Last month, the Commonwealth Fund, a private foundation that supports health care research, released a report calling England’s National Health Service the best health care system in the world. The Guardian duly relayed the good news, noting in all sincerity that “the only serious black mark against the NHS was its poor record on keeping people alive.” Count this another black mark: As the Telegraph reports, its fiscal outlook is dire indeed:
To see the awful truth, look no further than the Office for Budget Responsibility’s annual “Fiscal Sustainability Report”, published yesterday. On present trends, the OBR concludes, healthcare spending will rise from 6.4 per cent of GDP in 2018/19 to 8.5 per cent 45 years into the future. This might not seem so bad, given the demographic pressures. Unfortunately, the OBR’s estimate relies on some fairly heroic assumptions about the scope for productivity improvement. […]The OBR assumes that productivity gain in the NHS will match the long-term trend of 2.2 per cent for the economy as a whole. If it does, it will be a medical miracle tantamount to raising the dead. Productivity gains in health care are traditionally less than half that. If this poorer rate is applied, the OBR admits, you get a much more alarming public healthcare spend of nearly 15 per cent of GDP 50 years from now.
This is not to absolve the U.S. health care system of its many failings. Our long-term projections for health-care solvency don’t look so great either. But it’s worth noting that a single-payer system isn’t a catch-all solution to the overarching health care cost crisis. Fortunately, the United States and other developing countries are now seeing the point of bankruptcy recede just a little bit further into the horizon thanks to advances in technology and improved service delivery. Thanks to those developments, we’re still going bankrupt, but we’re doing so more slowly. That, not rate control, deserves greater attention.