The Commonwealth Fund is a US think tank that campaigns for reform to the American healthcare system. In particular, it wants the US to adopt the kind of universal healthcare coverage that is taken for granted in Britain and Europe.
Every few years, it puts the healthcare systems of eleven rich countries into a league table and the USA always come bottom. Fans of the NHS (may peace be upon it) like these reports because the UK always come at or near the top. The latest Commonwealth Fund study was published today and Britain came top again. In your face, Australia! Suck it up, Sweden!
Of the five criteria included, Britain does well on four of them. It is only the fifth criterion – health outcomes – that lets us down. When it comes to avoidable mortality, the NHS (may peace be upon it) is not so hot and its inability to heal the sick is, as the Guardian admits,’a significant weakness’.
But apart from that, Mrs Lincoln, how was the show? Well, we do well on ‘access’ because the system is free at the point of use. We do brilliantly on ‘equity’ because everybody gets an equally poor service. And we even do quite well on ‘efficiency’ because there is no time for doctors to be twiddling their thumbs when people are literally queuing up for treatment.
If our health service wasn’t so useless at keeping people alive, it would be a clean sweep. The report’s authors note that recent years have seen Britain do better than the other countries in reducing ‘mortality amenable to health care’, but there are still far more avoidable deaths here than in countries such as Switzerland and Australia.
There are lessons that could be learned from these countries. First and foremost, we could learn that it is possible to have universal healthcare coverage without the government trying to run everything. Unfortunately, the idea has taken hold in the British imagination that there are only two systems of healthcare. Either you have a 1940s state monopoly or you a devil-take-the-hindmost private insurance system which (supposedly) leaves people dying in the street. In short, you either have the American system or you have the British system.
But nobody wants to copy the American system and – despite our parochial illusion that it is the envy of the world – nobody wants to copy the British system either. That’s why nobody has copied them. When you see Britain and the USA propping up the league table on the only measure that really matters, you can see why.
