Does the NHS Provide Better Health Care?
For the last two days, the hashtag #welovetheNHS has been trending in the top 10, often No. 1, on Twitter. Yesterday this piqued my “argue with people on the internet” instinct, so I commented openly:
- 10:45 AM: For every #welovetheNHS story, there are people suffering because of the NHS.
- 10:50 AM: memo to everyone who says #welovetheNHS – UK cancer survival rates way lower than U.S. (BBC) http://sn.im/pqfr4
Some people straw-manned my position, citing the fact that “That cancer data is like 10 years old…” No. Shit. Sherlock. A study of five-year cancer survival rates necessarily takes time (at least 5 years) to complete, and then takes time to analyze and interpret. That said, data from 2000 is hardly ancient history. But there are plenty of sources on the interwebs which corroborate the claims that despite massive funding to combat cancer and diagnose it sooner, the NHS is failing at that task. They still spend three times as much on cancer treatment as do the Poles, and have approximately the same longevity results.
Some said I didn’t care about the poor or infirm. Cliché, right? In the U.S., the poor and infirm are covered by an amalgamation of “safety net” programs like Medicare, Medicaid, SCHIP, and laws which require hospitals to admit and treat anyone regardless of financial wherewithal, for emergencies. That many of these people elect not to use the programs at their disposal, can hardly be considered a market-failure. The fact of the matter is that only about 5% of Americans are involuntarily without health care — hardly an epidemic or national emergency.
Others said, “Look, health care in America is too expensive. Ours is free provided by the NHS”. Bollocks! Anyone with even a rudimentary understanding of economics understands the TANSTAAFL principle: There Ain’t No Such Thing as a Free Lunch. In a world of scarcity (i.e., the real world) this is basic metaphysics. Nothing is “free”. Ever.
A spokesman for the Department of Health said: “The NHS sees one million people every 36 hours and 93 per cent of patients rate their care as good or excellent. “
There is another way to state this: There are only 50M people in England, so doing some back-of-the-envelope calculations, once every 75 days, or five times annually, the average Briton receives some form of care provided by the NHS, which roughly squares with other available data on doctor’s visits. By this metric, however, the U.S. consumes twice as much care (measured as “visits” to a care-provider for lack of better comparison).
But criticism of the NHS isn’t coming just from libertarian whack-jobs who don’t care about the poor or infirm (like me) on the other side of the pond.
Karol Sikora, Dean at the U. of Buckingham Medical School claims that NHS patients are missing out. Specifically, he notes that the waiting lists for many routine procedures “can emulate Heathrow [London's notoriously overcrowded airport] on a bank holiday weekend,” and that “Only seven per cent of eligible patients get precision guided radiotherapy even though we’ve got the equipment (just) not the time to use it.”
Discussing his experience practicing medicine in the States, he was astonished. In America, he says, “Things are done instantly.” And since time is fleetingly scarce, “instantly” has a price tag, which might be measured in dollars (as it is in the U.S.) or might be measured in waiting lists and denials of service (as it is in the U.K.). Pretending that this price does not exist, however, is simply not an option.
Perhaps in America health care costs “more” (largely due to Government interference). But we get twice as much, we don’t have to wait for it, and we are still (at least partially) free to make our own decisions, including the decision to not insure.
Possibly related posts:
Related posts brought to you by Yet Another Related Posts Plugin.
About The Author
You are a shill for the Insurance companies. I claim my five pounds.
I have (very recently) outed corporate shills for the Insurance Companies, and highlighted attempts by Big Insurance companies trying to get monopoly power from the Gov't. I am vociferously anti-fascist, anti-corporatist, anti-big-business. A 30-second perusal of this blog would've given you a clue.
You are an idiot.
Re: cancer survival — the US has aggressive screening programmes, and this skews statistics. Allow me to explain:
Prostate cancer is not an automatic death sentence even untreated — and many men can carry prostate cancer for decades and not know it, and die of other causes. These cancers are often symptomless. In the US they would be caught by a variety of screening programs. In the UK, people are not screened until they show symptoms, which eliminates immediately all the long-term survivable symptomless prostate cancers. So when the numbers for the US and UK are compared, they are not drawing from the same populations.
…and the only reason they are not drawing from similar samples (you meant "samples" not "populations") is because the NHS does not offer the same treatment/procedures.
It's not some exogeneous factor that we need to control for, it is the variable under consideration!!!! That's a FAIL in my book.
Will cover other points as, when and if I have time. But I will say this in brief: I am a dual citizen, I have lived in both the US and the UK, and I have experienced healthcare, both insured and not, for self and family, in both places. The US is not the rosy place you paint it, and I have multiple examples of INSURED people missing out on necessary care due to hospital shortfalls, indifference, and HMO/insurer denials. Neither system is perfect — but the UK's NHS is infinitely less broken.
For the record, I do not consider the US some "rosy place." Just because I don't want an American NHS doesn't mean I think the "system" in America is perfect, or even admirable.
There are plenty of problems with it, and I've commented on those here a number of times. There are solutions to the problems that don't involve taxes or socialism.
We use more, we get better, and faster treatment, and we have higher survival rates for most cancers, but the UK's is "less broken." That's Orwellian, to say the least.
You know, it is conceivable that a national healthcare system could provide better quality than a free market system. The problem is that it would be provided in a wasteful way — that is, contrary to the priorities of those who fund it. While it is somewhat instructive to point out that socialized medicine is usually of lower quality than that in a somewhat freer market, this argument could be dangerous, because it's based on the same myopic vision that demands the funding of health care at all costs.
RWW, when you said "this argument could be dangerous, because it's based on the same myopic vision that demands the funding of health care at all costs," I agree – however in the context of the twitter-thread to which I was responding, the challenge presented was "The NHS is better." I conclude that it is not better.
However, I have to disagree with your introduction. Let me explain: You said that an NHS could provide better quality but it would be provided in a wasteful manner, as if those two properties can be isolated in a vacuum. I submit that they cannot. What good is "the best health care in the world" if only 1% of the population can receive it? Or if it is "provided in a wasteful way"?
The quality and quantity of the service both need to be taken into account.
The fact of the matter is that "health care for all, at any cost" as you point out is extremely myopic. The reality is that there are, and always will be trade-offs. Determining how much, and of what quality, and in what time and place a service will be offered are responsibilities for which the market is uniquely qualified, and the State is not.
What good is "the best health care in the world" if only 1% of the population can receive it?
But my point is that, even if the best healthcare in history could be provided to 100% of the population, by the nature of government it would be wasteful. If such a situation is possible but not accomplished in a free market, it can only be because people don't want that level of healthcare for all.
In this case, you are responding appropriately to a challenge on Twitter, but in general it is a fruitless approach to point out the failures of other socialist systems. Socialism is not a failure simply because of empirical observations (which always allow the assertion that this time we'll get it right); socialism is known a priori to be a failure.
Why did my reply get eaten?
It was a false-positive in the spam filter. I just "approved" it, but it sometimes takes a while for them to show up on the site under those circumstances.
RWW, in case your comment doesn't ever show up (I've lost some comments under these circumstances, mysteriously), I love the conclusion you offered:
"Socialism is not a failure simply because of empirical observations (which always allow the assertion that this time we'll get it right); socialism is known a priori to be a failure."
[...] Two posts from David Z. at No Third Solution: Is it “Un-American” to Disagree with Nancy Pelosi? and Does the NHS Provide Better Health Care? [...]