Columns 9.2.2018 08:03 am

Yes to universal healthcare

The survey covered questions such as how well pain was managed, the preparation of patients for care following discharge, and whether patients experienced communication from healthcare providers as respectful and easy to understand. Picture: Supplied

The survey covered questions such as how well pain was managed, the preparation of patients for care following discharge, and whether patients experienced communication from healthcare providers as respectful and easy to understand. Picture: Supplied

Americans spend twice as much per capita as Britons on healthcare. 

It began, as so many things do these days, with a Donald Trump tweet.

Frustrated by his inability to kill the Obamacare expansion of public healthcare provision in the US, Trump seized on a protest about the underfunding of Britain’s National Health Service (NHS) in London last Saturday to trash the entire concept of universal healthcare paid out of taxes and free at the point of delivery.

“The Democrats are pushing for universal healthcare [in the US] while thousands of people are marching in the UK because their system is going broke and not working,” he tweeted.

It was awkward for Britain’s Conservative Prime Minister Theresa May, who tries to avoid criticising Trump, so she let health secretary Jeremy Hunt respond, instead.

Hunt tweeted back that while he disagreed with some of the protesters’ opinions, “not ONE of them wants to live in a system [like the US] where 28 million people have no cover … I’m proud to be from the country that invented universal coverage – where all get care no matter the size of their bank balance.”

It’s true. The British population is growing older and needs more health services, but Conservative governments over the past seven years have not raised spending on the NHS to match.

As a result, many people are dissatisfied with the growing delays in treatment, but the NHS is the most beloved institution in the UK.

Not one person would want to replace it with a privatised, insurance-based system.

A huge controversy rages permanently in the US over public vs private spending on healthcare, with the Republican trying to cut the share paid out of taxes by federal and state governments (currently about half).

But there is no equivalent controversy elsewhere. Every other developed country has a universal healthcare system – and in an 11-country study published by the US-based think-tank.

The Commonwealth Fund last summer, the US came last in terms of safety, affordability and efficiency. Americans spend twice as much per capita as Britons on healthcare.

Health services account for 17.2% of American GDP – the highest in the world – compared with 9.7% in the UK.

Yet the British system delivers better results: life expectancy at birth is almost three years higher in UK (81.4 years, compared with 78.8 years for the US).

There really is no controversy: universal healthcare is better.

Since half of that enormous American spending on health goes to profit-making enterprises like insurance companies, there is an immensely rich lobby fighting to keep the public-private controversy alive in the US.

But elsewhere, even in poor countries, it is a no-brainer.

Like in India, for example.

Last week in the Indian parliament, Finance Minister Arun Jaitley announced a new government initiative that will provide the poorest 100 million families – half a billion people – with up to $7 800 annually to cover hospitalisation costs in case of severe illness.

People are already calling it Modicare after Prime Minister Narendra Modi. India presently spends 1% of its GDP on healthcare, so there’s still a long way to go.

Maybe in a couple of decades, India will have a universal health service like the NHS. Beloved, in other words.

Gwynne Dyer

Gwynne Dyer


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