Ten reasons we shouldn’t look to America for healthcare advice

By Theo Blackwell

A rejoinder: Conservative representative Dan Hannan recently disparaged the National Health Service on Fox Television in the U.S. On April 6th he went even further on his blog, warning Americans (or those of them who read his Telegraph blog) not to copy the British system.

Alan Johnson responded to Hannan’s Fox interview defending the NHS for Labour here on LabourList. But he didn’t go far enough in my view. More than ever people in the UK need to be reminded of the essential unfairness of the American insurance-based system, along side the merits of our own NHS.

The U.S. spends more on health care than other industrialised country, but the actual use of health services is lower. This is because healthcare is used more expensively, by fewer people.

The NHS, like anything created by human hands, isn’t perfect – but the U.S. model has serious flaws.

Yes I’ve seen the U.S. health care system work well for those who can afford it, but I’ve also seen how it caused real worry for those facing extra bills and panic for families who can’t afford cover.

As an American myself, I’ve witnessed all aspects of this in my own family.

If we want to go down the route of the U.S. healthcare system then here are some facts (just regarding people of working age and children) that the ‘Hannan-right’ should have should have in mind before they start on the journey of ‘creative destruction’ on the NHS:

1. There are lots of uninsured people in America. Nearly 46 million Americans, or 18 per cent of the population under the age of 65, lacked health insurance in 2007 according to the U.S. Census Bureau (2008).

2. Children too. The number of uninsured children in 2007 was 8.1 million – or just over one in ten children in the U.S. (U.S Census Bureau 2008).

3. Young people more so. 28 per cent of 18-24 years old have no cover. (U.S Census Bureau 2008).

4. The number of uninsured rose exponentially under the Republicans (the right is no friend of universalism). The ranks of the uninsured increased by almost 8 million people from 2000-2007. (Henry J. Kaiser Family Foundation)

5. Health cover is also sporadic. Nearly 90 million people – about one-third of the population below the age of 65 spent a portion of either 2006 or 2007 without health coverage. 29 per cent of people with coverage were “underinsured”, that is their coverage was so poor that they chose to postpone care. (Consumer Reports, 2007)

6. Having a job helps, but is no guarantee for health cover. In 2007, 37 million workers were uninsured because not all businesses offer health benefits, not all workers qualify for coverage and many employees cannot afford their share of the health insurance premium even when coverage is easy to access. (U.S Census Bureau 2008).

7. It’s both a working class and middle class concern too. Nearly 40 per cent of the uninsured population live in households earning 50,000 dollars or more – £37,000. (U.S Census Bureau 2008).

8. It’s worse in a recession. If your coverage is dependent on employment. Losing you job, or going part-time or self-employed as part of a restructuring can often mean less coverage. Today 9 million fewer Americans have health coverage due to the recession. (Henry J. Kaiser Family Foundation)

9. For the poorest triage in the A&E is often the only way. 20 per cent of uninsured say their usual source of care is the ‘ER’ or emergency room.

10. It costs lives and money. According to the Institute of Medicine an estimated 18,000 uninsured adults between the ages of 25-64 die each year, more than the figure for diabetes, a serious health problem in the U.S. and an emerging one here, in the same age group. The uninsured are more likely to be hospitalised for an avoidable condition, with the average cost of an avoidable hospital stay estimated to be around 3300 dollars, or about £2400 – can you take that on your monthly paycheck?

I could give you far more if you want figures on older people and care.

Conservative policy makers would do well to consider these facts before following the Americans in their healthcare model, or attacking our NHS.