Saturday, August 15, 2009


Case for NHS Being Robustly Made

My post on Daniel Hannan's scurrilouis attack on the NHS over US airwaves occasioned a vigorous and well informed attack from my old rightwing sparring partner, 'Michael Oakeshott'. In the final analysis we agree to disagree- it's a philosphical difference between a hard right Tory and a Guardian reading liberal- but, given the furore over the issue, I cannot resist another sally forth. The Guardian today offers more comparative data: OK life expectancy is only a one per cent difference(them 77, us 78) but under 5 mortality rate per thousand births is 6 to 9 respectively, suggesting major advantages for mothers on this side of the Atlantic.

Further, the number of acute care hospital beds per 1000 people is 2.8 in the US- 3.6 in UK. And those, like Hannan, who say the US should never adopt a system as wasteful and expensive as the NHS should consider that the US health insurance model takes up 16% of their GDP while the NHS, absorbs only 8.3% of ours. We get more for paying much, much less. Emeritus London University Professor Glickstein, writing today cites the excellent care he has received in London, saying 'it is the absence of fear of becoming ill that is the most important aspect of the system.' In the US unemployment can bring a terror of illness to low income families and to those who relied on employer paid health insurance for their peace of mind.

Glickstein also points to the fact that when doctors provide care 'no money changes hands'. My brief experience of the US system occurred in 1996 when my then wife had to make an emergency visit to a New Orleans hospital when she incurred a painful tear in her throat after eating some rough hewn salad in a restaurant. While she was waiting for an X ray a nurse asked 'would you like a lozenge to sooth your throat honey?' When we got the bill-it was about £1000 for almost no care at all- one of the items written up was 'Throat Lozenge- 1.5 dollars'. The hospital also continued to write threatening letters to me for months afterwards demanding payment when I had actually paid by credit card at the time while over there. So the NHS is not the only 'inefficient bureaucracy' either.

It's clear that Cameron and company realise the strengths of the NHS and appreciate the warmth with which it is regarded. So many of us or our loved ones would be dead without its ministrations, and despite its manifold weaknesses, it is a marvellous institution. The US system is the best in the world for treatment but access is limited to those who can afford the cost. Poor people often have to suffer the indignity of relying purely on charity. My picture shows volunteer medical staff offer free medical, vision and dental services to those without health insurance and in need at a special event in Los Angeles.

The irony of this debate is that Obama is not suggesting that the US should go NHS- he merely wants to use government funds to extend health insurance to the 46 m who remain uncovered. Peter Wilby makes a key point regarding the finance behind the US campaign of scaremongering and half truths:

The most determined, coherent and organised voices in any contemporary political debate are those of the corporate sector and its allies. It can afford the PR and advertising to change the terms of public discourse and it well knows that lies and half-truths – for example, that the NHS leaves the old and chronically ill to die, that 40% of British cancer patients don't see an oncologist, that Edward Kennedy would be left untreated in Britain for his brain tumour – can sow doubt in people's minds even if they are easily disproved. The corporate sector can also intimidate and compromise elected politicians.

Finally, Simon Hoggart has a go at the American right today:

All over the US there are people whose lives are being destroyed for lack of proper health care provision, and there is no sight more odious than the rich, powerful and arrogant trying to keep it that way.

Setting aside the arguments on relative merits of the NHS vis a vis the American system, there is a very simple point to make. As far as I am concerned, the last people to decide on my medical care should be an insurance company. Therein lies madness,
Anyone who trusts the state with their medical care is truly mad.

So fair enough Rich. You trust the state with your care. I trust myself, with the aid of an insurance company. The only difference between Richard T and myself is that he expects me to pay for his healthcare, whereas I take responsibility for my own.
Richard, Michael
State run systems are thought to be very bureaucratic but it is private insurance ones which are more so with a much higher percentage of administrators to doctors in trhe former compared witht he latter. Seems to me France has probably got the best solution- ranked number 1 in world by WHO- which is a combination of both approaches: a private system 'tops-up' the public. My friends in Ireland tell me theirs is not so different to the French- you have different levels of cover you can choose- though, incidentally, they also say the NHS is better than theirs. But funding a huge system like the NHS by the taxpayer is, I agree with the critics, is not, long term, a good idea: costs are bound to spiral upwards as our society ages.
And what happens if your like myself who had an accident who had a private insurance who was then told we have to cancel your insurance because you cost to our company is beyond the normal use of the service. I had a private insurance which i used for my accident, once the initial treatment was over they canceled it saying they could not pay for my care indefinite. Which is what UNUM Provident did in America, left America and has been in this country waiting for labour or the Tories to say OK it's all yours.
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