Topics: Obamacare

Diana Furchtgott-Roth: Britain's National Health Service shows Obamacare's future

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Opinion,Diana Furchtgott Roth,Columnists,Obamacare,United Kingdom,Health Care

LONDON -- If anyone wants to see Obamacare's future, come to Britain and look at single-payer health care in action -- and the parallel market-oriented system that has developed, not just for private health insurance but for pay-as-you-go medical services.

Britain's National Health Service has provided free or heavily subsidized care to registered residents for 65 years.

It sounds utopian, but the system is plagued by cost overruns, long waits for nonemergency care and denial of some preventive services considered routine in America.

Those who can afford it opt for private insurance and care.

Proponents of Obamacare argued that it would lower U.S. health care costs by reducing the use of emergency rooms for the uninsured. Since everyone will have insurance, people will visit their primary care doctors instead of using expensive emergency room services.

But headlines in Britain show that emergency room visits are rising under the NHS, from 18 million in 2005 to 22 million in 2012. That's an increase of 22 percent in seven years, above the population increase of 4 percent.

On Thursday, Jeremy Hunt, Britain's health secretary, warned that the increase in emergency room visits posed the "biggest operational challenge" to the NHS.

Patients, especially those with chronic conditions, are visiting emergency rooms because they can't get appointments with their doctors.

Dr. Kailash Chand, deputy chairman of the British Medical Association, said last week that "the ever increasing squeeze of funding to [doctors'] practices and the wider NHS, coupled with the impact of coping with an aging population and spiraling patient demand, has left the NHS facing unprecedented pressures."

America has the same difficulties with squeezed physicians, an aging population and spiraling patient demand. These are problems that the Affordable Care Act is supposed to solve. But Britain shows that a single-payer health service hasn't solved them.

Under the NHS long waits for nonemergency visits are common, and even scheduled surgeries arranged months in advance can be postponed without warning for lack of a piece of medical equipment.

It has become increasingly difficult to schedule a regular visit with an NHS doctor. Patients can see a doctor promptly if they call early in the day and say their problem is an emergency, entitling them to be seen in one of a limited number of same-day emergency appointments. Otherwise, the wait can stretch to weeks.

Some escape the NHS waiting periods through private insurance and private hospitals, with no waits and a choice of top-quality specialists. Employer-provided private health insurance is a valued benefit, just as it is in America.

Besides offering insurance, Bupa, Britain's largest private insurance company, provides "self-pay" physician services to those whom it does not insure but who want to escape the predictably long waits of the NHS.

Prices for a "self-pay" appointment with a general practioner range from $105 for a 15-minute consultation to $350 for an hourlong visit. Bupa also offers cosmetic treatments ($93 for microdermabrasion for the face, $308 for a wrinkle injection).

In the private Wellington Hospital, near Lord's Cricket Ground in northwest London, hospital rooms are like hotel rooms, with one patient per room, mini-refrigerators, armchairs and couches.

Nurses offer cups of tea in china cups and saucers. In the lobby, newspapers are in English and in Arabic: Many Arabs, living in London and abroad, come to the Wellington for private care.

America already has concierge medical services for the rich and walk-in clinics at drugstores for everyone else. Americans will seek a way out of Obamacare's lengthy waits for doctors and specialists. The invisible hand will come to the rescue, just as it has in Britain.

Washington Examiner Columnist Diana Furchtgott-Roth (dfr@manhattan-institute.org), former chief economist at the U.S. Department of Labor, is a senior fellow at the Manhattan Institute for Policy Research.

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Diana Furchtgott-Roth

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The Washington Examiner