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Oh, the Horrors of Socialized Medicine! The Horrors!

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So horrible it’s nearly Nazi.

I have spent over a month back in my homeland, watching with piqued interest the ongoing travails of the health care debate.  After the 1993-94 debacle (which I give a lecture on in a first year comparative politics class in the UK about how it’s sort of slightly difficult to get anything real accomplished in the American system) my hopes for proper reform are limited.  Cards meet table: I’m well in favor of single-payer, meaning in the current series of watered down proposals, the so called ‘public option’.  
I am getting absolutely pissed off at the ignorance and lies coming from the right about the NHS.  Which is bloody remarkable, seeing as how any of the myriad bills and administration goals working their way through the legislative process don’t come within sight of the suburbs of the NHS.  Of course, I should be calm and expect ignorance and lies from the right — it’s what they’re good at.  I am not at all surprised about the stupid tea-bagging malarky; when the right are not in power they take it as a personal affront and evidence that the USA is heading blindly down some anti-patriotic path of perfidy.  However, this is getting bleeping ridiculous.
This doesn’t surprise me all that much.  In a context where the state assumes responsibility for the health care of its citizenry, anecdotal tales of rationing and bureaucratic malfeasance will abound.  Fortunately, health insurance companies in the United States have no self interest in preventing care for anybody, no self interest in taking into consideration pre-existing conditions, or making it more expensive in terms of percentage of care covered or deductibles, so the status quo as exists in the US is in everybody’s interest.
Yes, the NHS do have to ration care, in a sense.  But then so do private health insurance companies.  The NHS rely on a much-derided (and unfortunately named) quango called N.I.C.E. to determine the cost/benefit analysis of the drugs that they will cover.  But then at least every single prescription in the UK is £7.20, regardless (unless it has gone up in the month I’ve been off the island).  Of course, if you’re under 16, like my daughter, or pregnant, or if you qualify under a number of other conditions, your prescriptions are free.  
There are no bureaucrats between me and my doctor.  I chose my GP, all by my foreign self.  My GP is in private practice — they all are.  She contracts with the NHS for her service.  (This leads to some problems, as with dentistry, as any British subject or resident of that island would immediately understand).  Her office is located in a “surgery” a whole three minute walk from my house.  At least in Plymouth, where I live, this is the norm — GPs are located in residential neighborhoods.
On the two occasions where I or my family have experienced a life-threatening need for the service, it has been provided, immediately and with no questions, no death panels, no profit / loss analysis, no insurance forms, no deductibles, no bureaucracy whatsoever, full stop.  It was just done.  The first instance was when my daughter was born in October 2006.  She was born with a Tracheoesophageal fistula, which was only discovered a few hours after her difficult birth.  Both her and her mother were immediately transported 120 miles north, to Bristol, where the best Children’s hospital in the Westcountry is located.  They stayed there for three months until Imogen was ready to be sent home.  She has to take daily meds for her condition until the age of about five, which (see above) are free.  
The second time was about me, and it was about cancer.  When my GP suspected cancer, there were no waiting lists, no lines, no death panels — again, it was just done, full stop.  I was in the hospital within two weeks for the first of several procedures to work out whether or not it was indeed cancer.  That’s the law, folks, according to my GP with the big C: a two week maximum wait.  (Incidentally, it was, it was very early, and now it’s gone, so it’s no more, but hey, I am the proud owner of a pre-existing condition!  Go me!)
Neither event comes at all close to the characterization of socialized medicine that the wingnuttery are busy producing.  I recognize that as anecdotes, these two stories are of limited value.  Furthermore, the NHS is not perfect.  I understand that had Imogen’s mother received the number of pre-natal scans common in the US, which is a greater number than the three she received in the UK, they may have caught Imogen’s condition between 20 and 25 weeks.  However, I would not trade it for the byzantine US system with its thick layer of corporate looting.  In the last month, I’ve had many discussions here with friends (old and new) and my partner about the logistics of health care and the myriad of plans on offer.  No doubt, as a tenured professor, I’d have a decent plan.  But for a lot / most people, the challenge of sifting through percentage covered / deductibles / etc. is a burden simply to have crappy care.  
And what if we were one of the 50 million uninsured when the daughter was born?
What is remarkable about this is that while the UK spends less per capita on health care than the US (about half I believe, corrections welcome, and while I do give a lecture on this, my notes are in the UK, not Oregon) the outcomes in terms of survival rates etc. are roughly the same (again, IIRC).  Indeed, as Scott points out here the US actually pays a higher % of GDP in public expenditure on health care, and while the UK is underfunded relative to the US, the outcomes are better in the UK on most measures (thanks to the commenter in Scott’s thread who supplied the link to that JAMA article) contra Steyn, but then who are you going to trust, the Journal of the American Medical Association, or Mark Steyn?
Of course, as with the BBC, not all of the British have a stinking clue about what they have in the NHS.  Fortunately, plenty do.  I do pay for this — my taxes are not low in the UK — but if I wanted to augment my care, I could always go private as well.
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