One important way the UK's NHS is much worse than America's private health system

I recently wrote about my experiences using both the UK’s NHS in London and the US system in New York. I concluded, after 20 years using both, that I preferred the NHS — it’s free, quick and the care is the basically the same. Americans need not fear socialised medicine!

Since then, I’ve had a huge number of emails from readers. (I’ve read them all, and tried to respond to as many as possible.) But the most interesting email came from Ross Binkley, who sent me a link to a US Centres for Disease Control study of waiting times in US emergency rooms. The CDC is America’s big public health research agency and its data is generally extremely reliable.

It turns out that ERs in America are faster at treating patients than the NHS:

In fact, the median and average wait times for accident and emergency room treatment in America are 33 minutes and 58 minutes, as this chart shows:

The study contains this note: “Because wait time is highly skewed, that is, a small percentage (5%) of visits have very long wait times (greater than 3 hours), median wait time is less affected by the skewed distribution and provides an alternative way of describing ED wait time.” That 5% stat would imply that 95% of Americans are getting to an ER doctor within three hours.

If you’ve ever been inside an American hospital, this will come as a surprise. About 41 million Americans lack health insurance and either go without care or pay cash. Frequently, uninsured Americans delay going to see a doctor until they become very ill, and they turn up at the emergency room as their first resort. Hospitals tend not to turn away patients, and treat them as charity cases. That cost that is then passed on to insurance premium payers.

It’s inefficient because it means that millions of people don’t get cheap, preventative care, and end up in ERs where treatment is its most expensive. That bill is then eaten by the people who do have health insurance — which is why Americans are always furious about the cost of their insurance premiums.

So the fact that American doctors are treating these extra patients faster than their British counterparts suggests they’re a step ahead.

In the UK, the NHS is paid for via general taxation, usually income tax. (Interestingly, Americans are convinced that tax rates in the UK are much higher than they are in the US. In fact, they’re similar. Most British people pay 20% – 40% income tax, depending on your income. You can compare the two nation’s tax schedules here and here. Americans are paying their insurance premiums in addition to their tax, too.)

On balance, I still prefer the NHS to US care. The fact that it’s “free” (and the tax hit is the same) is a trade off I’m willing to accept. But it does look as if the NHS might want to visit some American hospitals and figure out what they’re doing that we are not.

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