Imagine you want to set up a business. Let’s say it’s a software consultancy. And let’s also assume that you require some capital funding to get you started. You decide to approach a variety of sources from wealthy private investors to banks to venture capitalists and in order to impress them you draw up a Business Plan.
Only, there is no Business Plan because you are forbidden from charging your customers. Yes, that’s right, you are obliged to give away your valuable time and expertise for free. Which means you are not a business, you are a charity. No business, no Business Plan.
Insane? Bizarre? Economically illiterate? Intellectually retarded? Yes, yes, yes and yes.
And that probably explains why it has been adopted by the British Conservative Party as their big, bold, brand new idea for the National Health Service:
“During the health debate, Dr Fox will say that hospitals would be able to raise cash however they wanted and from whoever they wanted.
They will, however, be barred from charging patients for treatment”.
I am so resigned to this kind of stupidity that I can no longer bring myself to be outraged about it.
How marvelous that state hospitals will be able to go to anyone for their investment; only wihtout being able to offer a return, no investor will touch them and they will be forced to go back, cap-in-hand, to HM Government (and that means us) and we’re right back where we started. In other words, the Conservatives are opting for ‘no-change’.
Despite endless tampering, tinkering, revamps, updates, initiatives, policy changes, shifts in emphasis, new approaches, fresh ideas, radical thinking, more funding, down-to-earth measures, sensible guidelines, new directions, even more funding and more wishful thinking than you can point a stick at, Britain’s unworkable Soviet-model health care system still won’t work.
But coming to terms with that is a pain barrier that nobody is willing to cross.
Rationing is only a stone’s throw away.
There are easy solutions, though:
Let’s say that the Ritalin company sponsors a hospital’s pediatric wing. Of course, what brand are you going to use?
And who’s going to pay for it? Taxpayer.
Higher drug costs.
I’m not saying the system doesn’t need to be fixed. Badly. Just that this scheme is stupid, but not so stupid that it can’t be used to the advantage of people other than the taxpayer and the public.
No, the system does not need to be fixed, it needs to be destroyed. As long as it a theft based socialist system (i.e. taxation funded) it CANNOT work. If there is no connection between a person’s use of resources and their payment for those resources (i.e. a market), the ‘National’ Health ‘Service’ is doomed to incremental decay and increasing squalor. Socialism has been proved to not work everywhere it is tried over and over and over again, so why think healthcare would be any different?
There are plenty of financing plans for a no-charge hospital, none of them good.
First: patients are a wasteful expense. minimize patients, but maximize whatever govt help is tied to patent numbers, by tricks such as treating easy problems en masse and turning away complex expensive ones.
Second: raise money by intrusive advertising.
Third: rent hospital space to others, patients be damned.
Fourth: as above, surcharge for all materials (not just drugs). Then massively overuse whichever materials turn out to attract the best percntage surcharge.
Fifth: give away the treatment, but stupidly overcharge for any comforts. £100 each for a bowl of cereals at breakfast instead of thin gruel.
Sixth: charge for “priority attention” – without which, one might wait a half century to get a penicillin for a hangnail.
And so forth.
Welcome to the new NHS. That will be £200 for a non-confusing introduction, please.
There are plenty of financing plans for a no-charge hospital, none of them good.
First: patients are a wasteful expense. minimize patients, but maximize whatever govt help is tied to patent numbers, by tricks such as treating easy problems en masse and turning away complex expensive ones.
Second: raise money by intrusive advertising.
Third: rent hospital space to others, patients be damned.
Fourth: as above, surcharge for all materials (not just drugs). Then massively overuse whichever materials turn out to attract the best percntage surcharge.
Fifth: give away the treatment, but stupidly overcharge for any comforts. £100 each for a bowl of cereals at breakfast instead of thin gruel.
Sixth: charge for “priority attention” – without which, one might wait a half century to get a penicillin for a hangnail.
And so forth.
Welcome to the new NHS. That will be £200 for a non-confusing introduction, please.
The NHS was doomed to failure from day one, when the Socialists of the day ( Bevan et al), decided that it would be a wonderful thing to make the service free to all comers. Consequently there has been a constant stream of ‘freeloaders’ from all over the world, taking advantage of our ‘jewel in the crown’, and thus ensuring its demise. If only there had been some sort of residence or contribution requirement in place, then we would not have the barbaric system we now ‘enjoy’.
The whole scheme from its beginning has been a calculated fraud on the general public, especially on todays’ elderly people who have contributed to this Ponzi scheme all of their lives, and at their time of need find that the service they were expecting is not, and has never been there for them. How or why does the ordinary ‘working man and woman’ fall for the Socialist line that they are the party of the people.
The Conservatives are as much to blame for the state of the NHS, their so called ‘management techniques’, are now, and were then, a pitiful excuse for general ineptitude and stupidity – witness their new funding scheme for the NHS – Thatcher was no better than her Socialist counterparts in this respect, how she ever achieved her reputation is one of life’s little mysteries. I suspect that she just ‘got lucky’.
Let’s face facts. There’s a cultural aspect to socialized medicine that sometimes gets lost. Regardless of any rational argument provided against socialized medicine in whatever form in which it is provided (and those arguments are too many to count), there’s a romantic appeal to the concept.
Exhibit A: MDs, which is a new show on ABC in the US. From the website:
Set in a fictional San Francisco (where else? – ed.) hospital, Mission General, MDs highlights the lives and dedication of a few good doctors who find themselves battling a heartless health care system obsessed with the bottom line.
http://abc.abcnews.go.com/primetime/mds/show.html
“A heartless health care system obsessed with the bottom line.” There you have it. Never mind that, but for the capital spent to build the hospital, buy the equipment, hire the highly-trained and intelligent doctors, nurses and administrators, those “few good doctors” would not be able to save as many lives as they would otherwise! Unfortunately, Dr. Fox’s outlook is no different than a TV show writer’s. It’s probably not because Dr. Fox is no more intelligent, but they share the same cultural outlook.
The only major problem with the NHS is lack of investment. The notion that it is being ruined by all these pesky foreigners is merely racism, not supportable by fact. As to a pay system – live in America for a while and see its wonders – the insurance scams, the millions who don’t have coverage because they can’t afford it, and the sheer vast cost for an inadequate system.
I have no doubt the NHS can be improved as a service, but the fundamental problem is lack of investment.
The service should be funded by ring-fenced spending – a national insurance scheme kept separate from the main taxation stream and administered by a national agency, with lay people elected as well as medical and admin people. A proportion of excise duties from tobacco, alcohol (75% each) and fuel (50%) should be automatically part of the funding. Employers and workers would all contribute to the insurance system.
Within the NHS there should be a concerted program to manage health, in preference to curing disease – eg educating people as to the causes and consequences of diabetes, lifestyle help to encourage better eating and management of illness etc.
Calling the NHS “socialist” is merely how right-wingers avoid dealing with the issues by resorting to an ad-hominem form of attack. The NHS is what the vast majority of the British people want, and in America, most people would prefer something closer to the NHS for their health care, because health is so fundamental to people’s needs that it should be a right, especially in a wealthy society.
Dave Murphy: Ok, let me make sure I understand you… The NHS is a nationalised industry, right? Funded by ‘government money’ (i.e. stolen from you), right? It is run according to political rather than economic objectives, right? So how is calling the NHS ‘Socialist’ an ‘ad hominem form of attack? By any reasonable definition, it is the last bastion of pure socialism left in the UK that I can think of and it shows in the third world level of service.
A typical socialist reply – disagree with their thinking, or point out their stupidity(or lack of common sense), and out comes the “Racist ‘ cry. Go work in a NHS facility and get a first hand experience of the ‘freeloaders’ taking advantage of our system.
Financing for the NHS is already provided by that deduction on your pay slip for NI Contributions, or whatever they call it now. some 10% of everyone’s income is deducted for the purpose of financing Health and Pensions, the employer then contributes another 11% or so. That is one fifth of earned income, and is in addition to income tax. An individual can take out a private medical insurance for far less than that and receive a far superior service when the need arises.
If all countries offered a free ‘any comer’ service then fine , it may be workable, but for many years the UK was the only country providing such liberal service, and “freeloaders’ did , and still do , overwhelm the service. The medical services in many European countries, still do not provide a completely free service, try walking into an ER dept. in France or Germany, you will get treated, but it sure wont be free.
Residential or Contribution requirements would help to cure the problem of the NHS being overwhelmed by too many patients and not enough facilities to meet the demand.
In passing, just how much of personal income should be paid to the State by way of taxes, and other ‘contributions’, the percentage in the UK is well over 50% – even for the lowest tax bracket. what do you socialists want -blood?
America’s system is “a pay system” (to an extent) but also nearly as socialized as the UK – HMOs and suchlike evils are quasi-governmental organisations forced upon people by employment regulations.
In a truly capitalist healthcare system there would be just pay-it-yourself, insurance, and charity. But, without taxes to convince the sheeple they’ve “paid their fare share”, I suspect charity would recieve vastly more – enough to surpass the NHS. Drugs would also be cheaper – the current hyper expensive red tape certification (“for your own good” whether or not you’d prefer to take more risk) is what locks in the cartel of drug makers. Patients would also be able to freely choose doctors without a medical cartel locking out unconventional approaches or less qualified amateurs. Plus people would revert to the pre-socilalist tradition of not dashing to hospital for every sniffle and grazed knee.
“Socialism has been proved to not work everywhere it is tried over and over and over again, so why think healthcare would be any different?”
Because it sounds sort of nice if you don’t delve too deep (and most people don’t), and people are extremely gullible. Even the somewhat limited system we have in the U.S. hasn’t worked that well at getting the poor decent health care. I’ll bet that private charities could have done a much better job at a fraction of the price. What’s more, the price would have been paid by willing people as opposed to victims of burglary at gunpoint (the police’s).
Dave,
The US system is anything but pay-for-service. It is one of the last bastions of socialism in US society (along with public schools).
I would be interested to know how the advocates of a totally private health care system believe it coulc cope with advances in genetics.
Soon it will be possible to identify people who are genetically disposed to getting cancer, alzheimers and and other illnesses. Under a fully private health care system no-one will insure them. How will they get medical insurance if it is not provided by the State?
Perry,
You say the NHS offers a ‘3rd world’ standard of healthcare?
Have you ever stayed in a 3rd world hospital? I have, and I can tell you it makes the NHS look like the Ritz Hotel.
I know you’re trying to position yourself as a UK version of a shock-jock, and your journalist style is bombast, but some proportion please.
Robert
“How will [people with genetic diseases] get medical insurance if it is not provided by the State?”
The same way that smokers and achoholics get health insurance now. They pay a bit more for it. Also, if an insurance company does not require genetic screening, then they will have a competitive edge in attracting customers. While these companies’ risks will be somewhat higher, their increased customer base will allow them to ammortize the risk over a large number of people (using actuarial methods which have been around for decades). This is exactly what insurance companies do now (just with less precision), so there’s nothing particularly mysterious here.
Robert Harris: I have been hospitalised in Ghana and Croatia and recieved care which was just fine in both places actually… and I paid for it in both places too.
Robert Harris:
I had the misfortune to spend time at the new Guy’s Hospital in London. Do you think that having just three washbasins and three toilets (including one for disabled), for the use of thirty patients is anything other than Third world?. This in a hospital that was built new just six years ago.
Do you think that the total absence of any form of janitorial, cleaning service for the wards is anything other than barbaric?
The specifications for this new hospital do not even match the standards for the much decried Victorian equivalent.
I think this shows the totally cynical, arrogant disdain that the NHS management has for patients, and is so indicative of anything run by politicians.
EY
Lucas
I don’t quite understand your point.
Why would those people who have been given a genetic ‘bill of health’ choose to be insured with the provider that doesn’t require genetic screening? Almost by defintion the latters’ policies will be more expensive?