“The NHS is Britain’s national religion” stated then Prime Ministerial hopeful David Cameron before the last election. The phrase was meant to show he understood how preciously we hold the NHS to our collective heart, and that he wasn’t going to “tamper” with it too much.
He’s right that we hold it dear, and he’s right that we in the UK treat it as a religion, but he’s way off if he thinks this is a good thing.
A religion is a belief that operates on faith – without any evidence. Indeed, often the absence of evidence is a requirement. Even if there is evidence to the contrary, it merely serves to boost the congregations faith and proclaim their beliefs in a louder more vocal way.
The overwhelming evidence is that Britain, with it’s nation health service, has one of the worst healthcare outcomes in the western world. Everyone (almost) can provide some anecdotal story about how their Aunty Mabel received great treatment and that the nurses were very kind, but it’s just that – an anecdote. The fact is, even lucky old Aunty Mabel would have better treatment if she’d have been treated in Singapore, or Germany, or many other countries.
I have big problems with the healthcare system in the US. But those problems are the SAME as the ones facing Britain. The narrative in the UK is you either have our post-war NHS system, or you have an “evil” “private” system like the US. But what about the other systems, many of which, unlike both the UK and US models, are fairly free-market solutions?
The thing is though, pretty much all the ills with the American system are to do with the fact that it’s not a free-market system when compared to say, the cellphone market, or the grocery business. If the grocery industry was run like the US healthcare system, millions and millions of Americans would go to bed hungry every night. And more than a million every year would starve to death. But luckily, the comparatively free market grocery “system” in America means that the problems with diet over there are down to over-consumption (type 2 diabetes, heart decease and obesity), not starvation. I appreciate there are hungry people in the US, but I think we’re all smart enough to understand the problem in context. Tens of millions in the US will not go hungry tonight.
The US government contributes about 75 cents of every dollar spent on healthcare. There are anti free-market rules about not buying coverage in a different state to the one you live in, and if you do buy insurance, (or what they laughably call insurance but is really a system to pay for everything in advance, not just to insure yourself against unforeseen problems) you’re forced to pay for coverage for things irrelevant to you. But all that is for another post.
Basically healthcare the the UK and the US is faced with the same problem: the distance between the customer and the seller. If the majority of us had to directly buy your own health services and goods, the prices would fall and the quality would rise, at levels we can’t imagine now. That’s what happens in every other comparatively “free market” capital-intensive, zero marginal cost business/service. The problem in both systems, is the state stands in between consumer and service.
But you can’t make that argument in the UK. Because our Aunty Mabel said those nurses were so nice to her. Even when she went in for a chesty cough and contracted the norovirus on the ward. They were lovely. And the only alternative is the evil private American system where people die on the street because they can’t afford healthcare, right?