Technology

Andrew Sullivan says Brits expect bad healthcare. Is he wrong?

December 07, 2008
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This debate caught my eye. Do Brits expect bad healthcare?

Ezra Klein says: "About a quarter of Britons are satisfied with their health care system. Less than a fifth of Americans can say the same. Similarly, a mere 15 per cent of Britons want to dynamite the awful beast and start over. More than a third -- a third! -- of Americans feel the same way. Indeed, none of the socialised systems have even half as many of their residents calling for a totally new direction. Germany, where a robust 26 per cent want to start over, is the least nationalised of the lot, using semi-private insurance pools known as "sickness funds," and sure enough, they're the system that's closest to ours on total dissatisfaction. I guess you could say that private health care sounds like a great idea unless you live under it." Andrew Sullivan replies : "Satisfaction is a subjective function of subjective expectations. If you have the kind of expectations that many Brits have for their healthcare system, it is not hard to feel satisfied. The Brits are very happy with their dentists as well. And there is a cultural aspect here - Brits simply believe suffering is an important part of life, especially through ill health. Going to the doctor is often viewed as a moral failure, a sign of weakness. This is a cultural function of decades of conditioning that success is morally problematic and that translating that success into better health is morally inexcusable. But if most Americans with insurance had to live under the NHS for a day, there would be a revolution. It was one of my first epiphanies about most Americans: they believe in demanding and expecting the best from healthcare, not enduring and surviving the worst, because it is their collective obligation. Ah, I thought. This is how free people think and act. Which, for much of the left, is, of course, the problem."

My sense is Sullivan that is missing something here, even if his subjective expectations point must be right in theory. We at Prospect are in the middle of our mad publishing cycle, and we go to press on Tuesday night. So I plan to return to this then. In the meantime, let us know whether you think Sullivan, or Klein, is right.