By Natasha Galasso
In 1948 in a post World War II United Kingdom, the National Health Service was launched under Aneurin Bevan, the then minister of health. Bevan and many of his constituents believed strongly in healthcare as a universal right that should be available to all people in need, free of charge. A driving factor of the implementation of The National Health System was the disarray that the health system had been left in due to the Second World War, and the need of the people to access healthcare. Healthcare, and specifically a nationalized healthcare system, was thought to be one way Britain could help beat want, disease, ignorance, squalor, and idleness (Beveridge, 1942).
In 1948 in a post World War II United Kingdom, the National Health Service was launched under Aneurin Bevan, the then minister of health. Bevan and many of his constituents believed strongly in healthcare as a universal right that should be available to all people in need, free of charge. A driving factor of the implementation of The National Health System was the disarray that the health system had been left in due to the Second World War, and the need of the people to access healthcare. Healthcare, and specifically a nationalized healthcare system, was thought to be one way Britain could help beat want, disease, ignorance, squalor, and idleness (Beveridge, 1942).
Prior to the creation of the National Health System,
the British healthcare system was a mix of public and private institutions, the
latter run by councils or charities. Due
to this mainly privatized history, the idea of centralizing the healthcare system
faced opposition by members of the medical community as well as
politicians. During these initial
debates, which took place in the early 1940s, there were proposals for the
extension of health insurance (similar to the idea of the Affordable Care Act)
instead of the complete restructuring of the healthcare system. These proposals were eventually defeated in
favor of a centralized, state run healthcare system, funded through general
taxation.
The Nation Health System was founded on three
principles that remain at its core today.
- That it meet
the needs of everyone
- That it be
free at the point of delivery
- That it be
based on clinical need, not ability to pay
"The establishment of a
comprehensive health service designed to secure improvement in the physical and
mental health of the people of England and Wales and the prevention, diagnosis
and treatment of illness” (1946 NHS Act).
Although the healthcare system in the United
Kingdom is not without its issues, the fundamental values on which it was
formed have become ingrained in British society. The debates are no longer if access
healthcare should be the right of every citizen, but about how the current
system can be improved to better serve its citizens. Perhaps it is because of this focus that the
UK has been ranked to have the #1 healthcare system in the world by the
Commonwealth Fund based on Quality Care, Access, Efficiency, Equity, and
Healthy Lives.
Do
you believe it is it too late for the United States to have a paradigm shift in
its healthcare system?
Thanks Natasha for the information on Single Payer Model. It was very interesting to read that the United Kingdom is ranked # 1 in healthcare systems in the world. It was an eye opener to say the least. In order for the United States to follow the same model as the U.K. we need to get reed of big private insurance companies and have the government control the healthcare system. This will be an extremely difficult task since private insurance is about $800 billion-a-year industry. If the U.S were to make a shift to a single payer model it would lower healthcare cost, provide health care for all and provide quality health care. We currently have some single pay models like Medicare and Medicaid. Yet with Medicare you still need a private insurance to cover certain drug cost and other supplemental needs.
ReplyDeleteIt is never to late to improve healthcare. The United States has to refocus their priorities on the people of this country and providing them with the best quality health insurance the American people deserve.
Thanks Natasha. It takes political will and opportunity to make change. This is most evident in the Clinton's Health Security Act of 1993. The President and the First Lady did not take the time to build support in their party and build up the political capital to move the bill forward. It was essentially government run healthcare, like in the UK, but there wasn't enough support. Republicans would follow, and fail. President Obama had the luxury of majority, and the death of healthcare pioneer Ted Kennedy also contributed to building the political will to pass the ACA. It was not nearly as radical as the Clinton plan and took into account the fact that incremental change is also a victory.
ReplyDeleteArketa is right. Private insurance companies rule, and it's what single payer proponents and ACA opponents say is the biggest problem with the law. It gives more power to the insurance companies and doesn't address the quality and cost issues. But, given how legislation works in the US, the ACA is a necessary step to change the discourse around healthcare. Simply put- more people have access to health insurance and given the current framework in the US, that is a success.
As far as if we can have a paradigm shift, I'd say yes, but it will need to be slow and steady. It's politics. This is why I'm SO THRILLED that Bernie Sanders is in the Presidential race. Maybe he won't be the nominee, but he is forcing a shift in the dialogue, and that's critical. I believe this to be part of the shift, so yes.
But many, many other things will need to shift with it, from our behavior and expectations as patients to how we educate and compensate our providers. I think it's possible, but it cannot and will not be sweeping reform.
Thanks for the post!
I believe that we are finally in the midst of a paradigm shift. Can we continue on this path and progress towards an improved system? I completely agree with both of you.
ReplyDelete