no third solution

Blogging about liberty, anarchy, economics and politics

Does the NHS Provide Better Health Care?

August 13th, 2009

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)

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.




no third solution

Blogging about liberty, anarchy, economics and politics