RSS feedThe National Health Service (NHS) in the United Kingdom is celebrating its 60th birthday this year. NHS was created after WW II to provide free health care, or social medicine, from cradle to grave to the people of United Kingdom. This allows everyone to access their family physician and subsequently any hospital without paying in cash or with insurance. The funding for NHS comes from taxes collected. In contrast, healthcare in USA is not social, it is private medicine. Although there is the free Medicare programme, it is not universally applicable to everyone until you reach 65 years of age. Thus, if you are youngish, poor and cannot afford health insurance, you try very hard not to get ill. If you did get ill, you try to put it off until it is absolutely necessary before you visit the doctor. It is estimated that approximately 40 million people in USA has no health insurance at all.
A recent study by researchers from the Colorado School of Public Health looked at the relationship of socioeconomic status and disease stage, treatment and 5-year mortality rates in 4844 women with breast cancer, 4332 men with prostate cancer and 4422 patients with colorectal cancer (Cancer; 23rd June epub). The study showed that low socioeconomic status was associated with more advanced disease stage and less aggressive treatment for all 3 types of cancers. If you have a low socioeconomic status and have breast cancer, your age-adjusted all-cause death risk is 59 % higher than someone from a higher socioeconomic group. For prostate cancer, the death risk is 33% higher for someone with a low socioeconomic status. In USA, black women with breast cancer have a 30% higher mortality rate than their non-black counterpart. This disparity has been put down to delayed diagnosis, race and ethnicity. The researchers wondered if a substantial proportion of this disparity is really related to socioeconomic factors – how easy it is to access health care, how much they can afford to pay for the treatment recommended etc.
Paying for health care is a major headache in every country. Should the state pay for everything like the NHS, or should the people pay cash for some of the cost or should all health care cost be shouldered by an insurance scheme? The health care budget in USA is rising every year and the private health care system is in a mess. The insurance premium is rising because the cost of treating each patient is increasing. At the end of the day, even if you insist on a health insurance scheme, someone will still have to pay the premium.
No country in the world can claim to have an ideal healthcare system. For most citizens, be it in a first world or a third world country, knowing that you can have free access to essential health care must be a comforting thought. For example, if you require chemotherapy after the surgery, you should be given the treatment without having to worry about how to pay for it. However, if you want a face lift to look younger, I do not see why the state should pay for it.
NHS, while you are by no means perfect, I think the British citizens should be thankful that you are around and hope that you will still be around for another 60 years. Happy birthday.
