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I’ve been avoiding writing about the NHS. Health care, in all its ghastly detail, is so effing boring. And I’ve never been sick in either country. You never really know a system until you’ve depended on it.

But I’m the only one in my circle who has lived with no insurance, and under Blue Cross and under the NHS, so I feel obliged to weigh in. Even if much of my experience of anyone’s healthcare system is as an interested bystander.

First off, the NHS isn’t that bad. The horror stories you read in the Daily Mail — beloved of the Drudge Report — represent the worst failures of the worst doctors in the worst hospitals viewed through the jaundiced lens of a sensationalist media. If you took the worst failures of the worst doctors in the worst hospitals in the US, I’m certain we could match them wrong-kidney for missed-diagnosis. The truth isn’t in the outliers. The NHS is pretty good for most people most of the time. HOWEVER…

The NHS is pretty good, but it’s not quite good enough. The real picture isn’t in individual horror stories, but broader averages. As Theodore Dalrymple says, “Britain’s hospitals have vastly higher rates of methicillin-resistant Staphylococcus aureus (a measurement of the cleanliness of hospitals) than those of any other European country; and survival rates from cancer and cardiovascular disease are the lowest in the western world, and lower even than among the worst-off Americans.” (Incidentally, Theodore Dalrymple — AKA Anthony Daniels, MD — is a god. Google him and read all 92,500 hits. Do it now, Mister!).

They aren’t actually proposing an NHS, so comparisons aren’t all that meaningful. Not all government-run health systems are the same; some work better than others. The NHS was a bottom-up restructuring of public health, for better or worse. What Washington hopes to do is impose a bunch of new bureaucracy on an existing public system. It’s less “reform” than a controlled demolition. Like being nibbled to death by ducks.

The current US system is already a de facto universal solution. The old have Medicare, the poor have Medicaid, the rich live like kings amongst us and most of the rest have insurance through work. As armybrat and Bob touch on in the comments to the previous thread, nobody gets turned away for acute care, regardless of their ability to pay (which is one reason the system is so expensive).

So the main problem we have is middle class people who are uninsured (or underinsured) and have an unexpected or pre-existing serious, chronic medical problem. How many people are in that spot? I don’t know, but it sure as HELL isn’t 47 million. And fixing it sure as HELL isn’t worth completely shattering what we have now.

Because the US has the best medical care in the world. We get hammered all the time with how “broken” our system is. It isn’t. We have fabulous medical care — innovative, experimental, enthusiastic and scientific as shit. It’s just that not everyone has sufficient access to it. That’s a much narrower problem than the one Washington wants to “solve”.

Theres a lot more to public health care, of course. The cost of our existing programs, necessary taxes, more intrusion in our private lives, “death panels”, malpractice law, illegals in the system. But I’ve already bored myself stiff. And I’d really rather spend my time Photoshopping Obama’s head where no Obama’s head has gone before.