July 19, 2019

The Good, Bad and Ugly of Universal Health Care

“The fire alarm in our hospital room is blaring. Despite our attempts to stifle the sound with a towel, it is deafening. My husband sits on one side of our room in a stiff vinyl chair cradling our newborn baby boy in his lap, cupping his tiny ears to protect them from the noise, which has been unrelenting for 10 minutes now. He is weary. I am weary. This is our sixth day in a London hospital, and the third consecutive day of fire alarm “testing” on the postnatal ward to which we’ve been assigned. Babies are screaming. Haggard, sleep-deprived new parents like us are losing their minds. But in the hall, the medical staff march on, unfazed. They smile at one another, make small talk, and generally ignore their patients’ complaints. To them, this living hell is normal. It’s just another day in a National Health Service hospital.

The National Health Service, or NHS, is the United Kingdom’s public universal health system. It was established in 1948 after World War II, and has since grown to become a massive operation: The NHS sees a million patients every day. It employs 1.7 million people, which makes it the fifth biggest employer in the entire world. And of course, it is free at the point of use for U.K. residents. If you walk into an NHS hospital with a broken arm, you’ll walk out with a cast, a few x-rays, and zero bills to pay. That’s because people who live in the U.K., myself included, contribute to the NHS through taxes and national insurance payments (the U.K.’s version of Social Security).

While the NHS has long been the subject of some scorn in America, it is also often heralded elsewhere as a shining example of how universal health care can succeed. British citizens are fiercely protective of it. One survey found that Brits list the NHS as the number one reason they are proud to be British. And there’s good reason for this: The NHS is great. Having grown up in the States and become accustomed to the complicated web of insurance claims, co-pays, deductibles, and enormously confusing bills that plague the American health-care system, I found the idea that I could receive top-tier treatment for free here in London mind-blowing. After I got pregnant last year, the maternity care I received leading up to and during the birth of my son was outstanding.”

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