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Differences in health care systems
An English rose in Georgia
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Health care is one of the most politically-charged issues today – not only here in the U.S. but in my native England, as well. While not wishing to add gasoline (we call it petrol) to the fires of debate, I do now consider myself an expert user of health care systems on both sides of the Atlantic Ocean, I and thought it might be interesting to share my experiences.
Across the pond from whence I came (there’s a good, old English word not used much in the U.S.), our new coalition government is reforming the U.K.’s National Health Service (NHS) as it suffers from one of its worst financial crises in its history. In fact, in recent years the NHS has cost the British government the equivalent of about $180 billion dollars a year to maintain – and the U.K. is a small country, with only 20 percent the population of the U.S.
The origins of nationalized health care in the U.K. come from long before I was born and soon after the end of the World War II. On July, 5, 1948, the NHS was founded by the British Socialist Government of the time. It was based on principles unlike anything that had gone before in health care – free health care to all at the point of use and funded through central taxation. No other countries outside the eastern Soviet bloc had such a system, as most countries relied on insurance-based schemes.
The British nationalized health care system today is the responsibility of government, just like national defense and the judicial system. Care is entirely free at the point of use, and prescription drugs are also heavily subsidized. Everyone is eligible for care, even people who are temporary residents or visiting the country. However, in the U.K., we are heavily taxed to subsidize this – marginal tax rates on income up to 51 percent, inheritance tax up to 40 percent, and national sales tax of 20 percent.
Most doctors, nurses and healthcare providers are very dedicated in the U.K., but they are often frustrated and constrained by government target-setting and bureaucracy and not working within a free market. There is often a feeling of being “just a number” in the U.K. health care system: waiting lists for operations are sometimes long and many newer treatments are banned because of the cost.
Almost everyone in the U.K., from all sides of the political spectrum, complain about some aspect of the NHS – quality or speed of service, the cost or the basic philosophy behind it. In fact, an estimated 8 million British citizens have private health insurance – as well as paying for the NHS through their taxes – as they are dissatisfied with the quality of care given by the NHS.
My experience of health care in the USA since moving here has been quite extensive and my impressions very favorable – although, admittedly, my family is blessed with good health insurance, and Medicare was great for my elderly relative. I have had routine health checks myself, seen maternity services at work when my granddaughter was born last year and sadly had a great deal of exposure to emergency rooms, oncology and neurology services when caring for an elderly family member.
I have really felt like a customer in the American health care system. Although I believe there should be a safety net for those who really are poverty stricken and need urgent health care, it seems to me the current insurance-based system works pretty well. I have never seen anyone dying in the streets in America for lack of insurance – charities, churches and emergency rooms seem to me to help people who really need it but can’t pay.
However, I am not a politician, but merely an observer of things on both sides of the Atlantic.
God bless America!

Francis grew up in London, England, and moved to Richmond Hill in 2009 with her American husband, Carl, and English dogs. She can be contacted at or

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