President Donald Trump took to Twitter Monday to criticize Britain’s health care system, and in the process, attacked a goal that many other industrialized democracies share: universal coverage.
The Democrats are pushing for Universal HealthCare while thousands of people are marching in the UK because their U system is going broke and not working. Dems want to greatly raise taxes for really bad and non-personal medical care. No thanks!
— Donald J. Trump (@realDonaldTrump) February 5, 2018
Trump may have unintentionally conflated the objective (universal coverage) with the pathway (single-payer), but this distinction is especially critical to parse out as more and more Democrats warm up to the idea of single-payer health care — a system in which a public insurance plan pays for all medically necessary services.
Bernie Sanders’ single-payer bill, “Medicare for All“, was a much-touted track toward reaching universal health care, but it’s hardly the only option on the table. Founding Executive Director of Families USA Ron Pollack suggested various alternatives to the status quo that inch closer to universality, like expanding Medicaid and extending coverage to more immigrants. Other Democrat lawmakers have also introduced their own bills. The objective for each of these proposals is to get more of the 28.1 million people without insurance covered for the sake of their health and financial well being.
Moreover, while conservatives continue push back against universal health care, support is growing. The majority agrees that it’s the government’s responsibility to ensure health care for all. The question is how?
The United States could benefit by looking at how other countries deliver and finance health care, as T.R. Reid suggests in his book The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care, which details how other countries designed their health care system. The developed world, with the exception of the United States, has concluded that it’s essential to cover all citizens — Trump even supported this principle at one point — but how they accomplish this varies. Differences aside, most countries spend less on health care and achieve better results than the United States, including the United Kingdom:
But, of course, all health care systems have shortcomings, as is the case in Britain. A bit of background: the country’s National Health Service (NHS) goes further than other single-payer models as the health care is not only financed by the government through taxes, but most hospitals and doctors are also employed by the government. A New York Times article from last month described the dire situation in Britain right now:
At some emergency wards, patients wait more than 12 hours before they are tended to. Corridors are jammed with beds carrying frail and elderly patients waiting to be admitted to hospital wards. Outpatient appointments were canceled to free up staff members, and by Wednesday morning hospitals had been ordered to postpone nonurgent surgeries until the end of the month.
Cuts to the National Health Service budget in Britain have left hospitals stretched over the winter for years, but this time a flu outbreak, colder weather and high levels of respiratory illnesses have put the N.H.S. under the highest strain in decades.
While many conservative outlets were quick to use Britain as an example for why a single-payer system is doomed to fail, they failed to examine the reason for the shortcomings. Austerity measures introduced by conservatives in 2010 as a response to financial turmoil have only increased under successive governments. Those policies have underfunded the NHS, making it increasingly hard for the organization to handle waves of patients. The cold and flu season has also hit the U.K. especially hard this season.
As such thousands took to the streets to demand more funding for the program, a point that was made by Opposition leader Jeremy Corbyn of the Labour Party on Twitter:
Wrong. People were marching because we love our NHS and hate what the Tories are doing to it. Healthcare is a human right. https://t.co/Pmo2xYSqZh
— Jeremy Corbyn (@jeremycorbyn) February 5, 2018
Even so, leaders there are by no means suggesting they should give up on universal health care. And they also aren’t suggesting they should model their system after the United States’ disjointed, complex health care system. In fact, Britain’s Health secretary Jeremy Hunt angrily responded to Trump’s tweet, reminding him of the United States’ uninsured rate:
I may disagree with claims made on that march but not ONE of them wants to live in a system where 28m people have no cover. NHS may have challenges but I’m proud to be from the country that invented universal coverage – where all get care no matter the size of their bank balance https://t.co/YJsKBAHsw7
— Jeremy Hunt (@Jeremy_Hunt) February 5, 2018
The big picture is that Trump is among very few people who are suggesting that Britain should give up on a fundamental principle that health care access should not be contingent on income or geography.