Notwithstanding the media drama surrounding the current health care debate in Washington, the Senate version of the health care reform will pass the House in a matter of days and be signed into law by President Obama. There is some uncertainty about the reconciliation process, the “deem and pass” legality and thus what changes would become law to the underlying nationalized health care system, but the reality is that the US is now going the way of Canada, the UK and most western European nations with respect to the deliverance of health care services.
Moments like this lend themselves to wild and conflicting rhetoric in lieu of the public policy change of this magnitude, but history can be a useful guide as we try to access the impact of nationalizing health care in the US. There is no direct comparison but the United Kingdom offers as close of a study as one is likely to have for the US.
When the British people inexplicably in 1945 voted out Winston Churchill and installed Clement Attlee as Prime Minister, the Labor government created the National Health Service (NHS). By the 1960s the NHS had evolved into the fabric of the British culture and the share of GDP devoted to health care helped hurl the UK into the “sick man of Europe” in the 1970s. Any student of history knows Margaret Thatcher’s revolution restored Britain, alongside the US, as an economic engine and innovator in the global economic boom that lasted for 25 years. Unfortunately, necessary privatizations were lacking at NHS, compared to most other sectors of the British economy.
Today, the UK faces a fiscal situation that eclipses the US and its long term prognosis is graver than almost any other advanced Western nation. Although the UK spends upwards of $70 billion (USD) in defense and is in the top 6 nations or so in defense spending, it faces the real possibility of being unable to replenish its nuclear submarine fleet in the next five to ten years. In plain terms, the UK does not have the resources necessary to defend the island nation because its excessive public benefits, notably the NHS. They have been able to paper this over for decades in large part due to the economic and military might of the US but we all know this is rapidly coming to a close. Unfortunately, the American people do not have the luxury of a “rich uncle” who can serve as a backstop for our profligate ways. If we go the way of the UK with an NHS, over time this nation will find itself unable to defend itself without the good will of others.
It will not happen in a year but passage of a national health syatem will begin a process that will be the greatest test this Republic has faced since the Civil War.