Why do so many Americans seem against an equivalent of the NHS?

Great Debates
1

As a Briton I’ve grown up being able to visit a GP whenever I had a snivel, had all my vaccinations for free and known that if I was ever injured (as I was at about the age of 8 when I suffered a concussion from being pushed over in the playground) without having to worry about whether or not my self-employed father could afford it. Of course, private companies still offer private healthcare for those who can afford and are willing to pay for it.

The only complaints I’ve heard about the NHS come from how its run, rather than the fact it exists (indeed even the conservatives, who opposed bringing it in decades ago, have rushed to it’s defence so if they still don’t want it around they clearly don’t dare to admit it).

Now that Obama wants to expand free healthcare, there seems to be massive crowds of protesters comparing him to Hitler. Am I missing something? What is it in American culture or history that makes the idea of socialised medicine so terrifying? Especially when the US has strong political ties to Canada and the UK, which both have it.

2

For many years there have been stories about NHS type systems ration care. There are just way more people hearing those stories now.

3

Fear & ignorance, deliberately enhanced by propaganda from the private insurance corporations & Big Pharm, are the cause.

4

Yep. In other words political ideology.

5

This has been said twice, but needs to keep on being said.

6

And where do these stories come from? Certainly not from the Canadian and European friends I have (and their families) who have actually used them.

Oh yeah, there we go.

7

There is also a philosophical dislike on the part of many for government run services (other than the military and police, which they think run just fine). Because NHS is run by the government, they believe – often honestly – that it does a poor job. Since they assume so, they are willing to report on and to believe horror stories about it.

8

Actually there’s enough in your own culture and history of nationalized health care that alarms some people in the U.S. If you’ve had good health care coverage (and the great majority of Americans with private insurance plans feel this way), words like “rationing” raise concern:

*"Leaked documents passed to The Times show that while ministers promise patients choice, a series of barriers are being erected limiting GPs’ rights to refer people to consultants.

The documents reveal that health trusts across London have drawn up plans to establish panels that will “monitor” how many patients are referred to hospital by GPs. Local health trusts have been told that they must cut GP referral rates to those of the lowest 10 per cent nationally. This, the document claims, would save £25 million a year in the capital."*

An editorial from the Times of London reprinted in our local paper today:

*" THERE IS a truth about modern health care that is consistently ignored. Demand will always beat supply.

That is because the demands we have of the service are now out of all alignment with our willingness to pay for them. There are more pensioners than in any previous era and they are living to the ripe ages at which they contract expensively treatable diseases. The genius of health scientists has made more diseases treatable, usually with new drugs that are, at least initially, very expensive. It is not surprising that citizens demand all that can be done. In a public system, every citizen is sensitive to pain and insensitive to price.

At the same time, health care is getting less effective at preventing conditions such as obesity and its associated links with diabetes that are the upshot of dietary and lifestyle choices. Britain’s National Health Service has never really been that. It is a national illness-fixing service. The health of the nation actually has rather little to do with the NHS and that poor correlation is getting worse, to costly effect.

These are serious problems, but the solutions are not hard to enumerate, even if they are difficult to swallow. Health care will have to be rationed further. We can do this by price, by availability or by time. Patients can be charged for some services that are currently free; some elective and noncatastrophic services may have to be excluded; or people will again have to get used to waiting a long time.

It makes no sense to pretend that fully comprehensive health provision can all be funded out of general taxation. … The greatest danger to health care in Britain comes from those false friends who are still pretending that we do not need to change."*

– The Times, London

This is not to say that there isn’t concern and anger over insurance company rationing of some forms of health care, and many Americans see the need to expand coverage and prevent catastrophic illness from economically devastating as many people as it does. But we also know how badly our government can fart up things, and there’s a sense among many that even with Obama’s proposed “limited” expansion of government into health care we are not getting the full story of what to expect and how it will be funded.

So let’s not pretend it’s all a matter of American politics and “culture”.

9

Health care is rationed now. I can’t walk in to a hospital and ask for an MRI and expect my insurance company to pay for it.

10

In general the US is similar to Canada and Europe but there are some major differences - national health care is one. Also there are big differences in gun control, press freedoms, amount of people who go to church, etc.

11

I was going to say, that debates like this (and more particularly the gun control one) have shown me not how much we have in common with you lot, but how little.
Your ever-so-slightly-left-of-centre-with-a-teeny-little-social-conscience Democratic party still looks pretty Right to us.

12

–deleted—

13

You can’t do this anywhere in the world. No hospital will do such imaging without an MD referral, and even if they would no entity would pay for it. That’s not rationing, but rational medicine.

Are you engaging in debate? It looks more like IMHO comments to me.

14

You can’t purposely knock your house down and expect your homeowner’s insurance to build you a new one either. Yet no one would call construction services “rationed”.

And you can get pretty much any kind of non-invasive test you want, if you’re willing to pay for it.

15

I think the US is really different than other countries on a whole host of issues. We have less access to well made food (whole areas of the country are without any restaurants other than chains), we are much more religious, we don’t use the metric system, we have less vacation time, workers are less protected, we rely less on international road signs and more on signs with words, we have less public transportation, we make college students pay more of their own way, we have less small stores and farmer’s markets, our cars are bigger, we don’t embrace soccer, and on and on.

I just don’t know why the US is so different than the rest of the world.

16

True, but the reaction was still completely different. I don’t think there was ever any protests over the plans to introduce the NHS back in the 40’s (of course this was over 40 years before I was born, so I could be wrong). Indeed Thatcher was demonised for blocking its introduction (amongst other things).

Note that when a MEP of the conservative party recently spoke out against the NHS on US television, David Cameron (head of the conservative party) immediatly came out and basically said “No, the NHS is a vital part of Britain, this man does not represent my party’s views”.

17

It’s a combination of misinformation, a few nuggets of truth, and different philosophies.

Post-WWII politics in the UK were dominated by the general consensus that something would have to be done by the government to help the innumerable homeless and unemployed left after the war. Hence the creation of the UK welfare state, and the NHS.

By contrast, the groundwork for the welfare state was built before and during WWII, rather than afterwards, so Americans thought of it as economic-development spending (to help the economy out of the Great Depression) rather than social justice spending. Moreover, the US wasn’t devastated by bombing campaigns, and the populace, far from being poor, hungry and underhoused, were fat, happy, and ready to get back to work. That’s why they aren’t as attached to it (or to things like it).

18

One of the reasons, for many people, is that

Change is scary. This is true whether you’re finishing primary school, about to defend your PhD thesis, moving, or redoing your kitchen.
Add that they don’t have an experience of NHS to compare with. They have information that says it’s run by a cross between Dr Pasteur and Dr Barnard; they have other information that say it’s actually Dr Frankenstein. Without first-hand experience, those contradictory informations are just confusing and scary.

And even if this “NHS-like” system being proposed was the bestest invention since buttered bread, there are many ways in which its implementation can get derailed, go wrong, represent a huge expense for no result…

I grew up under Spanish SS and have lived and used or tried to use the medical systems of the USA, Mexico, Switzerland, France, Italy, the UK and Costa Rica. IME, single-payer (UK, France, Spain) beats the crap out of the multi-payer systems (US, Switzerland)… but I’m conscious that moving from one to the other can be extremely painful, and it’s not a process that takes months: it takes years. For Spain it was over 70 years since the first program of what would become Seguridad Social got implemented until everybody was able to receive a retirement pension from it (there’s people who don’t but that’s because they’ve opted out); the single-payer healthcare was implemented much faster and it still took decades.

And that’s another thing: it’s a very long process. People say that for a Japanese, “long-term” means 20 years; for an European, 5 years; for an American, 1. That’s an exaggeration and it’s not true for every person from those locations, but I’ve made enough plans with people from Europe and the US sitting around the table to know that we do think in different timescales. For people who are afraid to get paid monthly instead of biweekly because the idea of having to budget for a whole month is terrifying, the notion of a plan that will take decades to implement is a migraine trigger.

19

There is also a minority who already have decent health care, at reasonable prices, and see no reason to change. Especially when there is talk about taxing company-paid health benefits like pay, which would be a net loss for those people.

20

Actually since we’re trying to answer the question factually let’s go ahead and say it’s not true a couple times. The actual truth is that just yesterday a pro-reform coalition funded primarily by the pharmaceutical industry launched a $14million television campaign for Obama’s health care reform.

Other members of the coalition include the AMA, Federation of American Hospitals, and less notably SEUI.

PhRMA has committed to spend up to $150million in advertising and grass roots support building for Obama’s plan. So in honor of our troops, why don’t you stop making stuff up and encouraging people to repeat it?