How, indeed. Perhaps the first principle in answering this query is to point out, briefly, how healthcare systems are judged and ranked. This is done in multiple ways: Ease of access; waiting times; quality of each encounter, this itself is comprised of multiple measures; safety, again comprised of multiple measures; breadth of services provided; satisfaction of patients, physicians, nurses and other health workers; costs (not charges) of the system overall and whether individual patients have out-of-pocket expenses. All of these measures are used to measure one health system against another. In one of the more recent evaluations of 11 health systems in economically advanced countries, the UK system was ranked number one; the system in the US – one in which, I must say, I have spent my life working – is ranked #11 of 11.

This ranking was a part of a 2014 update of a study by Davis and colleagues sponsored by the Commonwealth Fund (Mirror, Mirror on the Wall – How the Performance of the U.S. Health Care System Compares Internationally). If you read the British Press, as I try to do, you will be aware that the UK National Health System is under severe strain now, primarily related to the under-funding of the NHS by multiple Conservative Governments as well as attempts by the present Government of Boris Johnson to privatize parts of the NHS. So these rankings may have changed in the past few years. But the central point is that it is these metrics that allow the British to make such a – true – claim. Through analysis of multiple of the metrics of what makes a health system better or worse, the British NHS is better than is ours in the US. While I am aware of many of the arguments in opposition, Medicare for All is a step in the right direction to help correct this.