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Samizdata, derived from Samizdat /n. - a system of clandestine publication of banned literature in the USSR [Russ.,= self-publishing house]

The envy of the world, eh?

It annoys the hell out of me when I hear the chattering classes in Britain describe this country’s decrepit socialist National Health System as ‘the envy of the world’… and it astounds me when idiots in the USA think it should be emulated over there.

As someone who has all too much first hand contact with the NHS, as well as having been at the tender mercy of other nation’s healthcare systems when I have broken bones, crashed cars, got shot, fallen through a weak floor, head-butted a flying bottle, been bitten by snakes/dogs/rats/, skied into trees, caught exotic unpronounceable tropical diseases and all the other things that happen to folks such as myself who travel to far off places and foolishly venture out of the hotel… and I can assure you that the NHS is at its best nothing special compared to much of the rest of the world and at its worst, it absolutely sucks. I certainly never saw a dirty ward in a hospital in Croatia or Ghana or the USA like those I have seen in Britain’s state run hospitals.

In reality, not only does the NHS provide indifferent care (an appointment I needed once took 11 months to arrange), it does so at vast cost and in reality a large chunk of the burden of healthcare is done privately. In fact, the NHS could not survive without a large healthcare private sector, the size of which Eamonn Butler points out over on the Adam Smith Institute’s own blog.

When my grandfather was gravely injured a few years ago, the treatment he received from the NHS was adequate – but after it became apparent that he was not able to look after himself any more due to brain damage, my family ended up shelling out well over £40,000 ($70,000) per year to keep him in a private nursing home which did not smell of piss. I am not complaining, after all what the hell is money for if not for something like that? However the role played by the non-state sector is a largely unsung one and I wish more people in Britain realised that the fact the state does not provide a healthcare service does not mean one will not be provided. If the state did not take such a whack of tax money to fund the monstrosity that is the NHS, far more people would have healthcare insurance.

Of course that might not end up costing much less than the existing system but the evidence outside Britain suggests it would certainly produce a higher quality system than the one of de facto healthcare rationing in use in the UK now.

14 comments to The envy of the world, eh?

  • Sven Ole Berg

    I agree wholeheartedly!

    Take myself as an example. Coming from Norway, which is arguable one of the most socialist democracies in the Western World, and then moving to the US, the freest country on earth, I can’t even begin to describe the improvement my quality of life experienced. And healthcare is just one of these improvements.

    Health Care is FAR better in the US than in Norway. I shudder to think about long lines of waiting for just basic services, endless beauracracy, poor equipment that I experienced in Norway.
    Getting healthcare in the US was like traveling through time to a modern sivilization.

    I wish Norway and other European countries would realize that privatization of healthcare is the only way to go.
    And I wish idiots like Hillary Clinton and Democrats here in the US would stop trying to force this socialist hell upon us.

  • Michael Hiteshew

    Sven,

    First, what a great Norse name you have! I feel like I’m talking to a viking! 😀

    Second, I’m somewhat shocked to hear you say that. For twenty years I’ve been listening to Europeans telling us what barbarians we were in the US to not provide “free” healthcare to everyone, on demand. I almost fell off my chair when I read your comment.

    For the last 4-5 years I’ve been turning the healthcare question over in my mind (yes, I’m a slow thinker). Clearly, the goal of getting good healthcare to everyone is a good one. But how? I too am leary of turning it over to a government beaurocracy. I keep imaging the long lines at the DMV just getting my drivers licence renewed.

    Insurance works on the concept that you spread risk over a large population and over time. I find myself wondering if maybe we could tune the insurance regulations to create incentives for insurance companies to cover the maximum number of people with small subsidies to cover the indigent.

    For instance, could we require a company to accept everyone in a geographic region at some basic level of coverage in order to do business in that region; with state subsidies paying for those below a certain income level?

    What do you think?

  • Shaun Bourke

    Sadly, down here in Australia it was many years till we were able to enjoy the luxury of a State Controlled Health System. However, having had a succession of top notch Labour Governments in the state of New South Wales, todays SMH has a number of articles clearly showing that the gap between what NHS delivers to you lucky blighters and we folk in the colonies is narrowing !!

    http://www.smh.com.au/articles/2003/12/12/1071125655184.html

    http://www.smh.com.au/articles/2003/12/12/1071125658578.html

    http://www.smh.com.au/articles/2003/12/12/1071125654971.html

    http://www.health.nsw.gov.au/pubs/i/pdf/invstgtin_hccc.pdf

    I wonder if we could ever manage to top Froggie Aged Care by cooking several thousand in a month ?? We have the proper weather conditions down here……

  • YogSothoth

    Personally, I always thought the “food stamps” model was the best for attempting to provide all Americans with a minimum standard of health care. Think about it – we don’t have the government run grocery stores, we let free enterprise do that and simply give folks who cannot afford the market-dictated price a mechanism to acquire the sustinence they need (food stamps).

    I mean, hell, the post office which as far as I can tell is a spectacular analogue of socialized medicine is characterized by long lines, surly employees, poor service and generally being so feeble as to give FedEX and UPS an incentive for coming into being, why in the world would we opt for that model especially given the evidence of the relatively benign alternative of the food stamps model?

  • Michael Hiteshew: For instance, could we require a company to accept everyone in a geographic region at some basic level of coverage in order to do business in that region; with state subsidies paying for those below a certain income level? What do you think?

    When the state interferes, it creates weird distortions and destroys market information. Now that expectations have created a demand for healthcare of a certain standard, why on earth do you think capital would not try to satisfy that demad without the deadening hand of the state making mandates? Are you so scornful of civil society to think it cannot produce charitable institutions for the indigent if it was not crowded out by the regulatory state? If it works for the provision of lifeboats in Britain without a penny of tax money, why not healthcare? ‘We’ should not require anyone to do anything if we want to find a better way.

  • Andy Duncan

    I had the misfortune recently to spend four days, on a training course, sitting next to this rampant Benthamite socialist. Oh, the fun we had in the coffee breaks! 😉

    He came out with all the envy of the world rubbish. Envy of the world? Why has nobody by North Korea or Cuba emulated this ‘fantastic’ system, this ‘best gift the British people have ever given themselves.’ No answer.

    Next coffee break, then, and apparently, according to this dork, only the state was big enough to obtain and use things like CAT scanners.

    How on Earth do they manage in the evil US, for CAT scanners, I asked? D’ya reckon they don’t have them. No answer.

    Then we got ‘only the state can deliver enough doctors through the combined state control of the health and medical school education systems.’ So why is Britain now stripping the ‘developing’ world of its doctors then, thereby creating worse health prospects for ‘developing’ world people? No answer.

    My advice. If you’re unfortunate, like me, to have to listen to someone spout this rubbish about the NHS, don’t sit there and take it. Attack them. Immediately. Make them defend their stupid opinions. Watch them crumble. There’s nothing a socialist fears more than someone who’s prepared to stand up to them, who refuses to grant them moral ascendancy. They take it as given that they always possess this, as of right, even if someone say, like a conservative, says they can come up with a better way of managing a state health system. Just attack the state system. Go for the jugular. Here’s some other suggestions, in addition to above. Enjoy! 😉

    MRSA infection rates.
    More bureaucrats than beds.
    Worse cancer survival rates than the rest of Europe.
    Poor old age pensioners using limited savings for private treatment rather than waiting years in pain for the NHS to get round to them.
    A 20% recent increase in funding and a 2% improvement in productivity.

    Finally, why on Earth do we have to ‘wait’ at all? Isn’t this the 21st century? People don’t wait in other countries. Why do we have to? It’s some gift where you pay more and you get less.

    The sooner the NHS is abolished, the better.

  • I see. Perfidious Albion is once again trying to despoil France of her much deserved grandeur.

    Yet you were counting without the frogman, Mr. de Havilland Sir!

    British baseness shall therefore be exposed forthwith: the best health care system that is, ever was and ever will be, the only true envy of the world is the French one.

    Should be obvious considering the repeated piles of the tax money that went into advertising that very idea.

    Don’t you have “Zee television” in Britain?

  • Larry

    The left in the U S says we don’t have universal health care. They, deliberately or ignorantly, conflate the terms health CARE and health INSURANCE. A Martian injured in an auto wreck on 23rd St in Panama City, FL will be taken by ambulance to the nearest (in this case, PRIVATELY-OWNED) hospital and given the best available health CARE. The only question is, “Who pays?”

    The answer is sufficiently complex to exceed the bandwidth limitations of this blog and is left as an exercise to the student.

  • Nancy

    For heaven’s sake, Perry, be more careful! Your mother must have a nervous tic by now.

  • Got shot ? Perry, do tell…..

    Michael, I grew up in France and have been living abroad for 8 years. I was educated to believe the US health care system was a total quagmire so I guess my talking like Sven could also reflect very low initial expectations. But I believe he is essentially right. Although things back home have improved and evolved since. Well they had to. (Granted, the families of those 15,000 elderly people who died in the heatwave while doctors and nurses were either tanning their noodle at the beach, or relaxing home courtesy of the 35-hour week, might not agree…)

    For instance, when I was a kid there was very little stuff available over the counter. If I caught the flu or some nasty cold, we had to go to the doctor and get a prescription when most Americans back then would have just gone to their pharmacist and gotten quick, practical advice for free, and fairly generic medicine for half the price of the antibiotics I had to take. How was that better ? Sure, we spent a lot more on fixing my little problem so statistically, I was getting “better” care : with $100 of doctor+antibiotics vs. $10.99 generic flu medicine, the former looks a lot nicer, and if, as the saying goes, the state pays for it…Except we all paid for it, and through the nose. That’s the thing with taxes. Once people pay them, it looks like they want the most out of ’em. Funny how that works…

    Sure, Europeans are frightened by the price of US private health care coverage, but most of those dolts don’t realize that Americans pay these fees *instead of* paying for a nationalized health care system. Sure, it’s insane to pay for one on top of the other and unaffordable to most. But that’s not what’s happening. The question is, does a dollar spent on health care in the US go farther and better than one spent in Europe ? Based on my experience – in France, Ireland and the US – the answer is yes. More choice across the board, and better care. And in my limited experience – I’m lucky enough to be a healthy guy – it’s better mostly because the standards are higher, and it seems competition and accountability through liability have something to do with that.

  • Shaun Bourke

    And we now find one of our larger hospitals has ‘thrown down the gauntlet’ in its efforts to bring that envy to Australia.

    http://www.news.com.au/common/story_page/0,4057,8158272%255E421,00.html

    I wonder what ‘Bonney Prince Charlie’ would have to say about the sign out front…..

  • Michael Hiteshew

    When the state interferes, it creates weird distortions and destroys market information.

    Actually, the state interferes on all sorts of economic fronts. What is Allan Greenspan’s job if not to ‘interfere’ with the relative cost of money? He uses the prime rate to both ecourage and tamp the rate of growth. Agree? What about the Sherman Anti-trust Act? Interference?

    Not that I think more regulation is always the answer. I don’t see any reason RNs can’t stitch wounds, deliver babies, give inocculations, etc. Why pay someone with 20-24 years of education to do those things? What an incredibly inefficient use of a valuable resource! The American Medical Association, a trade orginization for doctors, is largely responsible for keeping RNs from performing many basic services. I also strongly support torte reform to relieve doctors (and all of us, indirectly) of the onerous burden $100,000+/yr malpractice insurance policies.

    In Virginia, there are community based clinics where a person can walk in off the street and see a doctor. People pay according to sliding scale based on ability to pay. What’s wrong with a basic service like that? I’m not advocating doing away with private health care; I think I said that. I’m simply saying the market is NOT filling a certain need for many reasons.

  • Actually, the state interferes on all sorts of economic fronts. What is Allan Greenspan’s job if not to ‘interfere’ with the relative cost of money? He uses the prime rate to both ecourage and tamp the rate of growth. Agree? What about the Sherman Anti-trust Act? Interference?

    And do you think any of that is a good thing? That the Federal Reserve manipulates the value of US fiat money is self evident but it is hardly a good thing. The ‘price of money’ should be whatever the market thinks it should be, not what Alan Greenspan think it ought to be.

  • John Anderson, RI USA

    “In Virginia, there are community based clinics where a person can walk in off the street and see a doctor. People pay according to sliding scale based on ability to pay.”

    I don’t know about Virginia, but here in Rhode Island we also have such clinics. They are private operations, not run by the state. Funded by the state? Yes and no: they usually accept the state version of Medicaid – but any doctor or nursing facility can do the same, or not, as desired. They also take most forms of private insurance, Federal payouts such as MediCare, cash, etc.

    Will they treat without payment? Yes indeed. As will any certified hospital. Oh, they get paid to some degree: that is part of the reason two aspirin tablets cost paying patients ten dollars in the hospital, while that would buy a bottle of five hundred tablets in a store. And that is why people who use such things as the price of aspirin to claim the government could do it better and more cheaply are at best mistaken.