Against the NHS
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| Author: Patrick Crozier |
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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.
- it is free at the point of use. This is a form of price control and I am against price controls
- I believe it isn't as good as what went before
- I believe it isn't as good as freer systems found in other countries
- I believe it isn't as good as Britain's own private sector
- it is getting worse
- it lies about the scope of the treatment it provides
- I believe the free-market alternative would (in the long run) be better
Contents |
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Questions
But isn't it the case that the private sector is so much better because it has so much more money?
- Well, it is certainly one of the reasons. But I also believe it is just better managed. There are far fewer bureaucrats and targets (as James Bartholomew points out). It is also far better at keeping its hospitals free of infections like MRSA. I can't believe that that has much to do with the amount of money involved. There are also far fewer stories of waste in the private sector. Now, that might have something to with the NHS being publicly funded so people feel they have a right to know what goes on and so newspapers are far more likely to report on it. But, then again a private hospital that wastes money will have to charge its patients more and hence lose competitive advantage.
So, you're against price controls
So, how does this apply to the NHS?
- The NHS is free at the point of use. Therefore, 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 the product. 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 are 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
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The Scope
It lies about the "scope of the treatment"?
- Yes. The classic example of this is long-term care. As James Bartholomew points out although the NHS is supposed to look after stroke and Alzheimer's patients it finds ways of weaseling out of the commitment
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The Alternative
Why do you that the free-market alternative would only be better in the "long-run"?
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Comments
If you would like to comment on this article I suggest you make it here rather than attempting to use the Talk/Discussion page. I have recently received a large amount of Wiki spam and the only effective way of preventing it is to prevent the unmoderated creation of new accounts without which the page is uneditable (unless your name is Kieran or Jax).
