The Hacks have been keenly observing the current debates during the US Primaries about Healthcare (amongst everything else). Frequently in the British press, the ‘awfulness’ of the US Healthcare model is mentioned, without any view from the other side.
So how bad is it in comparison to our beloved NHS? Michael Moore wants to tell us that the private model in America is nothing short of horrific in comparison to our socialised system. But believing Michael Moore on a topic like this, is like believing in the truth of a documentary called “Why The Nazis Weren’t So Bad” by a certain Mr. A. Hitler.
First of all, I’d like to point out that the US does have a health crisis. But that is not to do with its health care. It’s the health insurance that’s the problem over there. Not everybody can afford it, plain and simple.
Because of this, the American healthcare system is ranked at a rather embarrassing (and unfair) No.37, according to the World Health Organisation. Interestingly enough, to anyone who has watched Micheal Moore’s Sicko, the WHO also list Cuba at 39th. Unlike the US, Cuba is ranked at 39th because its actual healthcare is awful, rather than any issues with insurance, and that’s based on the figures the dictatorship releases. Expect the real figures to be much worse.
The average American who pays $2,700 for their health insurance, receives the sort of cover than Moore doesn’t want us to know about, i.e. fully comprehensive, with no means-testing on what you’d be covered for. And no requisite for pervious health issues. Basically, without paying crazy money, $2,700 single-person insurance is pretty much as good as you’d want. You’d be seen within 24-hours by a specialist. From diagnosis to initiation of treatment is approximately 10 days. However, $2,700 is what the average American family spend – on the whole family, rather than each person. But remember that figure, it’ll become important in a few paragraphs.
You see, if you can afford it, healthcare in America is truly the best in the world. They are also the most pioneering. Most of the medical advances in the world are made in the US. With a private system, comes more competition, which leads to better treatment, both now and in the future.
However, most people, (including the politicians in the US), feel that the system doesn’t quite work as it should. They feel, as do I, that everybody who is a citizen should be treated for whatever their medical problem could be, no questions asked. But socialised medicine is not the way.
Remember the $2,700 figure from above? What is that in sterling? About £1,350. Let’s say £1,400 to round things up – my argument still holds even with that increase. For the same level of private health insurance in the UK, you’d have to pay BUBA or the like about £3,000. Again, most families with private insurance pay that for insuring the whole family, so for one person, that’d be fantastically comprehensive insurance. It’s more expensive in this country because there’s less competition in the private sector to bring prices down.
Currently, there has been a bout of anger in the US after one private firm who promised one of their plans takes you “from diagnosis to initiation of treatment in 15 days”. They have now, with very little warning, increased that to “diagnosis to initiation of treatment in 18 days”. Their customers went mad. The insurance firm had to invest to bring it back to 15 days, just to keep the peace (and its clients). Over here in the UK, Gordon Brown has laid out ambitious plans for “diagnosis to initiation of treatment in 18 weeks.” So let there be no doubt, private is better, regardless of your particular ideology.
We currently pour about just over £104 billion a year into the NHS, rounded down, (but my argument will still hold up even though rounding down isn’t in my favour), that works out at about £1,735 per person. Per man, woman and child. Every year.
Therefore my plan that would work but wouldn’t win, is to scrap the NHS, and use that money to fund an NHI – National Health Insurance. If you deduct about £100 per person’s allocation to fund the emergency service/number side, the point-of-service paramedics, etc. (though they could be privately funded too), that side of healthcare would receive unprecedented funding. But that would leave you with about £1,635, per person, per year.
Right now in the UK, £1,635 would buy fairly adequate private health insurance. But that’s in a UK with very little private insurance competition. If private is all there is, then the prices would fall to American standards very quickly. Especially if the government give tax-break incentives to some of the health insurance multinationals (many based in the US) to come here and pitch their product.
I know what you’re thinking; not everyone makes enough (or any) money to receive £1,635 back to buy their own health insurance. You’d be right, and I’d go further than that; many (as in the US) would spend their money on other things instead, and go without health coverage. In America, it is often said that 40 million Americans don’t have health insurance. If we look at this number, 20 million of them can afford it, but choose not to have it. This might be worrying, but actually most Americans are only without it for a maximum of 4 months, so usually this 20 million is to cover those who are in-between jobs, etc. Of the other 20 million, 13 million are covered by medicare or medicade, the two charity-run and government-subsidised healthcare services to those who cannot afford their own. The other 7 million can’t afford private insurance and don’t qualify for healthcare. These are the ones who need help. However, when you consider that this is 7 million out of 280 million, it’s not as “awful” as our Hacks in the news frequently make out.
My plan is not to give the public back the £1,635. It’s to have every regional government (say, each parliamentary constituency), BUY private health insurance for every citizen in its region, with that £1,635. If they can get a better price, then all the better. Because the MP (or whatever) would have to choose which private insurance firm to use, we can hold them accountable. And the big private health insurance firms would lick their lips at the prospect of all those customers. The economies of scale savings when a large business buys health insurance for all its employees is impressive. The savings for a whole constituency (and therefore the quality increase that can be bought for the money) would be staggering. And we re-evaluate what we’ve bought every year or two.
This would be a system that exploits the quality and low-cost of competition, while still providing healthcare to every citizen, regardless of their ability to pay. The best of both worlds.
I titled this essay “The National Healthcare Plan That Would Work – But Wouldn’t Win”. This is because while I have no doubt this system would work, and make us the envy of the world in a way we’ve never before been, it couldn’t win an election. Most of the British public are so dogmatically in favour of our National Health System, that they would never allow the politicians to dismantle the service for a series of private ones, no matter how better they would be.
Or at least for now. Both Labour and the Tories have produced public/private initiatives which have improved things, and both look set to increase this (the conservatives more, but that’s to be expect). So maybe the idea is slow but steady.
Until then, stay healthy.