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nationalized health care it's a bit of a conversation starter your opinion on those two words will likely depend on where you're from and we can probably simplify things further by saying whether you were born in the united states or not the fuhrer that surrounded the affordable health care act otherwise known as obamacare which came into being in 2010 highlighted just how divided americans are on such an issue but for the rest of the world it's simply business as usual while national healthcare is one step short of full-blown communism to many americans in many areas of the world it remains a cherished important part of society and there is no clearer example of this than with the united kingdom and its national health service it's like yeah i'm pretty far away from being a communist but i'm grateful that you know of healthcare if we could move back to the days before covert 19 and ask the uk's general public about their opinion on the nhs you'd likely receive two responses in one the first would be a general grumble regarding budget cuts and waiting lists but this would invariably be followed by a staunch defense of an ideal that even though it's faced difficult times has been a foundation of the nation since its inception in 1948. if you grew up in the uk like i did you've almost certainly come into contact with the nhs and its legion of workers who believe me they're not in medicine for money the coveted 19 crisis has added yet another layer to this complex story as those workers suddenly found themselves in the trenches in the early struggles as the pandemics swept across the country the idea of health care and how we pay for it has never been in sharper focus before we dive in with regard to the nhs it's perhaps important to first highlight the differences between these two different styles of healthcare this is a highly contentious issue with supporters of both sides struggling to see the benefits of the other but of course each system must have some redeeming qualities otherwise they simply wouldn't exist as i previously mentioned the usa is the only developed nation to still predominantly use private health care the aca may have shifted things a bit but in reality it's still a million miles from full universal health care so well what's the difference and why do people prefer one or the other universal health care means that everybody has access to medical coverage which is paid through taxes while private health care is paid for by individuals or their insurance policies countries with universal healthcare typically have some sort of private healthcare market should residents want broader coverage faster access to care or benefits that a private marketplace can provide the benefits of universal healthcare include lower overall costs especially with the price of prescription drugs and administration costs in theory this should also cut out unnecessary spending but in the wrong hands this could morph into cutting corners on the flip side universal healthcare often sees longer wait times for both seeing a doctor and outright surgical procedures healthcare budgets can sometimes balloon out of control and with a steadily aging population it's not entirely clear how this is going to work in the future like any kind of socialized initiative it also faces the argument of why healthy people should have to pay for other people's medical costs private healthcare typically does provide an excellent standard of care as long as you can afford it many of the best doctors in the world work in the u.s system which often attracts both wealthy foreign nationals and brits or canadians disillusioned with long wait times current data suggests that the average monthly cost of u.s medical insurance is north of 400 while that number might leave european citizens gasping in shock it is worth pointing out that american tax rates are often much lower than they are in europe so while you're paying insurance premiums each month you're paying less taxes generally private healthcare also gives you greater choice of care and access to a wider range of treatments and drugs cost is the quite obvious negative to privatized health care systems if you can afford it it's certainly great but many people can't which is a proposition that's further complicated by american tendencies to tie health insurance to full-time jobs for those that can't afford it and don't have a job that provides health insurance health care can become very difficult indeed the average cost of the non-surgical treatment of a broken arm or leg is about 2 500 it's currently estimated that between 25 and 30 million americans don't have insurance and around 75 million people receive medicaid a government-run plan to provide basic medical coverage to low-income families pregnant women the elderly and people with disabilities now things would be quite straightforward if private healthcare could guarantee better care but unfortunately that's just not the case at the moment the u.s spends more on health care per capita than any other country in the world and by a pretty wide margin ing to the world health organization american health care costs come to 10 246 dollars per capita while in the uk france germany and many other peer nations they report figures that are less than 5 000 per capita and as i said the extra spending doesn't translate to greater health in terms of life expectancy the u.s ranks 44th in the world just below cuba the uk sits slightly higher at 29th position with hong kong and japan leading the way the u.s also has a child mortality rate of roughly 5.6 per thousand births ing to the who which is almost twice as much as countries like australia germany and singapore this is a debate that still has plenty of distance to it and one that is probably not going to go away anytime soon but let's set this aside for the moment now that you've got some context on nationalized versus private let's take a look at the uk's national health service [Music] while britain emerged victorious from world war ii it did so as a shattered nation cities lay in ruin thousands were homeless and the rationing of food was to go on until 1954. winston churchill and his conservative party were booted out to power in the 1945 general election as the labour party swept into 10 downing street the controversial novel the citadel written by aj cronin and released in 1937 was an early touchstone to highlight the glaring drawbacks of britain's healthcare system before the war many of the ideas in the novel would eventually be incorporated by the labour party in the creation of the nhs but this was just one of many reports papers and books that had appeared since the start of the century which called into question britain's way of handling its health healthcare but the uk had already caught a glimpse of what national healthcare might look like during the dark days of the second world war the emergency hospital service had been established in 1939 to provide health care to the victims of war with 2 378 hospitals included and 68 000 beds provided in just london alone now this was by no means the sort of comprehensive coverage that we see today as it was very much a loose collaboration of hospitals and healthcare professionals sharing resources now fortunately the number of those who were injured during the bombing raids was actually lower than expected but the ehs still provided a level of health care that just didn't really exist before the war got started as the fighting ended things reverted to normal britain's 2 700 hospitals at the time were either run by charities or local councils and only those with certain jobs were provided with free health care the nhs was officially formed on the 5th of july 1948 at park hospital in manchester but came after years and years of hard work now i should add that while there was a change of government in 1945 winston churchill's party leaving the previous conservative government had laid much of the foundations for the nhs on this summer day in 1948 hospitals across the land doctors nurses dentists opticians and pharmacists all began working together for the first time when it launched the nhs came with three core principles one that it meets the needs of everyone two that it be free at the point of delivery and three that it is based on clinical need not ability to pay in reality things have started even before then and by day one an estimated 94 percent of the british population were already signed up for the service now it's easy to recall the national pride that the service eventually became but the truth was it faced severe criticism in the lead up to the 5th of july the main doctors union the british medical association were vehemently against the idea right up until its launch along with sizable portions of both the labor and conservative parties most of the misgivings came down to the belief that local councillors were more adept at running local healthcare services than the giant overlord that was the country's central government one memorable quote came from the extremely rich and privileged lord hoarder who famously proclaimed to the society of individualists in 1948 and yes that is the real name of a society if medicine were taken over by the state it would be as disastrous as the domination by the church in the middle ages a greater disaster because the church was cultured and yes that's also a real quote apparently but while some remained against it they could not prevent the momentous events in 1948. on the 5th of july a young girl by the name of sylvia beckingham was admitted to hospital in manchester to receive treatment for liver problems no doubt the young 13 year old had absolutely no idea of quite the importance attached to a visit to the hospital that day but sylvia buckingham became the first person to ever be treated by the new nhs [Music] and so began the nhs's bumpy ride to its current position its first year budget was recorded at 437 million pounds roughly 15 billion pounds today and while it must have been a huge relief to millions the complexities that came with balancing the books meant that it soon ran into financial difficulties in the first few years spending quickly overshot what was being predicted with prime minister adley even going on the radio to plead with the nation not to overuse their fledgling service unless they really needed it there's still some debate about the cause of the problems in these early years if you want to take the hard-line and somewhat classist opinion you would say that the poor began stripping pharmacy shelves and filling their mouths with fillings that they didn't really need alternatively and perhaps slightly more logically was that of course cost skyrocketed because a huge percentage of the population had never got anywhere near having such options with so many people living without the correct glasses a mouthful of mangled teeth or health conditions that weren't life-threatening you begin to see why the initial years saw such a big surge in the early 1950s prescription charges were brought in although they remained low at one shilling per prescription that's about one pound fifty today like most countries tend to do the uk sea sword back and forth between a conservative and a labor government over the coming decades as the conservative party gained control in the 1950s it faced a difficult decision ideologically they were opposed to the nhs but the service remained hugely popular across the country a committee was commissioned to see whether this was the best form of health care the resounding answer was that yes it was and the nhs remains mostly untouched over the years the nhs has seen its fair share of ups and downs that 1960s was relatively prosperous periods but with health care costs soaring it once again ran into difficulties during the 1980s not least in the shape of the formidable margaret thatcher but again even though the iron lady and her government may have been ideologically opposed to such a system they refrained from making any sizable changes to begin with she even made the famous statement in 1982 that the nhs was safe in our hands but things slowly began to change firstly with management processes but by the end of the decade with costs reaching uncomfortable levels the thatcher government introduced the internal market which split the purchaser from the provider to encourage competition and increase efficiency in a nutshell this meant moving slightly further towards the american model in which hospitals could compete with one another and receive greater rewards for their work known as payment by results tony blair swept to power in the 1990s promising to scrap the internal market something he never did while the first two decades of the 21st century have seen massive increases in health care costs coupled with one crippling recession and another one playing out as we make this video and that's before we even get to covert 19. the life of free universal healthcare apparently is never an easy one since devolution in 1999 the process which transferred much of the power from the main government to smaller regional governments the nhs has become subdivided into four home nations so you have nhs england nhs scotland nhs wales and nhs northern ireland with each operating in a slightly different way all offer the same basic services but the biggest differences come with prescriptions scotland and wales offer free prescriptions while in england and northern ireland they have a means-tested charge scotland offers free social care service to over 65s while the rest of the uk does not from the top of each of these organizations they are subdivided below based on geographical areas if we take nhs england as an example these are known as clinical commissioning groups ccgs from there various organizations below it provide a wide variety of care but all fall under this same umbrella these include acute trusts which provide secondary care within the nhs treatment centers the ambulance service trust nhs care trust which provides both health and social care and the mental health trust slightly outside of this lies the nhs pharmacies dentists and opticians while the names might change slightly the same rough structure is used all across the uk the nhs is currently the fifth largest employer on the planet with a staff of roughly 1.4 million if you're interested and i imagine you are the u.s department of defense the chinese army walmart and mcdonald's all plays higher it draws this number from far and wide and in 2019 13.4 percent of nhs workers were from outside of britain while the number of doctors was 28.4 percent for the fiscal year 2018-2019 the nhs budget was a hefty 129 billion pounds and that is a number that is only going one way spoiler alert is not down it's difficult to give any accurate figures right now because of the coveted 19 pandemic but even if that hadn't happened the budget would have likely grown by a minimum of 5 billion pounds the vast majority of funding for the nhs comes from general taxation with a small additional amount made from national insurance contributions which every adult in the uk pays one benefit of the system is that there is next to no billing which saves enormously on administration costs to the british people the nhs is both a source of frustration and also immense pride is a service that has gone through some truly difficult times over the years but it's always managed to battle through the covert 19 pandemic has shone a light on the nhs probably more than ever in recent years but while it has remained relatively stable it has highlighted huge deficiencies that have come from years of underfunding maybe we've all taken this grand old lady who reached 70 in 2018 for granted it's difficult to say where we go from this point logically you would say that the nhs will receive a massive spending boost that it deserves and we can all happily continue as normal but that will most likely depend on how deep a recession the uk lands in post-pandemic you would think that health care would be prioritized after the biggest health care crisis of the modern era but who knows when business and money become involved sometimes the less viable more expensive options get missed which is exactly what has happened to the nhs over the years as if this wasn't difficult enough the nhs will also need to grapple with the booming cost of medicine and as in many parts of the world an aging population currently 18 of the uk's population is over 65 with that number expected to rise to just over a quarter in the coming decades we're living longer than ever which is great news but it does come with an economic conundrum whatever you might think about universal healthcare and an organization like the nhs it's difficult to detract from the 1.4 million people who currently work for it from the doctors and nurses to home care workers and rehabilitation specialists these people have not entered medicine for the riches but instead chose to work for an organization that though it may be deeply flawed at times stands for an ideal that the british remain proud of the medicine should and must be free to all so i really hope that you enjoyed that video no matter what your opinion on the subject we hope to cover what the nhs was rather than be too divisive if you did enjoy it please do hit that thumbs up button below don't forget to subscribe also if you've got a suggestion for a future mega projects video please do leave it in the comments below and as always thank you for watching you