Liberals find it odd, and perhaps slightly irrational, that Americans so heavily criticize the British National Health Service. This has been of particular relevance in light of Donald Berwick’s “love affair” with the agency.
Britain’s Conservative prime minister, after all, often talks “of how proud we in Britain are of the NHS.” Just as with Medicare in the U.S., British politicians who talk of dismantling the NHS get hammered in the polls. (Despite Her Majesty’s Government’s surprise announcement this week of incremental market-oriented reforms to the program, the Tories under David Cameron have repeatedly pledged to preserve its funding.)
But describing the NHS as “popular” with British voters is a bit like describing cocaine as “popular” with crack addicts. Once people become dependent on heavy state subsidies, it is natural for them to feel insecure at the thought of losing them. Tocqueville long ago articulated how this problem inevitably arises from majoritarian democracies. And people who live under a single-payer regime have no way, short of moving abroad, of appreciating that there are better alternatives.
Having said that, Britons are frustrated by the indifference and inhumanity of the National Health Service. Its problems are covered widely in the British press. Here are some examples (and readers are welcome to provide others):
These problems are not an accidental side effect of socialized medicine — they are inherent to socialized medicine. Liberals who believe that technocratic experts can rationally allocate health care resources ignore the real-world examples, like Britain’s, of how that model fails in practice.
The American health-care system has its flaws, and real reform is urgently needed. But the reason why Obamacare is so unpopular is that most people would never trade our approach, warts and all, for that of Donald Berwick’s NHS.
– Avik Roy is an equity research analyst at Monness, Crespi, Hardt & Co., and blogs on healthcare policy at The Apothecary.