10 Health Care Systems Around the World



Thanks to the current health care reform debate, most Americans know Britain as the home of socialized medicine, complete with rationed health care -- in other words, two things that many Americans fear. Both counts are true. Britain has socialized medicine, which means that in addition to paying for all citizens to have insurance, the government also hires and pays the doctors and runs the hospitals. British citizens pay taxes, which the National Health Service (NHS) allocates to providers. When a citizen shows up for an appointment, all services that he or she receives are paid for, with the exception of prescription drugs.

The National Institute for Health and Clinical Excellence (NICE) is an administrative organization charged with evaluating what treatments the NHS will pay for. The organization does this with a fairly precise formula that takes into account how much the treatment will improve a person's life, how long the patient can expect to reap the proposed benefits and the cost of the treatment per year. To put it simply, if this formula yields a cost of more than $45,000 per year, then NICE won't approve it; this $45,000 threshold had been previously established by work done by the British Department of Transport [source: Harrell]. A year of life is deemed valuable for all -- a 12-year-old with his entire life ahead of him won't be judged any differently than a 90-year-old woman.

Some of NICE's decisions have proved controversial, particularly in terms of cancer treatment, which can be quite expensive. Britain does lag behind the U.S. in rates of cancer-related deaths.