Since We are on the Subject: National Healthcare

October 30th, 2007 | by rocketc |

Most who visit this blog are looking for personal finance posts, but as we enter the election season here in the States, the subject of healthcare is on everyone’s radar screen. Here are three pieces that I consider pertinent to our upcoming election, yesterday’s discussion and my pocket book.

The first is an article from the London Telegraph in August of this year. It states that UK cancer survival rates are the lowest in Europe. That fact is not so remarkable - many countries have difficulty with one disease or another. However, long waiting periods for health care are cited as the reason for the mortality rate.

The second piece is written by the National Coalition on Health Care that is based in Washington D.C. In it, England’s national health service is studied and evaluated. Here is an excerpt that Americans who plan to vote in the next election need to consider when making their decision.

The British health care system is experiencing serious problems with its funding, service, and staff that vary in severity across the region. A long-standing problem has been long waiting times for care, particularly for elective services and procedures. In the United Kingdom in 1990, 41.2 percent of Britons reported waiting more than 12 weeks between seeing a specialist and receiving surgical care. A NHS watchdog group reported that some PCTs lack essential senior staff, forcing “some practices to close their lists, while other areas suffer from a severe lack of district nurses. There are also long waiting lists for therapists, particularly physiotherapists.” Another study found that for the past several years, waiting to see a specialist and waiting for elective surgery have been ranked as the first and second most critical failures of the NHS.12 There are also allegations of declining quality of equipment and staff; another group, Audit Scotland, found that a quarter of all NHS equipment in Scotland has become dangerously outdated, while “only half of Scotland’s health trusts could demonstrate that staff had a proper understanding of the equipment.” Together these factors have contributed to serious dissatisfaction with the health care system. In the London Telegraph, Sheila Lawlor declared that the question was “who provides the healthcare and whether we get value for money. The answer, patently, is that we do not.” Those who can afford it may opt for private care: conservative shadow health secretary Liam Fox suggested that the number of people opting for private care rose by 29% in 2001 because of dissatisfaction with the NHS.  A recent poll found that 35% of British citizens ranked health care the most pressing national issue. A 1999 poll found that a slim majority of 55.7 percent were very or fairly satisfied with their health care system, while 42.3 percent were fairly or very dissatisfied with it.

Citations for the above quotation are found in the original document.

A third more recent article also comes from the London Telegraph and states:

Record numbers of Britons are flying abroad for essential medical treatment, in order to avoid long NHS waiting lists and the rising threat of deadly hospital superbugs. Patients needing vital surgery are travelling as far as India and Malaysia, where operations cost half the price charged in Britain’s private hospitals.

The British system of nationalized health care seems to be in worse trouble than the current US system of private health care, yet we are being told that our system should look more like theirs. Do you want to put the people who have bungled education, social security and a whole host of other things in charge of our health care too?

What does this mean for me? It means that while healthcare in the US is certainly expensive, at least I can get it for myself and my family. I certainly could not afford to outside the system to purchase my own private care or fly to India for surgery.

Maybe I will have the money if we raise taxes to pay for nationalized healthcare. Not likely.

  1. 9 Responses to “Since We are on the Subject: National Healthcare”

  2. By plonkee on Oct 30, 2007 | Reply

    It’s certainly true that there are many pressing problems with the NHS, especially the cleanliness of the hospitals (cleaning is contracted out) and the long waiting lists (there was a previous shortage of practitioners). Aspects of the NHS that are more privatised tend to fare worst however - for example dentistry is mostly private and many people (including me) can’t find an affordable dentist.

    What people in the UK would like is a system like in the rest of continental Europe, the US is usually held up as an example of why privatised medical care is a bad idea - free medical care is almost sacrosanct.

    If I could choose, I would have the level of payment for healthcare tied to income and the level of medical care received tied to need. The method of provision is probably what is at fault in the UK, and I don’t think anyone is suggesting that the entire US healthcare system (hospitals / doctors / ambulances etc) be nationalised, merely the method of payment.

    The NHS does a lot more for less money than is spent by the US government per head of population. The NHS is definitely not a good model of efficient practice, which to me implies that you in the US could do a lot better with the money your government currently spends.

    Private healthcare is as much part of the system in the UK as elsewhere and the costs are less than the full freight price of healthcare in the US.

    Finally, medical tourism started as a trend in the US, and has since spread to the UK. The most common procedures to take place abroad are cosmetic surgery and IVF, which are only partially available on the NHS. I don’t think it’s fair to say that the UK is worse than the US on this point.

  3. By plonkee on Oct 30, 2007 | Reply

    I seem to have written an essay. Sorry.

  4. By rocketc on Oct 30, 2007 | Reply

    Actually, I appreciate it. It is very difficult to get a real “handle” on what is happening in other countries.

    I think the bottom line for me is, private companies are more efficient than government beauracracy. I would be in favor of a system that gave people money in an account that they could use in whatever they see fit - as long as it was for medical needs - and introduce market forces to healthcare. Right now, even our private insurance system makes it seem like we are spending someone else’s money. so we don’t shop for the best price or service. Furthermore, when doctors know that insurance is paying, they raise prices or recommend elective procedures.

    Thanks for your viewpoint.

  5. By plonkee on Oct 30, 2007 | Reply

    I wouldn’t oppose the sort of system that you propose, providing it was combined with some sort of catastrophic insurance and everyone got some sort of basic amount. I’m actually a big fan of the market as long as everyone is appropriately handicapped.

  6. By rocketc on Oct 30, 2007 | Reply

    I think that people would have the option to use their “health account” to purchase any type of insurance they would like.

    I find your phrase “appropriately handicapped” to be very interesting. Can you explain it a little?

  7. By plonkee on Oct 31, 2007 | Reply

    There is some Nobel prize winning piece of economics that basically states that you can get a market to solve any relevant problem (like paying for healthcare) as long as you adequately handicap people.

    In this case it would probably mean that you redistribute a small amount of wealth so that everyone gets a fair shot at decent healthcare and that you would make catastrophic cover affordable regardless of the health of the individual concerned. You’d also need to make catastrophic cover compulsory so that you don’t end up with people dying the streets - which is ok if it is affordable.

  8. By rocketc on Oct 31, 2007 | Reply

    The Nobel Prize doesn’t carry the same weight these days - since they gave it to Gorbachev, Carter and Arafat. . . but I do like allowing the market to solve such problems.

    Anyway, I think compulsory insurance is a good idea - as long as private companies can be allowed to compete for it. Car insurance in the states is completely open to the free market - and features affordability and great customer service. I think I feel another post coming. . .

  9. By plonkee on Oct 31, 2007 | Reply

    We too have compulsory free market car insurance and it works reasonably well. The Nobel Prize for Economics is different to the Nobel Peace Prize, and in any case Gorbachev and Arafat were reasonable winners. Not perfect, but they made an effort to do the difficult but right things.

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