As I continue my overview of healthcare systems of other developed countries, it is time to examine the British healthcare system. Yes, it is time to use the “S” word—Socialized Medicine.

In Britain, healthcare is provided through the NHS (National Health Service), a government-run, publicly funded system. The government pays hospitals and doctors directly for services, and patients do not receive any bills from the NHS.

Just like I used the three dimensions of cost, quality and access when assessing the American and French healthcare systems, I will use the same approach here.


Britain spends only 8.3% of its GDP on healthcare, about half what the US spends. Annual healthcare spending per person is $2,723, just above the median for all developed countries. The main reason behind these low costs is that the government does not cover care that is deemed cost-ineffective, such as experimental cancer drugs and some cosmetic surgeries. Some people consider this a good use of resources, while others refer to it as “care rationing.”


In a 2008 study comparing 19 industrialized countries on “amenable mortality,” a measure of deaths that could have been prevented with good health care, Britain came in 16th (meaning it had the 16th highest mortality rate). It's a little bit better than the US that ranked 19th and last, but not really something to brag about.

In an older study ranking all countries on healthcare system efficiency (how effectively governments spend their money on health, how well the public health system prevents illness and how fairly the poor are treated), Britain ranked 18th among 191 countries (the US came 37th). Life expectancy at birth is at 79 years, just above the US but not that much better.


All citizens and legal residents are universally covered by the NHS. Patients have the choice in deciding which physicians to see and which hospitals to go to. Wait times have always been notoriously long. However, they have dropped considerably in the last few years as the government increased the supply of doctors and funding for the NHS, set rigid waiting time targets, and introduced market based reforms.

So all in all, the “socialized” system in Britain does really well on low costs and universal coverage, OK on quality outcomes, and not so well on availability of treatments and waiting times, even though that has been changing lately.