The proposals in the US at the moment seem to be ranging between extension of a non-exclusionary scheme like Medicare to anyone that wants it on the one hand and public health co-operatives on the other. Whether that would be a single co-operative for the US, one for each state or many more remains to be seen.
It is clear that what is not being proposed is the American Health Service. In the former case above, the state commissions a lot of healthcare; in the latter case, co-ops pool risk, presumably remaining competitive even if they have to take everyone because they don’t have to make a profit. Neither of these cases has the key feature of the state actually owning the hospitals and employing the doctors (although Medicare does pay for the bulk of residency training in the US).
According to the 1951 Census, the population of England & Wales was 43,744,924 while the population of Scotland was ~ 5,100,000 according to the GRO*. In other words, when the NHS was set up, the population was just south of fifty millions, the great bulk of whom were covered under the National Registration Act 1939. The Labour government had a strong majority in Parliament, a charismatic advocate in Nye Bevan and a mandate for action. Plenty of people from all sides of the political spectrum supported implementing the Beveridge Report in some form (though not as comprehensively as the NHS would be).
The US population today (according to the US Census Office’s Population Clock ) is 307,196,354. That’s six times larger and spread over fifty polities that have differing healthcare systems. Moreover, the design of the US constitution makes it very hard to implement big changes and Obama is not providing the leadership on the issue that one might want.
I believe it was Nye Bevan who said that he thought Britain should remain a unitary state because it was the easiest way to achieve socialism but that the USA should remain a federal system because it was the easiest way to achieve socialism there (note to wingnuts: it was the leader of a party affiliated to the Socialist International who was feted so often in the US). For socialism, read systemic change: the drive to reducing carbon emissions was and is stalled at the federal level while real progress is made by some of the states. Similarly, it might be better for healthcare to be delivered by the states. Two states, Massachusetts and Minnesota, have compulsory insurance with subsidisation for the poorest, while New Jersey has a variation on the theme. They could be expanded. Some parts of the US remain resolutely conservative; they are going to be very hard to convince. There is no particular reason that their objections should stand in the way of, ahem, more enlightened parts of the country having better public healthcare provision. Nota bene that this is not quite the same as the left-right split. Minnesota, for instance, has two Democratic senators, but did have a split delegation, and has a GOP governor.
A brief end-note. There have been lots of anecdotes about the excellent/appalling care/death sentence received/imposed by the healthcare systems/death panels of the US/UK. In the period April 2008 to April 2009, the NHS saw five million emergency admissions. That works out at around one every six seconds, over the entire year; add to that everything else the NHS does and you have a lot of doctoring going on. I’m guessing the figures for the US are proportionately higher. In both systems, there will be examples of outstanding care and examples of poor care. Judging the entire system on one case is illiterate.
xD.
* – It is now 50,431,700, according to the ONS mid-2005 population estimate, while the population of the UK as a whole is 60,209,500.