Like all modern healthcare systems, the National Health Service -- Britain's centralized, universal healthcare system -- has room for improvement. But there's much more to the story than that presented by Dr. Theodore Dalrymple in his Aug. 8 Op-Ed article, "Britain's cherished, lousy National Health Service."
The NHS' widely known strength is primary care. And time and again it has been shown that a strong primary-care system is at the heart of a healthy population. In part because of Britain's focus on primary care, the country has lower age-adjusted rates of diabetes (about half our rate), heart disease (about two-thirds our rate) and cancer (about half our rate), as shown in a 2006 study published in the Journal of the American Medical Assn. And in terms of rates, this disparity between the two countries might be understated. Unlike Britain, the United States still has roughly 50 million people who may never have been screened for any of these diseases simply because they are uninsured.
The British certainly do have poorer outcomes for some diseases than we do. The United States is widely respected for its advances in cancer care, but the results are arguably only marginally better.
Consider this: The United States spends at least double per person what most other developed countries (including Britain) spend on healthcare to get these better outcomes. So the 30-day heart attack mortality rate difference reported by Dalrymple (6.3% in Britain versus 5.1% in the United States) seems almost silly once you consider what we spend to get there. And is it really worth spending double to get a boost of 1.2 percentage points in "survival" among those diagnosed rather than reduce the rate of heart disease to levels comparable with Britain in the first place? Is it worth spending double to get a 15-percentage-point increase in five-year "survival" for those diagnosed with colon cancer rather than apply the funds to reduce cancer rates to levels comparable with Britain in the first place?