I’ve watched with some entertainment the latest round of scraps across the pond about health care, which has now turned into a Brit-bashing exercise. Apparantly the NHS is ‘Orwellian’ and ‘Evil’ (allegedly that particular accusation was from the eminent scholar and international expert Sarah Palin) according to the American right-wing – which, when perceived from this side of the Atlantic constitutes most of the political spectrum compared to what is considered centrist here – all of which is news to most people in Britain, barring the usual suspects on the fringes of the Conservative party that their own leader would like to disown, but who always turn up on American TV because no-one listens to them over here.
I live in a Crown Dependency which unfortunately doesn’t benefit from the NHS, and frankly I’d love to have it over here, instead of paid-for primary care and state-run specialist care as we have (I’ve spent an awful lot of money on physios and doctors over the years). My parents moved back to the mainland a few years back and have had nothing but positive experiences with the NHS since; when we were visiting, my Mum was taken ill late at night and an NHS doctor was on the scene at her home within 45 minutes, all for no charge – something you would pay through the nose for here. It’s not perfect, but frankly IMO anyone who considers it optimal to have profit interests involved in the process of saving lives is either smoking something, or has a vested interest.
But, regardless of your point of view, it’s the blatant lies which are most amusing. My favourite is this quote from the editorial in Investor’s Business Daily, a national American financial newspaper:
“People such as scientist Stephen Hawking wouldn’t have a chance in the UK, where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless,”
For goodness sakes, who writes this nonsense? Prof. Hawking has lived in the UK all his life, and has hit back himself at this article explaining that he’s around today precisely because of the NHS, not despite it. Clearly facts are irrelevant when it comes to reinforcing your personal point of view. They’ve tried to take it back, but it just makes them look a little more stupid, especially casually tossing the word ‘Colony’ in there to somehow bolster the emotive side of the argument (taking speech tips from Mugabe now? not smart). Stephen Hawking was ‘a bad example’? In other words, they’re just making it up.
August 14th, 2009 at 2:31 pm
Well everyone who doesn’t want a single payer system loves to hear anecdotal stories of how Canadian or British health care system screw people over, but you can find those in America too.
The better argument use actual statistical evidence. Things like the NHS providing lower 5-year cancer survival rates then the US (and most of Europe). If we trust the statistics, which could always have issues, that implies the NHS (its NICE panel perhaps?) has decided to allocate less of its resources toward certain cancers and patients. Which is the kind of “Evil” and “Orwellian” decisions people talk about.
Then you get to the issue of personal freedom. In the NHS system you couldn’t even buy your own drugs (even if the NHS didn’t cover them) until recently. Which just backs up the argument that if the government is the sole provider of care and they say no your are screwed. In the US if the insurance company says no you still have options.
To make matters worse, people were opposed to letting patients buy uncovered drugs themselves because it would violate the principle of “equal care” in the NHS. I love socialism: forced mediocrity for all.
August 14th, 2009 at 2:57 pm
The ‘choice’ argument is totally bogus. If you want 100% personal choice regardless, go private. Then you’re in exactly the same situation as in the US anyway. No-one is forced to use the NHS if they want to pay for their own health care.
The difference is that the default is to provide your health care for free, which in the vast majority of cases is everything you need. Sure, you can’t mix-and-match private and NHS, but in the US you only have private anyway so the comparison is void. In the UK, if you want private health care instead of the NHS, knock yourself out, it’s there for the buying (as is health insurance). It’s telling that it’s a minority of people who feel the need to do that.
It’s not socialism, it’s called providing options, regardless of how much money you have. The way some people in the US are portaying it, it’s some Stalinesque setup where everyone has to queue for a couple of days in the snow to get rationed care. It’s bullsh*t propaganda and bears no resemblence to real life. The vast majority of British (and Canadian, I believe) residents are very happy with the setup and would hate to go to a commercialised system.
August 14th, 2009 at 3:20 pm
I don’t know how accurate this is (Wikipedia – but it has been talked about elsewhere) but if we’re talking stats, this is interesting: http://en.wikipedia.org/wiki/Health_care_in_Canada#Canadian_health_care_in_comparison
Notice how in that list the US ranks the lowest in terms of life expectancy & infant mortality, and yet the US already spends more government funds on healthcare per capita than any other country, almost 3 times what the UK spends, and far more than other countries with universal healthcare systems too (twice as much as even France and Sweden, whose healthcare systems are legendary). That suggests there’s some *major* skimming off the top going on in the US, my bet is by the medical profession and pharmaceutical companies. It’s certainly not in their interests for things to change I’m sure…
August 14th, 2009 at 4:16 pm
Life expectancy and infant mortality are very broad subjects and are not reflective of quality of healthcare ( crime, car accidents etc, different ways of classifying infant mortality)
In terms of quality of care and expected outcomes, the US has the best in the world, period. ( we are talking here survival rates, high end equipment saturation, waiting times etc )
The only problem which needs to be solved is how to make it affordable to about 20% of population who , for various reason, are unable to participate at this point.
August 14th, 2009 at 4:24 pm
True about the life expectancy & infant mortality.
But where’s the evidence for the ‘best care in the world’ claim? The WHO doesn’t agree – France and Italy took the top spots last time it compared (both socialised), and the US was 37th. http://www.photius.com/rankings/healthranks.html This is in 2000 but I doubt things are substantially different today.
If you don’t accept their criteria, the NYT takes a look at a number of different metrics and doesn’t seem to think it’s so awesome either: http://www.nytimes.com/2007/08/12/opinion/12sun1.html All while costing the government 2-3x as much per capita as anywhere else (which is at odds with the claims that socialised medicine will bankrupt the country), which seems odd if so many people have health insurance, as is claimed. Shouldn’t it be less if the insurance companies are the ones coughing up?
August 14th, 2009 at 4:29 pm
Well according to Wikipedia, I know a dubious statement, private health care in the UK is pretty anemic: http://en.wikipedia.org/wiki/Healthcare_in_the_United_Kingdom#Private_health_care
This means it doesn’t provide for all the things the NHS would provide, so it doesn’t seem like private care is really a viable option. So you really are forced to go with the NHS because everyones forced enrollment and contributions to it has made the private system a sub-standard option.
So the public “option” has really removed the private one completely. The public option is also not free, its payed through in taxes and the loss in economic productivity those create (In the UK its ~%23 of all government spending) The government crowding out the private sector is what people are afraid of in the US.
As for the implication that the US system involves “skimming” I would call that false unless you have information to back that up. I have seen some corrected figures (can’t site hem) saying that if you remove things like the high us murder rate from the life expectancy figure the US comes out near the top. Also the debate is so partisan and dirty here, if some company was reaping large profits that would of come out by now. In US people just get newer & flashier (ie. more expensive) care, extra care they don’t need, and sue there doctors too much.
I personally feel that the US is the worlds “early adopter” for health care. We bear the brunt of paying for the development of the newest drugs, medical technologies, and procedures. Once they become more common or have generic equivalents, they become cheap enough for organizations like the NHS to start using them.
August 14th, 2009 at 4:36 pm
@Joe: Emergency / critical care isn’t the kind of thing you ‘shop around’ for anyway, since you’re in no state to do it.
“The public option is also not free, its payed through in taxes and the loss in economic productivity those create (In the UK its ~%23 of all government spending)”
.. which, per capita is still about 1/3rd of what the US government spends despite its citizens also paying health insurance. You can massage the figures all you like saying it’s because of legal battles and ‘advanced’ treatment, but honestly, can that really account for a factor of two to three times, not even counting the amounts that the health insurance companies pay up? That’s an insane multiple in anyone’s books. Do you all get gold-plated plaster casts or something?
August 14th, 2009 at 4:36 pm
NY stuff is mostly typical “soft” BS ( satisfaction , access, fairness ?)
When you look at things that matter, there is just no comparison.
http://www.telegraph.co.uk/news/uknews/1560849/UK-cancer-survival-rate-lowest-in-Europe.html
August 14th, 2009 at 4:48 pm
Yep OK, US is awesome at cancer treatment at least. Maybe that’s where all the money goes.
August 14th, 2009 at 5:44 pm
Although, thinking about it, are these survival rates a % of the people that can afford to be treated, rather than a % of all those contracting? Is your survival rate 0% if you don’t have insurance, but unrecorded in these stats? No idea, just thinking aloud here, because obviously everyone gets treated in a universal system (NHS still lags others in that group though).
August 14th, 2009 at 5:49 pm
Articles like this would worry me too if I lived in the US:
http://www.msnbc.msn.com/id/20201807/ns/us_news-gut_check/
http://www.msnbc.msn.com/id/20186938/ns/health-health_care/
It reminds me of the cases in ‘Sicko’ – which I know were obviously picked to make a specific point so need to be considered in that context, but clearly life-destroying gaps in health cover are possible for ordinary people. And who want’s to have to deal with insurance companies trying to wriggle their way out of a contract as soon as it gets expensive, when you’re already dealing with the medical problems? If it’s as routine as these articles claim, it’s horrible.
August 14th, 2009 at 5:55 pm
I am not arguing that we spend to much on health care, I did find an interesting article on why costs are higher in the US: http://content.healthaffairs.org/cgi/content/full/23/3/10
August 14th, 2009 at 6:12 pm
So, a significant contributing factor is the wastage through all the completely unnecessary admin built into the system. I bet plenty of it goes to the insurance companies, their employees and their shareholders, to no benefit of the patient. That’s what I mean when I make claims of ‘skimming’.
August 14th, 2009 at 7:11 pm
I wish the public debate here in the U.S. was as respectful and generally fact-oriented as this comment thread has been. Alas.
August 14th, 2009 at 9:05 pm
I’m not American, but I lived in the states for 5 years. I still keep up on a lot of American news.
The health care debate has been ridiculous. Opponents have continually tried to link the health care bill to emotionally charged, but completely false ideas such as government run death camps (“Do you want the government deciding when to pull the plug on grandma? Hell no!”)
Historically the republican party was at least respectable and consistent within it’s own agenda and values (minimal government, fiscal conservatism, etc). But the party has undergone a huge swing to social conservatism, picking up wide support among fanatically religious Americans, who resound more to faith-based and emotional arguments than logical or scientific ones. (I use the word “fanatical” here because I certainly don’t view all religious people in this manner.)
This has made national debates over issues like health care into a bad joke, as one of the two sides debating the issue simply doesn’t care much about the facts. Why spend all that time reading and thinking, when you can just take a word like “socialist” (now taking the demonized crown from “terrorist”), and shout it really loudly while accusing your opponent of being unpatriotic?
August 14th, 2009 at 9:14 pm
(oops quick correction: “death panels” not “death camps”.)
August 15th, 2009 at 1:30 pm
I think had they felt they could get away with ‘death camps’ as a claim, they would have gone with that too.
August 16th, 2009 at 7:32 am
Lobbyist? I hate them, I mean really hate them. They are just bunch of people who muscles all their political connection and use mass media to champion their interest – not the people interest.
From my understanding, there are lots of incentive (read:interest) for the status-quo, so Obama’s recent initiative being labelled off socialist is highly expected.
And yes, I agree with the term socialist being feared out of proportion where in the true world, you are actually mixing capitalism with socialism in lots, lots of places. It doesn’t matter, and what really matter is the implementation – what its to citizen, its benefit etc etc. Just pure common sense which doesn’t seem prevalent these days.