Comments on: The British NHS http://www.medrants.com/archives/1675 Internal medicine, American health care, and especially medical education Sat, 11 Feb 2012 15:15:48 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Matthew Holt http://www.medrants.com/archives/1675/comment-page-1#comment-2916 Matthew Holt Fri, 12 Dec 2003 13:42:53 +0000 http://medrants.com/archives/2003/12/12/the-british-nhs/#comment-2916 There's a little cheating going on here. Most of what the author is talking about is what's called long term care in the US. That is funded by a mix of public (Medicaid) and private (mostly cash) sources here, but provided almost entirely by private sector facilities (including for-profit ones). That's similar to the UK other than the money comes more from the state. In the UK, private <i>provision</i> of standard health services is used mostly as a safety valve so that middle and upper income people can get around the queue for NHS surgery. That's been around forever, as allowing specialists to see private patients was part of the deal cut in 1945 by which they agreed to support the introduction of the NHS. NHS surgeons in specialties like orthopedics or gynecology can (quite legally) double or triple their incomes doing private work on the side. But in the US context this is all misleading. Not even the most radical single-payer advocate believes that the government should <b>provide</b> all health care, they just think that it should pay for it. What this post ignores is that the every country apart from the US provides some kind of universal system of payment for care, ususally delivered in a mixed public/private system. In virtually all of those countries you can "trade-up" with your own money to get better amenities or jump the queue in the public system. There’s a little cheating going on here. Most of what the author is talking about is what’s called long term care in the US. That is funded by a mix of public (Medicaid) and private (mostly cash) sources here, but provided almost entirely by private sector facilities (including for-profit ones). That’s similar to the UK other than the money comes more from the state. In the UK, private provision of standard health services is used mostly as a safety valve so that middle and upper income people can get around the queue for NHS surgery. That’s been around forever, as allowing specialists to see private patients was part of the deal cut in 1945 by which they agreed to support the introduction of the NHS. NHS surgeons in specialties like orthopedics or gynecology can (quite legally) double or triple their incomes doing private work on the side.

But in the US context this is all misleading. Not even the most radical single-payer advocate believes that the government should provide all health care, they just think that it should pay for it. What this post ignores is that the every country apart from the US provides some kind of universal system of payment for care, ususally delivered in a mixed public/private system. In virtually all of those countries you can “trade-up” with your own money to get better amenities or jump the queue in the public system.

]]>