A couple of days ago, BBC journalist Nick Triggle wrote an article entitled ‘10 charts that show why the NHS is in trouble‘. In a rather fatalistic and defeated manner, he concludes there’s no hope of reducing the human suffering and deaths that are happening as a result of the NHS’s shortcomings in the foreseeable future. Chiefly because the current government is very unlikely to increase the NHS’s funding even more than it has pledged to and because UK taxpayers, at least according to the BBC’s poll, aren’t prepared to pay higher taxes.
Is it any wonder people get so despairing about the NHS when BBC journalists are declaring there’s no hope for improvement! The author sees no hope because he assumes there is no other way of providing health and social care services that meet increasing/changing demand than through a much more expensive government-run system, which the public doesn’t want to pay for and which the current government isn’t willing to fund with further borrowing.
So, is health care, if you’ll pardon the pun, paralysed? No. There is a way out, another way: a free market in health and social care. However, this alternative doesn’t occur to the author because he is apparently working from two widely accepted but false premises. One, the illegitimate ethical principle that all people have a right to consume or benefit from the property of drug producers, the services of medical institutions and the labour of medical professionals – in the same way they have the right to not be murdered.
Two, the false economic belief that there is no difference in terms of the resulting quality and cost of care provided to patients between hospitals, clinics and care homes managed for profit and those managed by a government bureaucracy.
In other words, that these two means to the same end are capable of producing the same quality care at the same cost and thus privatised healthcare can be substituted for government-run healthcare without a reduction in care quality and an increase in cost. (Speaking of costs, did you know that Department of Health administration swallows up £3 billion (yes, billion) of taxpayers’ money every year).
It’s a good job we have found it in ourselves to trust in freedom enough to allow free market society to supply itself with food because that’s precisely why no one starves and we don’t have food shortages. If the government put itself in charge of feeding society as well as healing the sick and saving lives, then it would be a very different story (consider what’s currently happening in Venezuela).
We must expand our faith in freedom and trust free market society with providing people with medical, health and social care, so supply has the freedom it so sorely needs to meet increasing and changing demand. Otherwise, avoidable human suffering will continue just as the BBC’s Nick Triggle fears it will.
It’s taken several decades, but it’s now obvious that the NHS will never catch up to increasing demand and cannot adapt quickly enough or at all to changing demand. Therefore, we must remove all government barriers to providing medical and social care in the UK and open the market to anyone who wishes to enter as a provider. Or, to be precise, we must re-open it.
In the minds of today’s generation, the NHS is to health care what the big bang is to the universe: the beginning, the point at which everything came into existence. It’s been forgotten and lost amidst the fog of socialist myth, but before health care was nationalised and mutated from a market into a government department, Britain had a substantial healthcare system, a world-leading one which emerged spontaneously from its free market society.
In a piece for The Telegraph, James Bartholomew, author of ‘The Welfare State We’re In’, discusses the state of health and medical care in the UK prior to the NHS.
“By 1936, the voluntary hospitals took 60 per cent of those requiring acute care. British medicine was widely admired around the world. It was a leader in medical innovation, its greatest triumph being the discovery and development of penicillin. This was just in time to save thousands of lives during the liberation of Europe and subsequently has saved millions of lives around the world.
Healthcare in Britain was very substantial and impressive prior to 1948. Even the Labour Party pamphlet, which recommended a “National Service for Health” in 1943, could find little to criticise. There is mention of only one waiting list, for “rheumatic diseases”. That implies that there were no waiting lists for all the other specialties and no waiting lists to see consultants. There was no mention of any shortage of doctors (which is so chronic now) or, indeed, of nurses. There was no complaint either, about the quality of care.”
The UK’s free market supply of health care in the early 20th century was doing a decent job of meeting the demands of society. That’s not to say that it was perfect or that there was no room for improvement. No market ever has or ever can produce perfect outcomes, but it does seem as if the level of health care that was generally available at that time was of a quality that most people were satisfied with.
This suggests that the widely accepted narrative on the reason for the NHS’s creation isn’t the truth. It lends weight to the suspicion that health care wasn’t nationalised by politicians because the public was so dissatisfied with the supply and quality of private/charitable health care, but merely because the political and intellectual Left at the time proclaimed that free health care should be every man’s legal right.
The only way to grant everyone such a right was to nationalise medical institutions and fund them through taxation. As soon as that was done, the supply and quality of health care in the UK was condemned to forever be less and lower than it otherwise would have been had the free market in health care not been all but destroyed.
It should pain us to think of the higher quality and lower cost health and social care we aren’t benefiting from thanks to several decades of government monopolised health care. This is the unseen consequences of it. Furthermore, ‘free’ socialised health care has engineered a people with a diminished will to health and a propensity to pop pills and frequently visit their doctor. In other words, the UK’s free health care system itself is one of the causes of the increasing demand that it is now so obviously failing to meet. Socialised health care is its own cancer; the orchestrator of its own demise.
Not only does socialised health care breed hypochondriacs and obesity, but it also fosters regressive political attitudes. In recent years, the NHS has started charging overseas visitors for non-urgent medical treatment in a bid to boost its funding. But here’s the thing. About 11 million people of working age in the UK aren’t paying income tax, but only foreign non-contributors (to the NHS’s operation) are being billed for medical treatment.
Clearly, then, it’s what’s written on your passport that determines whether one is entitled to free NHS medical treatment or not. Contrary to what the government Health Secretary claims, the NHS isn’t charging overseas visitors because they haven’t made “fair contributions” to the NHS’s upkeep, but because they are not British citizens.
What term best describes this practice? Nationalism. Imagine if only black people were being charged for non-urgent medical treatment. The public would be outraged! But, as far as I’ve seen, there’s been no outrage about this nationalism on the part of the NHS. In fact, according to the BBC’s poll, nearly three-quarters of people surveyed said they felt charging overseas visitors was an acceptable way of increasing NHS funds. Socialism breeds nationalism. And nationalism never leads to good things in terms of prosperity or international peace in the long term.
I suspect the British public, which otherwise isn’t especially nationalistic, is overlooking this blatant practice of nationalism by the government because they believe it should do everything in its power to increase the NHS’s funding. After all, Every British citizen has a right to free health care of the highest quality and it is the government’s duty to provide what people are entitled to.
If free market society of the thirties could provide good health care to all, then it is perfectly reasonable to believe that 21st-century society can. After all, in terms of GDP, today’s economy is four times more productive than it was back then. Just think of the standard of health and social care we could achieve with the much greater supply of wealth, human resources and technology we have today. All we have to do is follow where our reasoning minds lead us and expand our faith in freedom.
If we choose to save socialised health care out of sentiment or ill-founded faith by continuously pouring more money into it, then we kill our chances of significantly reducing the human suffering and deaths that are happening and will continue to happen as a result of the inherent inferiority of health care run by government.
The bottom line is this: if we want enough hospitals, doctors and nurses to provide the best possible care to everyone, then we need far fewer bureaucrats. Ideally, 100% less of them. Abolishing the Department of Health requires setting health care free from the limitations of being funded by taxation.
Doing this would be like opening a damn, and private/charitable supply of health and social care would flood in to meet society’s demands. Sadly, I think it’s unlikely this metaphorical damn will be opened in my lifetime, but if the UK did abolish socialised health care, then it would once again be a shining beacon of liberty and progress in Europe.
While I wouldn’t agree with full privatization, I do agree that the NHS has to be radically reformed and adopt a more market-orientated approach, perhaps on the model of somewhere like France, Australia or Germany. However, a major problem – as you point out – is the almost-nationalistic fervour built up around the NHS. Meaningful debate is always quashed by screams of “SAVE OUR NHS!” and nobody can say anything about it without being branded a Thatcherite or Evil Capitalist. A very unfortunate state of affairs.
The NHS needs to be disbanded and reborn. Unfortunately operational managers- generally failed, minimally qualified nurses are the incumbents of these roles-they have destroyed the NHS as we know it. Consultants and senior nurses cannot bow to their incompetence any longer- decent people leave the NHS every day- the sludge remains
“About 11 million people of working age in the UK aren’t paying income tax, but only foreign non-contributors (to the NHS’s operation) are being billed for medical treatment.” And not to mention millions more children and retired who do not pay enough tax.
So what do you think would happen to these millions of people should free at the point of use health care end? Clearly, a private health care system would have a major flaw – millions would get ill and die.
And the idea that the NHS should be free to foreigners – that really would be just plain stupid.
[…] But I wonder. There does seem to be a deeply rooted attachment to the NHS that goes beyond all logic and reason. A service created in the late 1940s, run as a monopoly (private healthcare in the UK is relatively small versus the NHS), paid for out of tax and delivered free at the point of use. Result: its services must be rationed. Some of its actions are pretty good, some far less so. I got treated for water on the knee last year and was dealt with reasonably well, although the diagnoses given were so wide and contradictory that in the end I learned more by surfing the internet and talking to some medically savvy friends. Many people’s experiences with NHS treatment vary from excellent to terrible. It does certain things very well, but in my view is poor at area such as tracking patients after their initial encounters to make sure they are keeping on a regime, etc. I think that the UK could and should move towards privately healthcare provision for the bulk of the population, via a mix of healthcare accounts that one builds up over time (people will tend to draw from these funds more as they enter middle age), insurance (for large, catastrophic spending) and some public provision for those in serious poverty. The Soviet model that we operate under seems not just anachronistic, but dangerously resistant to innovation and change. (James Bartholomew had good thoughts on the NHS in this article.) […]
Appreciiate this blog post