Home
The Blog
Transport Blog
Wiki
All pages
CATEGORIES
Economics
Trade
Environment
General
Health
Media
Immigration
Housing and Planning
Rail
Roads
Safety
Ulster
I am against the NHS because:
- it’s funded by taxation which I am against.
- it is owned by the state and I am against state ownership of healthcare.
- it is free at the point of use. This is a form of price control and I am against price controls
- it doesn’t seem to be very good
- it seems to be getting worse
What’s the problem with the NHS being free at the point of use?
- Because it is free at the point of use there is every incentive for customers ie the public, to use it. So, they do. At the same time, because they get paid whether they treat people or not, there is no incentive for people working in the NHS (managers, doctors or nurses) to increase supply of healthcare. So, they don’t. That’s why you get 7 hour waits in casualty and two-year queues for operations
But, surely, without the NHS the poor wouldn’t get treated?
- This rather assumes they get treated now. First off all sorts of treatments are unavailable in the UK. Secondly, most people (Prime Ministers excluded) have to queue. Many die before they get treatment. Thirdly, the standard of treatment in the UK is much lower than that in comparable countries.
It is, of course, impossible to say what precisely would happen if healthcare was liberated from the state. But it strikes me that there are two distinct possibilities. Either people do care about those unable to afford healthcare or they don’t. If they do, then they are likely to give to charities and in other ways make sure that the less well off are looked after. If they don’t then they are going to be unconcerned about the outcome.
Having said that there are good reasons to believe that people will rally round. After all, that is what they did before the NHS came into being and at the time healthcare was more or less universal. Not only that but (according to James Bartholomew) it was, for the day, of an extremely high quality, if not the best in the world.
But, without the NHS, wouldn’t there be all sorts of inequalities with the rich being able to buy themselves better treatment than the poor?
- Yes, there would be inequalities. But then again, there are inequalities in all sorts of things, for instance, food, holidays, cars and housing.
Inequality is (in the long run) a good thing
Inequality a ‘’good’’ thing?
- Yes. Look at the things around you, the things you like having. Like electricity, for instance. When that first got going very few people could afford it. They bought it. They created markets for power generators and manufacturers of electrical equipment. As more players entered these markets they found ever cheaper ways of supplying their products. Eventually, more and more people could afford to have electricity in their homes, to the extent that nowadays, everybody does. Ditto, computers and cars (well, sort of). In other words, inequality breeds prosperity and ‘’equality’’. Why shouldn’t that happen with medicine? My guess, is that when, for example, anaesthetics were first introduced very few could afford them (though my guess is that in reality it was a bit more equal than that). Doctors got experience in using them, thus creating a support industry, thus creating competition, thus bringing the price down. Thus, eventually, bringing the benefits of anaesthetics to all
Early anaesthetics equal?
- Now, I am not sure quite how it worked in the 19th Century but my guess is that when the pioneers were doing their pioneering their main concern was to find patients upon whom they could experiment. And, bearing in mind that (as I understand it) many hospitals were charitable concerns, it seems likely that the hospitals may well have paid a large proportion, if not all, of the costs of the (then) experimental treatment
The Alternative
Why do you that the free-market alternative would only be better in the “long-run”?
But don’t we already know what the alternative would be like? It’s the American system and that isn’t very good either.
- As I understand it, there are all sorts of things wrong with the American system. However, as I understand it, the US government intervenes in American healthcare almost (but not quite) as much as the British government interferes in British healthcare.
Here’s an example of things not going well in the US. And here is another. Here is an example of the difficulties a lung-cancer patient has had in getting her insurer to pay for her medication.
Nothing yet but you never know...