- Hollis Johnson/Insider
- Adam Kay used to work for the National Health Service (NHS), the UK’s national healthcare system.
- Now a comedian, he’s written a bestselling book about his time working as a baby-delivering doctor, called “This Is Going to Hurt.”
- He said the NHS wasn’t a perfect place to work, but that it far outperforms the US health system, where healthcare isn’t “free at the point of service” and is not always considered a “human right.”
- “I feel like America’s been gaslit about what the NHS is,” Kay told Insider. “There are no death squads, there is no rationing.”
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Any way you slice it, healthcare in the US is expensive. It doesn’t have stellar results, either.
In the US, life expectancy is tumbling (now just shy of 79 years), while infant mortality remains high when stacked up against other rich countries. If you ask, most Americans will tell you they’ve avoided medical care at some point because it costs too much.
British writer, comedian, and former obstetrician Adam Kay says there’s another way. He grew up in the UK, where he says he never paid a single medical bill for care. Instead, a national health service (the NHS) has been guaranteed for all Brits, free of charge, for over 70 years.
“It’s our closest thing, I think, to a national religion,” Kay, the author of the bestselling book “This is Going to Hurt,” told Insider. “The NHS was set up on the basis that it’s free at the point of service, and it’s based on clinical need, not on bank balance.”
This is not to say that the NHS is perfect, but patient outcomes on the national healthcare plan are generally good, while administration and drug costs are far lower than in the US. Most importantly, no one goes without needed care because they are scared to even try to guess what the price tag may be.
“I feel like America’s been gaslit about what the NHS is,” Kay said. “There are no death squads. There is no rationing.”
Gaslighting is the practice of using psychological manipulation to make someone doubt their own sanity, or their perception of reality. Kay says when it comes to the US health system, it’s pretty clear who’s doing it.
A “very rich,” “very powerful” lobby is gaslighting the US, Kay said
“I suspect a lot of this is coming from a very powerful, very rich lobby who’ve got significant skin in the game, and don’t want any of this touched at all in case their bottom line is affected,” Kay said of the US, where roughly 1 in every 5 dollars is spent on healthcare. “I speak to hugely intelligent people over here who’ve just been slightly brainwashed into the idea that healthcare is just rationed [in the UK] and you can’t get [what you want]- this is the country where you can’t get what you want!”
“You should never have to sell your house because you got ill,” Kay said. “You should never, ever have to say, ‘I can’t afford this medical treatment I need.’ I’ve just grown up in an environment where it’s effectively a human right. You get the healthcare you need.”
People wait to see a doctor in the UK, but the same is true in the US, where some people don’t seek help at all
The NHS has plenty of problems, especially in the winter months. Every year during flu season, wait times for everything from cancer screenings to routine general practitioner appointments mount, as doctors work long hours to deal with the increased demand.
For about a decade now, the NHS has been underfunded, a trend that Prime Minister Boris Johnson promised to reverse last week, when he was re-elected. Because the British system runs like an emergency room and prioritizes people based on need, there are about 4.4 million people waiting for care on the NHS, for an average of about two months apiece. There are also staffing shortages for nurses, doctors, and other medical workers.
Still, none of this is actually worse than how things are going in the US system, where there’s also a growing doctor shortage.
Many people don’t even bother to wait the weeks or months it might take to get an appointment in the US. More than half of Americans have delayed medical care because they couldn’t afford it. Even some with insurance are financially crippled by annual deductibles that soar into thousands of dollars.
Once the appointments and procedures are over, there’s the medical debt. It is the most common kind of debt in the US, affecting Americans of all ages and income brackets. It pounds the credit ratings of roughly 20% of US consumers, according to the Consumer Financial Protection Bureau. It’s also a top reason that people get denied mortgages for a home, Bloomberg recently reported.
“People make decisions about what job to take based on what the health plan’s like,” Kay said of the US system. “That’s just not a thing back home. You just know that if you get sick, if your grandmother gets sick, if your kid gets sick, you just take them to the hospital, it’s free, and they get sorted out.”
Some Americans want to overhaul the current healthcare system
Though Kay says the US has clearly “got this wrong” when it comes to healthcare, he readily admits that he doesn’t have any simple fixes for transforming the US health system.
“It’s a big change from where you are now,” the writer said of national care. “I don’t know what the baby step is that would be easy to achieve that could be a proof of concept.”
Not all Americans are opposed to overhauling the current system. A 2018 Reuters poll of nearly 3,000 people across the US found that the overwhelming majority of respondents supported the idea of a “Medicare for All” plan, including more than 50% of Republicans and nearly 85% of Democrats.
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