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Guest opinion: British patients deserve better than single-payer — so do Americans

SHARE Guest opinion: British patients deserve better than single-payer — so do Americans

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“Medicare for All” remains popular with a slim majority of Americans, according to polling from the Kaiser Family Foundation. 

Perhaps they’ll change their minds after taking a look at how government-run health care is faring across the Atlantic. A new report from the British government shows that patients in the country’s National Health Service are waiting hours for emergency care and weeks for necessary but nonurgent care. Some are dying on waiting lists. 

Long waits for subpar care are exactly what’s in store for U.S. patients, if Medicare for All comes to pass on this side of the pond.

The British NHS has a lot of the same features as Medicare for All. Most notably, both would make care free at the point of service — no deductibles, co-pays, or coinsurance.

But while everyone in the United Kingdom has access to health care in theory, things don’t work out so cleanly in practice.

The NHS doesn’t have the capacity or resources to treat every patient in a timely matter. Doctors are spread thin, working long hours for low pay in an attempt to keep up. Close to 60% of NHS employees work unpaid overtime each week, according to a survey of staff. The average general practitioner in the United Kingdom makes under $135,000 a year — considerably less than the $220,000 taken in by the average generalist physician in the United States.

Rather than stay in these unsatisfactory conditions, many health care personnel leave the NHS entirely. The number of permanent general practitioners working in the NHS has fallen 6% since 2015.

Britain’s shortage of qualified health care personnel is one of the main reasons patients face such long waits for care. From 2018-19, 629,000 people waited over four hours for admission to the emergency room, according to the latest figures from the House of Commons Library, a government research body. The number of people waiting more than 12 hours for admission to an emergency department rose sharply from 2012 to 2019.

Emergency rooms aren’t the only places with unreasonable waits. Nearly 4.6 million people were queuing for specialist treatment as of March 2019 — a 40% increase from just five years ago. Patients who need diagnostic tests are facing the longest waits in over a decade.

British patients who need surgery must deal with constant uncertainty. Close to 4,000 urgent operations were cancelled between October 2018 and September 2019. During that same period, more than 79,000 elective surgeries were cancelled for nonclinical reasons the day the patient was supposed to arrive.

Cancer patients face some of the worst waits of all. More than three-quarters of NHS facilities fail to meet the government’s goal of treating urgent cancer patients within 62 days of referral from a general practitioner.

These delays can be life-threatening. Every year, roughly 115,000 English cancer patients receive a diagnosis too late to receive the most effective treatment, according to the charity Cancer Research UK. Thanks in part to this inefficient treatment, the United Kingdom has some of the lowest cancer survival rates in the developed world.

Things are better in the United States, where patients have better access to screenings for cervical, breast, and colorectal cancers, according to the World Health Organization. The average five-year survival rate for Americans with all stages of prostate cancer is 13 percentage points higher than it is for British patients. 

It’s hard to believe that a majority of Americans is enthusiastic about importing British-style waiting lists for health care. But that’s exactly what Medicare for All would do. 

Sally C. Pipes is President, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute.