Dismantling Conservative Lies About British Healthcare

David Hogberg, a Senior Fellow at the National Center for Public Policy Research made some egregious claims about British health care in comparison to the US system.
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Ben Cohen
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David Hogberg, a Senior Fellow at the National Center for Public Policy Research made some egregious claims about British health care in comparison to the US system.
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A couple of days ago I posted the video of the roundtable discussion I took part in on Thom Hartmann's show where I got into a pretty heated back-and-forth with David Hogberg, a Senior Fellow at the National Center for Public Policy Research over the issue of health care.

Hogberg made some ludicrous claims about the British National Health Service (NHS) that obviously couldn't be fact-checked while live on air, so after reading his follow-up blog post I wanted to respond to his most egregious assertions.  The specific language Hogberg used is important here, so I'll respond to this statement (highlights are mine):

Cohen, who is from Great Britain, suggested that I didn’t know how his home country’s single-payer health care system works because I claimed that there were bankruptcies due to medical bills in the U.K...

The link I was referring to in that exchange is a report from Britain’s Insolvency Service entitled “Causes of Failure in Bankruptcy and Compulsory Liquidation.” Here’s Table 2 from page 10:

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Additionally, a report from the World Health Organization also cites research that “within the United Kingdom, sickness or disability accounted for 5% of households in financial difficulties in 2002.”

This is so transparently ridiculous that I am surprised Hogberg was brave enough to post this. The NHS is tax payer funded, so that means patients never, ever see a medical bill after getting treatment. So how could they go bankrupt from bills that don't exist? Also, the NHS is a health care service, and isn't responsible for making people sick. It can't cure every disease under the sun either, so claiming that the NHS makes people go bankrupt makes about as much sense as blaming public libraries for illiteracy.

Digging the hole deeper, Hogberg goes on:

The idea that single-payer systems don’t have medical bankruptcies is based on the fact that health care is “free” at the point of service in such systems.  After all, if people don’t have to pay for health care (at least not directly), how could they have a bankruptcy due to medical bills?

For starters, medical bills are not the only way a medical bankruptcy can occur.  For example, if you have an illness that requires a major operation in Britain, you are likely to end up on a long waiting list.  And if the illness renders you unable to work, then the longer you are on the waiting list the more your finances will be strained.

To repeat: Medical bills are not the only way a medical bankruptcy can occur.

So now it's not about medical bills?

Shifting the goal post, he conveniently makes it about long waiting lists for medical care, which wasn't his point in the first place.

Anyhow, this new line of argument would make sense if Britain had 100% socialized medical care, but it doesn't - there's a very lucrative private health care system that runs alongside the NHS that allows those with private insurance to get the surgeries they want at their convenience. The problem is, not everyone can afford private insurance, so they use the NHS, which admittedly isn't perfect. But at least you get medical care, unlike the States where you don't get surgery at all if you can't afford it. A survey released in 2012 by the Henry J. Kaiser Family Foundation found that 58 percent of Americans went without the healthcare that they needed due to prohibitive costs.  While it is difficult to calculate how many people actually die because they do not have health insurance, an in-depth Harvard Medical School and Cambridge Health Alliance study estimated that lack of health insurance "causes 44,789 excess deaths annually" in the US.

There are inherent problems with health care in both the UK and US, but the fact of the matter is, the UK outperforms the US in virtually every department. In 2014, The Common Wealth Fund, a highly-respected orginization released a comprehensive comparison of 11 western countries healthcare outcomes and found that:

1: "The United States health care system is the most expensive in the world, but this report and prior editions consistently show the U.S. underperforms relative to other countries on most dimensions of performance."

2: "The U.S. also ranks behind most countries on many measures of health outcomes, quality, and efficiency. U.S. physicians face particular difficulties receiving timely information, coordinating care, and dealing with administrative hassles."

3: "On indicators of efficiency, the U.S. ranks last among the 11 countries, with the U.K. and Sweden ranking first and second, respectively."

4: "The U.S. ranks a clear last on measures of equity. Americans with below-average incomes were much more likely than their counterparts in other countries to report not visiting a physician when sick; not getting a recommended test, treatment, or follow-up care; or not filling a prescription or skipping doses when needed because of costs."

5: "The U.S. ranks last overall with poor scores on all three indicators of healthy lives—mortality amenable to medical care, infant mortality, and healthy life expectancy at age 60"

No doubt Hogberg will take issue with the report and claim there is some sort of liberal agenda behind it (any organization that aims to improve access to healthcare for the most vulnerable is usually a target of conservative attacks), but given virtually every reputable study not done by conservative think tanks shows how incredibly inefficient and costly the US healthcare system is, it defies belief that a rational person would defend it. The mere fact that more than 45 million Americans do not have health insurance should be enough evidence to suggest the healthcare system is broken. Anyone defending America's healthcare system clearly has an agenda because the statistics are indefensible.

I'm not an ideologue and don't have any particular pride that the UK's health care system is better than America's. I just feel sorry for Americans who go through the indignity of not getting health care because they cannot afford it, or going bankrupt if they did decide to pay for it. This isn't a 'my country is better than your country' pissing contest, but an argument over getting access to health care.

There are many, many problems with healthcare in the UK, but getting seen by a doctor isn't one of them, and neither is going bankrupt due to prohibitive costs.