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Healthcare in England, in fact, in all of the United Kingdom, is funded by the taxpayers of that country and is called a "universal healthcare system." This form of healthcare is also known as "socialized medicine" or "single-payer healthcare." The single payer referenced in that last item is the British government. In other words, when a patient goes to a medical provider for any kind of healthcare, the patient pays nothing, and the government pays for the visit.

The governing body of that healthcare system is the National Health Service (NHS). The NHS was established in July of 1948, in order to replace the volunteer hospitals which the country had come to rely upon during World War II. That system had become totally inadequate for the needs of the English people. It was set up to minister to all of the United Kingdom residents and all immigrants.

The National Health Service provides the vast majority of the country' healthcare, including primary care. long-term healthcare, ophthalmology, inpatient care and dentistry.

Those who can afford to pay for private options are allowed to do so. Many employers offer private health insurance to worker as part of a benefit package, and those people opt out of the National Health Service because they prefer, and can pay for, private medical treatment. The benefit of this option is that patients can avoid waiting lists and choose their own specialists.

Private healthcare also offers secondary care. The term "secondary care" is more specialized treatment like elder care, hospitals, mental health treatment. Additionally, people who are registered with NHS are allowed to use the private sector for secondary care including rehabilitation and treatment for addiction, specific surgeries which are performed in private hospitals, diagnostic tests for many conditions, cosmetic surgery, or one-time specialist treatment, for example, a visit to a dermatologist or ophthalmologist.

Contrary to what you might read or hear, NICE does not factor age in when making medical decisions. Rather, a "life-year" of a 90-year-old is worth the same as that of a 25-year-old, and that 90-year-old has access to the same treatment as the 25-year-old.

The National Health Service has a division called the National Institute for Health and Clinical Excellence (NICE), which decides which is responsible for, among other things, deciding and publishing which new drugs and treatments NHS will pay for.

One of the factors NICE takes into account while making the decisions of whether to approve funding for a new drug or treatment is cost-effectiveness. NICE has apparently set their threshold at £31,700 or roughly $45,000 per "life-year" gained, and it is rare indeed for them to go any higher than that when approving a new drug or treatment. Put another way, NICE does not generally want NHS to spend more than £31,700 in order to extend a patient's life by a year. While there is anger expressed, often by non-British people and specialists who treat cancer, HIV, and other prolonged and complex diseases, the majority of English citizens accept as necessary the boundaries defined by NICE as crucial to keeping universal coverage affordable.


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