The United States government spends substantially more per capita on healthcare than the UK (a number which, to be clear, excludes people's private spending and if anything understates things because it doesn't include the cost of tax breaks for employer plans), but fails to guarantee healthcare to everyone and has developed an underclass of people who have substantially worse healthcare than many second world countries.

The UK system is, in many ways, unique, in that it's severely underfunded but gets outstanding bang for buck. I wouldn't recommend it here, because I'd be pretty skeptical we could transplant the necessary consensus political support and willingness to say no to stupid treatments.

I broke my collarbone (clavicle, whatever) snowboarding - I go to see an orthopedic surgeon, or rather I go to the local hospital's orthopedic department and see somebody who I assume is a surgeon (he was in fact an MRCS) who tells me, "Collarbones heal on their own just fine in about 95% of cases" - my response - "According to this very out of focus x-ray I was given in France, my collarbone is in a gazillion pieces - maybe I'm in the 5%" - to which he replies - "Collarbones heal on their own just fine in about 95% of cases, I can write you a sick note".

My nephew, my brother's child, was born with what at the time was assumed to be a hole in the heart but which later turned out to be a particularly obnoxious genetic disorder (CHARGE), my brother and his partner lived in a central London hospital for six months while their son lived on life support and underwent open heart surgery. He will need a fairly high level of medical support his entire life, the cost to his parents $0 - in the US this could bankrupt an extended family.

Perhaps my point about not doing stupid treatments was badly phrased, though: your collarbone example is one such treatment, and stupid isn't exactly the right word. Humans seem to have this inborn tendency to always overestimate the effects of medical care. The USA healthcare system thrives on that impulse: if there's any procedure at all that could conceivably do something and you can afford health insurance, you get it, from a full array of pointless tests to highly invasive surgery.

In the UK, the system seems to work on the opposite assumption: because every cent spent on healthcare is a cent that the government doesn't have access to, it vigorously refuses treatments if at all possible. Hence, your collarbone example: most collarbones (apparently) heal easily enough on their own, so it's cheaper to assume it will and treat it later than it is to treat all of them to the maximum extent possible. "Death panel" is fairly histrionic, but it does have some validity to it. The issue is that if we want to get the American system's spiraling costs out of control, we need to recognize it doesn't have enough death panels (i.e. a willingness to say, no, it's better to give half-assed or no treatment here and perhaps sacrifice some level of well-being in order to save a couple bucks).

I personally believe that people place way too much faith in the ability of medical science to perfect outcomes, and that much of what we do amounts to modern voodoo. So I tend toward thinking that doing the minimum treatment that can be justified is the better way to go.

I know it may sound pedantic to argue over little words like that, but I think people's lack of understanding around basic economics contributes to the problems we have. Promoting the notion that healthcare can somehow be "free" does little to fix the problems we see in our current system here in the US.

Sort of, but not exactly. I was implying that a household with that income would be making close to a median contribution to the tax base so, purely in my own opinion, would be paying a "fair share" in absolute terms. That is, they should not be either highly subsidized or a major contributor. But.. let's run the numbers to see if my hunch is wrong! :-)

Said household would have a gross income of £30000, pay £4505 in income taxes, pay £2732 in "national insurance" (ostensibly to fund social security, sick pay, and various benefits), and be left with £22,762, or 75.9% of pre-tax income.

(A "hidden" part to this is that (most) employers also make employer "national insurance" contributions, in this case of £3164 so it could be argued this is a hidden salary cost for employees.)

The total NHS budget in 2008/2009 was £94bn and there are around 25 million households in the UK. This gives an expense of £3760 per household or 36% of the total earned in direct taxation on our imagined household. This is double the percentage of the national budget dedicated to health, so my initial assumption may have been wrong.

However, with indirect taxation, especially VAT at 20% and high fuel duties, and subtracting the contribution of things like corporation taxes to the tax base, the total tax paid vs the absolute "fair share" is likely to come pretty close for this family.

Sorry if this is boring but I was intrigued and thought I'd look into it! :-)

I get the distinct impression that taxes in the UK are just thrown into one big pot anyway so NI contributions are just another general tax.

Technically NICs are for the social security system generally, including most major benefits, state pension, unemployment, and sick pay. On their own they couldn't be able to fund all of this plus the health service (I don't have the numbers but I'd be surprised if they could even fund just the health service).

I get the distinct impression that taxes in the UK are just thrown into one big pot anyway so NI contributions are just another general tax.

Essentially, yes. The government has been considering merging the two into a new, higher income tax in recent years.