Why British Healthcare Won't Work Stateside

The UK health care system may do moderately well at controlling costs, but it's a model no one - even on the American left - really wants to pursue.

I agree with almost all of Stanley Goldfarb's points in his piece about the UK healthcare system's numerous flaws. But it's important to note that the system in the UK isn't exactly a "single payer" system and, if we're honest about it, isn't the model that Obama or anyone else on the American left wants for the United States.

The UK system, which lumps all medical care--hospitals, doctors, nurses, ambulance, clinics and everything else--into a giant government agency (the National Health Service, larger than the United States' Department of Defense) is a "single provider" system. It's distinctly different from the systems in Canada (one public insurer in each province but significant private care delivery), Germany (many competing insurers combined with employer and government subsidies for most people), or France (a bare-bones "welfare" system dominated by a single government-supported enterprise combined with a minimally regulated private insurance and out-of-pocket payment for day-to-day maladies or more perks.)

The UK system has done moderately well at controlling costs but provides care that's--at best--spartan but effective and, at worst, downright inhumane. Implementing something similar in the United States would require a massive effort to nationalize every hospital, clinic, doctors' practice, ambulance company and everything else. Whatever the advantages of a system like this, it's not a model anyone really wants to pursue.

The plan the current UK government wants to pursue, if successful, would leave the UK with a health care market a lot like Canada's but, aside from dismantling the NHS altogether, it will still be a very long way from a market-based system.

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