# What are the obstacles to universal health care in the US?

**URL:** <https://boards.straightdope.com/t/what-are-the-obstacles-to-universal-health-care-in-the-us/723232>\
**Category:** Great Debates\
**Created:** [June 23, 2015, 1:08pm UTC](https://boards.straightdope.com/t/what-are-the-obstacles-to-universal-health-care-in-the-us/723232 "2015-06-23T13:08:32Z")\
**Posts on this page:** 1\
**Showing post:** 41

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**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\
**Post date:** [June 23, 2015, 7:42pm UTC](https://boards.straightdope.com/t/what-are-the-obstacles-to-universal-health-care-in-the-us/723232/41 "2015-06-23T19:42:51Z")

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> [@Mr\_Smashy](#):
>
> Yes there are definitely areas for possible efficiencies, but to say that a private system must definitely be less efficient than a government one, without any hard data, is tough to swallow.

I didn’t say it _must_ be less efficient. I said our system is less efficient than almost any UHC system we could install in its place. You are a federal contractor. I am, in essence, a healthcare administrator. Our system is utterly broken.

Since you asked for hard numbers: [“In 1999, health administration costs totaled at least $294.3 billion in the United States, or $1,059 per capita.”](http://www.nejm.org/doi/full/10.1056/NEJMsa022033) Today, the NHS budget for England is about [$182 billion](http://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/nhs-budget), rising to a little under $220 billion when the rest of the UK is taken into account. That’s to cover every man, woman and child in the UK, or one fifth of the US population. Throw in BUPA’s [total global revenues](http://www.bupa.com/media/1053138/bupa-annual-report-2013.pdf) of ~$9 billion,\* and you have a total UK health expenditure budget of $230 billion.

If you want to compare the UK figures to 2015 US administration costs, the disparity is even more bleak. And it’s not like the UK NHS is a byword for efficiency; far from it. It’s a pretty middle-of-the-road system that is fully nationalized. There are far more efficient models for us to emulate.

\*BUPA controls 40% of the UK private health insurance market but derives 70% of its revenue overseas, so its total numbers are a reasonable proxy for total UK private healthcare spending.

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