Sunday, February 01, 2009

Your health

This weekend I have been recovering from a minor operation. I am somewhat sore and limping, but, above all, grateful. I am lucky enough to live in a country with a National Health Service.

I got the latest hospital treatment and, especially as this Hull, experienced nothing but friendly helpfulness and a down-to-earth sense of humour. Since the first symptoms occurred and I was forced to seek treatment, I have met wall-to-wall niceness. And it cost me nothing, other than the taxes that I, unlike many major corporations, actually pay.

As this is the season for lecturing President Obama, I would tell him that if he wants to do one thing of unquestionable benefit to the American people, he should come and have a look at our NHS. It is something we should be proud of.

However, the cheery professionalism of the clinicians can easily be dispelled with a single magic word - 'management'. This is not simply the usual moans about those who manage from those that do, nor is it solely a reflection of the current trend for the creation of internal markets in the public sector, it reflects a hostility to an insidious political agenda. Part-privatisation by stealth is still a threat to one of our most important collective rights.

Just as I cannot conceive why anyone would want to waste money by paying for private health insurance, other than for social cachet and an illusion of better treatment, so the idea that privatisation could conceivably be a benefit to anyone apart from the profit makers, is beyond my comprehension. The 'reform' agenda has dropped out of the news lately, but when the time comes for you to need health care, it is a real reminder about just how much it should be resisted.

12 comments:

Anton Deque said...

I had a very very short conversation with a cold caller (no pregnant silence so no warning):

Me: B– L–....

She: Can I speak to B– L–?

Me: I am B– L–.

She: Oh, hello I am calling on behalf of Shipman Healthcare (wotever) ...

Me: I'm with the NHS ...

She: Thank you.

End.

The Yanks will never ever get a national health service. Doctors will not stand for it since they go into medicine to make money and lots and lots of it. American doctors appear remarkably indifferent to suffering if the sufferers are poor enough. Patients (taxpayers, even poor ones) regard nationalised healthcare as Socialism (correctly) and Un-American. Millions and millions of dollars spent on 'space travel' and 'finding water on Mars' but no comprehensive health system. That must tell us something.

Anonymous said...

I'm glad the NHS has looked after you properly.

I was recently diagnosed with the benign form of skin cancer. It takes the form of an ulcer on my temple which doesn't heal so is constantly bleeding, and over time will just get bigger and bigger.

I was told I'd have the operation to remove it in 6 weeks. But the appointment was moved back 2 weeks, and then another 4 weeks.

I don't fancy having a superating cancerous tumour festering away on my face for months on end, so I'm going private to get it removed. 1 week to the op!

Graeme said...

It's not cancer if it's benign.

Cipriano Mera said...

My experience, Anonymous, is that if you're really in deep sh*t the NHS is marvellous - my father died of cancer on it and never had a complaint. If your complaint can be interpreted as not entirely lethal, or not exactly the kind of complaint the administrators need to hit their targets, you can wait for ever. Shame only on the bean-counters and target-mongers, not on the NHS staff who generally show exactly the right attitude.

The Plump said...

All services are rationed in that everyone cannot be treated immediately. They can be rationed by time determined by clinical need, or they can be rationed by money.

Anonymous said...

"They can be rationed by time determined by clinical need, or they can be rationed by money"

Plump one I disagree with you on this. I think you are guilty of Pie-ism; the view that there is a pie of a fixed size and the job of government is to work out the best way of dividing it up.

My private health care money increases the total spend on health in the country, and so means more treatment can be delivered this year.

The Plump said...

Anon.

I was talking about general principles rather than specifics.

In terms of spending on private health, it is additional spending but due to the relationship between the public and private sectors it does not always mean additional services.

There are times that public can displace public. The other problem is that private would be difficult to maintain without huge public spending. Most staff are NHS trained and the private sector is sometimes maintained through public sector sub-contracting.

The public sector also has to stand by if something goes wrong (hope it doesn't for you!) and deal with emergencies from the private sector. And that is before we talk about the Byzantine nature of funding.

That said, if the money is there, yours can be a rational choice. I don't know what I would do in the same situation. And if the buggers stop treating 'the obese' due to our self-inflicted plumpness, I may be buggered anyway :-)

Dom said...

I think we all agree that the public sector should stay out of most things in our lives. We prefer to make out own choices. The private sector usually makes sure that things are distributed more or less evenly, simply because there is more profit in this. Blazingly fast and small computers are for everyone in the way we wish healthcare was, and no one has to wait in a queue to buy one just because he needs it only to play games, as opposed to something more serious. If the government had said "computers are for everyone", we would not have GUIs, or the internet, or blogs, or email, and we'd all think this was the best possible world.

Why is it that when it comes to important things, such as healthcare or education, we think the private sector and its profit motif can't be trusted? If government stayed out of healthcare, I bet it would be much cheaper, and more available, than it is now.

BTW, I'm glad your operator was a success.

The Plump said...

Dom

If government stayed out of healthcare, I bet it would be much cheaper, and more available, than it is now.

The only answer is empiricism. Where it does, it isn't.

It is a false analogy to compare a consumer good with a public service. It is also false to say that the only motivation for improvement a person has is profit. I work in public sector education and have been driven by an ethic that borders on self-exploitation. I would actually argue that ethical motivation is far stronger than economic motivation in some situations.

Much health care is not, nor could be, profitable and is avoided like the plague (sorry) by the private sector, such as long-term chronic care of the elderly poor.

The creation of the NHS was a response to the failure of a private system.

Thanks for the good wishes - back tomorrow for the removal of dressings.

Dom said...

"Where it does, it isn't."

But where does government stay out of healthcare? Certainly not in the US. You may think you know the nightmare of US healthcare, but trust me, you don't.

"It is also false to say that the only motivation for improvement a person has is profit."

The economist's idea of profit is generally misunderstood. If there is a need for clothing, then (if the price mechanism is left to supply and demand), there is more profit in manufacturing clothing. If I chooses to go into that business, am I greedy or just supplying what most people want?

"Much health care is not, nor could be, profitable and is avoided like the plague (sorry) by the private sector, such as long-term chronic care of the elderly poor."

You're right. I have no answer.

The Plump said...

And just another point, it would be hard for there to be anything other than a monopoly in private provision. Imagine the spare capacity you would need (and the waste of scarce resources) for there to be meaningful competition as there is in the consumer goods market.

Anonymous said...

In education and health I think a mix of state and private works well. Each challenges the other to provide a better service, and if one were to disappear, the other would become complacent.