An international embarrassment

The prestigious Commonwealth Fund just released a letter to health professionals documenting the failure of the U.S. health care system: “A new five-nation survey of public attitudes toward health care reveals that the United States has the highest share of residents facing access problems, driven in large part by the difficulty many face in paying for care. At least one of five Americans reported problems paying their medical bills, filling prescriptions, getting medical care when they had a problem, or getting a physician-recommended test. Americans with below-average income reported more health care access problems than their counterparts in the other four countries.”

The Fund’s study, done in conjunction with Harvard researchers, examined health systems in Canada, Australia, New Zealand, United Kingdom and the United States. Most of these countries have largely public systems with a limited role for private interests.

This is not just an international embarrassment, but also a serious problem. As millions in the U.S. are suffering unnecessary increases in premature mortality and increased morbidity, and as Congress and the White House have failed to act on this crisis, the labor and people’s movements are moving in a different direction.

An editorial in the British medical journal, The Lancet, pokes some fun at those opposed to increased public spending on the National Health Service (NHS). The plan to double government health spending over 10 years, the editorial says, “has been hailed as a return to the red-blooded socialism of tax and spend.”

The editorial continues, “Chancellor Gordon Brown’s budget is being seen as the centerpiece of a renewed old Labor strategy that puts social justice before the needs of business. To be sure, this welcome financial commitment to the health service will reverse decades of corrosive neglect. The principle of universal access to care, free at the point of need, has been dramatically reasserted.”

The new direction of the NHS will focus on primary care, patient input, information management, dramatic increases in the workforce – 35,000 more nurses and 15,000 more physicians – and an increase in attention to public health.

This rekindled funding of the NHS does carry some worries. Health policy activists are concerned that the Blair government might want to increase private, for-profit investment in the NHS.

Blair still has a political commitment to privatize as much of the NHS as the people will allow. In addition, there is a move toward devolvement of the NHS, i.e., decentralization. But, given the understanding of financial accountability and faith in the central government, this may not become a problem.

Although there is not such debate for national health legislation in the U.S. as is taking place in the UK, the 2002 elections can change that.

The author can be reached at pww@pww.org