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My turn: American health care system can learn from the Brits

Posted: Friday, July 03, 2009

As an expatriate Brit and now resident here, I have watched the debate over impending health care reform with interest and sometimes incredulity. Having had almost 40 years experience of a "public option" health care system, I wanted to add my two cents to the debate and try and clear up some misconceptions that seem to abound.

1. A public option does not equal socialism. In Britain, the National Heath Service is supported by conservatives and liberals alike. Indeed, the official Web site of the Conservative Party states "Few things matter more to our country than the NHS - it's an institution that binds the nation together. ... We will always provide the funding the NHS needs and are committed to real increases in health spending." The party of Margaret Thatcher is hardly full of raging socialists.

2. A public option does not mean second-rate doctors. In Britain, we have private hospitals as well as public hospitals. Most of the consultants who work in the private hospitals do so as an adjunct to their work in public hospitals. In fact, you cannot get certain services in private hospitals (e.g. emergency care). Most doctors are 100 percent committed to the health care service and in fact many are so principled about it that they refuse to work in the private sector. Are British doctors so much more altruistic than their American counterparts? I doubt it.

3. A public option does not mean second-rate care. True, there are waiting lists for non-urgent procedures, and I don't pretend that the system in Britain is perfect by any means - for one thing, it is still seriously underfunded, and bureaucracy needs to be trimmed. But to take a personal example, when my sister was diagnosed with breast cancer following a mammogram, she did not have to wait weeks or months - her mastectomy took place the following week, followed immediately by chemotherapy. All free at the point of service. If you need immediate treatment, it is available.

4. A public option does not necessarily mean massive tax hikes. Yes, the way Britain pays for its health care system is founded largely on taxation. We pay national insurance contributions which come out of wages on a pay-as-you go basis. Hey, sounds a bit like our Social Security and Medicare contributions. Exactly. Perhaps contributions will have to increase - that's for the politicians here to work out. But in Britain, you would be hard pressed to find someone who would rather save 25 a month in their paycheck than have a universally available health care service.

A few years ago I watched my mother die in an NHS hospital. After an unexpected massive stroke, she lay in a coma for more than a month being fed intravenously. The hospital was built in the '60s and was in dire need of a face-lift. Yet I couldn't have asked for better care. The nurses treated her with dignity and respect, turning and washing her every day, talking to her as if she was still fully conscious and aware of her surroundings. My family owes them eternal gratitude for their kindness. How much more traumatic would it have been for us that month if we had had to deal not only with the knowledge of her imminent departure from our lives, but also that we would be left with thousands and thousands of pounds of medical debt to try and deal with? There is something very, very wrong with the American health care system. It needs to be fixed. Now.

• Kate Hudson is a Juneau resident, married with two young children, who works for the state of Alaska so her family has health insurance.



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