July 5, 2023 is the 75th anniversary of the opening of the National Health Service in the UK. The NHS was established in 1948 by the Labour government that had won the election of 1945. The main principle of the NHS was that medical care should be free at the point of service.
The NHS is not an insurance scheme, such as exists in Canada and most European countries with universal health care systems. The NHS is funded out of general taxation. Everyone is covered, not only citizens but non-citizen residents, and even persons visiting the country. It remains free at the point of service, except for some types of dental and eye care.
Opponents, and there were many, argued that the infant service would never work. The country couldn't afford it, they said. But that child has survived for 75 years, and is the most beloved institution in the country.
Although I have lived most of my life in the USA, I have extensive personal experience of the NHS. I lived in Scotland until age 6. I returned to the UK numerous times as a professor of British history, and moved to London in 2009.
As a young boy I remember receiving penicillin for ear infections and extensive care for a vision problem caused by measles (the measles vaccine did not exist then). But I did not remember much about the NHS during my early years in the USA.
During the Cold War in the 1950's and early 60's, I learned that socialized health care is communist; that it does not work; and that the American fee for service system was the best in the world. Who was I to dispute it?
None of these claims was true. But if you hear a lie often enough you may begin to believe it. I suppose I did although I’m not sure I was ever completely convinced. In any event, several things led me to a different view.
One is that I studied British history as an undergraduate in the mid-1960's, and later earned a PhD in Modern British history. Among other things, I learned about the NHS, the poor provision of health care that preceded it, and the marked improvements since.
Second, and more important, I discovered the reality of the NHS through personal experience as an adult. I benefited the service (free of charge) in 1971 while residing in the UK as a PhD student, and on other occasions while doing research as a history professor.
Since moving to the UK in 2009, my family and I have benefited numerous times from the NHS, for minor and major ailments. My wife received excellent care on two occasions when she was in hospital for life-threatening conditions. I received similar care and attention after suffering a heart attack in June 2021.
Since moving to the UK in 2009, my family and I have benefited numerous times from the NHS, for minor and major ailments. My wife received excellent care on two occasions when she was in hospital for life-threatening conditions. I received similar care and attention after suffering a heart attack in June 2021.
Because we are over 60, our prescriptions are free. For under 60s, they cost a flat fee of £9.65 or @$12.00 at current exchange rates.
Another great plus of the NHS is that I do not fear medical bankruptcy, which strikes about 600,000 people a year in the US. Less important, but still significant, I do not have to fill out insurance forms when I need service. Nor do I have to choose from a bewildering array of insurance options.
The NHS is expensive, as any health care system will be. But it is far more efficient in a fiscal sense than the chaotic mess that masquerades as a health care system in the USA. As proportions of national income, the UK spends about half the amount that the US does. That is also true of European countries with national insurance systems. The US public is being ripped-off bigtime.
The NHS is not perfect. Far from it. Americans are told that waiting times for service are long. That is sometimes true, and they have gotten longer in the last few years. The pandemic and Brexit have been the main causes, combined with inadequate investment in the service during the last thirteen years of Conservative (Tory) government.
The pandemic forced an overstretched staff to put off treating many chronic disorders to focus on saving acute cases of Covid. Brexit caused an exodus of staff from the EU. Insufficient investment and poor planning led to underpayment of staff, causing further losses of nurses, doctors, and allied health professionals. Many of them have left due to a combination of overwork, stress, and falling real incomes.
Opponents of a universal system in the USA claim that care in the NHS is "rationed" and that "death panels" decide who will live and die. This is total rubbish. The US has de facto death panels called "health insurance" corporations. They can decide who will and who will not receive a particular treatment. Such decisions can and often are a death sentence.
Some British politicians, mostly Tory, would like to privatize more of the system, to make it more “American.” That would be an utter disaster. The NHS is the best present the British ever gave themselves.
Anyone who has paid attention to the rest of the world should realize by now that some form of single payer system that covers everyone and is free or nearly free at the point of service, is both more humane and more efficient than anything that exists or is even under consideration in the USA.
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