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1 1 (March 1, 2023)

handle is hein.amenin/aeiaenj0001 and id is 1 raw text is: The UK's National Health Se rvice at 75: What Are the Root Causes of the Current Discontent? By James C. Cap retta March 2023 The UK National Hea:t ;ervice (NHS), row in its 75th year, has devcoted supporters inside and outside the country who ad ir its egalitarian ethic and pubic-service orientation. -iovever, the rapid deterioratin oc its perorm iance in recent years, and especialy after the COVID -9 pancem ic, is too glaig and d angerowu to overlook. A najor challenge is the health service's near-exclusive reiarce on poli ical and bureaucratic processes for resourcs and organiza ional ireceion Fr e rat the point of service and pu h Ily owned hospta sustain da NHS s pop- ularity, long wits r or neded care, even when the senvices are free, harm patients. Neither major political ;artvappcars ready to exolor sysernic reforr, :ut if oolitica c ndit create r r cpering, UK leaders migh c nsider noving the NHS Ooser to the pu lic-privat node-s ound in otner European ecornoies, as has been suggested at various points in its histpE y and also recently. The lessor for other c-untries from the NHS's ongc'ing crisis is that fuil governmental control of medical care hrings risks, not ust potential and of.en--overstated rewards. On February 15, i94, with D-Day approachin, Brit- ish Prime MidIister Winston Churchill ci ired a cab- inet meting with. an agenda that went beymom'd te ever-present military and diploma tic concerns, In par- ticular, those in attendance that winter evening wem asked to review for a final time a draft white paper on a planned postwar National Hcalth. Service (N-.{S) (UIK Government Na-inal Archives 1944a). The gov- ernment's decision to proceed witi publication and dissemination of that seminal document cnanged the course mo der British history. Within three years, Parliament had created what became the world's most studied single-payer health system. In early .944, however, nothing was firrly decided. Political support for standing up a national healsh systen had been building for dckade-, and the pub- lie's experence with wartime medic no added to the momentum. Howcverfkey deTi orthe service's design were still being fomrelated. Am ong the major outstand- ing quessions wos the sreatnent 0f the nratioe ' exte:- sive network of voluntary (and privately run) hospitals and private physician practies. The cabine wkas also stiil assembling ;ption for dividing the costs between taxpayers and users of the services. The July j.94 gcneral election effectively settled all the outtstanding questions by handing full power over AMERICAN ENTERPRISE iNSTITUT E

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