The news that the White House may be retreating from its insistence that a “public option” be included in any health care reform bill appears to herald a victory for Republicans. But while conservatives in the U.S. may be celebrating, the row over the future of health care in the country is causing problems for David Cameron, the leader of Britain’s Conservative Party.
Britain has found itself dragged into the U.S. health care battle in recent weeks. Opponents of ObamaCare highlight failings in the National Health Service as part of their campaign against “socialized” health care, and proponents of ObamaCare hold up the British model as one that America should seek to emulate. The NHS-bashers seem to have got the better of the argument — at a recent town hall in Montana, President Obama felt compelled to reassure Americans that he didn’t want to adopt the British system.
In Britain, however, Cameron has been forced to defend the NHS after Daniel Hannan, a Conservative member of the European Parliament, attacked it on U.S. television in interviews with Glenn Beck and Sean Hannity.
For all its flaws, Britons have a soft spot for the NHS, and the Conservatives are traditionally seen as being hostile to the service. Gordon Brown’s governing Labour Party — divided, discredited, and facing meltdown in the general election that must be held in the next ten months — has seized on Hannan’s remarks as evidence that the NHS would not be safe under a Tory government.
And so Cameron and Brown have been competing over who loves the NHS the most; the prime minister — always with an eye for the latest gimmick — even lent his support to a “we love the NHS” campaign on Twitter. The British press has weighed in with attacks on the U.S. system — attacks which mostly feature sweeping generalizations or are based on an unhappy personal experience. Britain may be on the verge of electing a center-right government, but much of our media retains a condescending attitude to all things American — Obama excepted — which transcends the political divide.
There’s a great deal of misinformation on both sides of the Atlantic. Anyone watching the TV news in Britain would think that opposition to ObamaCare was limited to a few swastika-waving crazies, led by Sarah Palin and funded by sinister “special interests.” There is little mention of “Blue Dog” Democrats, tort reform, Obama’s deal with the drug companies, or the fact that most Americans are happy with their health care. And the figure of “47 million uninsured” is trotted out daily, when the actual number of U.S. citizens who are long-term uninsured and who are genuinely unable to get coverage is probably closer to eight million.
Come to think of it, there’s not that much difference between the reporting in Britain and that in the New York Times.
Likewise, the British system is not nearly as bad as has been suggested by opponents of ObamaCare. But it’s fair to say that if Britain were setting up a health care system from scratch today, it wouldn’t bear much resemblance to the NHS. The service was established more than 60 years ago in a country battered by war and when the ability of the government to run such enterprises was unquestioned. Back then it did its job of providing basic health care for all admirably. But with people living longer, medical advances producing new and more expensive treatments, and the bureaucracy growing increasingly byzantine, the NHS has become a black hole sucking in ever-more public money. Labour has more than doubled spending on the NHS since coming to power in 1997 with little to show for it, and the service is projected to face massive funding shortfalls in the next few years.
Yet to talk of reforming the service is political suicide. The NHS employs around 1.3 million people — it’s thought to be the world’s third-largest employer after the Chinese military and India’s railway service — and remains broadly popular with the public despite a steady flow of horror stories (it’s just been revealed, for example, that more than 30,000 people have died in the past five years from infections picked up in NHS hospitals). Assuming the Conservatives win the next election, it’s unlikely Cameron will have the courage to propose significant reforms in a first term.
The simple fact is that while neither system is as terrible as their detractors claim, both have undeniable flaws. And while we can trade facts, figures, and anecdotes all day, a couple of things are clear. The first is that the poor enjoy a generally better standard of care in the UK than in the U.S. The second is that Americans with decent insurance enjoy a better standard of care than most Brits — survival rates for all the major cancers are considerably better than in the UK, and screening and treatment for heart disease and other chronic conditions is more widely available.