The British system is probably the most instructive example for Americans to evaluate because of the similarities in economy and government structure between the two nations. According to the NHS Web site, the system “was set up on the 5th July 1948 to provide healthcare for all citizens, based on need, not the ability to pay” (National Health Service 2007). Originally conceived as a response to the massive casualties of World War II (1939–1945), the system survives and continues to evolve in the early twenty-first century. The NHS is funded by taxpayers and managed by the Department of Health, which sets overall policy on health issues. Individual patients are assigned a primary care center (with doctors, dentists, optician, pharmacist, and a walk-in center) managed by a primary care trust (PCT). The NHS explains its system of referrals this way: “If a health problem cannot be sorted out through primary care, or there is an emergency, the next stop is hospital. If you need hospital treatment, a general practitioner will normally arrange it for you” (National Health Service 2007).
The PCTs are responsible for planning secondary care. They look at the health needs of the local community and develop plans to set priorities locally. They then decide which secondary care services to commission to meet people’s needs and work closely with the providers of the secondary care services to agree about delivering those services.
The NHS may be the world’s most sophisticated socialized medical system, but the modern world’s first such system was established by the former Soviet Union in the 1920s. Whereas the NHS demonstrates that socialized medicine can exist within a capitalist economy, the failures of Soviet medicine demonstrated how corruption within a society can distort any system. China, Cuba, Sweden, and most of Scandinavia have successful and completely socialized health care systems.
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