RUTHFULLY YOURS

The NHS is in the middle of its annual winter crisis—wherein central planners forget which season follows spring, summer and autumn and must reschedule surgeries and leave the ill in hospital hallways because the health service hasn’t prepared for its busiest time. Hospitals are running at 95% occupancy, and patients are waiting longer for urgent treatment. Only 85% of emergency-room patients were seen within four hours of arrival in December, the lowest share on record and well short of the NHS goal of 95%. January was probably worse.

The pressure for more spending is constant but it must compete against other demands in a country with already high tax rates. Spending on the NHS has increased by 1.3% annually in inflation-adjusted terms since 2010. That’s faster than British living standards are growing as wage increases have lagged inflation since the 2008 financial panic.

The default is to ration care. Last year the NHS in England abandoned its decade-old pledge to deliver non-emergency surgeries such as hip replacements and cataract operations within 18 weeks of referral by a general practitioner. This is supposed to free up hospital space to improve abysmal emergency-room performance. British patients also wait longer than most other Europeans to see primary physicians and get tests such as CT scans.

Treatment for British patients diagnosed with common cancers such as lung, breast and prostate lags most other developed countries. Of women diagnosed with breast cancer, 90.2% of those treated in America now survive for at least five years, according to a study published last month in The Lancet. The five-year survival rate is 85.6% in Britain. In America the five-year survival rate for prostate cancer is 97.4%, compared with 88.7% in the U.K. That translates to thousands of “excess” deaths—people who would have survived in a health system other than the NHS.

This sure sounds like a health system that’s “broke and not working.” Britain will need to spend more money on health care as its population ages and life spans lengthen. A report last month from the government’s Office for Budget Responsibility estimates health spending will increase to 12.6% of GDP by 2067 from around 7% today. But much of that will be wasted in an unreformed NHS.

No health system is perfect, but most other European countries do better than Britain’s waiting lists and poor outcomes by allowing markets to help. Germany requires every resident to buy health insurance and subsidizes coverage for the poor, but it allows greater market competition among health-care providers to encourage efficient use of resources.

Yet Britain’s political class, and especially the Labour Party, insist on a straw-man argument that the only alternative to Britain’s failed socialist model is America’s non-market “market” system. Their main health-care brainwave is to throw tens of billions of additional pounds at their union friends in the current system, no matter the poor-health consequences for low-income Brits who can’t afford private insurance. The Bernie Sanders left in America believes that too and wants to import something resembling the British system.

Nigel Lawson once quipped that the NHS is “the closest thing the English people have to a religion.” Mr. Trump is no Martin Luther, but he’s right that British health care needs a reformation. It’s certainly no role model for the U.S.