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How It Works. Britain's new social security plan requires everyone to pay for health insurance, but nobody, doctor or patient, has to sign up for the health service. Any Briton who wants free medical care for his tax money simply goes to a doctor of his own choosing. The doctor may turn him away for good & sufficient reasons (e.g., the doctor is too busy). But generally, the applicant is put on the doctor's permanent list of patients. Thereafter, the doctor is obliged by law to treat him any time, and for any length of time, free of charge.
If the treatment requires medicine, the doctor writes a chit for anything from aspirin to penicillin. The druggist hands over the medicine and passes on the chit to the government, which pays him. If the patient needs spectacles, a truss or any other medical appliance, the doctor signs another chit. If in the doctor's opinion a case requires the attention of a specialist, he will present the patient with a list of specialists from which to choose one. If necessary, the doctor also arranges for hospitalization. The plan even provides for domestic help for people too ill to run their own households.
Any patient who does not like his doctor can sign up with another one. If a Briton does not like the idea of "free" treatment and has money to spare, he can ask for private treatment from any doctor who has time and inclination to give it.
How Much Does It Cost? Britons pay nothing directly to the health service. They make a weekly payment (deducted from their salary) which covers all social security, including unemployment insurance, old-age pensions, funeral benefits, etc. For employed men over 18, the weekly contribution is 4 shillings 11 pence (98¢); for women over 18, 3 shillings 10 pence (70¢).
This is not the whole bill. The British government now takes, in taxes, almost one-third of the income of the nation. A full quarter of the government income (8.25% of the national income) goes to social service, including the medical plan. The medical plan itself costs about $1 billion a year, of which over $800 million is paid out of taxes. In last month's House of Commons debate, Bevan disclosed that his estimates for the first year had been £58 million lower than the actual costs. More doctors, more health centers are needed. For some years, at least, the cost of Britain's medical service seems certain to increase.
Can Britain afford this burden of social service? British leaders, looking at both the budget and the health of the people, ask the questions familiar to every man who has ever confronted an insurance salesman: How much can I afford to carry? How much can I afford not to carry? In Britain, the Labor government's answer is: carry all you need.
The staggering bill for such social services is, in the last analysis, a charge on industry. The cost raises the cost of Britain's export products. As the sellers' market comes to an end, the British may find that the cost of social services has helped to price them out of their chance of economic recovery. On both the credit and the debit side of the ledger, socialized medicine essentially means more medicine —more benefits and a bigger bill.