Britain, the Land of Free Medical Care

The view outside the large, cleanly wiped windows was absolutely spectacular: across the River Thames on the Westminster Bridge is a full panorama of the House of Parliament, with Big Ben proudly standing on one side as if an attentive soldier on guard. As the afternoon sun began its descent, a bright red hue lit up the sculptured details of the historical building, giving us, right on the spot, an artistic feast of representing the glorious heydays of the British Empire. And as bright red hue disappears into the darkness of a typical autumn night, subtle yellow and green lights around the building project the fullness of the imperial beauty into the River.

And all this, from a well-maintained bed on the 8th floor of one of the most reputed comprehensive hospitals on the British Isles. Dinner is served as we messed around with the fully functioning bedside Internet system. You may ask just how much were we, the poor students of LSE, were willing to pay for this experience (not to mention the idea of actually getting sick to end up in a hospital). But shockingly, a fully-accommodated three stay at the St. Thomas Hospital, inclusive of all treatments and clinical tests, only came out to be...completely free.

Yes, for some reason or the other, the British medical care system take care of foreign students without local registry just as one of her own. A classmate of mine, who was unfortunate enough to suddenly discover a major medical condition through abrupt pain after class, somehow was fortunate enough to discover the condition in a country like England. Rushed to the hospital completely oblivious to the local medical system (and certainly, medical insurance system), the process of identifying her sickness was completed without a single mention of hefty bills and payment installments for the efforts of the hospital staff.

"There is no such thing as free lunch," people would say. Surely enough, we collectively do have some complaints about the bureaucratic inefficiencies that led to her surgery being delayed for weeks. But, I cannot simply be too vocal about my protest when the surgery, and all the medicines that will keep the patient functioning like a normal person til then, are completely free of charge. After repeatedly hearing the rumors of "European welfare states falling apart under financial and demographic pressures" for four years as an Economics student, I simply could not believe this sort of treatment still exist somewhere in the world.

Just imagine the same situation were to occur in the US. Sure, the same procedure may have been done just as dutifully and perhaps more efficiently, but without insurance, the combined costs of emergency treatment, medicines, and various expenses for hospital stays would result in a long-term financial scar much more painful than anything felt physically. The patient would have felt that he or she should never have gotten sick at all. Especially for the student, all the continuing expenses for surgeries and check-ups could have meant temporarily giving up full-time studies for lack of tuition funds.

The same is true for most other countries, even when some sort of social safety net with respect to medical care is in place. Systems of government-required (even financed) health insurance mean little in the case of utterly poor students with serious, costly treatments. Whatever "discounts" to treatment achieved through enrollment in medical plans cannot change the fact that the high cost of being in a hospital for a long time will be a life-changing "financial decision." And young people's confidence in their own health (thereby doing reckless things while being too cheap to buy insurance) certainly do not help the overall situation.

It is hard to predict how long the current system of free healthcare for students will last here in Britain, but at least, the existing status quo is worthy of admiration. A hard-working, high-earning population conditioned over peaceful decades to pay high taxes for sometimes empty-sounding promises of certain unbelievable social benefits is hard to come by in this day and age of selfish, short-term individualistic economic interests. Maybe enough Britons benefited under schemes like free medical care to learn to trust the government.

And as for the government, it did its part by committing to the lofty words of communal benefits. Because it genuinely did provide good (if not excellent or impeccable) services at extremely low costs, it earned and is still building up the trust of the citizenry. The long-term unwritten cooperation of the government and citizens is a lesson for others around the world. It calls for governments to be more accountable for promises of welfare, while not using them as code-words for corruption and embezzlement for personal benefits of certain officials.

Comments

  1. Oh!  Public Health!  :D

    Well, there's two issues at hand...

    As someone who's studying economics, you should know of the difference between value and worth.  That's one of the key problems in medicine and nationalized healthcare.  If medical care is free, then people may abuse the system by overutilizing it.  You'll have people coming in for a simple cold when normally people would have waited it out.  It can also be more crazy...For instance (this is true), you can have healthy yet lonely elderly people coming to the doctor just to talk.  This increases the wait time for people who really need care.  I believe places like Japan have ID cards that track your utilization of healthcare services to avoid such problems...but not all systems have that in place (I don't believe Obama's plan does but i don't think us privacy-loving Americans would like such a system).  There were some downsides to the ID cards but i can't remember all the details....

    There is also a "gatekeeping" model where you have to see a primary care doctor before you can get further treatments and such... it's designed to keep costs low, but it also tends to increase wait time.  

    But then again, if you have a good primary care system, the idea is that you can catch problems before they become more costly problems (ie excising a small tumor instead of doing massive chemo).  An even better solution would be to promote healthy behavior, but people don't really change easily (noncompliance).

    But you're right... because of health care expenses, many people choose not to see the doctor until the problem is more dangerous and more costly.  In the US, its not even the poor people who have it worse (they have Medicaid).  As you inferred, its people who are too rich to get Medicaid but too poor to afford insurance who often have the hardest times with medical procedures and costs (students could be a good example, though many colleges require students to enroll in a Univeristy program).

    Unfortunately, there is no perfect system.  When I was studying these various systems (UK, Japan, France, US, Taiwan, Cuba etc), I believe that Taiwan had one of the best systems... until it went bankrupt or something.  haha.  But Taiwan was so rich that they just kept pumping in money to keep the system afloat.  Free healthcare is nice, but it is ultimately either unsustainable or will require massive cuts and sacrifices to keep the system afloat. 

    Maybe I'm being pessimistic, but i don't think there will ever be a perfect system.  People are just greedy.  Patients will utilize services "just because they can," doctors want to increase costs to get more money, politicans write stupid laws and ideas into healthcare plans so they can get reelected, etc...  but i suppose we need to start somewhere, especially since the system in the US isn't all that great to begin with (though i have doubts about obama's plan too).

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  2. Thanks for the reply as usual!

    The problems you mention are definitely big deals already.  The bits about people showing up with little problems and lonely old people showing up to hospitals to chat are already prevalent in the Japanese system, in particular because some people somehow slip through legal loopholes to apply for medical subsidies so that they actually make more money by going to hospitals than they actually spend.  The end result is, as you said, medical care systems have to disproportionately drain their resources on treating tiny colds while not doing enough for major surgeries...

    And as for the "gatekeeper" bit, using general practitioners (GP) to see patients first before the patients get to see the specialists, is, well, not workable here.  People will just wait til the problem gets bad enough and then show up at ER.  Its not like they are paying for it anyways, why go through the trouble of going to the GP's office, wait for the GP to set up appointments with specialists, and get the exact same treatment one can get at ER without waiting in a line?

    At the end, whether the system like one here in the UK can last really depend on the ethics of the patients.  If they sufficiently understand the necessary sacrifices and costs made to keep the system going, they perhaps would not be as wasteful of medical resources...but of course, thats just asking way too much from people like foreign students who dont even pay taxes in this country.  I have to say, in the end, I am just as pessimistic as you are on this subject...

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