Living in both the US and the UK for the past seven years, I have had a good opportunity to compare the two medical systems. I can tell you, after all this time, that the NHS, Britain’s National Health Service is absolutely amazing.
But the NHS is not without its problems, and one of its biggest problems is how to fund the service. Over the past few weeks, many in the NHS, from junior doctors to nurses have gone on strike, and with good reason. They are underpaid and over-worked. And while all medical services and prescriptions drugs are free to UK citizens, there are often long waits for procedures; often very long waits.
When I first moved to the UK, I was a bit concerned about the quality of British medical care; having lived in New York, what I considered to be an epicenter of great medicine — which it is. I can tell you after so many years that quality of care I have received in Britain is as good, if not better, than what I was used to in New York.
The problem with the NHS is one of funding. The state funds the NHS and that means taxing people to pay for it. If you want to improved the salaries that NHS staff receive, if you want to expand the facilities, if you want to improve waiting times then you need more money; which so far has translated to more taxes.
I think there is another way.
It is a bit of a radical idea, so hear me out.
I think there should be two NHS’s — the existing one that needs to be expanded for all UK citizens and remain free, but also a second one. Let’s call this one NHS International.
This is in fact not so radical an idea. The BBC, which is also provided free of cost, though supported by the license fee as opposed to taxes, also has a commercial wing that sells BBC programming all over the world. As The BBC provides some of the best television in the world and the world comes to The BBC to buy it, so too does the NHS provide some of the best medicine in the world, and the world will also flock to Britain for it.
Britain has some of the best health care and most advanced medicine in the world. As such, Britain should be a Mecca for people, particularly Americans, who want to find cheaper alternatives to the crushing cost of health care and procedures in the US. Some already go to Mexico or Colombia for things like knee replacments or hip replacements — they could and should come to the UK, and NHS International could serve their needs, for cash.
What do I mean by that?
In the US, a hip replacement can cost as much as $45,000. In the UK, the same operation costs £10,000 ($12,500) — a considerable savings. In the US, a knee replacement costs $50,000. In the UK, the same operation costs £12,000 ($16,000). A triple coronary bypass costs $200,000. In the UK, the same surgery costs £8,500 ($10,000). A facelift can cost as much as $40,000 in the US; £10,000 ($12,500) in the UK.
You get the idea. The UK has an outstanding, world class medical product to sell to the world, but they don’t sell it — yet. If they did, I am willing to bet that thousands and thousands of people in the US (and many other countries) would flock to Britain for its amazing and cutting edge medicine. A commerical branch for the NHS — completely separate from the current free NHS for British nationals, could provide enough money to fund a great deal of the no cost NHS and help to expand and improve it.
When Boris Johnson was campaigning for Brexit, he said that leaving the EU would bring in £350 million a week for the NHS. This, of course, turned out to be pure fiction. But here’s an interesting statistic. In the US last year there were 600,000 knee replacements and 330,000 hip replacements done. And that’s just a tiny fraction of all medical procedures.
Last year, people in the US spent $4.3 trillion on health care. If the UK could snare but 1% of that, that would be $43 billion in new revenue.
I think you could easily hit and surpass Boris’ fictional £350m a week and this one is real. And this does not even include the revenue from medical tourism — airfares, hotels, families accompanying the patient and so on.
Of course, to make this work, the government would have to make a substantial capital investment in the NHS — more doctors, more hospitals, more facilities — but this would be a one time investment that would pay off for many years to come. It’s a much better investment than building a new aircraft carrier or the astronomical cost of the fast train service from London to Birminham. This investment would show real returns for years to come.
As the population of the US and other western countries gets older and older, medical care will become a huge business. The UK should be at the cutting edge of this relatively new business. Continuing to provide free universal health care to all UK citizens is a given. This could pay not just for the existing NHS but help to greatly expand the service and pay UK medical professionals what they deserve.