In the UK the government provides all healthcare services, and those who work in the NHS are classed as government employees. Overall this nationalised system is something most Brits are proud of: the idea of ‘universal coverage’ paid for directly by the government from general tax revenue. However, no-one disputes the problems within the system - particularly the issue of waiting lists and delays in receiving treatment. Although highly centralised, the British system is not strict and citizens are allowed to choose private healthcare over the NHS. It is here that my issue lies. Although only some 10% choose to “go private” in the UK this number is growing. I feel this already creates a 2-tier system reflecting the injustice of the insured vs. uninsured in the US.

I can’t accept the benefits of the UK’s private healthcare system. Like a ‘fast-track’ queue for a ride at a theme park, I feel that the addition of the privilege for some only contributes to delay and inefficiency for all the rest. I see the private system draining the resources of the public system, with Doctors choosing to work privately for better pay and conditions. I can understand that with wealth comes a desire to spend more money on healthcare but I can’t help but judge it as the selfish choice if it is at the disadvantage of others. I believe that if we are to have a nationalised system this privilege should ultimately be limited to the option to pay for supplementary services that are not covered by the national system. It is then down to the government to reform the system for the benefit of everyone, not for the rich-poor divide to grow in access to, and quality of healthcare. Perhaps with a more strict system, and its own healthcare reform, the UK could one day be a model of a good NHS! (indeed Michael Moore uses it as a good example in his movie SiCKO)

France does not have an NHS but the French system assures healthcare for everyone. A basic level of healthcare insurance is provided by the government, after that employers are obliged to provide healthcare insurance and the government provides insurance for the unemployed. Patients pay up front for healthcare and are then reimbursed by insurance. However, practitioners are entitled to charge above the price that will be reimbursed. Obviously there is an element of competition between different physicians in France and some variety in the quality of healthcare, but physicians receive a limited wage and the government regulates the number of medical students each year. Overall the French healthcare system seems to avoid the stark divide of a 2-tier system that is so apparent in the US and UK systems. Maybe I have done well to come and live here! That is not to say France has the perfect system: it is often criticised for its expenditure and everyone tells me the paperwork is a nightmare.

There is no ideal healthcare system out there right now but there are definite lessons to be learnt from the strengths and weaknesses of systems throughout the world. If anyone can take the information and use it to go someway to combating the injustices in some of our systems I hope that Obama can.