ABSTRACT
Established in 1948 as part of a wave of social welfare legislation after World War II, 1 the British National Health Service (NHS) is the world’s largest taxpayer-funded, single-payer health service. It delivers more than 87% of the country’s health care and spends about 8.4% of the country’s gross domestic product, half as much as in the (slightly more affl uent) United States. In the United States in 2005, the fi gure was 15% and the public fraction (Medicare and Medicaid) just 5%. 2 By these measures, the U.K. system is much more socialized than ours. Yet the Brits and other European nations spend much more time worrying about health economics and how to align economic incentives with health-care outcomes than we do in the United States. It’s hard to get a precise fi gure, but there are many university centers for health economics in the United Kingdom, and almost none in the United States, a country about six times as populous. A Google search in 2009 for “health care economics U.S.” yielded “about 17,900,000 results,” a large number, it would seem-until you do the same thing for “health care economics U.K.” and get “about 131,000,000 results.” In the study of health-care economics, at least, the United States seems to be lagging well behind.
