Holy crap, the Guardian have published something worth reading!

Wednesday 18th May 2011

About the government’s health reforms. I’ve mentioned in the past that some of the arguments against the proposals seem somewhat blinkered. The Guardian published an article today which looks at those arguments in a similar sort of way:

“The media debate has ignored the most obvious evidence: the fact that almost everywhere where they have been tried, market approaches work better than centrally planned government ways of running the same activity. Not all markets work well, but even the bad ones seem to do better than central planning.

Many arguments against competition in the NHS seem stuck in a 1930s time warp and ignore 80 years of world history that have taught even the Chinese Communist Party that planned economies are a failure – and this is true even when compared to very imperfect market ones.”

I still don’t understand why people think that healthcare should always be provided by the state. As far as I can see it, such strict adherence to state provision is the answer to a question that no-one is asking. The basic desire – that I think most people can agree on – is to have a good service, for the best value for money, which is accessible to everyone. In that case, as long as the government pays for the treatment, does it really matter who provides it? Shutting out providers other than the NHS simply means that we’re excluding providers who might, potentially, be able to do something better, cheaper or quicker than the NHS can. Can anyone explain why this is a desirable thing?

Some people will say “ah, but we don’t want to be like America, do we?!”. No, and the proposals do not mirror the American system. The American private insurance system, which means that some people simply can’t afford care, is not good. And that’s also not what’s being proposed. The market bit of the American system works well, and it’s notable that countries like France – which has private providers and a public insurance scheme – generally have better health systems than our own. The evidence stacks up, and as far as I’m concerned that trumps any ideological misgivings.

Posted at 11:14 pm | Posted In: Politics Tagged:



Tuesday 31st May 2011, 12:46 pm

I can’t remember where I read the article – think the Observer but maybe wrong – but read somewhere that actually there are plans afoot to move us over to an insurance model whereby the NHS would not be a provider of care but of insurance. That’s almost a direct quote.

I don’t think this is the article I read, but:

Also I think this may have been the article in question:

Argh. Been massively distracted now…


Tuesday 31st May 2011, 12:49 pm

In countries with an insurance model those who cannot afford insurance do not get care as good as those who can. This is true across any country with that sort of a model. The NHS is lauded across the world as A Good Thing. It may not be perfect, but the fact that healthcare is free to any UK citizen for any health problem is something we should be so proud of, and it *is* under threat. These proposals – see my links above – do come perilously close to (if not indistinguishable from) the US system, if you ask me.


Tuesday 31st May 2011, 2:34 pm

“In countries with an insurance model those who cannot afford insurance do not get care as good as those who can”

That would be a fair criticism of a private insurance model, as exists in the US (or existed; I’m not sure what Obamacare was all about, what changes he’s made there). That’s also not what’s being proposed.

Instead, it’s a public insurance model. The state still pays for healthcare, but doesn’t necessarily carry out the work. So no-one has to afford it, because – as with the NHS – it’s available to everyone. That availability is the best thing about the NHS, and no-one (at least no-one sensible) is proposing changing that.

I’ve never heard that the NHS is “lauded across the world”. Certainly, places that have this mix of public insurance and private provision (or even mixed provision) seem to have better healthcare than we do, whilst maintaining the availability to everyone. Who can be against that?


Tuesday 31st May 2011, 11:32 pm

I’m afraid that there is a definite move for the public to pay for their own healthcare with the NHS being a provider of insurance. Here is a direct quotation from my second link:

Writing in the Health Service Journal, Britnell also suggested that the NHS would be better served by breaking with the mantra that all services should be free at the point of delivery by allowing co-payment, where patients share the costs of care and drugs.

“It appears that countries that have a mixed blend of public and private provision, co-payment and social insurance are possibly more capable of providing resilient healthcare systems.”

It doesn’t appear that ‘public’ insurance is really, long-term, what Britnell, Lansley et al are after.

And yes, the NHS is seen by many people in many countries as A Very Good Thing Indeed. You’re right, we shouldn’t stick to principles just because they’re principles, if other plans get the outcomes those principles are after in a way that is better for everyone, but I’m yet to be convinced that what you say is possible or true.


Thursday 28th July 2011, 9:51 pm

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