America is the home of the brave, they say, but a lot of us brave folks are terrified of the way the British do health care.
We’re even afraid of other Americans who aren’t afraid of it, like Dr. Donald Berwick. President Obama nominated Berwick to lead the Centers for Medicare and Medicaid Services a few years back, but Senate Republicans were so united in their opposition to Berwick that Obama had to wait until Congress was in recess to appoint him. Berwick struck fear in the hearts of the senators when a few years earlier he said a few positive things about Britain’s National Health Service.
The truth is that those most frightened by the National Health Service—then and now—are insurance industry executives. My former colleagues have been unceasing in their depiction of the NHS as “socialized medicine.” How could anything in the world possibly be worse than a single-payer system in which insurance companies would be unnecessary?
When I was an industry PR guy, I was part of a never-ending effort to defame the NHS, usually by citing a few anecdotes about Brits who claimed to endure long waits for needed care.
The industry’s propaganda got little resistance from the media or the American public. Few folks on this side of the Atlantic bothered to ask the Brits why they would put up with such an obviously inferior system and why they weren’t clamoring for American-style health care.
To make amends for the years I worked to mislead folks about the NHS, I’d like to recommend a couple of recent articles about Brits who have received care in both the U.S. and the U.K.
The headline of the January 12 story in The Guardian is about all you need to read, quite frankly. “Too many choices, high costs and bureaucracy: British expats grade American healthcare system ‘a pain in the arse.’ ”
The subhead was even more of an indictment of the way we do things here: “Moving to the U.S. for work has advantages for British citizens. The healthcare system is not one of them. It’s so bad that some expats fly home for treatment.”
The article begins by relating the experience of Scottish-born David Gray, now living in Brooklyn, who was recently given the unfortunate news that his doctor was no longer in his insurance company’s network of providers. He was turned away.
“Gray is far from alone,” the article noted. “The American ‘health insurance’ system comes as a nasty shock to many British expatriates working and living in the United States.”
What also comes as a shock is the fact that “many Americans stay in a job they hate for 20 or 30 years mainly because it provides health insurance for them and their families.
“That strikes Brits as a kind of serfdom in The Land of The Free.”
The article quotes Helen Colquhoun, who moved from the U.K. to Boston 12 years ago, as being baffled “why so many Americans are opposed to the idea of what they call ‘socialized medicine’ and why health insurance has anything to do with employment.”
“Why it is tied to employment is beyond me,” she says. “It is a massive burden on business like another tax.”
The other piece I recommend was written for Business Insider by Jim Edwards, a businessman with dual citizenship.
In the January 29 article, Edwards recounts his experiences getting care in both countries for a recent inner ear problem. He wrote about how long it took him to get an appointment with a doctor in the U.S. and then the long wait to be treated after he arrived at the doctor’s office. “I have read many a back issue of Newsweek in my primary care doctor’s office” he wrote.
In the UK, by contrast, “I showed up at 9 a.m. and was seen instantly.”
“For an American, this was bizarre: My butt barely touched the seat in the waiting room before my name was called. Turns out my doc and her staff are serious about patient scheduling.”
Both The Guardian and Business Insider articles noted how Americans are often buried in paperwork after getting medical care.
“If you ever had any health issue that required more than a simple doctor visit, you will know that it precipitates a seemingly never-ending series of forms, bills and letters,” Edwards wrote. “You will be paying bills months, years, later. And it’s almost impossible to correct a billing error. It’s stressful. I developed an intense hatred for health insurance companies in the U.S. because of this.”
In the NHS, he wrote, “there was close to zero paperwork.”
Neither article paints the NHS as nirvana. But none of the Brits would trade the NHS for American-style health care.
“Americans think they have the best health care in the world,” Edward wrote. “Take it from me, a fellow American: They don’t.”
Help support this work
Public Integrity doesn’t have paywalls and doesn’t accept advertising so that our investigative reporting can have the widest possible impact on addressing inequality in the U.S. Our work is possible thanks to support from people like you.