England’s strained health care system should ring alarms in the US
The National Health Service in England, founded in 1948 to deliver health care directly to all in need following World War II, is in trouble.
Not only is it broke, but it is also broken, as the new British Prime Minister Keir Starmer just pointed out in response to a recent government study.
The waiting lines for care are prohibitive. A recent study revealed that 8 million people in the United Kingdom are waiting for their care, with 40 percent waiting for more than 18 weeks. An incredible 14,000 people died just last year while waiting for care in England's emergency rooms.
Despite the well-meaning and compassionate doctors and nurses in the NHS, it is impossible to justify a health system when you have to wait so long for potentially life-saving care. If you aren’t seen, it is impossible to determine severity and urgency.
We aren’t there yet in the U.S., but there are several warning signs that we are heading in the wrong direction. A survey last year by the American Association of Nurse Practitioners found that more than 40 percent of respondents have “longer than reasonable” wait times, with 26 percent waiting more than two months for care.
It is simply impossible to deliver excellent care with a two-month waiting time. Keep in mind that 45 percent of insured people in the U.S. are relying on public health insurance, at a cost of nearly $2 trillion a year for both Medicare and Medicaid. Yet this insurance by no means guarantees the care you need, especially given the growing shortage of health care providers, particularly in rural and underserved areas.
A few years ago I visited a federally qualified health center in Dunkirk, N.Y., which had more resources due to the Medicaid expansion but was still struggling because of a lack of physicians to deliver actual care.
Things are almost as bad in our private health system where health coverage also doesn’t automatically equal health care. Whereas 60 percent of those under 65 still get their health coverage from their employer, 40 percent delay their health care because of cost.
Obamacare's state exchanges continue to demonstrate the difference between coverage and actual care. Although Vice President Harris intends to further expand these exchanges if elected president, the provider networks that take Obamacare insurance plans continue to narrow, and high deductibles continue to present a roadblock to actual care.
Now is a time of high physician and nurse burnout. We need an adequate supply of satisfied providers to enable satisfied consumers, but we don't have it.
Now is also a time of growing technology, including artificial intelligence. We are heading in the direction of personalized health plans that require doctors to administer the latest health care solutions.
Technology itself will provide us with the ability to decentralize health care. One day soon, I will be able to fully monitor my patients' health from their homes. Telemedicine is one step in that direction. AI is another.
But we also need well-motivated, well-compensated practitioners to monitor your care remotely. The type of medical marketplace we need to administer the healthcare solutions of the future will not fit with one-size-fits-all health insurance or empty governmental assurances.
The NHS crisis in England is an important lesson to us here in the U.S. It is a lesson we are clearly not learning.
Marc Siegel, M.D., is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent and author of “COVID; The Politics of Fear and the Power of Science.”
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