NCPA - National Center for Policy Analysis


May 8, 2007

The Painful Prescription, an analysis of the British National Health Service (NHS) by Henry Aaron and Bill Schwartz, show how rationing within a health care system can lead to shortages, says John C. Goodman, president of the National Center for Policy Analysis.

Although British politicians for years described the NHS as "the envy of the world" -- because the program has promised health care free of charge to all its citizens -- Aaron, Schwartz and coauthor Melissa Cox show that the British are routinely denied services Americans take for granted.  For example:

  • Bone marrow transplants per capita are one-third more frequent in the United States than in the United Kingdom.
  • The rate at which the British provide coronary bypass surgery or angioplasty to heart patients is only one-fourth of the U.S. rate.
  • Britain has only one-fourth as many CT scanners as the United States and one-third as many MRI scanners.

In addition:

  • The NHS hip replacement rate is only two-thirds of the U.S. rate.
  • To provide the level of intensive care unit (ICU) services that US hospitals have, British hospitals would have to increase their spending by five fold.
  • The population-adjusted treatment rate for kidney failure (dialysis or transplant) is five times higher in the United States for patients age 45 to 84 and nine times higher for patients 85 years of age or older.

Overall, to achieve a level of care comparable to U.S. standards, Britain would have to increase its level of spending by one-third, according to the authors.

Source: "Applying the Economic Way of Thinking to Health Policy: Rationing," National Center for Policy Analysis, May 7, 2007.

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