Britain's National Health Service Meltdown
S E E D E D C O N T E N T
The American left can't seem to quit its desire for single-payer Medicare for All. So it's worth noting that the United Kingdom, which already has a system resembling that socialist dream, is rethinking it amid another winter of healthcare misery.
The National Health Service's winter crisis has become an annual tradition, but this year's troubles for the free-at-point-of-service system are significantly worse. The NHS never recovered from the Covid pandemic. That means the normal winter wave of flu, Covid and other respiratory ailments is swamping hospitals and doctors' offices already coping with a backlog of patients awaiting tests and treatments deferred by lockdowns.
Meanwhile, unions representing nurses and ambulance drivers have gone on strike for days at a time to demand higher pay from their government employer. Perhaps sensing the political weakness of Prime Minister Rishi Sunak’s Conservative Party, the unions are resisting calls for work-rule changes to boost efficiency. They claim strikes don’t affect critical care, but work stoppages inevitably mean more treatment delays.
The effects of all this on patient care can be lethal. Waiting times for ambulances for the most serious calls are getting longer , with the average response time reaching 10 minutes 57 seconds in December, compared to a target of seven. Once patients reach the emergency room, 35% now face waits above four hours between a decision to admit and transfer to an appropriate bed for treatment, the worst performance since 2010.
Care is no better for non-emergency patients. As of November, some 7.2 million patients have been referred for treatment but are waiting for it to start. Of those, 2.9 million have been waiting more than 18 weeks. The NHS considers itself a success if it starts treatment within that four-month window, which is the epitome of defining failure down.
NHS delays may be contributing to the 1,000 weekly excess deaths in recent weeks—deaths above the normal average level, excluding the pandemic years—according to an analysis by the Times of London . Excess deaths in 2022 were the most since 1951, excluding the pandemic.
This is occurring despite ever-growing NHS demand for more taxpayer money. Former Prime Minister Boris Johnson in 2021 pledged an additional £36 billion over three years for the NHS and related home and nursing-home care, funded by a payroll-tax increase. Mr. Sunak and Chancellor Jeremy Hunt followed in November with another £3.3 billion a year for the next two years. The service’s total annual budget is £153 billion.
This second, better tier of healthcare is embarrassing in a country where the NHS’s supposed egalitarianism is a point of national pride. Now private care is looking like a solution. Some NHS hospitals are offering patients the option to pay out-of-pocket for diagnostics or treatments to skip NHS queues, the Observer newspaper reports.
A senior politician in the opposition center-left Labour Party has even suggested that the NHS fund more treatments at private hospitals and clinics. Using taxpayer money to pay the market rate for these treatments would help the NHS clear its patient backlog. Despite Labour’s deep attachment to the NHS, party leader Keir Starmer now says it shouldn’t be treated “ as a shrine rather than a service .”
The U.K. is probably years away from NHS reforms that could permanently fix the system. For all its flaws, the NHS and its false promise of healthcare equality remains deeply rooted in British culture. But that shouldn’t stop Americans from learning some lessons.
The U.S. suffers a chronic problem of healthcare financing but not of health-care delivery. Britain shows that with single-payer you end up with both. The U.K. also shows that single-payer’s biggest victims are low-income people who can’t afford to opt out. Sen. Bernie Sanders and other Medicare for All spinners will always be able to afford quality care.
Will you?
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I guess this is why those who can afford it come to the USA and are more than willing to pay out of pocket for urgent medical matters.
This is a side that the Medicare for All group never wants to talk about, or they will just reject the possibility. But we saw this to an extent during Covid when routine and non-emergency care was postponed due to Covid shutdowns and limitations. There were hospitals that shut down surgeries and focused on Covid patients, with all the expected results. Groups of medical staff were laid off as surgery recovery wards were not needed. Rural hospitals actually ended up closing their doors because all they could treat were Covid patients which were reimbursed at the Medicaid rates which were not enough to cover the bills of rural hospitals. I know of several doctors groups who have stated if they are forced to accept only the Medicare rates they would need to close their doors as they cannot afford to stay open. Most doctors offices now have a limit on the number of Medicare / Medicaid patients they will accept as they cannot afford to have too large a number that pay at the government rates. This is an issue that must be resolved before America can go to any sort of system like NHS but typical government operations, the feds only care to work on the one side of the issue. Kind of like the state of higher education in this country where the feds only came in to guarantee the student loans but did nothing else to control/manage costs and expenses on the college side and/or work to insure that students actually got an education towards something that could have put them into a better life and could allow them to pay back their student loans. Instead the feds fucked up and gave us the student loan issues we see today. Can we truly expect they can do a better job with health care?