Late last week, Conservative Member of the European Parliament, Daniel Hannan, appeared on Fox News. His statement that the US should not attempt to create a new health care system, based on the British model of the National Health Service (NHS), ignited a firestorm in England. On Friday morning, the British airwaves and print media, not to mention the blogosphere, went into overdrive with comments which amounted to a national self examination verging on a societal inquisition.
Hannan’s remarks caused the Conservative Party leader David Cameron, heir presumptive as the next Prime Minster, to immediately send out a letter to all and sundry heaping praise on the NHS. In addition, he promised that when his Party returned to power it would increase spending allotments to the NHS.
What is that likely to cost British taxpayers?
The most compelling argument against having the government dishing out your aspirins comes from an analysis of basic economics. There is no such thing as universal free medical care. The money has to come from somewhere. The 2010 projected budget for the UK Department of Health will be £110 billion (roughly $187 billion US), most of which will go to pay for the NHS. The latest population figure for Great Britain is just over 60 million souls, of which 29 million are in the workforce.
So each taxpayer is now paying roughly $6,450 per person for basic care, provided you meet certain age and pre-existing condition guidelines. Compare this with the leading complete-service private insurance program in England, BUPA, which charges $2,180 for an entire family. The government-run NHS charges 3 times more for a far inferior service. And it’s getting worse.
These sums explain why the Conservative Party has not ruled out upping the Value Added Tax (VAT) to 20 percent should the next election turn out the tax and spend Labour Party. VAT (the national sales tax) is charged on most goods and service businesses in the UK. This is on top of the import duties for any foreign made products. In other words, VAT is like always tipping your ‘waitperson’ 20 percent on any dinner tab, no matter how bad the service is.
Opinions from Friday’s various discourses ranged from whole-hearted support to echoes of Hannen’s position. In general, it was argued that while the NHS tended to be monolithic, it was equitable (need, not class based). Where the NHS falls short, most agree, is in establishing preventative programs and providing cutting edge treatments and medications.
Full marks to Steven Glover for his analysis in The Daily Mail. He wrote what most Brits would categorize as “the bleeding obvious.” The medical care provided by the NHS is not a chamber of horrors, nor is it wholly incompetent. However, facts are facts.
“In treating almost every cancer, America apparently does better than Britain, sometimes appreciably so,” Glover observed. “According to a study in Lancet Oncology last year, 91.9 per cent of American men with prostate cancer were still alive after five years, compared with only 51.1 percent in Britain. The same publication suggests that 90.1 percent of women in the U.S., diagnosed with breast cancer between 2000 and 2002, survived for at least five years, as against 77.8 percent in Britain.“
Glover admitted that it was painful to see the NHS cited – by angry Americans in town hall clashes across the US — as a model for what can go wrong with government provided health care. He also said that the pain came from knowing that it was the truth which hurt. By way of full disclosure, I have to say that when I fell and dislocated an elbow several years back in Covent Garden, I had a very positive experience with my emergency NHS treatment. One friend, by way of comparison, was just diagnosed as having a large uterine fibroid tumor and was told to “live with it.” She is 80 and is in otherwise good health. Is this a case of health care rationing? In the US, this tumor would be removed immediately. She wants it removed. The government has said no.
In the past week, the Conservatives announced that — should they take back Number Ten Downing Street — they would see to it that everyone could access their own medical records on line and to add comments which they think would be useful to physicians. What would keep that kind of open centralized government system from being technologically overloaded? One also thinks of how, just two weeks ago, a young British man with a form of autism (Asperger’s Syndrome) was ordered to be extradited to the USA to face charges of hacking into the Pentagon’s computers. How secure will open access medical records be with the threat of data hackers looming somewhere? Who wants to risk having their private medical history released to the public?
A recent report published by The Institute for Fiscal Studies offers three possible future scenarios for NHS funding. The categories are: tepid, cold and arctic (with apologies to global warming enthusiasts). All require raising taxes even higher to maintain present NHS levels of care. Demands on the system are expected to increase along with an aging population, decreasing taxpayer base, and with absolutely no guarantee patients will not continue to die from superbugs whilst in hospital. This includes ye olde MSRA bacterial infections and new foreign imports from returning “medical tourists” who went abroad to escape long waiting lists for basic surgeries like hip replacements.
Another publication: “From Cradle to Grave — 50 Years of the NHS,” warns that the state of public finances will now — more than ever — require “difficult trade-offs.” Sounds like code words to die for. The IFS study concludes that the future of the NHS is “far from rosy,” a dainty understatement if there ever was one.
But wait, it gets better. If a free-for-all National Health Service is so dandy, why is one major London hospital producing infomercials to raise private funds? Well, because they need the money. So out are trotted cancer-ridden children with wide-eyed appeals to help pay for “Linda, my nurse, who gave me so much love.” Or so that “Mommy can stay with me when I am here.”
These sad sagas are virtually identical to the TV appeals mounted for stray dogs and even donkeys. Yes — now British television viewers are told about unfortunate donkeys that fall over in the desert and cannot get up. FYI: there are no deserts in England. Where these poor beasts of burden are falling over is not mentioned in pleas to contribute just £3 a month to stand them back up again. We shall not lapse into jokes about subsidizing asses. Feel free to make up your own.
Should you be interested, a current copy (January 2009) of the National Health Service Constitution for England is available on-line here.
It offers a glimpse into what may be the future of your health care – and what it could cost you – if Obama gets his way.