NCPA - National Center for Policy Analysis

What ObamaCare Can Learn from Britain's National Health Service

October 10, 2013

As the United States embarks on an overhaul of its health care system, Britain's government-run system is showing signs of age, says Philip Klein, a senior writer for the Washington Examiner.

Founded in 1948 on the premise that health care should be made available to all without charge, the National Health Service (NHS) remains a tremendous source of national pride. In Britain, the NHS is often described as the "envy of the world." A vast bureaucracy boasting 1.7 million workers, it is the fifth-largest employer on the planet, according to the BBC.

Though the NHS has been subject to an endless stream of reorganizations and reforms over the decades whenever the government has transferred power, no prime minister -- not even "Iron Lady" Margaret Thatcher -- has had the political will to make fundamental changes. As Nigel Lawson, chancellor of the exchequer under Thatcher, famously put it, "The NHS is the closest thing the English have to a religion."

  • A drawback of the NHS system is that it prides itself on creating equity by putting the needs of society as whole ahead of any given patient, meaning that the needs of individuals often get lost in a sea of managers, administrative targets and rationing decisions.
  • The NHS budget more than tripled between 1997 (the first year of Tony Blair's Labor government) and 2013.
  • It now stands at roughly $160 billion -- roughly one-sixth of government spending and nearly triple Britain's defense budget.

As America embarks on a vast health care experiment, it must consider what is to come. While British doctors are on salary and typically aren't very worried about the threat of lawsuits, and thus have little incentive to order tests that may prove unnecessary, this means individuals cannot get tests within the NHS if its doctors don't approve them.

If America's bitter health care debate over the past several years is any indication, more government control means increasing politicization of health care. And that is something that has been a constant in British politics, even though both major parties accept the basic principle of government provision of health care.

Source: Philip Klein, "Health Emergency: On Eve of ObamaCare, Britain's NHS Needs Political Therapy," Washington Examiner, October 4, 2013.


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