"Dr. Sikora, do you feel there is a need to expand competition and choice for people in this country?" asks the interviewer. "Absolutely," says Dr. Karol Sikora, a senior British oncologist and former head of the World Health Organization’s cancer program. "There’s no incentive to offer people services in a state monopoly."
Dr. Sikora’s interview is part of a TV ad campaign that’s using the tragic stories of patients failed by Britain’s National Health Service to block Obama’s health care reforms. The ads are made by a group called Conservatives for Patients Rights, set up this year by the medical entrepreneur Richard Scott, who ran the $23 billion Columbia/HCA hospital chain until it was charged with massive Medicare fraud in 1997; the PR firm is CRC Public Relations, which masterminded the Swift boat attacks against John Kerry in 2004. Other segments feature a young woman whose cervical cancer went undiagnosed because NHS cervical screening starts at age 25 and who now may not make it, and another whose mother had to wait too long for kidney cancer surgery and subsequently died. This, they claim is the kind of thing that will happen to Americans if the medical business is made to contain its costs and open its doors to the poor.
While watching the ads on the web this morning I was also taking care of a piece of domestic business, trying to get through to our GP’s office on the phone. Our ten-year-old son may need minor surgery; the appointment letter from the surgeon I chose with our doctor three or four weeks ago hasn’t yet arrived. I had to call a couple of times before someone picked up, and I began to get irritated and read some of the endless news stories on the internet about the failings of the NHS. Then I spoke to the practice secretary. Ten minutes later, I got a call from the surgeon’s office, offering us an appointment for next week. Sorted.
Like most British people, I have a love-hate relationship with the NHS, which definitely has its problems. There can be long waiting times for diagnosis and surgery; there is the so-called "post-code lottery," which means that treatment (especially cancer treatment) varies a lot depending on where you live. The bureaucracy’s complexity is legendary. Expensive and potentially life saving or life extending drugs are not available to everyone who needs them. Hospitals are understaffed; MRSA infections are an ongoing issue.
But in the 14 years we’ve lived in London, members of my family have had, without a single bill: two hospital births, one attended by midwives in a birthing pool, the other requiring weekly scans by a top fetal medicine specialist; child development checks and vaccinations; lithotripsy for kidney stones; a tonsillectomy; physiotherapy for a broken arm; annual consultations for a chronic chest condition; and countless GP appointments for minor ailments in and out of hours, as well as free medicines and eye exams for the children. The practitioners and staff we have dealt with have been, almost without exception, professional, dedicated, overworked, and very kind. (I’ll never forget the vigilant theatre nurse who watched our daughter wake up from a general anaesthetic.) The doctors we see often roll their eyes at the frustrations of the system, but they also know how to get the best from it for their patients. I have never once felt that cost was a factor in the treatments we were offered–though I know this might be different in some cases. Given the choice between an NHS teaching hospital and one that’s run for profit, I know which I’d choose every time.
British politicians and commentators endlessly debate the future of the health service, which celebrated its 60th birthday last year: how to finance and manage it, how to make it more responsive to patients, how to pay for new generation medicines and techniques and meet the needs of an aging population. But even the Tory leader (and probable next prime minister) David Cameron has pledged to keep it free at the point of use. (His severely disabled son, who died earlier this year, was cared for by the service.) The right to healthcare is as fundamental as the right to education; the question is not whether but how that right is respected. When I talk to American friends about what we have here–especially those who live without decent insurance–they stare in disbelief. Don’t be put off by the horror stories. Yes, the NHS sometimes fails people. It needs reform, and money. But most of the time it does a fantastic job–and it does it for everyone.
Correction: An earlier version of this post said that Richard Scott "founded and ran the $23 billion Columbia/HCA hospital chain." In fact he founded Columbia Healthcare, which merged with the Hospital Corporation of America to form Columbia/HCA.