I’m not sure what’s more sad about Steve Silberman’s An Eye-Opening Adventure in Socialized Medicine, the fact that someone from a wealthy, democratic country—the USA—was totally shocked about being treated, essentially for free, in London when he came down with a bad case of conjunctivitis, or that the NHS as we know it is still under threat from aggressive Conservative-led policy.
Silberman’s story highlights a poor aspect of US healthcare and the best of British. Having spent a large number of dollars battling with his US provider (“The Kaiser rep simply repeated her question in a more brittle tone of voice and added, ‘Just answer yes or no.'”), he finally got ‘permission’ to phone a London number for emergency care.
Amazingly, a human being picked up the phone right away — an affable guy with a disarmingly chummy accent and an empathic manner. Yes, yes, of course I should see a doctor right away. Where should they send him?
What? This guy was offering to dispatch someone to examine my eyes immediately in my apartment in the middle of the night?
He then ends up discovering, having heard about the evils of British healthcare, that there weren’t in fact thousands of people fighting for attention in the waiting room, that the staff were generally courteous and efficient, and, eventually, that the entire event cost him under a tenner for the prescription. The consultation was, of course, free.
In the comments, there are notes from people that Silberman only didn’t get charged because it’s too much hassle for the NHS to bother for such a small incident and consultation, but this nonetheless highlights two important things. First, the NHS was willing to spend some resources on a tourist, without any questions over insurance; secondly, that this is the default level of service you can enjoy with the evils of ‘socialised’ healthcare—and it costs a fraction of US healthcare insurance, along with being available to all.
There’s also a second point made, in that the NHS isn’t ‘free’ but ‘free at the point of entry’. But this is still a safety net that surely beats the US model, where you often aren’t even covered if you travel out of state. (Imagine telling a Londoner they’re not covered in Wales… they’d just look at you as though you were bonkers.) It’s strange that in a country that has ‘socialised’ aspects (police forces, benefits, various industries), health is such a sticking point. Why would it be a terrible thing for the USA to set up its own NHS? It’s not like you’d be forced to use it—after all, the UK has additional paid-for tiers—but at least then everyone would be covered and not petrified about losing their healthcare if they should lose their job. And the argument against—Why should I have to subsidise someone else’s healthcare?—makes no sense, given that this is precisely what you’re doing with insurance-based systems anyway. Insurance costs are always based in part around the people who are not insured, which drives premiums up.
The NHS isn’t perfect and I’m sure there are plenty of things that could be done to tighten things up. Yes, waiting lists are sometimes long and there are inconsistencies throughout the service. But the day the NHS is morphed into any kind of privatised service will be very sad indeed.