They do things differently in the colonies

Jolly old BBC Washington correspondent Matt Frie has droll encounters with the U.S. health care "system."

He gets a toothache, and as his bowler and bumbershoot hang on the rack in the dentist's office, he is given an elaborate presentation describing a two year plan for oral perfection. He passes on the offer, and settles for a root canal. Then he gets a crick in his neck and goes to the chiropractor, who straightens out the kink and then proposes a two year program, at $150 a week, in pursuit of vertebral excellence. Frei stiffens the upper lip and gets on with his life. Then his son notices he is holding the Sunday Times Crossword away from his face so he heads for the optician where he gets prescription glasses. (I buy my old-man glasses at the CVS for $19.95, by the way -- but in many states, that's against the law.) Then his feet start to hurt and he ends up getting bunion surgery. For the next eight weeks he is a certified representative of the Ministry of Silly Walks. I have no idea whether the surgery was necessary, but whatever the merits of the treatment in his case, a lot of Americans get it for largely cosmetic reasons.

Sometimes we hear criticisms of the British National Health Service: that people have to wait several months for elective surgery, and they won't authorize procedures that people who are lucky enough to have insurance routinely get in the U.S. Well, waiting isn't a bad idea. Sometimes problems get better, or after reflection surgery doesn't seem like such a great option after all. And the Brits have an agency, called the National Institute for Health and Clinical Excellence, that actually studies medical procedures and drugs, not just to figure out whether they do anything at all, but whether they are actually worth it. Since they spend half as much on health care as we do, while living longer and being healthier, that's probably not such a bad idea.