PLANS ARE THE SAME.
Germany has SHORTER wait times than the US and they SPEND LESS,$3,673 compared to $6,402.
The US should create its own unique health care system, by pulling the BEST features from other countries health care plans and incorporating what is good in ours.I like the Common Wealth Fund’s motto; WHY NOT THE BEST?
Trashing another country’s health care DOES NOT make ours better.
OVER 18,000 PEOPLE DIE every year in this country from lack of health care and every day thousands of people are DENIED TREATMENTS by their INSURANCE COMPANIES, this is American style, HEALTH CARE “RATIONING”.
anon #5,
Your comment makes absolutelt no sense at all.
anonster next time you get sick than go to those other countries to get your health care since you claim they are better than us . always anti u.s.a typical far left , hate the u.s liberal .
I got treated in Canada several years ago and had great service.
The system here as it is now sucks, we must do better.
FYI_ Asperin is one of the best treatments for blood thinning, every other treatment has potentally fatal side effects.
anon said: “Nice try, but the comment you site is long before Obama became President, and inevitably learned how in control insurance companies, big pharma, etc. REALLY are.”
Obama is a dirty dog who will not say that his ultimate goal is still single payer. His mantra now is the “government option.” He knows that his government option will destroy private medical insurance. Obama is a liar.
the grating one, Why is it anti-American to want a better health care system? When did progress and change become dirty words in America?
You right-wingers need to STOP PRETENDING that the US is number one in everything, WE HAVE FALLEN BEHIND the rest of the world in health care and education.
Just saying you’re “the greatest country in the world” DOESN’T MAKE IT SO.
DEEDS and RESULTS as evidenced by our investments are more important than WAVING CHEAP FLAGS and PHONY PATRIOTIC WORDS.
This country was made great because we had innovators and progressive, educated people, everything that YOU WING-NUTS NOW DESPISE.
YOU are ANTI-AMERICAN!
anonster said: “YOU are ANTI-AMERICAN”
anonymous says: “Not likely.”
I exposed BHO for the liar and fraud that he is.
#16 Oh boy, you used your super-duper, extra , sleuthy powers on BHO, your in-depth, hard charging expose,’ filled with shocking facts and juicy details……….except, YOU LEFT ALL THAT STUFF OUT!
Your “because I said it, therefor it must be true” logic is astounding, I can understand why you’re so impressed with yourself.
One can always design a perfect “healthcare system” run by the government. The problem with running and controlling human activity is that any human enterprise, i.e. healthcare, constantly evolves with limitless human ingenuity. Government run system can never keep up with microeconomic changes and can rarely keep up with macroeconomic changes. Eventually, the government run system degenerates into an abomination that noone could foresee, i.e. VA Healthcare, Medicaid, County Hosptals, British system, Canadian system, Workers Comp. Designing the perfect system for a point in time is doable, and that is what Obama wants. However, maintaining such a complex economic system based on constantly evolving science is impossible. There is only one system that is able to keep with evolving paradigms – free market capitalism. Government’s role should be to shine the light on the markets for transparency and regulate markets where there is asymmetrical knowledge about a product or service.
Hopefully, someone will start talking about that in Washington DC. What is needed is more patient financial involvement and less insurance and government. It is difficult but doable. Read Arnold Kling, “Crisis of Abundance”.
Alternatively, there many innovators thinking out of the box in developing alternative healthcare delivery methods. Once these go on line, the system may evolve in that direction naturally, unless governtmental involvement removes incentives for that.
#17 anonster,
This is what Obama wants (single payer):
http://www.youtube.com/watch?v=fpAyan1fXCE
He has not backed awaay from this – single payer is his ultimate goal.
This is how he intends to get it:
The “government option” will destroy private medical insurance.
A very simple deception – what don’t you get about this?
Ronald Reagan on socialized health care – still applicable (3 min. video):
http://www.youtube.com/watch?v=kOZsD9X4R6A
Thank you Dr. SJM – I couldn’t agree more.
Dr. SJM, We HAVE a “free-market” health care system now, how’s it stacking up? Do we have “perfection” yet?
According to your criteria, the “evolvement” of our health care system is coming to its “natural” conclusion; SURVIVAL of the FITTEST. In other words, only the healthiest and wealthiest among us DESERVE health care.
Free-market capitalism may work for cars and banks (oops), but should NEVER apply to health care. Life and death decisions can’t be left to the bottom line driven, profits first, people second, business model.
I’m sure you are some “doctor”, yikes!
Dr. SJM would surely then support eliminating the tax free benefit provided by the government for employer health care plans so as to put everyone on a equal footing and help restore a “free-market”.
#19 anonymous, I am glad to know that Obama supports single-payer health care.
Why do you think a “government option” would destroy private medical insurance?
Could it be that the government can deliver the same level of health care at lower costs while giving people peace of mind, because they will never be “dumped”, just like medicare does?
It’s high time we took the profit out of health care.
There is an article in yesterdays LA TIMES business section that speaks to this issue;
Insurers Refuse to Limit Policy Cancellations; Lawmakers ask three executives if they’ll stop dropping honest customers. All say no.
“The hearing on the controversial action known as rescission, which has left thousands of Americans burdened with costly medical bills despite paying insurance premiums……An investigation by the House Subcommittee on Oversight and Investigations showed that health insurers WellPoint Inc., UnitedHealth Group and Assurant Inc. CANCELLED the coverage of more than 20,000 people, allowing the companies to AVOID PAYING more than 300 million in medical claims over a five year period.”
“It also found that policy-holders with breast cancer, lymphoma and more than 1,000 other conditions were TARGETED for RESCISSION and that employees were PRAISED in performance reviews FOR TERMINATING the POLICIES of CUSTOMERS with EXPENSIVE ILLNESSES.”
This is why the US needs a “government option”!
#20 anonymous, some old folksy RR speech about the US having “the best health care in the world” is sorely dated and flies in the face of all the evidence to the contrary. Irrelevant.
What is the dirty secret of Obama’s “healthcare” plan?
The following movie trailer will provide details of the Obama plan – code named “Soylent Green.”
http://www.youtube.com/watch?v=SVpN312hYgU