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Doctors do not have it so bad

Sam Bowman has written a rip-roaring article about the NHS junior doctors dispute. Instantly win any debate with your NHS-worshipping Facebook friends.

18 comments to Doctors do not have it so bad

  • QET

    More money for doctors means less money that can be spent on NHS patients

    What the. . .?

    The debate I’m interested in is the debate whether to have a NHS-style system at all, and everything in this piece just shrieks NOOOOOOOOOOOOO! The commodification of health care and the proletarianization of doctors continues apace even in the US by large private consortia that function as appendages of the State, but there is a qualitative leap involved in a NHS regime that we just should not want to make.

    there does not seem to be any shortage of reasonably smart people who would like to be doctors

    How comforting. NHS–where reasonably smart people can get jobs. Doesn’t exactly roll off the tongue, does it? Maybe let Don Draper have a go at improving it?

    This reads like a US negotiation between the mayor and the firefighter’s union or teacher’s union. How dare doctors demand more taxpayer money! Here’s a thought–what if the taxpayers don’t pay for it????

    The NHS is spelled D-I-S-A-S-T-E-R in every piece I read on it. And as for the nannyism of the doctors, it originated outside of medicine and is inculcated in UK doctors by almost every UK institution long before they ever lay eyes on their cadavers (assuming there are enough of those to go around for all of the reasonably smart people queuing outside of the nearest medical college).

  • Rob Fisher (Surrey)

    QET, I think you’re overestimating the state of the debate in the UK. He’s pointing out that the doctors’ union is creating the shortage of doctors. This is useful. Most people here think it’s something to do with Tories not spending enough or just being evil or something.

    I agree the article could do with pointing out that it doesn’t help doctors or patients that there is a monopoly employer and monopoly union. But it’s an omission; it doesn’t make his other points invalid.

  • QET

    A fair point, Rob. I just couldn’t limit myself to the particulars here. The US is about to fall over the edge and into a NHS-like abyss, and our experience with mini-NHS’s here reek of the same public employee union politics that I see in this article (here’s a nice example, not involving wages though), so I got up on my horse.

  • Julie near Chicago

    QET, leaving Mr. Bowman and his article out of it altogether, What QET Said.

    Although I’ve been reading that Canada’s version of nationalized “healthcare” is, or was until very recently, even worse than the UK’s, because at least in the UK it’s not actually illegal to pay a doctor, using your own money, to see you privately.

    I have the nausea-inducing impression that the interest here is to follow the Canadian system rather than the Brits’. I pray to the Great Frog that I’m wrong about this.

    On the other hand, there is a tiny ray of hope: “until very recently”…. Haven’t I read that in one or two of the Provinces they are reluctantly permitting a few private practices?

    Meanwhile, I do think Cruz is the only one who’s sworn he’ll get every word of Obamacare repealed. (Um, doesn’t it take an act of Congress to repeal a law? Don’t ask me. I’m just a girl.) But if he actually sticks to that, and puts his back into it, wow! would that be a blessing for us and our children and their children and….

    YESSSSSD, Ted, and tell them it’s for the CHILLLLDREN!!! Believe me, it would not be a lie.

  • You can set up a clinic and charge for services in Canada. The only real constraint is that all real, government defined medical services, must go through the government’s single payer system.

    You can charge for cosmetic crap and other things that the Canadian health care system does not cover.

  • Julie near Chicago

    Ah! Thanks, Chris. So the long waits for tests and treatments that we hear about down here are due to shortages in personnel and equipment, because the Canadian government can’t really afford (isn’t collecting enough taxes) to pay for them?

  • the other rob

    Although I’ve been reading that Canada’s version of nationalized “healthcare” is, or was until very recently, even worse than the UK’s, because at least in the UK it’s not actually illegal to pay a doctor, using your own money, to see you privately.

    Pretty much, though the NHS has its own little wrinkles that will bite you in the butt. Say you have a chronic or terminal condition. The NHS will only provide drugs that are on a list promulgated by NICE. Often, there are drugs that are more efficacious that, while having successfully passed clinical trials, are not on that list. “No problem,” you think “I’ll just buy them myself to supplement the NHS treatment.”

    Not so fast. If you do that, for even one single medication, the NHS will cease paying for all treatment for your condition. How dare you disagree with the judgement of the death panel?

    Here in Texas, I voted for Cruz and still hope to see him become president. But, if it comes to it, I’ll hold my nose and vote Trump over Clinton or Sanders. Because the NHS has killed more of my family than even Trump is likely to.

  • “The only real constraint is that all real, government-defined medical services must go through the government’s single payer system.”

    I’m not sure what the word _only_ is doing in that sentence. An activist judge might indeed decide that a law banning you from doing anything the government defined as a medical service also banned you from doing things that were not so defined but were colloquially called medical services, but I can see that the actual wording of the banning law could hardly say in so many words: “That which is _not_ defined as a medical service herein is nevertheless a medical service”.

  • John B

    The entire problem summed up in three letters N H S.

    Denationalise healthcare, break the State monopoly on provision AND payment, let the free market sort it out.

  • nemesis

    the other rob
    March 12, 2016 at 12:46 pm
    ‘Although I’ve been reading that Canada’s version of nationalized “healthcare” is, or was until very recently, even worse than the UK’s, because at least in the UK it’s not actually illegal to pay a doctor, using your own money, to see you privately.’

    May be not illegal, They will just arrest you if you refuse NHS treatment;

  • the other rob

    Nemesis: my post quoted something that Julie wrote, so you are, in fact, replying to her rather than I.

  • Paul Marks

    The NHS is a religion (indeed a fanatical cult) in the United Kingdom – so, sadly, I see no point in discussing it.

    Any failure of the system (a failure too obvious to hide – say a pile of dead bodies) will be blamed on either “Tory Cuts” (fictional “cuts”) or “privatisation of our NHS” (basically the Max Kaiser presentation of the world – a tissue of lies).

    It is very sad – but there we go.

  • Julie near Chicago

    nemesis, I remember that business from before. It’s good to know the little boy seems to be cancer-free now.

    I would like to say the NHS’s action was unbelievable, but unfortunately I believe it all too well.

  • Although disgraceful cases like the one linked to above do occur, generally in the UK, you may go to a private hospital if you choose. Provided you pay your taxes, including the NHS bit, you can then relieve the NHS of the need to fund your health issues to as great an extent as you like. Although there are people here who would bring in Canada’s law if they could, no actual chancellor till now, or any past shadow chancellor (but one wonders about Jeremy Corbyn’s) has ever been insane enough to reject that good deal.

    Thus we have private hospitals to compare to NHS ones in the UK. A typical private hospital has one administrator to ever four or five nurses. In the NHS, the number of administrators grew to exceed the number of doctors and nurses long ago.

  • In my comment above, the administrator comparison is to the number of doctors and nurses in both cases; I omitted a ‘doctors and’.

  • Julie near Chicago

    Niall, I’ve become a great fan of Sir Humphrey Appleby and his Minister and then P.M. Jim Hacker (not to mention the wondrous Arnold, Dorothy Wainwright, and of course the verbalist Bernard Woolley (sp?). (This is llamas’s doing, by the way, so if you don’t like it take it up with him. *g*)

    Therefore I’m in a position to report that at one point the head of H.M.’s Govt. was trying to figure out how to get patients into a brand-new 18-month-old hospital, complete with 500 staff, the bulk of them administrators and office people, but no medical personnel and not a single patient in any of the empty 1000 beds.

    Perhaps the creators of Yes Prime Minister, which I think was broadcast in the early ’80’s, were claivoyant; or perhaps, merely observant. La plus ça change, so forth.

  • Julie, there are doctors in the NHS – including some who by nature are very left wing – who now look back on Margaret Thatcher’s period of administration with nostalgia – and that is more despite than because the ‘Yes, Minister’ episode about the hospital with everything – except patients – dates from her first year in power IIRC, and the power of unions in maintaining this state of affairs saw _some_ diminution during her years. More than one left-leaning doctor I know has said (over a year ago) ‘about 15 years ago’ and similar while explaining when some current issues with the NHS began a marked downward step, though, unlike me, they do not then say – or think – “so about when the Labour party resumed effective control of it”.

    (In one of Thomas Sowell’s books – not at all sure it is in “A Conflict of Visions” but I’ll take the opportunity to recommend that one- he notes that “A doctor can be right-wing on medical issues but left wing on economic and social issues” as an example of how people are often more right-wing about subjects they know.)

    I recently thought that Bernard’s line to Sir Humphrey about Dorothy Wainright, “I’m sorry, I cannot tell you – _her_ name” might be recyclable in some sketch about the (only arguably, alas) most awful of the candidates for a certain november election. Alas, Bernard’s good line in the script for just before he said that was lost in the episode. In the script and book, when Sir Humphrey, going through the list of issues where there might have been “movement where the civil service wishes there to be no movement”, hits on the right one, Bernard switches from saying ‘no’ to saying ‘I can neither confirm nor deny that’. In the episode, Bernard makes a vague noise and the tiniest nod of his head. Presumably they had to shave off a second, or maybe they thought the change was better, but to my mind the script line was funnier.

    In the periodic re-showings of the series, it has more than once been blandly announced that, “Tonight’s episode is a change to the published schedule” because the one scheduled had an unfortunate coincidence with a topic that had blown up on the news. I recall this happening with the one where Jim must pass on to the PM the warning an army brigadier gave him about arms being supplied to terrorists but do it “in such a way that the PM does not hear him”. I think there was at least one other such occasion, but I cannot recall its context.

  • Re (il)legality of private healthcare in Canada, I did a little research and found this link.