In all of the debate about the U.S. healthcare system lately, those in favor of Obama care and plans like it often point to Britain’s National Healthcare System (NHS) as a model on which the U.S. system should be based.

Instituted in July 1948, the NHS is England’s publically-funded healthcare system, and the oldest single-payer healthcare system in the world. In the simplest terms, citizens of the United Kingdom pay into the system through taxes, and can then access healthcare services from doctors, hospitals and specialists at no charge. There are fees for some services, such as dental, vision and long term care, but those services are less expensive than one would pay through a traditional health insurance provider.

Photo by : Old Shoe Woman

Another feature of the NHS is that it allows those who are within the borders of the United Kingdom—whether tourists or illegal immigrants—access emergency services free of charge if they have an accident while in the country.

More than 90 percent of the British population participates in the NHS, although the number of citizens using private health insurance is rising. In the 64 years since the NHS was established, the specifics of the program have changed, but the general foundation has remained the same.

Early Years

Before 1948, healthcare in England was fractured, provided by a variety of charities, and private and municipal programs. After World War II, though, the government decided that healthcare of the citizens needed to be a priority, and appointed a new Minister of Health to develop the National Health Service, which would bring all of the country’s healthcare providers under the same umbrella. Doctors were initially opposed to the idea, claiming it would hinder their independence, but were eventually brought on board by the prospect of higher payments. On July 4, 1948, the new service was unveiled with great fanfare.

Over the next several decades the service adapted to meet the changing needs of the British population. A prescription plan was introduced (and today, all prescriptions are about eight Euros each, with some exceptions) and access to advanced treatments, such as MRI, improved. In fact, the NHS is a world leader in access to birth control, offering free contraceptives to all women of the NHS regardless of income.

NHS Today

Public sentiment toward the NHS depends on who you ask. Some users report excessive waits to access services (in 2009 NHS created a policy that users will not have to wait longer than 18 weeks to access services from a specialist after a referral from their general practitioner) and dissatisfaction with the quality of service. However, according the NHS surveys, the vast majority of citizens are happy with the NHS, and feel that their healthcare coverage is adequate.

The NHS is vastly different from the American healthcare system, which relies heavily on private health insurers. In fact, a large percentage of Americans forgo health coverage due to the high cost of premiums, or rely on free care or low-income assistance programs provided by the government. Some argue, though, that the American system provides greater freedom of choice, as patients can generally choose the providers and services that they want to receive, unlike the NHS, which places strict limits on patients and healthcare providers.

With the passing of President Barack Obama’s healthcare plan major changes are coming to the American healthcare system. Within the next few years, the vast majority of Americans will have some sort of healthcare coverage, ensuring they will be able to receive the care they need. The expansion of access to healthcare will mean greater opportunities for those who hold a master of public health or human services degree, as there will be an increased need for public health educators and nurses to educate the public on healthcare issues, as well as human services professionals to manage the many public health programs expected to develop. As the U.S. moves closer to the British model of healthcare delivery, this type of education and management will be necessary to control costs, and ensure high quality levels of care.

It’s important to note that although the NHS has been in place for 64 years, it has been constantly evolving. In a recent study, the NHS was ranked second among the top healthcare systems in the world.

About the Author:

Patrick Armstrong is an international relations consultant and pharmaceutical representative.  His career has taken him nearly all the way around the world, but he will always call San Diego, CA home.