England

8 Universal Health Care System FAQs #4

Does England have socialized medicine?
Yes. The National Health Service (NHS) directly provides the majority of the health care delivered in England, with most services free. Ultimately, the system is paid for by taxation. There is a parallel private health care system, but it is mostly used supplementary, and even then, only rarely.

Why is England able to deliver health care so cheaply?
While the American system encourages almost unlimited health care use, the English system discourages use of the system. Since the majority of the doctors are employed directly by the NHS, the NHS can dictate the payment scheme used and they have decided upon capitation. Capitation means that the doctors are paid a fixed rate based on the number of patients under there care. This differs greatly from the fee-for-service model. The physician makes the most money by performing fewer services, such as tests.

With the emphasis on less care, how is the quality of health care service in England?
Although the system doesn't appear to be nearly as bad as its reputation suggests, the perception is that the quality of health care service is poor in England. There are long, often substantially, waits for care. Still, the UK as a whole ranked 24th in level of health, compared to 72nd for the United States. This suggests that their health care system performs better than ours in quality of care. In 2007, the NHS announced a major initiative to improve the quality of care.

Is the English system feasible in the United States?
I would not be so arrogant as to suggest that there is nothing we can learn from the English system. Quiet frankly, they insure their entire populace, their citizens are healthier, and they accomplish this while spending much less than we do on health care. I would say that their system is already better than ours. Still, it will never happen here. Our doctors will not go to work for the state. As our survey of universal health care systems shows, there are many systems that make better models for a new US system than the UK model.

Sources (Ezra Klein, Wikipedia, Reuters, World Health Organization)

Previous Entries in This Series (Canada, France, Germany)