Debates about health care are often personal. Policy is full of statistics  mortality rates, spending per capita, cost of drugs, length of hospital stays  and full of hysterical predictions of what disasters change will bring. But in discussing which system is best, patients turn to their own experiences and those of their families, friends and acquaintances. People believe in the hospital and doctors where they had good outcomes; they deplore those that have let them down.

As an American who now lives in Britain, occasionally writes about the health service, and uses public and private medicine here (as well as back home, occasionally), I have seen firsthand the arguments from all sides. Certainly, as someone who in the 1980s paid $333 to have an emergency room doctor at Georgetown University Hospital remove a piece of toilet paper from my ear after I had unsuccessfully tried to use it as an earplug, I applaud a system that is free.

Founded in 1948 during the grim postwar era, the National Health Service is essential to Britain’s identity. But Britons grouse about it, almost as a national sport. Among their complaints: it rations treatment; it forces people to wait for care; it favors the young over the old; its dental service is rudimentary at best; its hospitals are crawling with drug-resistant superbugs.

All these things are true, sometimes, up to a point.

The N.H.S. is great at emergency care, and great at pediatric care. My children have enjoyed thorough treatment for routine matters  vaccines, eye tests and the like. A friend who had cancer received the same drugs and the same treatment, I was assured, as she would have in the United States. When, heartbreakingly, she died, her family was not left with tens of thousands of dollars of outstanding bills, or with the prospect of long, bitter fights with hardened insurance companies.

But there are limits. Without an endless budget, the N.H.S. does have to ration care, by deciding, for instance, whether drugs that might add a few months to the life of a terminal cancer patient are worth the money. Its hospitals are not always clean. It is bureaucratic. Its doctors and nurses are overworked. Patients sometimes are treated as if they were supplicants rather than consumers. Women in labor are advised to bring their own infant’s diapers and their own cleaning products to the hospital. Sick people routinely have to wait for tests or for treatment.