Teaching Comparative Government and Politics

Friday, May 01, 2015

Affordable care in the UK

While the Affordable Care Act is an issue of controversy in the US, the only controversy over the British National Health Service seems to be about how long it takes to see a physician.

Britain’s National Health Service, Creaking but Revered, Looms Over Elections

[T]he health system, now creaking under the strain of an aging population and tight budgets, remains a touchstone of British life, an institution that has, to a remarkable degree, escaped the ideological conflicts that have characterized the debate over health care in the United States. With the governing Conservatives and the opposition Labour Party locked in a tight race, the political jousting over health care essentially boils down to one question: Who would spend more on it?…

In an era when Britons disdain their politicians and detest their bankers, government officials see the National Health Service as “the most revered public institution in this country,” said Chris Ham, chief executive of the King’s Fund, an independent health care charity…

Health care in Britain is funded by general taxation and payroll deductions, and with a few exceptions, such as dentistry and medication charges, treatment is delivered without any money changing hands. Britons can buy additional private insurance for more choice in treatment, but at the start of 2014, only 10.6 percent of the population was covered by such policies…

Partly because the Labour Party created the system, voters still trust it more on health than the Conservative Party, which, according to opinion surveys, scores better on economic competence.

Though decades have elapsed since treatment was denied to those unable to pay, the founding principles of the British health system retain a strong grip.

Last year, Bruce Keogh, medical director of N.H.S. England, described the service as “an international icon of the British social conscience,” designed “to replace fear with hope.”…

The Conservative-led government argues that it has protected health spending since 2010 despite deep cuts in other areas. Labour claims that standards are slipping. Partly because patients struggle to get appointments with family doctors, many go directly to emergency rooms instead.

Figures for England showed that 91.8 percent of visits in the first three months of 2015 were dealt with in four hours, below a government target of 95 percent…

Beneath the fog of competing statistics, the N.H.S.’s performance is hard to assess. In 2014, the Commonwealth Fund, a foundation based in the United States, ranked England’s as the most impressive of the 11 national health systems it compared.

A less generous verdict came from another research institute, the Health Consumer Powerhouse, which is based in Sweden and ranked England’s health service 14th out of 36.

But rarely do British politicians risk asking whether the structure created in 1948 can withstand the pressures of the 21st century…

In his memoirs, Nigel Lawson, the chancellor of the Exchequer under Mrs. Thatcher, wrote that… “The National Health Service… is the closest thing the English have to a religion.”

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