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There's a fantastically (and unintentionally) ironic sentence in a piece on US attitudes to the NHS in today's Guardian:
As myths and half-truths circulate, British diplomats in the US are treading a
delicate line in correcting falsehoods while trying to stay out of a vicious
domestic dogfight over the future of American health policy.
For myths and half-truths one needs only look to most UK coverage of the US health system, which is full of half-baked notions, lies and distortion. Until I came to the JC, I was a health-care policy wonk. A few years ago I testified before the US Senate on healthcare in the UK and EU; I'd say that, overall, the level of knowledge of our systems amongst opinion-formers on the other side of the Atlantic is far greater than ours about theirs, so that even intelligent adults in the UK carry around with them bizarre ideas of how health care works in the US.
Myth one: it's fine if you're rich, but heaven help you if you're poor.
Utter nonsense. The poor are covered by Medicaid. The sheer quality of care available in the US puts the NHS to shame. If you offered me access to US care solely via Medicaid, as an alternative to the NHS, I'd bite your hand off to grab it.
The problem lies not with the poor but with those on middling incomes who either can't get coverage through their employer, don't have an employer and can't afford sufficient insurance, or won't take out the right insurance. That's the area of real concern. If you're poor and need treatment, you are far better off in the US than the UK.
Myth two: 44 million Americans are uninsured. True, but entirely meaningless, because that figure is a snapshot. It's like counting the number of adults in the UK who are out and about at any one moment and saying that they are homeless. The figure that matters is not those who, at any one moment, don't have coverage, for any number of reasons - between jobs, moving, don't want it etc; it's those who are chronically unable to get coverage. That figure is far too high - somewhere around 9 million, according to the most reliable estimate - but it is not the usually cited and completely misleading figure of 44 million.
The plain fact is that if you have a serious disease or need long term care, if you have the right coverage you are so much better off being treated in the US that the NHS is not even comparable. The crucial words, of course, are "if you have the right coverage", and clearly the US system is not remotely a model to be followed. It needs real reform. But to leap from that to the conclusion that the NHS is 'better' is dangerously deluded. The NHS is a system designed for an era when food rationing
was the norm, and is metaphorically, ideologically and financially bankrupt. We can offer no lectures to the US when it comes to healthcare.