Trump-Thought: UK’s National Health Service

I’ve actually experienced interminable waits for late-night emergency care at a London hospital under England’s government healthcare program. It is no secret that British wealthy have their own private doctors (like those on London’s famous Harley Street), outside the government’s NHS, often under an expensive alternative concierge medical insurance plan (we have these here as well). As long as NHS doctors put in 40 hours a week, they are free to take on private clients. And there is also insurance for those elements that NHS does not cover. But notwithstanding these criticisms and workarounds, most folks in the UK are reasonably satisfied with their government-provided universal healthcare, and when they get private insurance, for most, it is simply picking up costs outside of the government plan.

“People living in Britain can obtain private insurance, and about 10 percent of them do. About one-third of people with private insurance purchase it with their own money, while the rest receive it as a benefit of employment. Many of the big multinationals provide such insurance, either to all their employees or to senior executives. It’s considered a plum perk for everyone, and most expats coming to work in the UK consider it an essential benefit.

“Private insurance covers care provided outside the tax-funded NHS system. Sometimes, people use it to obtain items that the NHS has chosen not to cover, like medications or devices with low cost-effectiveness ratios... But that’s unusual. Far more commonly, the insurance is used to purchase services that are freely available in the NHS, such as subspecialty consultation and elective surgery.

“The delivery side is more interesting – and fraught – than the insurance side. Private insurance generally doesn’t cover primary care; most patients seem relatively satisfied with their publicly funded general practitioners… and most GPs [doctors who are general practitioners] make enough money that they don’t seek more work.” The Health Care Blog from Bob Wachter, MD (1/16/12).

Britain has had universal healthcare since 1948, and funding issues have always been political footballs. Brits love to criticize the NHS, but they are completely committed to keeping that system and, ultimately, to improve the service. Donald Trump seems to equate protests and criticisms as conclusive proof that universal healthcare cannot work. When he made that connection and uttered that opinion recently, he did what Brits think he does best: rally Brits against him.

As Laura King, writing for the February 6th Los Angeles Times explains: “After protests in London over the weekend demanding improvements and better funding for Britain’s National Health Service, President Trump tweeted Monday [2/5] that the NHS was ‘going broke and not working.’…

“He united them in outrage when he retweeted anti-Muslim videos posted by a far-right British party. He galvanized popular support for London’s mayor when he accused the mayor of not taking terrorism threats seriously — even as London was recovering from a deadly terrorist attack. And after a visit to the White House last year, Prime Minister Theresa May was mercilessly mocked in the British press for appearing overly sycophantic toward Trump, to the point of walking hand in hand with him.

“Now comes a presidential broadside against Britain’s National Health Service — and Britons, by and large, are having none of it… After large-scale weekend protests in London demanding improvements and better funding for the public health service, which offers most medical treatments free of charge or at low cost, Trump tweeted Monday morning that the NHS was ‘going broke and not working.’

“The president, who has sought to scrap the Affordable Care Act, known as Obamacare, one of his predecessor’s signature achievements, accused rival Democrats in the U.S. of “pushing for Universal HealthCare while thousands of people are marching in the UK.” Characterizing the protests as a call to get rid of NHS altogether, Trump said of any move to provide single-payer care for Americans: ‘No thanks!’

“Virtually no one in Britain considers the NHS perfect: The need for urgent reforms, such as reducing waiting times and adding doctors and hospital beds, was the declared point of the weekend demonstrations.

“But Trump’s critique touched a raw nerve in a country that considers universal access to medical services to be something akin to a national treasure, under a system created just after World War II and now relied on by millions of people.

“After Trump’s tweet, Britons went on social media and related personal stories of having received free or low-cost medical treatment for debilitating or life-threatening ailments, and denounced a U.S. system under which serious illness can lead to bankruptcy or death or both. Others pointed to Britain’s lower healthcare costs and longer life expectancy when compared with the United States…

“[UK Prime Minister Theresa] May has generally been reluctant to criticize Trump, with aides citing the long-standing ‘special relationship’ with Washington, Britain’s closest ally, and noting Britain’s hopes of forging a strong trade relationship with the United States after a planned exit from the European Union. But May said through a spokesman that she was “proud of our NHS” and extolled the healthcare system’s top world ranking.

“May also publicly backed her health minister, Jeremy Hunt, who had earlier said on Twitter that he disagreed with some of the marchers, ‘but not ONE of them wants to live in a system where 28m people have no cover.’ He added: ‘NHS may have challenges but I’m proud to be from the country that invented universal coverage — where all get care no matter the size of their bank balance.’

“‘Similar views came from across the political spectrum. Jeremy Corbyn, leader of the opposition Labor Party, flatly declared Trump ‘wrong’ and said people were marching ‘because we love our NHS and hate what the Tories’ — May’s Conservative Party — ‘are doing to it.’” Mr. Trump is wildly unpopular in a nation that claims that “special relationship,” and getting less popular by the day.

“Polls have consistently shown Trump to be a highly unpopular figure in Britain, and fear of hostile crowds may be one reason the president has yet to go to the country [and why he has yet to visit California?] — an unusual omission for a U.S. leader after more than a year in office. Last year, almost as soon as Trump was inaugurated, May was sharply criticized at home for inviting him to pay a state visit, a ceremonial, pomp-filled affair that would probably involve an audience with Queen Elizabeth II.

“Distaste grew in Britain when Trump launched Twitter attacks against London’s mayor, Sadiq Khan, after a terrorist attack in and near London’s Borough Market in June that killed eight people. In November, he told May, in essence, to mind her own business when her spokesman condemned the president’s retweet of virulently anti-Muslim videos posted by the extreme nationalist party Britain First.

“‘Theresa May, don’t focus on me, focus on the destructive Radical Islamic Terrorism that is taking place within the United Kingdom!’ Trump wrote on Twitter.” LA Times. Well, Donald, when Brits do focus on you, they see a different kind of terrorism. But don’t worry, Donald, your base will stick to you like glue, hanging on your every word, even as they face illness and accelerated death without healthcare coverage. Just know that there is no such thing as a medical bankruptcy in the UK!!!!

I’m Peter Dekom, and as we coddle our rich, I continue to be staggered at how badly we treat those at the other end of the economic spectrum.