Welcome, America, to the British NHS. That may not be what you were promised when your president first dreamed up Obamacare. But the National Health Service is what you’re going to get all the same.
I did warn you about this, four years ago in my (depressingly) prophetic book “Welcome to Obamaland: I’ve Seen Your Future and It Doesn’t Work.” I noted, for example, that your future president had grossly underestimated the costs of socialized health care. I warned that though he said at the time that it would cost between $50 billion and $65 billion, it undoubtedly would cost 10 times that amount. Look it up if you don’t believe me. It’s on Page 37.
But since last week’s Supreme Court ruling, we are where we are, unfortunately. So let me, as a Brit who has been living the whole socialized-medicine nightmare his entire life, give you a few tips as to what you can expect (assuming Mitt Romney doesn’t get in and boot the whole thing into the dustbin of history, where it belongs).
First, don’t panic: It’s not all bad. The National Health Service is what in Britain we call a “curate’s egg” - which is to say, it’s good in parts. The problem is, on any given occasion, you never quite know which it’s going to be. Will the hospital, doctor and nurses’ treatment be as it would by the cloyingly sycophantic maitre’d of your favorite high-class restaurant? Or will they treat you like Oliver Twist with his begging bowl, pleading piteously for a dollop of gruel? Are you a cherished customer or a darned nuisance? The NHS can never quite make up its mind.
Over the past couple of decades, I’ve experienced plenty of both. Only last week, for example, my wife had major surgery on her ear, performed brilliantly by a tweedy, well-spoken surgeon with a perfect bedside manner and a bushy Spitfire-pilot-type mustache. The hospital - Guy’s - in which she had the operation done was clean and well-run. And the nurses were not only efficient, caring, friendly and able to speak English but also - though this was of more interest to me than it was to my wife - extremely hot. For this complicated surgical procedure - which, no doubt, would have cost many thousands of dollars in the United States - my wife paid precisely zilch. (Well, so long as you don’t count the gazillions she pays in taxes.)
I also would love to tell you about a similarly successful operation I had a few years ago on my rear end. But you really don’t want the details, especially not at breakfast. Suffice to say the problem was treated most effectively and - again for no money - I was relieved of much suffering by a first-rate surgeon.
Everyone in Britain tells stories like this about nice experiences they’ve had with the NHS. But - at the risk of being cynical - this is a bit like captives of Somali pirates exchanging stories about how nice it was of Mohammed this morning to spit only once in their meager bowls of rice rather than twice. What I mean is that because of our rose-tinted nostalgia about the NHS - and our misplaced notion that, if we didn’t have it, there’d be no free medical care and people would be dying in the streets just like in America - we tend to accentuate the positive while turning a blind eye to its many and manifest failings.
Mind you, sometimes they are quite impossible to ignore. There are scandals, like the mid-Staffordshire hospital in which up to 1,200 patients were found to have died, while many more were caused “unimaginable suffering” by incompetent, neglectful staff who would neither bring them water nor change their filthy sheets. And there are awkward international studies like the one of “mortality amenable to health care” in which Britain came in last of 19 countries surveyed.
Then, of course, there’s the eye-watering cost for this (often) second-rate service. The National Health Service costs the British taxpayer around $150 billion a year - almost as much as the Education and Defense departments combined. If this brings taxpayers the kind of world-class service the NHS’ propagandists often claim it does, how come 55 percent of senior doctors pay for insurance for private medical treatment rather than expose themselves to its tender cares?
No one is saying the U.S. health care system was perfect. Yes, it probably did need reform, but the option you should have gone for - and which Mr. Romney should be considering if he wants to be taken seriously by conservatives and make amends for having more or less invented Obamacare in the days when it was Romneycare - is something more akin to the Singapore model, not the British one.
In Singapore, everyone pays into a health insurance scheme, but there are benefits for those who don’t use it. There are incentives for those who choose healthier lifestyles or decide to forgo expensive treatment. Instead, what you’ve opted for is British-style rationing supervised by box-ticking bureaucrats and technocrats. This will lead to wide variance in the quality of treatment you get; long waiting lists; surly, grudging, unionized service (think of the U.S. airport experience); and truly astounding levels of waste.
Oh, and once you’ve got it, you’ll never, ever get rid of it.
Good luck with that one, America.