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The Journal Gazette

Friday, January 12, 2018 1:00 am

Britain's dilemma in health care inescapable

Bloomberg View editorial

Can a relatively low-tax country run a high-quality, taxpayer-funded health service that's free to all? Britain's National Health Service suggests the answer is no.

The NHS is good at some things but bad, bordering on disastrous, at others. Its great virtue is truly universal coverage, no questions asked – and by international standards, the system is also cheap to run. As a result, it's perpetually short of money, and the service is erratic.

Prime Minister Theresa May has apologized for a breakdown that has seen operations postponed and emergency-room waiting times rise well over the promised four-hour maximum. That comes a year after the British Red Cross declared the service was on the verge of a “humanitarian crisis.”

Britain's population is growing and getting older, and as medicine advances, treatments become more sophisticated and expensive.

Years of meager funding are taking their toll. In relation to population, the U.K. has fewer doctors, CT scanners and MRI units per capita than most other EU countries, and ranks toward to the bottom in infant mortality. Other universal-coverage systems score better on avoidable deaths, cancer survival, innovation, consistency of service and other measures. Long waiting times for some non-urgent treatments are leading more patients to tap savings or borrow for private treatment.

Granted, more money by itself won't cure the system. One former head of the Treasury called the NHS a “bottomless pit.” Even so, bearing in mind how little the NHS costs, more money is surely part of the answer, as long as it's combined with further efforts to run the system more efficiently. For instance, social care for the elderly and other groups hasn't kept pace with what's required, placing an added burden on more costly medical professionals. Fixing that kind of misallocation would improve the system's value for the money.

The public's devotion to the principle underlying the NHS is undiminished: The British see health care as a right. Increasingly, though, they are also demanding higher standards of care, and those come at a price. Taxpayers must either dig deeper to maintain service – deeper still to improve it – or else accept that the NHS will continue to disappoint.