Why we should scrap the NHS

The NHS doesn’t work, because like all Socialist enterprises it breaks the essential direct link between the people paying for the service and the people providing it.

This is bad for both the healthcare providers and the patients:

1. The NHS destroys respect for healthcare providers.

Every weekend, after 11:00pm, the local hospital’s Accident and Emergency department will be filled with drunken youths demanding their right to unlimited treatment for self-inflicted injuries.
http://news.bbc.co.uk/newsbeat/hi/health/newsid_7588000/7588865.stm

Every night people call out the ambulance service because their child has a sniffle, or even to check if their chinese take away is safe to eat.
http://news.bbc.co.uk/1/hi/england/cornwall/7582515.stm

38% of all ambulance call outs do not actually need an ambulance:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1285673/

Abuse of healthcare providers is an everyday occurrence:
http://news.bbc.co.uk/1/hi/england/7712545.stm

Healthcare providers have no choice about who they treat, people can waste their time, abuse them and treat them as appallingly as they like and still demand their “right” to free treatment.

2. The NHS destroys respect for patients.

Patients can’t take their custom elsewhere and the health care providers are paid regardless of whether or not the patient is satisfied with the care they receive.

As a result serving patients takes second place to reducing costs and patients are put into:

unclean,
http://news.bbc.co.uk/1/hi/england/cornwall/7886537.stm
http://www.dailymail.co.uk/news/article-1382293/Rodent-horror-childrens-hospitals-

MSRA ridden wards:
http://www.wakefieldexpress.co.uk/news/local/three_cases_of_superbug_mrsa_in_new_hospital_1_3332556
http://www.newsoftheworld.co.uk/notw/_news/1263370/Leeds-NHS-top-MRSA-shame-table.html

or left alone on trolleys in corridors.
http://www.dailymail.co.uk/news/article-1374415/Hospital-bosses-apologise-woman-patient-left-trolley-SEVENTEEN-HOURS.html
http://menmedia.co.uk/manchestereveningnews/news/s/1419158_tragic-grandad-in-5-hour-wait-on-ae-trolley?all_comments=1
http://www.thisisstaffordshire.co.uk/news/6-hours-death-hospital-trolley/article-3435917-detail/article.html

They are denied life-saving expensive treatments
http://www.hc2d.co.uk/content.php?contentId=18139
http://www.dailymail.co.uk/health/article-1375057/Zosia-Knight-2-denied-NHS-treatment-sight-threatening-birthmark-finally-smile-again.html?ito=feeds-newsxml
http://www.warringtonguardian.co.uk/news/8984984.Counting_the_cost_of_your_treatment__GPs_told_to_deny_medicine/

and sent home before they are well,  to “free up beds”.
http://www.dailymail.co.uk/news/article-1247568/500-000-hospital-patients-sent-home-soon.html
http://www.dailymail.co.uk/news/article-1379260/Mother-dies-brain-haemorrhage-hospital-sent-home-painkillers.html
http://www.mirror.co.uk/news/top-stories/2011/04/14/lad-dies-of-meningitis-hours-after-being-sent-home-from-hospital-115875-23059729/

the treatment of high cost elderly patients is particularly poor:
http://www.dailymail.co.uk/health/article-1379419/Patient-neglect-bad-decade-ago-1-5-treated-dignity.html
http://www.burtonmail.co.uk/News/Sick-OAP-was-sent-home-in-pyjamas-22042011.htm

Patients are treated not as valuable customers who pay everyone’s wages, but as an annoying distraction that uses up the budget.

3. “The NHS is bursting with administrative staff”

The one thing that state run bureaucracies are good at is empire building. Finding reasons why more non-productive underling bureaucrats are required in your fiefdom is a guaranteed way to rise up the bureaucratic hierarchy.

These people add no value to the customer, but considerable expense to an organization. That’s why they tend not to exist in the competitive environment of the private sector

In the total NHS workforce of over 1.5 million people, (only the Chinese People’s Liberation Army, the Wal-Mart supermarket chain and Indian Railways directly employ more people) less than 50% are clinically qualified.
http://www.nhs.uk/NHSEngland/thenhs/about/Pages/overview.aspx

We have such a blind love affair with the NHS that few ever question if it should be kept. But if anyone dares to, and anyone bothers to put forward any reasons, these are what we hear:

“But without the NHS the poor would be denied medical treatment and die”

The supporters of the NHS are keen to point out that without medical care people may die and since the poor cannot afford private medical cover they may die.

But this argument is easily seen as false, we also all need food, without food we will certainly die. We do not have a National Food Service (NFS) so why aren’t we all, and the poor in particular, starving to death?

The reason we don’t need a National Food Service is that the private sector does an amazing job of getting the things people need, to the locations people want, at the time they want them, at a price they can afford.

The poorest are given benefit money with which they buy their food from the provider who best meets their needs. Even from a socialist perspective you could just increase the amount of benefits given to the poor so that it allows for health care costs. Every man, woman and child in Britain pays over £1,500 a year for the NHS so there is plenty for the socialists to to re-distribute.

This is the type of system they have in Switzerland.

Swiss healthcare is widely recognised as amongst the best in the world. According to the latest OECD figures it outperforms the NHS on every metric:  More doctors, nurses and hospital beds per person, more CT Scanners, MRI Scanners and acute beds, longer life expectancy, lower infant mortality, better survival rates for cancer, stroke and cardiovascular disease. Waiting lists are almost unheard of and surveys show that the Swiss system has one of the highest patient satisfaction levels of any country in the world.

Swiss health care is provided to everyone through a system of compulsory health insurance, much like our own car insurance system. Those that cannot afford to pay for it have their insurance subsidized or paid for entirely by the state. Working people do not find it hard to afford because, without the burden of a giant NHS to fund, the Swiss have one of the lowest tax rates in the world.

Patients are free to chose where they are treated from competing healthcare providers in what approximates to a free market.  Service abuse is discouraged and good health encouraged by means of insurance excesses and no claims discounts.
“But Medical Costs Are So High That Only The Rich Will Be Able To Afford the Best Treatment”

There are a number of objections to this argument.

1)      Private medical insurance can be taken out for high cost medical needs. Having your house burn down would be too expensive for most people to cope with, but by sharing the risk through insurance everyone can be protected for a relatively low premium.

2)     If medical procedures are too expensive for all but the very rich then market forces will drive invention and entrepreneurship to lower the costs to the mass market. When the motor car, or the television or the mobile phone were first invented only the rich could afford them. In a free market the prices are driven down until they become affordable to the masses, because that is how the creators make the biggest financial return. If cars had been provided free of charge to everyone by the state regardless of cost, we would all still be driving around in very expensive Model T fords.

3)     It is irrational to assume that everyone can have an unlimited “right” to resources. A right to have them from whom ? If a new cancer treatment was developed that required the patient to spend 6 months in a space station at a cost of £50 Million and every cancer patient is entitled to this, who will pay for it? The socialist solution is that if not everyone can have it then nobody will. The result is that more people die than was necessary and the market processes of innovation and costs reduction outlined above cannot start.

The NHS is a non-profit organization. Allowing the private sector to take over would mean money going to profits instead of it all being spent on healthcare.

The same argument could of course be applied to the establishment of a National Food Service. In socialist countries where the state has actually taken over the non-profit production and distribution of food we should therefore see this “better system” improving things for the people. What we actually see is customers travelling for miles to get to their nearest, dirty, food store. Here they queue for hours in the hope of buying a stale loaf of bread and half a turnip from a surly state employee.
(Personally I prefer the free market Tesco experience)

It should really be no surprise that our socialist medical system is closing local hospitals making customers travel for state convenience, has dirty wards, long queues for treatment and staff that treat patients like a nuisance. We are even being told what life choices to make to ensure that we don’t cost the state too much. We must take regular exercise, eat 5 a day, drink less than x units of alcohol a week, stop smoking and even stop wearing certain types of shoes, so that we are less of a burden on the state.

http://www.telegraph.co.uk/health/3113691/29m-surgery-to-cure-high-heel-foot-damage.html

Every socialist experiment in history has tried to drive out the “waste” of private profit and each one has reduced the living standards of its people. Sometimes the process is delayed by the appropriation of natural resources of the confiscation of wealth created by others, but once left to its own productive capacity socialist enterprises consistently fail to deliver as much as their free market equivalents.

The best way to improve the quality and lower the cost of health-care in the UK would be to scrap the socialist NHS and let the free market get on with what it does best, meeting consumer needs in the most efficient and effective way possible.

The way to provide effective healthcare to the poor is to use a Swiss style system that ensures universal health care but does not break the vital financial relationship between service user and service provider. It is the financial relationship that ensures everyone is treated with respect and the system is run to maximize customer satisfaction (clinical results) and minimize financial waste.

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  • Sl1970

    All of these terms are out of date in my opinion. So lets replace them – right simply – who has the best health care system in the world and lets emulate them. I think its France – but I cant say more than that Im not conventionally well educated so I cant express myself as well as I would wish. We need something radical and bold to change the way things are – otherwise its just a swing from left to right forever . Also I dont think the NHS is that bad. Also I think sometimes whether socialist or not – you have to take responsibility for your own health as much as is reasonable – eat healthily, exercise more etc – these values have slipped because more money is made from junk food consumerism – alcohol – and smoking and people watching TV soaked in advertising. Why so many ads for pizza hut- all family friendly style? come on. The real problem is here is the lack of education and the selfish greed amongst certain shady money makers.

  • Pygmalion

    You really think the market will reduce healthcare costs to the level the poorest people in society can afford? Really?

    As an (ex) American who suffered without healthcare for so long, your view of the US system is highly naive. There is a reason there are millions upon millions of Americans who simply cannot afford healthcare. If you truly think the market would lower health care costs then you really, really need to study the ins and outs of the American system.

    I’d love to be one of your “rich”, but bad health has prevented me from being able to be “rich” in my lifetime. I’m just happy to be alive, and if it weren’t for the NHS, I would be dead now.

    • Anonymous

      The poorest people in society will never be able to afford comprehensive healthcare on their own. My point is that if you are going to pay for the healthcare of the poor, you would get better value by giving them money and allowing them to purchase health insurance in a market environment than funding a system that is totally oblivious to the satisfaction of its patients and not subject to the competitive forces that drive up efficiencies and drive down costs.

      • Pygmalion

        In the brief period I had insurance in the US, it was horrible. They were, unlike my experience of the NHS, “oblivious to the satisfaction of their patients”. They treated me horribly, I had to argue to get mental health treatmentcovered (even though it was specifically outlined in my documentation), etc. If you think the NHS is impersonal and doesn’t care about patients, have a look at many American insurance companies. Most of them won’t even cover pre-exisiting conditions.

        I don’t want choice. I don’t want a market. I just want good healthcare provided by competent professionals. I and everyone in the UK get this in the NHS. Most Americans only wish they could be so lucky.

        The market is not a cure or solution to everything, and neither is profit. Some things are more important than money, but sadly, Ayn Rand fans really don’t see this. They see only themselves, money and their own self interest. They don’t understand that some of us care more about their fellow human beings than the size of our bank balance.

        • Anonymous

          My own experiences differ, my aunt died in hospital because they failed to carry out basic diagnostic tests to find out what was wrong with her. My mother was nearly killed in hospital because the doctor on duty didn’t read her notes and gave her a treatment specifically noted as dangerous. My father was in hospital with cancer and was given five times the dose of a drug he was supposed to have because the foreign agency nurse didn’t understand the instructions. My grandmother went to hospital with a fall and was about to be sent home despite the fact that she was speaking gibberish. After the family kicked up a fuss they finally did some tests to discover the reason for the fall was a stroke. In every case they were fed slops that I wouldn’t give to my dog and were in wards that frankly looked like they needed a good clean. Getting a nurse was almost impossible, they were always “too busy”, but could often be observed chatting to each other about their latest boyfriends while patients were calling for assistance.

          In my experience private medical cover has been first class, with clean hospitals, modern equipment and staff who want to help the patient and I have never had a problem getting a bill paid.

          Why would an insurance company cover a pre-existing condition. It is a bit like asking a house insurer to cover your house for fire, after it has burned to the ground! Insurance is about sharing risk of things that might happen in the future, it is not a charity giving free money to people after the risk has happened.

          It is ironic that you try to take the moral high ground, you say:

          “I don’t want choice. I don’t want a market. I just want good healthcare provided by competent professionals”

          You miss out the most important part which is:
          “paid for by somebody else!”

          Of course you don’t care how efficient the system is or how much it costs, as long as you get everything you need and you don’t have to pay anything for it?

        • Anonymous

          I deal with your point about:
          “some of us care more about their fellow human beings than the size of our bank balance” in my latest post:
          http://www.libertarianview.co.uk/do-you-really-care-about-others-take-the-coffee-test/

  • Asdfasdf

    For sure the NHS system has its failings, but I think it’s naive to ignore the well-documented criticisms of the American-style system you endorse.

    America, the only developed country with a system like you suggest, has the highest per-capita healthcare spending in the world – 2.5x spending in Britain – and yet in healthy life expectancy they’re ranked 29th – while the UK is 24th.

    Spending 350% as much for the same outcome, doesn’t sound like an improvement over the British system to me.

    • Anonymous

      The US system is far from perfect, but it is an error to try and judge the quality of a healthcare system based on life expectancy. The US suffers from the highest rates of obesity in the world and this would likely reduce life expectancy in most circumstances. There are also differences in medical practices that would change outcomes. e.g. procedures with better average patient outcomes but a small risk of serious complication (and hence litigation) would be avoided in the US and probably adopted in the UK. The 5 year cancer survival rates for the US are much better than for Europe.
      http://mjperry.blogspot.com/2009/08/5-yr-cancer-survival-rates-us-dominates.html

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  • Sl1970

    Why do we always compare the UK with the US and not countries that have excellent health care such as France? Can someone tell me that?

  • Roger Thornhill

    The US is a bad model to compare against as it has massive State unterference, even before the new legislation kicks in.

    The Swiss have a pluralistic system, Ie multiple providers. Each Canton (county) decides what the basic level of coverage an insurance provider must provide. Providers are free to offer more, or additional top-up packages. The Swiss “basic” was described as comparible to a good German private scheme. This basic package spec plus multiple providers means lower price and higher quality become the deciding factors. The destitute will get assistance for the basic package. This is a step in the right direction. To mr it is a staging post to aim for before deciding on the details of any next stage of healthcare reform. It is not perfect, many libertarians do not like the idea of Canton control, but moving from a Nanny-based system this seems like a viable plan.

    We would suggest that the County ability to set healthcare basic levels be sunset after 5 or 10 years to ensure that it is of Socialism by the back door. I suspect we would need curbs day 1 to stop Health Nazis hijacking the County boards to push thief ridiculous, Authoritarian agenda.

    • http://www.libertarianview.co.uk Murray Rothbard

      It certainly sounds as if the Swiss are on the right track.

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  • Meggg

    You’re missing out the main  reason why it costs so much. Foreigners can come in and use the health care system, they contribute nothing towards it and come in their droves to abuse it. Make the NHS available only to BRITISH citizens, and it would save A LOT of money. Also suggesting that medical care can be as easily distributed and obtained as food is completely ludicrous. Food is A LOT easier to come by, than sophisticated medical care so it can be sold to people at a cheaper price. Shops can afford to sell chicken fillets at £2.60. Hospitals can NOT afford to sell cancer care at £2.50. You’re argument that people manage to feed themselves and so can obviously manage to provide medical care for themselves is therefore totally stupid. Expecting a poor person to be able to pay for life saving treatments or large operations is like expecting a poor person to dine on Fillet steak, lobster, caviar and Champagne every night. Also you say that we should just up benefits so poor people can afford health care. Well where do you think that money will come from???? More tax or the money left over from the NHS you want to spectacularly scrap! The NHS is flawed, but it does a lot of good. It needs it’s creases (admittedly large creases) ironing out, it does not need to be scrapped.  From my experience, medical insurance companies can be nothing short of evil and are not the better alternative, just look at the behaviour of car insurance companies if you an example of how unscrupulous and un wiling to pay out, insurance companies can be.