There are merits to both the US and the UK systems – but these attacks on the NHS are unfair and untrue

By Amanjit Jhund

There has been a huge debate taking place in the press as to the relative merits of US vs UK healthcare. Much of this debate has focused upon the negative aspects of our healthcare system.

As a medical student I was given the opportunity to work at Massachusetts General Hospital while attached to Harvard University. Even back in 2003 its premium services were light years ahead of any public or private hospital I have since experienced in this country. In the towering buildings, from mobile CT scanners (nicknamed flying donuts) to the early adoption of Radio-Frequency IDs, a constant stream of innovations, new services and technology were being introduced to improve patient care.

These gleaming spires of innovation and technology were only one half of American medicine. In the basement of the hospital in the Emergency Room (ER) I saw the other side.

Under the Emergency Medical Treatment and Active Labor Act (EMTALA) it is illegal for an ER to refuse emergency treatment to anyone. Despite this, those without insurance were given the most limited of treatment and summarily expelled from the hospital as soon as they had been “stabilized”.

These people were given no access to even the most rudimentary long term care or follow up. As many conditions have both chronic and acute components, I saw many patients given only a quick patch up job before the patient was “stabilized” and “turfed” back onto the streets.

This was further exacerbated where an individual had a serious long term condition such as cancer or heart disease, at which point many face the heart wrenching dilemma of bankrupting themselves to pay for a loved one’s essential operations and treatment.

As the EMTALA only covers emergency medical care much of the care that we take for granted is denied to uninsured citizens. In many parts of the United States people queue overnight for the prospect of free healthcare provided at vast open air clinics in scenes more reminiscent of a third world country than the world’s richest democracy.

Seeing these sights first hand made me appreciate the NHS more than I ever had before.

In an effort to prevent the Obama administration from pursuing reforms to this system, the right wing American media are peddling scare stories about the NHS.

Waiting times for cancer patients in the UK have been attacked, but under the NHS we now have systems in place ensuring that the 2 week wait for cancer referral is now one of the most rigorously enforced covenants at the heart of the modern NHS.

The National Institute for Health and Clinical Excellence (NICE) is attacked as a “death panel” rationing essential care and ensuring that the elderly are culled in an “evil”, “Orwellian” dystopia of a healthcare system. Their arguments ignore the fact that insurance companies in the US have similar panels to determine not only wether a treatment is warranted by an individual’s level of cover, but also if in fact a payout should even take place. This can result in even those with insurance being refused treatment and “sentenced to death” as the right wing media would put it.

Not only are many of these attacks patently untrue and utilise false figures, but they are detracting from the possibility of a reasoned and mature discussion in the US as to the inherent deficiencies in their own system.

Ultimately most of us recognise that neither system is perfect. On this side of the Atlantic we have looked to emulate the US by increasing patient choice and fostering innovation and intrepreneurship through schemes such as Lord Darzai’s £220 million innovation fund. Conversely, President Obama is seeking to adopt the best principles of the NHS in an effort to end the inequalities that pervade their society.

I wish him all the best, and it may be that we can all achieve the best of both worlds.