As the United States embarks on an overhaul of its health care system, Britain's government-run system is showing signs of age.
Typically, when people need health care in the U.K., they visit general practitioners, who serve as gatekeepers who will either treat patients directly or refer them elsewhere, depending on the diagnosis. Because doctors are on salary and typically aren’t very worried about the threat of lawsuits, they have little incentive to order tests that may prove unnecessary. In 2010, just 41 MRIs and 77 CT scans were performed per 1,000 people in the U.K., according to OECD data, compared with 98 MRIs and 265 CT scans per 1,000 in the U.S.
The drawback of such an approach is that because the system prides itself on creating equity by putting the needs of society as whole ahead of any given patient, it means that the needs of individuals often get lost in a sea of managers, administrative targets and rationing decisions.
“The individual is essentially a supplicant,” said Philip Booth, program director at the Institute of Economic Affairs, a free market think tank in London. “He's irrelevant to the whole system as far as the National Health Service is concerned.”