A friend living in England (the philosopher Jamie Whyte, actually, whose writing has graced this very blog) sends along a little vignette for the benefit of my American readers who see European health care systems through rose colored glasses.
A 64 year old breast cancer survivor suffering severe back pain is told she’ll have to wait five months for an appointment with an orthopedic surgeon through the National Health Service (NHS). She therefore (and perfectly legally) chooses to pay 250 pounds (about 385 dollars) for a private appointment. He puts her on a waiting list for surgery to remove a cyst from her spine, surgery which is routinely covered by the NHS. But the NHS decides that since she can afford 250 pounds for a private appointment, she can also afford 10,000 pounds (over 15,000 dollars) for private surgery. They therefore deny to provide her the surgery for which she’s been paying taxes her whole life.
This was not an isolated incident; until recently, cancer patients were routinely denied further NHS treatement after privately purchasing lifesaving drugs that are not available through the NHS.
More details here. It’s worth reading the comments, where readers excoriate the patient for “queue jumping” because she used the price system to signal her high demand for medical services. Note that nobody complains about “queue jumping” in the market for, say, oranges, because oranges are not rationed by government bureaucrats and therefore do not generate queues.
The lesson, I think, is that once an inefficient bureaucracy becomes entrenched, a certain fraction of the electorate becomes incapable of imagining anything better. In this case, that fraction seems to have forgotten first that some people need medical care more desperately than others, so that “queue jumping” can be desirable, second that private payments to doctors actually call forth more medical care and therefore shorten queues, and third that maybe it would be better to have a system that didn’t require queuing in the first place.
I think Jamie Whyte is awesome. His book “Crimes Against Logic” is funny and sharp. Does he have a blog or something?
It’s not quite accurate to say that “They therefore deny to provide her the surgery”. Rather, she would have to queue for it, for longer than she would have had she never seen the doctor privately.
(The exact times aren’t quite clear from the article, it took them 2 months of thinking she was in the queue to tell her this, but it’s not clear to me whether 18 weeks is the queue just for an appointment or for the operation. So at “worst” she turned the 18 weeks into 26, at “best” if the wait for the operation is longer the percentage extra delay is smaller.)
Nevertheless I fully agree that this business of vengeful rationing is crazy.
After reading the comments, perhaps I should clarify that I assumed above that there is only one waiting list for NHS-funded surgery.
Several commenters apparently believe that a private consultation could result in a place in a different, shorter waiting list for the same service. I find it hard to believe that there could be such an obvious loophole, so I suspect they are wrong…
>> maybe it would be better to have a system that didn’t require queuing in the first place. <<
I'm going to see an allergist today, a followup to an appointment a couple of weeks ago… after I was told in December by my dentist that I needed to see an allergist, when I had a rather severe flare-up of an allergy-like symptom. December was when I started trying to get that appointment, late March was when I actually got it. And it wasn't as simple as just waiting in queue, it also involved the confusing ritual of "referral" through my primacy care doctor, located elsewhere, who wasn't even the one who'd seen the symptoms and recommended it in the first place.
Where is this mythical "system that doesn't require queuing"? I may want to go there sometime.
Improbable – it used to be the case that you would be able to skip the waiting list through paying for a private consultation (based on personal experience from about 10 years ago).
Alas it’s election time and the NHS always get dragged into it with stories of questionable veracity or relevance (another war of Jennifer’s ear). I thought Jamie Whyte would know better than to peddle this stuff….I wonder who’s paying him….
Can’t seem to read the comments section for some reason.
What would you say to what I expect would be a typical reaction:
So you want to make the lines non-existant by having poor people die?
Dave: I would say: “Huh?”
Steve has been kidnapped and replaced by an inverted Michael Moore! There are any number of horror stories from USA healthcare system of insurance companies pulling the plug on funding etc. It is not really a good idea to base arguments on this sort of example. As Steve has said before, there must be rationing. In the USA it is done in a different way than in the UK. Where there are rationing systems in very large organisations with many millions of transactions, there will always be examples of apparently unfair, even bizarre, outcomes.
So lets get to the proper argument. You say she used the price system to signal her high demand for medical services. The NHS provides care on the basis of need, not just first come first served. If the system was working correctly, her need for medical services would have been taken into account when the appointment was booked. Her wait would be proportional to the urgency of the need, within the overall budgetry limits. This means that the need was assesed as not urgent, or that the system did not work correctly in this case, or the overall budgetry restrictions were too tight. I do not know which happened here, and the NHS does get it wrong. Generally speaking, the NHS will have short waiting times for non life-threatening conditions – but sometimes longer than the public might want. However, it would be extremely unusual to have to wait 5 months for an appointment for a condition causing severe pain. The Brits could have shorter waiting times if they were prepared to pay more through their taxes. As they are not, we can assume they have the waiting times they are happy with. The level of satisfaction with the NHS is extremely high.
The system is assumed to run on the basis of need. There is a parallel private health system also. You can therefore pay for your treatment if you prefer not to use the NHS. What cannot work is a system where you can pay a small fraction of the NHS costs to “jump the queue”. This would mean the system no longer worked on the basis of need. By paying a small amount to get in early, you have delayed someone else who’s need has been assesed as greater than yours. There is no increase (or very small) in the amount of healthcare provided, but the cost is higher, and the needs are dealt with inefficiently. The principle is therefore either go with the NHS or go private. Either way you must pay for the NHS. This is not entirely unfair as many of the costs of private medicine are in fact paid by the NHS – emergency cover and training for example.
The costs of the NHS are significantly lower than the USA health care costs. Any Brit. wanting better healthcare can take out a private insurance policy and still probably pay less than a USA citizen. That most people do not either take out insurance or wish to pay more tax indicates that they do not want to pay more for better healthcare.
I don’t think you believe that the USA has got it perfectly right, but a quick comparison could be illuminating. According to Wikipedia, the UK Govt. spends 15.8% of its revenue on healthcare. Somehow, the US Govt. spends 18.5%.
http://en.wikipedia.org/wiki/Health_care_compared#Cross-country_comparisons
Somehow, despite having mostly private heatlthcare, the US Govt. spends more of its money on healthcare than the UK! USA costs per capita are $7290. UK costs are $2992. Overall, the NHS is incredibly efficient. I think the USA healthcare is probably marginally better than the UK (for those with insurance). I do not think it is anywhere near 2.5 times as good. You have said before that poor people would not chose to spend $300 on emergency ventilator insurance. I bet that most people would not be prepared to spend $4298 a year for the difference between UK and USA healthcare. In the USA people do not have the choice to pay UK prices for UK healthcare, but I bet a lot would take it.
So your lessons: “that fraction seems to have forgotten first that some people need medical care more desperately than others, so that “queue jumping” can be desirable” Absolutly not. If you need healthcare more than others you get it in the NHS. Under a private system you do not, you get only what you can pay for regardless of need. Second – private payments call forth more healthcare. This may be true. In the USA it seems to have called forth far more healthcare than is good. The USA either pays much more for the same healthcare (gross inefficiency), or pays much more for the little bit extra. I think the value from that $4298 / year is very poor. Third – of course it would be better to have a system where queuing was not necessary, but would it be worth the cost? Most brits could insure themselves for far less than $4000 / year and eliminate queues, but do not do so. Therefore they do not think it worth the cost.
Harold (taking my cue from Steven): huh?
Harold, please, you say this: “If the system was working correctly, her need for medical services would have been taken into account when the appointment was booked. […]”.
No Harold, you miss the point. I think the point that Steve is making is that centrally planned economies just cannot work; sooner or later, they fail; be it in one sector, like health care, or be it economy wide, like the Soviet Union or Cuba. Centrally planned economies fail because bureaucrats do not have and cannot have all the information and incentives to make the “correct” decisions.
You say that the U.S. health care system has its horror stories, too. True enough. During the health care debate in Congress, Democrats marshaled one sob story after another. BUT …. BUT…what got lost in these sob stories is this: here in the US you DO have alternatives, you can complain to the government, you can raise a stink with your congressman, you can try and change insurers, you can complain to the insurer directly.
Try to do this in England. Try complaining to the government about the NHS, that same government that RUNS the NHS. See how far you get.
And the other point that gets lost is: why do most people who need highly delicate medical treatment come to the U.S. and do not go to Europe (including that wonderful NHS)?
It’s Deja Vu all over again.
It seems to me that as someone who understands there is no free lunch that you should be smart enough to realize that a good like healthcare MUST be rationed. I suppose every good must be rationed but I am getting off topic.
You can ration healthcare by charging money for so that poor people can’t get much or you can ration it some other way.
You must admit that people with insurance have a greater incentive to use medical care covered by that insurance more than people who don’t have insurance to pay part of the bill.
However, shouldn’t THE BIG QUESTION be which health care system is better over all?
If you could choose, which one would you choose? I realize you can’t isolate the health care system but….
Assume that the US health care system is both better and more expensive than England. Do you agree or disagree?
Therefore, your choice comes down to this. Would you be willing to pay the extra cost that the US system costs to get the benefits that the US system has?
I think that the obvious answer is NO!!!! The UK system is not that much worse and is significantly cheaper.
I don’t doubt that a high end Lexus is a better car than a low end Toyota but I would assume that the huge majority of people in America would choose the cheaper car and spend the difference on other things.
I would much rather have the UK system and use the savings for other things.
FWIW, I have lived in England and my daughter was born using the NHS. My other children were born here with private insurance.
The first question is whether this should be done via a price system where every individual can signal their own need or via a public system like the NHS where a queue is formed based on how badly/urgently each patient needs care.
If we choose the second system, is it wrong for some people to pay extra to ‘jump the queue’ and see a private doctor, then move to the other queue for surgery? Does this somehow harm those who are in queue for the surgery or for the initial appointment?
If these queue jumpers are put at the back of the line for NHS funded surgery, then they do no harm to anyone already in line for surgery. They also benefit anyone behind them in line for a consultation by moving into the next queue, which those people may never need to go to. The people who were in front of them in the queue for a consultation lose out the the extent that they might end up behind this person in the queue for surgery, but this only exactly offsets the benefit to the people who were further back in line.
Only patients who need a surgery will be in line for it. If this system resulted in the surgery line increasing in length as some of the complainers seem to believe, then it would reduce the value of going to a private surgeon, until eventually no one was willing to pay extra and we would be back to the system with longer queues for consultation and then shorter queues for surgery. The only way to reach a stable equilibrium is to allow people to ‘jump the queue’ by paying a private doctor. Only people who value their time at more than the cost of the private doctor will go this route. People with a lower value of time will stay in line.
As a result, this system takes into account not just how badly you /need/ surgery, but also how badly you /want/ it and how /costly/ it is for you to wait for it. If, all things considered, it costs me $100 per day to wait in line and it costs you only $50 per day to wait in line, then why on earth should I be in line behind you? And why would you be upset if I and others like me left the line by paying doctors who otherwise wouldn’t be in that profession? Those private doctors increase the capacity of the system to handle more patients, and they are funded by people who want to be done with the process so quickly that they are willing to pay to make it happen. You get your consultation sooner, and your wait for a surgeon is the same, so what legitimate gripe do you have about queue jumpers?
The point that has been overlooked is that the NHS system rations based on how badly someone else thinks you need care, not based on how much the care is actually worth to you, which is not the same thing as how badly you actually need care, nor is it the same thing as how badly you think you need care. It is simply the amount of other consumption you are willing to forgo in order to obtain this service. Any system that doles something out to people based on something other than how much it is worth to them is allocating resources sub-optimally. The queues make it even worse, because any time spent navigating the queue or dealing with the NHS is time wasted that could have gone to a more productive use, for example, applying to Medical School.
Neil–you assume that the only issue is the cost of healthcare vs. the value of services received. But this is only a fraction of the difference between a free market and a command and control economy. One major difference is the ability of markets to rapidly adapt to changing conditions and consumer preferences, and also to reduce costs and increase supply through competition.
Imagine two countries, Waldavia and Ruritania. 20 years ago, Waldavia socialized their cell phone industry, guaranteeing every Waldavian citizen a two pound, $2,000 cell phone. Ruritania let the free market reign, rationing cell phones based on the ability to pay. Only the rich could afford them, and most went without. 20 years later, every Waldavian still has a government supplied 1990’s era cell phone. Despite (rather, because of) government non-intervention, today virtually every Ruritanian has a $100 cell phone that’s 10,000 times as good as those in Waldavia.
This is an exaggeration, of course. Even centrally planned economies show some technological progress, and cell phone technology has advanced faster than in most industries, but the point remains.
When everyone is covered by the NHS, what people signal by offering to go privately is not their need but their wealth. If person A is prepared to pay £10,000 for a treatment and person B is prepared to pay £20,000 for it, the most likely deduction is simply that B is wealthier. There’s no reason at all to deduce that B needs it more than A.
And the NHS is hardly centrally planned; it is centrally funded. Medical decisions are made by doctors based on examining the patient, but the cost of the treatment is paid for out of taxation. There is rationing, just as there is in any system, but this is based on many factors such as the likely improvement in quality of life, the probability of success, and so on. The only thing that isn’t factored in is the ability of the patient to pay. Obviously there are horror stories just as there in any large organization, but that is inevitable based on the general incompetence of people!
Harold,
The American horror stories where someone is denied a payout by their insurer is not rationing in the sense that Steve is using the term. When an insurance company denies coverage, it is because the insured did not have sufficient demand to pay for coverage in that situation. Health insurance is a contract which provides conditions which trigger a payout by the insurer.
If you are denied coverage, it is because you did not bargain for it when you bought your insurance policy (unless there was a breach of contract, in which case the courts will sort it out). If you did not buy coverage, it was because the cost of the coverage was higher than the benefit you anticipated getting from the coverage.
Whenever there are insurance contracts, there are going to be horror stories of people who were denied coverage. Of course you are going to want coverage, which you did not pay for, when an improbable event occurs!
If I am responsible for a wrongful death later today, I am certainly going to wish I had robust liability insurance. But am I going to go out and buy that insurance right now? No, I’d rather take the risk, and just try to not kill someone.
Neil Wilson-
In the US system (or rather, the former US system), I get to make that choice for myself every day. I can choose little health care today, none tomorrow, cheap care yesterday, and cadillac coverage next week. I don’t need to consider the total spending of the country and try to set it at the optimal level for all of us while making assumptions about what everyone else wants.
In the UK system, I get no choice. Everyone else has chosen for me, and I am stuck with the exact same care as you, my neighbor’s kid Billy, and my Grandmother. Some of us might want more. Some probably want even less. Yes, as someone mentioned, we all set the level by setting our taxes, but unless everyone’s health care preferences are identical, this system fails compared to the US system where I can get a lot of health care if I value it highly or less health care if I don’t value it highly.
It all boils down to the same basic point: If you’re going to provide something for people, do it in the lowest-cost way possible, and give it to the people who value it the most. Anything else results in a net loss for society.
Daniel, the insurance companies are not infinitely wealthy. We cannot spend the whole GDP to try to keep 1 person alive. There is always rationing.
There is a debate to be has about private medicine and the NHS, the effects they have on eachother etc. That is not really the point here. If someone wants to go private, they can. If you want to get your back operation faster, then you or your insurance company can pay for it. The issue here is if they can spend a tiny portion of the total cost to buy an earlier operation which is then paid for by the NHS.
Manfred, if the point is that non-market institutions must fail, then the NHS does not demonstrate this. It has succeeded to provide good healthcare at less than half the cost in the USA. In the UK you do have a choice- you can go private or not. In the USA you do not have the choice of UK prices for your healthcare. The comparison seems to show that the non-private model is more succesful at providing good healthcare to most people. Most people do not travel to America for care. The very tiny percentage that do travel tend to go in that direction. This is what the huge level of spending has provided – the best medicine at the cutting edge which benefits very few people at very high cost.
Wasn’t some of that choice an illusion, though? Most people who claimed they could choose whatever healthcare they wanted, didn’t. They took whatever their job gave them, or chose from the selection their employer had available. Retirees continued to have benefits dropped. If insurance companies deny you for something like high blood pressure, or being overweight, then your average retiree won’t have much choice when their company decides to drop coverage.
If you’re unemployed, or self-employed, there’s always buying insurance yourself. But the last time my family looked for health insurance for my sister, the lowest quote we got was $1750/month, for a $10k deductible catastrophic plan with no prescription drug coverage. But this is the problem with anecdotal arguments. You give me your horror stories about rationed care, and I’ll give you mine.
Wow. Nathan and Douglas seem to live in a world completely detached from the world where real people live.
Nathan: Using cell phones is a great example. Why are US cell phones so far behind countries like Japan and Finland and the UK? We have far fewer regulations concerning cell phones. Why do the cell phones in the US suck?
But getting back to medical care. If you want to make the argument that the great advances in the US trickle down to the rest of the world and the cost of these great advances is that the US pays about double what the UK and Japan pay then I, as an American, am sick and tired of paying to improve the healthcare of Europe and Japan. Is there any other product where the US pays so much more than the rest of the world?
Douglas: Do you really get to choose your healthcare on a regular basis? I don’t know about you but my company gives me a few limted choices once a year. I know that I can not go and start a small company with a friend of mine because the insurance costs would be too high after COBRA runs out.
In any event, I would love to pay 60% of what I am paying now to have the healthcare that they have in the UK or Japan. I have lived in both places. No one, OK very few people, in either country would want to have the US health care system.
Why does a significant portion of the US want a system similar to the UK, or Canada or France or Germany or Finland or Japan or virtually anywhere? Why does basically no one in any of those countries want a health care system like we have in the US?
I certainly don’t think Steve Landsburg is arguing that the current US health care system is ideal. In fact, the government contributes 50% of all health care spending currently and this will certainly rise in the future. As the government gets more and more involved health care becomes less and less efficient. Why anyone would think even more government involvement would make it more efficient is beyond me.
Second, to compare health care costs in the US to other countries and then to suggest socialized medicine is the cause of reduced health care cost in other countries is suspect. US citizens have life style choices that have increased the cost of health care in the US that has nothing to do with the medical system. In the US, 30.6% of the population is obese and compare this rate to the UK with a rate of 23.0% or Canada at 14.3% or Japan at 3.2%. I would bet my bottom dollar that if the US obesity rate were 3.2%, as in Japan, then health care expenditures would be significantly lower. To impose socialized health care rationing in the US to reduce costs to match the costs in UK or Japan would be equivalent to NAZI death camps exterminating the sick and unhealthy.
Neil–always conducive to good debate to accuse others of being detached from reality.
As to your specific question, I have no idea about the relative state of cell phone quality in Finland and Japan. Do they have something substantially more advanced that the iPhone and Blackberry? Investigation into a particular technology would require lots of research and analysis on a subject about which I care very little. I chose cell phones as an example of technology that has improved dramatically over 20 years precisely because of the benefits of competition and free markets. I could have also chosen computers, or televisions, or automobiles, or any number of other things.
Anyway, you say you’re sick and tired of paying to improve health care for the rest of the world. That seems awfully churlish and xenophobic for someone who supports socialized medicine. You don’t mind redistributing wealth as long as those damn foreigners don’t get it?
Your solution is apparently that we should adopt a socialized medical system and stop subsidizing the rest of the world. That’s sort of like chopping off your nose to spite your face. As I tried to demonstrate with my cell phone example, the only reason we now have $100 cell phones that also send texts, email, surf the web, play music, and have GPS, is because 20 years ago rich CEO’s, wall street bankers, and doctors were willing to pay $2000 for a 2 pound brick that only made phone calls.
In medicine, you can currently get your entire genome sequenced for around $100,000. Sequencing the first human genome cost 3 billion. Estimates are that the price will be around $1000 within a decade or so as competition and improved technology drives prices inexorably downward. Without such market forces, we’d be stuck in a world where individual genome sequencing would be considered impossibly expensive.
If the US turns to a command and control economy in health care, we’ll lose one of the major forces driving forth medical advances and all of us will be worse off as a result.
I read the comments. I’m not sympathetic to those who think she is “jumping”.
She pays taxes for a place in the line.
She pays a little extra to get ahead. The others in line can also do this.
What’s not fair is that she’s now barred from the line, which she’s already (and still am) paying for.
i think that if they ever had an explicit policy saying, “once you use go private, you can never go public”, people would be outraged. Using the bureaucracy, you can get the same result, with a fig leaf and without the outrage!
I assume that the reason a “mixed” system of private and socialized health care cannot co-exist is that the private sector sucks the resources out of the socialized sector. We see that happening to some extent in the United States, where providers are reluctant to accept Medicaid patients, and now Medicare patients as well.
Anyone have any bright ideas on how this can resolved short of a fully socialized or fully privatized health care system?
Neil-
A fully private system, but where the poor/elderly/disabled/whathaveyou are directly subsidized with cash would do the trick.
Tom Dougherty – you are the first to bring a comparison with Nazi Germany, and therefore lose the argument.
My summary is: Using an example of poor care to demonstrate a failure of a large system is suspect.
The figures and levels of satisfaction show that the socialised medicine in UK, Europe and Canada are not failures. They are also not perfect.
The system in the USA is much more expensive than socialised ststems, for small benefits to the USA population. It is not perfect, nor is it a free market system. It may possible be a combination of the worst aspects of all worlds.
There may be a better system such as suggested by Douglas Bennet, but this has not been tested – or has it?
What I think is more troublesome is that funding the NHS changes the incentives for the government to be involved with the private life of the population. Nothing is sacred, millions are spent advertising life style changes (don’t smoke, don’t drink, eat veg, do exercise) with the sole aim of prolonging life by an inconsequential and possibly undesirable amount. No consideration is given to the possible enjoyment that can be achieved through not exercising and eating what you like! When you take away the responsibility for your actions that you take away the ability of people to make the right choice for themselves, essentially infantilising the entire population (although some people are more susceptible than others).
The buzz word in the UK is equality and illogically it is equality of outcome that is desired by the government. It is of the utmost importance that there should be no deviation in life expectancy, becuase inequality has been redefined to mean bad by those who use it.
Equality of outcome is easier to measure than equality of opportunity, so it is the one that politicians care about.
No idea if anyone’s still reading, but here’s a few points on this I’d like to offer.
1) It has been mentioned that the US system is more “efficient”. What do we mean by this? I think Steve et al mean more “economically efficient”. There are two facets to economic efficiency: productive efficiency and allocative efficiency – where both are maximised we reach a pareto optimal situation.
I would say that the US system is more allocatively efficient, because it can deliver what consumers want and need compartively better.
But I would say that empirically the UK system is better for productive efficiency. The UK has substantially lower costs per capita and the economies of scale the central government procurement achieves is something that isn’t possible in the US system.
So there’s a balance – the US is better for consumer provision, but worse for keeping costs down and providing a cheaper service. I would say there’s probably no one pareto optimal point where both types of efficiency are maximised – instead there’s a constant tradeoff.
2) There is a difference between being economically efficient and socially efficient. The US system is more economically efficient, but less socially efficient. The UK system is the reverse.
You can maximise your insurance firm’s profit by kicking poor people off the register, or those with pre-existing conditions. That’s economically efficient. It’s not socially desireable though.
The same principle is why we don’t privatise defence (private defence might be cheaper but it would cause a whole load of other problems too!), and why in the absence of government intervention, it is in companies’ interests not to employ disabled people: non-handicapped people are more productive and don’t require expensive accommodations like ramps and lifts.
3) The free market system works well in certain conditions. In others it does not. This has been well documented.
I would put forward some limiting factors as to why the market fails in healthcare:
a) Consumers know so little about healthcare that they can’t provide a feedback mechanism.
b) The people who supply consumers (doctors) also generate demand by ordering tests and so on.
c) A large amount of healthcare is subjective and not objective – a hypochondriac would feel aggrieved by a rationing system like in the UK, but an impartial observer might note that their treatment was on time and cured their disease.
CB: regarding efficiency, is this where we can all argue in circles, both being correct? The same word with several meanings?
A quick word on NICE – National Institute for Clinical Excellence. This decides whether to approve a drug by calculating the number of “quality adjusted life years” or Qualys that the drug provides, and basically doing a cost / benefit analysis. This way the NHS rations the money in the most efficient way. This is what has been called the “Death Panel” (possibly not by the most respected commentator). It has been castigated for not allowing expensive cancer drugs on the NHS, to such an extent that the QUALY has been re-defined (or re-valued)for end-of-life cases. It would seem to offer an approach that Steve would approve of. As there must be rationing, lets do it on the basis of the best evidence available.
So at the worst, this Englishwoman will have to wait 5 months for a surgery? The number of people in the USA without insurance is right about the same number as the total population of England (http://pn.psychiatryonline.org/content/38/12/1.2.full), how long would their que be for this operation?
Not long ago you posed as rational the notion that parents beating their children was not as bad as not having children at all (or at least no worse) because abused children were likely to concede that a lousy life is better than none at all. I suspect that a Brit, even after waiting in pain for 5 months would prefer their system to the one that would let them suffer indefinitely or drive them into financial ruin.
The sad fact is that the UK is not a terribly wealthy economy but if they chose to spend, per person, on their healthcare system what we spend, per person, on ours the problems of queuing would disappear. In the end, though, even the UK which has the worst universal healthcare system in the world (arguably) the results are a generally healthier public.
To continue with previous analogies, bashing Britain in this case is like bashing the Bangladeshi garment factory for providing such crappy working conditions while you sit in your cushy office watching your fellow citizens pick through trash for food at the nearby garbage dump.
And it is disingenuous at the best and dishonest at the more probable worst to use Britain’s NHS as an example of “European health care”. Especially when it has been made perfectly clear in the media how anomalous the structure of Britain’s insurance system is compared with the majority of European healthcare systems.