My wife is a doc and she worked in the UK for about a year. In her experience, the docs work their required number of hours for the national health care system, and then spend another few hours each day working for private practice where they do procedures for people who despise the NHS or who are under-serviced, meaning that the govt has decided that their health problems are low priority so they either have to wait months/years for a procedure, or can't get it done at all.
As for the docs themselves, they feel that they're underpaid and many of them immigrate to the US where their salaries more than double due to supply/demand for their services.
Regarding quality of care, if you discard reports of excessive wait times and flat out refusal to provide treatment based on tables and charts that show average cost/benefit ratios for various problems and treatments, the care is probably reasonable. One example my wife ran into stands out though... Apparently women over age 60 there can't get breast cancer screening because, on average, if a 60 year old women has un-diagnosed breast cancer that metasticizes (ie. spreads to the whole body) followed by unsuccessful aggressive treatment, the patient will die a horribly painful death around the time they reach the average female lifespan anyhow. They match the cost of continued screening for women over 60, compared it to the cost of aggressive cancer treatment for those who get cancer over 60, and factored in fact that some women will die horrible deaths, and decided that it was cheaper to just not provide screening past age 60.
That's one example of the inevitable set of decisions that MUST be made under a "free" public health care system. Demand for a "free" good or service is infinite, so limits on services must be made. My problem with the way it gets done is that instead of the docs who go through a decade of training making the decisions, it's accountants and politicians making the decisions based on actuarial tables and re-election concerns.
Me, I'd rather let my doc make the choice. For "basic" health care like broken bones and flu shots, I'm 100% in favor for a system that makes that stuff available to everyone for an extremely low price. The problem is where to draw the line, and at what point people have to pay for their own care. Most people seem to want the line drawn really high, with the govt providing some very expensive treatments for "free". I would rather see the line drawn as low as possible with fixed costs to the hospitals and govt oversight to keep costs under control, then let supply/demand with govt regulation take care of the rest. Regulations? What regulations? Things like monitoring relationships between suppliers and doctors that lead some doctors or hospitals to do things like prescribe half-dose pills that must be taken 2 at a time, instead of full-dose pills that can be taken one at a time. And reining in the out-of-control legal expenses that ALL doctors face. I'm sorry, but my foot isn't worth 5 million dollars. No way, no how. If a hospital cut off the wrong foot, I'd expect compensation for lost future wages and free medical treatment for life to compensate, but a huge cash settlement is just retarded even though I'm in a career field that pretty much requires me to have 2 feet. So there must be regulation of hospital expenses and control of the insanely hostile legal environment in which hospitals and doctors operate.
