The British and Canadian healthcare systems compared with U.S. reform options

¶ … Public Policy -- Healthcare Reform

The British Medical System from the Middle and Upper Income Perspective

From the perspective of middle and upper income citizens, the British medical system, or National Health Service (NHS), offers tremendous advantages over the current state of United States health care. That is primarily because healthcare in the U.S. is extremely expensive; they are expected to approach 40% of the entire national economic productivity within a decade without significant reform (Kennedy, 2006; Reid, 2009). Under the current U.S. system, low income individuals qualify for government-subsidized healthcare but middle income and upper middle class families must absorb the cost of healthcare without assistance. So many people are unable to afford private health insurance in the U.S. that the unavailability of affordable healthcare is directly responsible for as many as 40,000 premature and preventable deaths annually (Kennedy, 2006; Reid, 2009).

Under the British system, healthcare is provided to all at government expense (Kennedy, 2006; Reid, 2009). Costs are reduced by controlling the fees to which healthcare providers are entitled and by incentivizing the high quality and beneficial results of healthcare. Preventative medicine and performance-based fees are extremely positive features. The principle negative aspect of British healthcare is the long wait for specialized services because of availability shortages (Kennedy, 2006; Reid, 2009).

Medicare Expansion and Mandatory Health Insurance Issues and Concerns

From the perspective of middle and upper middle income families in the U.S., the expansion of Medicare and the mandatory provision of healthcare by employers would be a tremendous benefit. From the employers' perspective, the associated costs could be prohibitive. Mandatory requirements for individuals could be problematic for those at the lower end of the group income spectrum; however, it would be no less fair than the current situation that forces everyone who pays for healthcare to (in effect) subsidize those who choose not to (Kennedy, 2006). In all likelihood, the only way to make mandatory health insurance work would include expanding Medicare, at least to compete with private health insurers. Naturally, this interferes with their profits, but there is no fundamental right to profit excessively from providing basic healthcare and public agencies could perform the same function as private insurers at approximately a tenth of the cost charged by private insurers (Kennedy, 2006).

Privatized Healthcare with Government Subsidization

Some hybridized version of healthcare that included elements of both privatization and government subsidies (such as through a voucher program) might be the most beneficial to middle and upper middle income families. It would severely reduce the profitability of private health insurance companies, but only because that industry has established an unreasonable and unjustifiable profit margin that has made healthcare unaffordable in the U.S. (Kennedy, 2006).