Martin Schmalenbach · Shebbear College
All - I'm a Brit & grew up in a universal single-payer healthcare system and my wife worked within it for a number of years. We now live in the USA, and have seen close up how the US system works.
Simply demanding a universal, single payer system does not solve the problems. There are aspects of the US system that work so much better than the system in the UK. We should take the best of both, and I think the core of this comes down to how things are funded, more than making sure there is enough in the budget each year.
For example, because here in the US healthcare is first and foremost an industry, there are inherent meachanisms for proving a good level of resources of all kinds - without them a healthcare provider is potentially missing out on business! The upside from a patient perspective is that waiting times are lower, and that can have a huge impact on recovery - especially for trauma cases. The downside is that healthcare providers see plenty of incentive for keeping a patient in hospital and/or under treatment, perhaps beyond the point where treatment is medically needed. In the UK, because keeping a patient in hospital longer does not bring in more money, there is an incentive to release patients sooner. To avoid the mistake of releasing a patient too soon, there are penalties to be paid if a patient has to come back too soon after being released. But resource levels are severely stretched in many places.
I was in a car accident 18 months ago - nothing severe for any of the folks involved. I was seen very quickly, especially once the hospital realised this was an insurance job - I had good car & health insurance etc. I quickly got X-Rays and CT scans and after 3.5 hours was released. The bill, before discounts etc (of which there were none in the end, because the other party's car insurer was paying everything - the other driver ploughed in to the back of us at speed when we were stopped at a red traffic light...) - the bill was just over $16,400.
$16,400 for some scans. And $178 for a neck brace I wore for 30 minutes. I was seen by 3 doctors, only one of whom treated me. The other 2 each charged $1000 approx for looking at my charts and taking my pulse etc. I know hospitals are expensive to build & run. I looked in to that. I could find financial justification for less than 1/2 of that $16K bill. The rest clearly is price gouging. Oh, and this is also why car insurance here in the US is ridiculously expensive compared to back home in the UK (not helped by the fact that folks in the US are 2x more likely to be in a car accident than in the UK)
So let's see about taking the best of both systems and building a truly excellent, universal healthcare system. That really would be something to shout about!