We are developing the social individualist meta-context for the future. From the very serious to the extremely frivolous... lets see what is on the mind of the Samizdata people.

Samizdata, derived from Samizdat /n. - a system of clandestine publication of banned literature in the USSR [Russ.,= self-publishing house]

Samizdata quote of the day

On the NHS, that has gone far beyond a joke. It is not enough to value the idea of universal healthcare free at the point of use as a concept – one must “love the NHS”. Doctors and nurses are not doing their job in difficult circumstances – they’re fighting on the front line. Nobody wants to reform the NHS – Labour leader Ed Miliband wants to “rescue” it. The debate is uncritical, nostalgic, what The Economist called “ideological, ahistorical bunkum” – and nothing short of cowardly.

Andy Burnham, Labour’s Shadow Health Secretary, has warned that there are “24 hours to save the NHS” so often over the past five years that people are beginning to doubt his grasp of Babylonian concepts of time.

Andy Silvester

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15 comments to Samizdata quote of the day

  • ap

    It occurs to me that the British reverence for the NHS is very much like the American reverence for our public (i. e. state) schools. Each nation was a pioneer in establishing their respective institutions. Each absorbs vast amounts of money. Each produces dismal results. Each provides vast numbers of jobs for left leaning voters.

  • Tedd

    Interesting observation, ap!

    The climate surrounding health care in Canada is much the same. Make the slightest critique of how the system works and you are immediately branded as wanting “U.S.-style” health care. End of debate. That’s why there has been little in the way of change in how the systems works, despite Canada’s ranking on health care steadily falling for decades. The only acceptable change is spending more money. Without raising taxes, of course.

  • John Galt III

    Tedd,

    I live within easy driving distance of Lethbridge, Calgary and Ft McLeod Alberta and SE BC. Our hospitals run adds in the BC and Alberta newspapers. Every doctor in those two provinces knows where to tell their patients to go if they want immediate care.

    In BC it can take up to 3 years to get a colonoscopy. Here in Montana our two hospital parking lots are full of BC and Alberta plates. You make an appointment and it in a few weeks your are treated: colonoscopy, MRI’s, knee replacements. Quick and easy – just have the cash.

    Nationalize health care and you ration it. The rich can get treated instantaneously; it’s the middle class and poor who get to die.

  • Tedd

    JG III:

    Yes, even the most ardent supporters of Canada’s health care system that I know go to the U.S. when it’s their own health that’s at stake. But that does not alter their opinion of our health care system on bit, so far as I can tell.

  • KTWO

    UK debates sound similar to budgeting in the US. A nearby state university system took a $20m cut out of $1.7b in the last legislative appropriation. Local TV, and the university operated public broadcasting station immediately predicted the end of mankind.

    For the same year the university had alrready raised student tuitions by over $100m. But that didn’t count and was not to be discussed.

    At least local TV will shut up about it in a week or two. The university station will whine forever. Floods in 2025 will be blamed upon it.

  • The public deserve better

    says the article’s author. Do they really? The politicians don’t pluck their stance out of a clear blue sky, they are merely protecting one of Middle England’s sacred cows (up there with the BBC and house prices) from blasphemous remarks. It’s not the politicians which are the problem, it’s the bloody public.

  • Runcie Balspune

    From many NHS employees I know well, from having close family in nursing, the culture is very different, almost diametrically opposed, from regular corporations where I work. Whistleblowing is frowned upon and can get you in serious trouble, overtime is always unpaid and often demanded at short notice, pay is low in respect of responsibilities, liability insurance is employee responsibility (the hospital almost never takes the rap), unions are ineffective, management is incompetant, sickness is rife, too many staff are unsackable and behave poorly to the point of uselessness, no wonder as when the money runs out, as it often does, the staff will be “asked” to work for nothing.

    Many leftists are happy to bash private enterprise as treating staff poorly, but from what I constantly hear nothing compares to how the NHS treat its staff, knowing that many of them are mainly caring and dedicated the NHS takes takes the p*ss to extreme, it is not an organisation I am proud of.

  • bloke in spain

    One thing I’ve noticed when talking with people here about the health service – and with watching my father expiring in its dubious clutches, there’s been a considerable amount of talking – is the absolute impossibility of discussing anything except in the context of health care being a limited resource needing a strict table of priorities. When I say I expect to get medical attention whenever I feel like it, I get looked at like I’m slightly mad. It’s just regarded as a total impossibility & that I must be fantasising or something.
    Due to residence location, I’ve been paying insurance to a company provides heli-ambulances. When a neighbour fell & badly broke a leg, the response was under 15 minutes & he was in hospital 6 minutes later. Here, that’s regarded as a “waste of resources”. It’s trying to explain, not using the helicopter would be a waste of resources. It’d be sitting unused. That if helicopters were in short supply, they’d just buy more helicopters. It’s what we pay for. This is regarded as somehow, wrong.

  • Tedd:

    Yes, even the most ardent supporters of Canada’s health care system that I know go to the U.S. when it’s their own health that’s at stake. But that does not alter their opinion of our health care system on bit, so far as I can tell.

    It’s the same thinking everywhere, by people who can actually afford choosing private options over the nationalized ones in any area, including healthcare. The “reasoning” goes like this: ‘Sure, the private option is far superior to the nationalized one, and I will use it in times of need, because I can afford it. But, the poor can’t afford it, so the nationalized system needs to be in place to serve them’.

  • Tedd

    Alisa:

    I think you’re mostly right about that. But there’s deeper hypocrisy at work in Canada because one of the first things out of the mouth of any supporter of our system is, “We don’t want a two-tiered system.” What they love about our system is that everyone gets the same standard of care, rich or poor (at least in theory). But it’s obvious that this one-tier system only works because there are options outside the country for those wealthy enough, so it’s only one tier in a very narrow sense. It takes a significant effort of will not to notice that, but most Canadians seem up to the task.

  • Fraser Orr

    @Tedd
    > Yes, even the most ardent supporters of Canada’s health care system that I know go to the U.S. when it’s their own health that’s at stake.

    I think fairness and red pill thinking demand that we acknowledge that today more and more Americans are going to Costa Rica and Thailand to get their electives done. The reason being that these places are much less ridiculously overpriced due to the insanely over regulated system, and massive disconnect between consumption and payment, that represents the American healthcare system.

    I am certainly in favor of a free market system in medicine, with an equally free market system to ensure quality of delivery and care, however, let’s just be clear, the American medical system is not that. Perhaps more so than Canada and the UK, but let’s all clearly dispel the myth that the American medical system is some sort of wild west cowboy free market system.

    It is this myth that let’s the people who are destroying the American medical system to get away with notion that the arsenic pills that have been prescribing to cure the disease are in fact only inadequate in dosage rather than entirely the wrong medicine.

  • Indeed, Tedd. Call it hypocrisy or something more charitable – fact is, there is no limit to the number of perfectly contradicting ideas to which most people can subscribe concurrently in their minds. It is quite fascinating.

  • Tedd

    Fraser:

    Please don’t mistake my remarks for endorsement of the status quo in the U.S. I’m only trying to point out that we in Canada have attitudes toward our system not unlike what have been noted on this blog regarding the NHS in the UK — i.e., hypocritical and contra-factual.

    There may well be Canadians going to other countries for medical care, too; I don’t know. But the overwhelming majority of Canadians live within a reasonably short drive of the U.S. border, so it is the obvious alternative for us. The most common reasons for people I know to go to the U.S. for medical care are: more rapid diagnosis (not waiting months to get an MRI, for example); and relatively inexpensive elective surgery, such as joint operations. More involved treatments are not a realistic option for most Canadians, we simply have to wait for the system to process us.

    For what it’s worth, I think one of the main differences between health care in the U.S. and health care in Canada is that the U.S. system is driven largely by what people are willing to pay (however reluctantly) for their own health care whereas in Canada the system is driven largely by how much people are willing to pay for everyone’s health care, collectively. The former is obviously a great deal more than the latter, which explains why there is a lot less capacity in the system, in Canada. Some argue that the U.S. system leads to waste — too much MRI capacity, for example. That would be “waste” defined by outcome-based optimization of the system. I’m sure that’s at least partly true. The corollary to that is that the Canadian system results in under capacity (i.e., waiting lines). Neither system is optimal in a technical sense, but the U.S. system does provide better care for those able to afford it — which is most people, albeit with some belt tightening.

  • bloke in spain

    Reading my own post above I realise it mightn’t have made much sense without the context. For which I apologise. The “here” I refer to is the UK where my father lived & died & where I’ve, by necessity, had to be for a while. Reluctantly.

  • Paul Marks

    To be fair…. the alternative presented by the Economist magazine is also problematic.

    Have the government pay the bills – but have private companies deliver the service.

    This has been the case in the United States for some years now – with government subsidy programs (Medicare, Medicaid, “Emergency Care”…..) and endless regulations, leading to costs rising vastly.

    Even David Ricardo understand that if the government piles in subsidies to something – the costs go up and up.

    There is also the question of how closely linked the Economist magazine is to the companies who want the taxpayer contracts.

    I am not defending the fanatical faith in the current system – just sounding a note of warning about the whole area of thought.

    Not that much thought is going on politics at the moment – as the post quotation correctly says.