England's National Health Service has always been a political punching bag, but usually, the jabs are aimed at British politicians, and they are most often thrown by the English electorate.
Iowa Republican Sen. Chuck Grassley's recent off-the-cuff remarks in which he mentioned that he had heard that Sen. Ted Kennedy might not get care for his brain tumor in England, have put the English health system into a very different kind of fight. Now, the English are facing off against the U.S. political right.
Usually, international learning is vital to crafting strong policies. However, in the current health care debate, looking across the pond is actually making American and English health policy worse. Instead of looking at what we can learn from each other, both countries are so paralyzed by each other's faults that neither country can move forward.
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The British are intuitively skeptical about the U.S. health care system. The English system was founded on two principles: that coverage was comprehensive and that care was free and not based on ability to pay. The English simply cannot understand the idea that an estimated 46 million Americans go without insurance coverage.
However, they do not realize that the 46 million uninsured Americans statistic is misleading. While un- and underinsurance are indeed huge problems in the United States, the 46 million tally includes individuals who are without insurance for very short periods of time. Further, many of the uninsured are under 30 years old, a surprising number are making more than $50,000 annually and almost a third are already eligible but choose not to enroll in federal coverage.
This misread of the U.S. statistics in part reflects why England was slow to adopt competition and reluctant to embrace private sector health care providers.
This malaise historically didn't do England any favors. Competition can be the engine to drive quality and innovation and fundamentally it can improve the patient experience. Indeed, it's partly the result of competition that high intensity care for cancer and strokes in the United States is so much stronger than it is in England.
Of late, England has begun to more actively embrace competition, and as a result, patient satisfaction and patient outcomes are improving.
But the United States is equally guilty of letting anecdotes get in the way of policy. Americans cannot understand the concept of long waits for care, or the rumors of rationing care in England.
However, just as the 46 million uninsured statistic is misleading, so, too, are rumors about waiting times and rationing. Waiting times have plummeted in England over the last decade to the point where they are no longer a problem. Likewise, England has taken big strides to improve access to the latest cancer medications.
And yes, Kennedy would have received cancer care in England.