It might be an exaggeration to say that the National Health Service (NHS) is the pride of the United Kingdom, but it doesn’t exactly fall that short of the truth. Having attained an almost “mythic” status in both the UK and abroad, the NHS is likely to remain front and center in post-Brexit policy debates, especially in light of the recent coronavirus pandemic.
A Brief History of the NHS in Post-war Britain
Inaugurated by Health Minister Aneurin Bevan on the 5th of July, 1948, the NHS was lauded for its ingenuity, offering “free” healthcare services to whomever was in need. Following a spike in medical costs, as well as overall health complications stemming from the war, economist William Beveridge established in his Report on Social Insurance and Allied Services that “comprehensive health and rehabilitation services” should be put in place in post-war Britain.
Influential in what would become known as the “Welfare State”, the Beveridge Report hoped to address the “five giants” known as idleness, ignorance, disease, squalor, and want. Many of the policies in the Report were depicted as a sort of “recompense” or “reward” for the public’s sacrifices made during the war.
It might be an exaggeration to say that the National Health Service is the pride of the United Kingdom, but it doesn’t exactly fall that short of the truth.
Although enacted by Clement Attlee’s Labour government, the NHS managed to somewhat surpass party lines, partly due to the overwhelming support received from the British public. The British Medical Association (BMA) and other doctors’ trade unions fought tooth and nail against the NHS, but ultimately to no avail.
Even classic conservative figures appear to have shown restrained support towards the NHS. In a March 1944 speech to the Royal College of Physicians, Sir Winston Churchill declared, “The invention of healing science must be the inheritance of all.” He also affirmed that the responsibility of setting up a national health service fell upon the government.
Margaret Thatcher also famously claimed that the “NHS is safe with us” (although past archives may reveal otherwise), and current prime minister Boris Johnson has repeatedly thanked the NHS after a severe case of Covid-19 threatened to take his life. The NHS has thus managed to remain intact since 1948, even celebrating its 70th anniversary in 2018.
Influential in what would become known as the “Welfare State”, the Beveridge Report hoped to address the “five giants” known as idleness, ignorance, disease, squalor, and want.
Besides obvious health benefits, the NHS has likely strengthened social ties within the UK, resulting in its far-reaching support. As Tory politician Nigel Lawson once said, although somewhat sarcastically, the NHS is the “closest thing the English people have to a religion.”
The recent pandemic has demonstrated the need for personal sacrifice – from wearing a mask to a full-on lockdown – in order to work together as a nation. In the United States, where rampant individualism, identity politics, and political polarization have slowly chipped away at any sense of unity Americans once had, the NHS might just serve as an example of some much-needed social cohesion.
How does the NHS differ from other social programs?
While some social programs may be more “difficult” to justify in terms of their selectivity, healthcare – along with education – tends to benefit the majority. Not all of us will need unemployment benefits or social housing, but most of us will rely upon public schooling or medical care at least at some point throughout our lives.
Just as society generally benefits from a higher level of education, better healthcare translates to a better quality of life for all. When the burden of healthcare is shared amongst a population, individuals are more likely to look out for one another in order to promote public health.
Such a sense of social responsibility is thus more likely to entice individuals to reduce the health costs that they impose unto others. This is especially true in the case of Covid-19, in which the adoption of sanitary measures, such as social distancing and frequent hand washing, has helped slow the spread of the virus.
The United States ends up paying more for healthcare than the United Kingdom (or any country in the world for that matter), all without providing universal coverage.
Although many Britons have been slow to adopt the mask, the American-style partisan debate surrounding them has for the most part been avoided. Furthermore, public support in the UK towards the NHS in the fight against Covid-19 has been overwhelmingly positive, tending to unite the population on the whole (at least in this regard).
This comes as quite a contrast to the United States, where the lack of universal healthcare has not only fractured the social fabric of the country, leading to furthered individualism at the cost of solidarity, but also to significantly higher monetary costs, as well as lives lost.
Collective moral responsibility aside, the United States ends up paying more for healthcare than the United Kingdom (or any country in the world for that matter), all without providing universal coverage. The explanation behind such a phenomenon partially explains why Covid-19 has taken such a drastic toll on the United States.
When an American starts to feel sick, he or she is going to try to “wait out” the problem rather than have a check-up. Most times, symptoms get significantly worse instead of just “going away”, and what could have been solved by a simple doctor’s visit turns into a costly trip to the emergency room.
When the most vulnerable Americans cannot pay for these services (or must seriously indebt themselves to do so), it’s the Federal government that foots the bill. And while the NHS can undoubtedly be criticized for its long waiting times and shortage of doctors (primarily due to inadequate funding), it is precisely for this reason that it does a better job of providing comprehensive coverage without spending as much as the United States.
When Private Interests Reign
In addition to furthering social cohesion, national healthcare systems are not incentivized to merely see individuals as a “commodity” used to turn a profit. When there is little to no government regulation of healthcare, corporations can often “profit off” of others’ sicknesses. Such has been particularly clear within the pharmaceutical industry, and most notably in what is now the Opioid Epidemic in the United States.
When an American starts to feel sick, he or she is going to try to “wait out” the problem rather than have a check-up. Most times, symptoms get significantly worse instead of just “going away”, and what could have been solved by a simple doctor’s visit turns into a costly trip to the emergency room.
Purdue Pharma, the company that produced the drug known as OxyContin that started the Crisis, provided lucrative bonuses – totaling $40 million in 2001 alone – to sales representatives who managed to increase their number of sales to physicians. Other elaborate marketing schemes included all-expenses-paid conferences for healthcare professionals, as well as branded “swag” items such as OxyContin fishing hats, stuffed plush toys, and music compact discs.
The Opioid Crisis has caused more than 40,000 deaths per year since 2016, not to mention its role in ongoing heroin addictions. It is difficult to imagine an epidemic of this scale occurring in the UK or any western European country for that matter due to stricter government regulation of drug prices and distribution.
Neglecting healthcare on a national scale can have devastating consequences not only for human life but for society as a whole. Although political polarization exists in many forms throughout the UK and continental Europe, the United States has pushed it to an extreme, making effective healthcare legislation next to impossible.
Steps must be taken immediately to improve healthcare legislation in the United States, starting with keeping pharmaceutical companies in check. Other solutions might include requiring hospitals to make their “price list” more transparent or reducing the influence of “middlemen” – also known as insurance companies – in healthcare.
It would seem that much of the current legislative “gridlock” stems from a sense of individualism that is unique to the United States. Community ties have fallen victim to increasing paranoia, and where they do exist, they are often limited to a number of “sub-groups” within the broader populace.
Solutions might include requiring hospitals to make their “price list” more transparent or reducing the influence of “middlemen” – also known as insurance companies – in healthcare.
This lack of “national unity” has led not only to profound social divisions throughout the United States, many of which have been present for some time yet recently brought to light by the Covid-19 pandemic. It has stifled the development of social programs, such as that of a national healthcare system, that might just ease such tensions.
The best solution would thus be one that provides healthcare to all, while also increasing social cohesion and thus reducing political polarization. Maybe the United States should take a card out of the UK’s book – where the right to health has, for the most part, managed to surpass party lines – and form its own version of the NHS.