On a recent business trip to London, I was struck by the strangely comfortable debate in the air. In each successive story I encountered, the tenor of the language was strikingly familiar around big questions on future healthcare needs and funding. And it was the same with education, but that is not the remit here.

To be sure, the intrinsic structures at the centre of the debate are different in the UK and the US. But the language, angst and sharpness (tonality) around healthcare questions in both places was virtually the same to me. The similarity gave me the uneasy feeling that I was now like the main character in the Jim Carrey film “The Truman Show,” in which the script of my life had already been prepared by producers. So wherever I went, I would be getting the same fare.

There was an interesting scrutiny of a new plan to push GPs to the centre of a reorganisation of the NHS. The plan included doctors forming consortia to commission services for their patients, and the government buzzwords that the reforms would improve patient choice, with doctors, not bureaucrats, taking treatment decisions.

Then there was an issue with referrals for certain procedures and certain patient populations (obese people or smokers for instance) not being granted. It brought headlines of “rationing” due to claims that treatment orders by GPs were being blocked by a murky all-powerful referral management centre.

Over this brief time, there was also a shrill report warning of a potential future bed-blocking crisis in NHS hospitals. Inadequate planning and funding for long-term care facilities for the elderly would leave many of the hospital beds effectively blocked. They would be filled by elderly patients who could be released but needed to stay because they required medical support but had no long-term facility to house them.

For our purposes, the details above are less important than the concept. The overwhelming healthcare issue of our time is how the world’s wealthiest economies come to grips with ageing demographics that lurk to potentially overwhelm the system and budget. There is an ancillary overarching issue of the size and fiscal health – immediate, near-term and long-term – of government.

The similarity of the intrinsic issues, and the similar tonality in the debate spinning around them, makes a steadfast remaining difference between the UK and US stark in comparison.

Despite converging healthcare challenges and angst, the two sides often look at one another across the Atlantic as the most demonised of acceptable options.

Dr Donald Berwick is a controversial appointment by President Barack Obama as the administrator of the Centers for Medicare & Medicaid Services (CMS) - the US federal healthcare programme for the elderly, disabled and poor. What is one very big reason he is held in contempt by so many in the US? He has stated publicly his admiration for the NHS. A quote that opponents hold against him is that he views the NHS as “one of the great human healthcare endeavours on earth”.

But let’s look at the other side of the pond. It is virtually certain that a similar reaction would be had if a senior UK official (a top NHS position, for instance) would declare to be “a fan of the US healthcare system”. I can state with confidence that the public reaction would be more pointed than that received by Dr Berwick in the US. A Conservative member of the European Parliament veered toward this in the US a few years ago and David Cameron, still a budding candidate for the Conservative leadership, had to swiftly distance himself.

The fact that no one in any UK report I saw was calling the referral management centre a “death panel” did provide me with a humour noir laugh. OK, the debate is different in that respect. But I have thought for a while now that a hybrid of some varying degrees – a meeting-in-the-middle-of-the-Atlantic of the UK and US systems – will ultimately be the answer to the most daunting socioeconomic challenge arriving at the doorstep of these and other western societies.

It would be an underlying social contract coupled with the speed and genius of the private sector – giving everyone a net-plus option with some personal responsibility added to the mix. We just have to stop thinking the other side is crazy. That’s a start.

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