By: Caroline Maas, foreign correspondent
With the question of healthcare consistently on the forefront of American politics, it is important to analyze and consider the implications of the United States Healthcare system. The United Kingdom, a society developmentally comparable to the United States, takes a vastly different approach to healthcare. While the U.S.’s system is privatized and provides healthcare based on the ability individuals have to pay for it, the United Kingdom operates on the premise that the right to health is earned simply by being a member of the society.
“The prevailing opinion amongst healthcare policy leaders is, from a practical perspective, that the U.S. does not consider access to healthcare a right that is afforded to all,” says Phil Fesial, president of Spartanburg Medical Center, of the U.S. healthcare system.
For a country that shares so many similarities with the United States, the healthcare system of the United Kingdom is one aspect that contradicts America’s ideology completely. Health and human right scholar and IES professor Daniel Wang says the ideology of the system “is based on the idea that access to healthcare should not depend on whether you can pay for it or not. Rather, the need should determine the care you receive. It’s the idea that it is the duty of the community/state to provide. You are entitled to receive healthcare because you are a member of the community.”
The United Kingdom is made up of four countries: England, Scotland, Wales and Northern Ireland. It operates its healthcare system under the officiation of the National Health Society (NHS). The NHS, founded in July 1948, receives its funding directly from taxation. The right-to-health ideology that so distinctly marks the United Kingdom’s healthcare system is reflected in the three core principles of the NHS: “that it meet the needs of everyone, that it be free at the point of delivery and that it be based on clinical need, not the ability to pay.”
America has been historically criticized as lagging behind many European countries in its ability to address the costs of medical care instead of the wages lost to sickness. This malady in the U.S. system is supported by the very traceable rise in medical costs throughout and beyond the 20th century in the U.S.
It was not until the Great Depression that a concern for healthcare began to cement itself into the American political system, with the passing of the Social Security Act and the conversation it began about improving public health and medical care. During this same time, Blue Cross became the first company to offer private health care coverage to their employees, beginning the system of the employer-based insurance model that currently prevails in the U.S.
Both the U.S. and the U.K. experienced major changes to their systems in the 1970s. In 1974 the U.K. reorganized its entire system to bring all services together under the umbrella of the Regional Health Authority, a change that was propagated by increasing financial concerns and a sudden realization of the need to redirect focus toward monetary efficiency.
Meanwhile, in July 1965, U.S. President Lyndon Johnson passed Medicare and Medicaid into law under the Social Security Amendments of 1965. Medicare, an insurance program for elderly Americans, and Medicaid, a joint federal-state system that provides healthcare coverage to low-income individuals, begins the system that is currently up for hot debate in the U.S. today.
Shortened to “Obamacare,” President Barack Obama’s “Affordable Care Act” was an attempt at bringing health insurance to the approximate 15 percent of Americans who lacked it by requiring that all Americans have health insurance, but also making it affordable for them to do so. Currently, the continuance of this policy hinges on the Trump administration and their judgment regarding the direction for the future.
In some ways, the Medicare and Medicaid programs are the closest the U.S. has come to mimicking the ideology of the U.K. healthcare system. Fesial remarks, “The U.S. has created a model based on curative care, which places greater emphasis on highly specialized care as opposed to preventative care. This is reflected throughout the U.S. system in terms and services, programs, financing and payment of services. It should be noted, however, that this has also resulted in great technological advances in areas of cancer and cardiac services, just to name a few.”
When asked what the biggest issue within the U.K. healthcare system is, Wang responds, “Funding. Funding is a big problem. The system doesn’t have the resources it needs. The current government is a conservative government, and they have a policy of austerity, so the idea is that they have to control public spending. But this has an impact on healthcare. Currently they are discussing an increase in income tax to further fund the NHS.”
Both the U.S. and the U.K. healthcare systems boast ideologies that make sense in principle, but how effective have they proven to be in action? The United Kingdom, operating under the seemingly morally upright and logical idea that everyone has a right to health, is currently facing the problem of limited funds to supply this right to health.
Similarly, the United States and its policy-makers are restless with the implications of morality accompanying the idea that one must earn the right to health. Still, can something really be a right without personal responsibility and if it is the responsibility of someone else to pay for it? As is brought to light by the U.K.’s system, is the alternative even remotely feasible?
These questions are essential to ask ourselves as Americans whose health is buried deeply in years of amended public policy and hinges deeply on impending change to this policy as time moves on. As the collective hands and feet of America’s future, questions and criticism of a system that has brought us all this far are essential to understanding and determining where our healthcare system will go from here.
