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periodic commentary and analysis on news items from a worldview perspective

 previous issue                                          issue #19,  posted 6 / 25 / 2011                       archive of all  issues

 Health Care, Religion, Beliefs, Attitudes--US vs. UK

in the news: The June 18 2011 print edition of The Economist contains much on Britain's National Health Service, including the remark, "NHS veterans repeated the old saw that the NHS is the closest thing Britain has to a national religion."   A few days later Gallup released well being survey results from which they conclude, "Low-income Britons have worse wellbeing and are in poorer physical health than their high-income counterparts, despite universal access to healthcare."  And in the US, Fox News' America Live ran a seven minute segment on President Obama's health care reform record, eliciting the charge from the non profit watch dog group Media Matters that it "featured a deluge of falsehoods and distortions". Against a backdrop of British satisfaction with the NHS at an all time high and continued controversy in the US over health care reform legislation passed last year, I  think a comparison of US vs. British related data and measures of beliefs/attitudes can provide a starting point for discussion.   

commentary and analysis (by Stephen P. Cook, founder and manager, project Worldview, www.projectworldview.org):  The table below provides a numerical summary of health care stats of interest.

What does the dramatically greater US health care per capita expenditure buy? Inspection of these data suggests that it buys affluent Americans a slightly greater feeling of well being than their British counterparts.  On the contrary, health-wise, it's much tougher to be poor in America than in Britain. The much larger gap in low income well being vs. high income well being in America vs. Britain undoubtedly says something about how each country looks after its poor in terms of state-supported social services.  And certainly no one in America can argue that any social welfare state type program  resembles a "national religion"!

What differences in American and British worldviews might explain the above?  Certainly a greater % of Britains than Americans are comfortable with Social Welfare Statism (worldview theme #49a). And it seems the British are less willing to tolerate income inequality than Americans.  A recent World Values Survey asked people what they felt about income inequality^. The responses could range from 1 (incomes should be made more equal) to 10 (we need larger income differences as incentives). While the mean response value in the U.S. was the highest (ave score ~6.3) among the participating countries, the average score in Britain was significantly lower: (ave score ~5.5) ranking it #8 of the 13 countries polled. Though it has declined in the last two decades, a still significant 36% of Brits surveyed in late 2010 backed policies to redistribute income from rich to poor. 

Worldview differences in religion and morality between the US and UK are even more telling--starting with Belief in a Personal God (theme #8b).  A 2004 BBC survey found only 9% of Americans not believing in God, compared to a large  44% of Britains! Another survey documented a striking difference in conceptions of morality between the two populations.  When asked, in a Pew Research Center Global Attitudes Project survey in 2007, "Is it necessary to believe in God to be moral?" 57% of Americans answered yes, versus only 22% of Brits. Try connecting these data with the morality of such questions as "Is it right for hospitals and insurance company executives to deny service to those clearly in need but lacking health insurance?" It's tough!  Could it be that the land of Adam Smith, the intellectual father of laissez faire capitalism, has turned its back on Economic Individualism (worldview theme #19) more so than its onetime colony? Or perhaps the invisible hand working for the common good in terms of access to health care is just not operating very well in America?  

As far as the NHS being "the closest thing Britain has to a national religion" the data make more sense. Hundreds of years ago--say when the King James version of the Bible was published 400 years ago in 1611--the Church of England filled  that role. Today, according to the Church of England, average Sunday church attendance has dipped to approximately one million, or just 4% of the country's supposedly still rather large Anglican population.  In contrast to Britain, where less than 20% attend weekly religious services, according to 2007 data from the Pew Forum on Religion and Public Life, close to 40% of US residents attend. I suspect those Americans would overwhelming tell you that theirs is "one nation under God."  Skeptical British among the 64% of them who were either very or quite satisfied with their NHS, might reply, "Perhaps so. But you're still a land of the "haves" and "the have nots" as far as access to health care is concerned!"