For the flaw in 'Medicare for all,' just look to Britain's NHS

By | January 23, 2019

Obamacare did not solve America’s healthcare and health insurance problems, and Democrats have taken the next step. A “Medicare for all” plan, now in the hands of Sen. Bernie Sanders, I-Vt., is now fashionable to discuss once again. However, public health insurance simply cannot function to the level of private insurance. And if you want to see why, look no further than ambulance service under the United Kingdom’s National Health Service.

Last semester, I studied abroad at the University of Oxford. One Sunday, I and several of my American friends were invited to our pastor’s house for snacks after our evening service. After a wonderful night of rocky road brownies, tiny pizzas, and a thorough explanation of the Electoral College, my roommates and I gaily began the two-mile journey back to our flat. As we walked down the road, in the distance I saw a woman sitting on the sidewalk, covered with a blanket, while two men stood next to her. As we began to approach the scene, it became clear the woman had been injured.

Her eye was developing a nasty bruise and blood dripped from her nose. A bike laid crumpled on the side of the road. I asked the men with her what had happened and whether I could assist them by calling an ambulance. The woman had been hit by a taxi. They assured me that no assistance was necessary, because they had already called the ambulance. They had called it 45 minutes ago.

I was shocked. They weren’t. They told me these types of wait times were typical for ambulances and that emergency services frequently have to be rationed. I offered my pastor’s car knowing he would be willing to help, but the gentlemen refused. After making sure there was absolutely nothing I could do to be of use to them, and not wanting to be a burden, I continued my walk home.

This story is not an isolated one. After years of failing to meet the blanket target response time of 8 minutes for NHS ambulances — a goal comparable to the actual U.S. average of 7 minutes — the NHS last year decided to lower its standards. Call requests were divided into four main tiers. The first tier deals with “life-threatening emergencies.” For those calls, ambulances were given a goal of 7-minute response times. The second tier deals with “emergencies,” including reported strokes and heart attacks. For this tier, the target response time is 18 minutes. That’s a lifetime for someone suffering a stroke.

According to data collected by the Labour Party, average response times for tier 2 emergencies has been close to 22 minutes. Since this new plan was implemented, approximately 157,000 people have reportedly waited over an hour for responses to tier 2 emergencies. This is according to data collected by the Daily Mail.

Because resources are so limited, NHS has resorted to doing triage over the phone. This can be highly unreliable. Last year, a pregnant woman named Gail Bailey died after waiting nearly three hours for an ambulance. She had called 999 after experiencing severe abdominal pain. She was later found to have had an ectopic pregnancy, but over the phone she had been misdiagnosed with appendicitis, and so dispatchers believed it was safe to put her at the back of the queue. Her husband called again later to inform emergency services that Gail was drifting in and out of consciousness. The ambulance didn’t arrive for over an hour after this call.

In the wake of this mess, U.K. lawmakers continuously call for more and more spending on the system. These outcries reveal the woeful lack of understanding as to what’s really at play here. Again, in the United States, the average ambulance response time is 7 minutes, and that takes into account the 14-minute average wait in more rural areas, according to the Journal of the American Medical Association. The U.S. system works so well because it is privatized. Care does not have to be rationed in the same way because in most cases patients and insurers pay for the full cost of their ambulance ride.

Extend that same reasoning to the full array of medical procedures, and it still holds true. It really is that simple.

So why do Democrats insist on pushing toward single-payer healthcare? They would be foolish to believe that they will be the ones to finally get it right. The NHS has been around for nearly 70 years, and they still haven’t worked out the kinks.

Haley Smith is a freelance writer.


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