Wednesday, 12 August 2009

The NHS and Professor Hawking

There has been a huge fuss in parts of the US left-wing blogosphere and commentariat after a dumb comment in Investor’s Business Daily, suggesting that Stephen Hawking would not have survived under the NHS. For those Americans not especially familiar with scientific academia it is an understandable error – he ‘speaks’, after all, with an American accent (which he chose to keep when offered a new English-accented speech synthesiser, as he by then identified with that voice).

It seems some of the howling criticism is far more flawed than the original article, which at least had a valid point despite the erroneous example.

Hawking himself, an old leftie, makes a ridiculously claim that he “... wouldn’t be here today if it were not for the NHS”, but no apparent attempt to justify that assumption.

Ezra Klein claims that the IBD was telling lies, a truly inane suggestion; if they had known Hawking was British then they would never have published the article. It is not as if there was any chance of the error slipping by unnoticed!

Yes, the article does over-simplify the calculation NICE makes of the value of extended life or improvement in quality of life. However nuanced it might be, that calculation is still made, and the monetary figure given is roughly correct. The inclusion or exclusion of nursing care is irrelevant to those whose life (or quality of life) is dependent on drugs or surgery, and they pay the same into the system. Who is to say they should suffer?

The wonderfully-named (and it appears otherwise sensible) Donklephant* suggests that talk of rationing is an intellectually-bankrupt scare tactic. Here is where my tale is told.

I was earning in total roughly £4-6000 below average wage (depending on weather, luck and economics). I was employed part-time, paid for time I worked, so I could also work self-employed in other capacities. Therefore I was only paid as and when I worked, and simply could not afford to take time off.

I hurt my back. I could not physically work more than an hour or two in my employment, and legally was unable to work at all in the role I was hired for self-employed. I had a choice, which was to wait six weeks to see a consultant, then an indeterminate time (by previous experience a modest three weeks in that area of the country, but no guarantee) for physiotherapy, or pay for a consultation and physio, a total the thick end of £500, which I did not have spare.

Of course I paid; what did you think, I could afford to drop my pay by 70% for a couple of months?

What is that but rationing? Waiting is still rationing, whether the patients rationed out of play recover without treatment, give up and accept chronic illness, pay for private care or die. That is still rationing.

The final insult was the VAT on part of my bill (I needed an assessment to prove I could do my job, and although treatment is VAT-free that was not), 17.5% going to pay for people paid more than I to receive healthcare I could not have.

This might be only one example, but in order to destroy the entire left-wing basis of the NHS there is only need of one counter-example. How can anyone possibly justify charging me tax to pay for the NHS under those circumstances?

*Donkey = Democrat, Elephant = Republican, for those less familiar with US politics.

Update: the Telegraph has an excellent article on the NHS with reference to US healthcare.

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Rebecca said...

No, actually, it takes a lot more to destroy the entire left-wing basis of the NHS than your tale of having to spend less than $1,000 USD to fix your back. Compared to 50 million people who can't afford their insurance premiums, much less actual treatment, that's nothing. Compared to the hundreds of thousands of Americans who are literally bankrupt because someone in their family had a medical condition, your measly 500 pounds is enviable. According to the Telegraph article, the NHS may soon be facing somewhat of a crisis. It will STILL be better than what we have here in America. Oh, and the quality of health care in the U.S. has been ranked below that in the U.K. for years.

Doubting Richard said...

Where in that comment is any justification for forcing me to pay for something I don't want and am unable ever to use, when I am on rather low pay?

I am not comparing it to the USA, although by any statistic it is measured by the US system has better outcomes than the NHS. The quality of care is not worse in the US, you simply made that up. There are far more carers, doctors and surgeons per head in the USA, there is far more equipment and far more drugs are administered. The chances of recovery, and the speed of treatment are far superior.

I am certainly not saying the US system cannot be improved, it certainly needs to be (at the bottom of this post I actually point out some thoughts I agreed with on a decent start for making some necessary improvements). I am saying that the current plans are probably wrong. Of course they don't even address the criticisms you make of the US system!

The NHS is already in crisis if you look at how it treats patients, and the Telegraph points that out. This is also a huge drain on the UK economy, as I point out in another blog.

Doubting Richard said...

P.S. I forgot to thank you. My first really strongly dissenting opinion. I am glad to receive them, and expect robust discussion when I do!

James said...

Rebecca: 50m? Do you mean the "40m without insurance" figure, which includes many millions of illegal immigrants (who have other reasons for not staying "off the grid" as far as possible), people eligible for Medicaid who haven't bothered enrolling, people who are "without insurance" for 24 hours or so as they switch policies... Yes, there are some people who genuinely can't either afford coverage or qualify for Medicaid or similar programs, but nothing like 50m.

You've also missed that the author has already been forced to hand over thousands of dollars each year in compulsory premiums for the NHS which failed to provide the treatment he needed; even if his c $30k salary didn't qualify for any public assistance, the thousands of dollars of premiums he paid would probably have bought at least basic insurance coverage which would actually have involved treatment.

Thatsnews said...

The reason they wrote the original article was because they were too dumb to do any research.

Don't they offer investment advice?

Look out for next week's article: "100 reasons why you should invest with Bernard Madoff."

Doubting Richard said...

Cheers James; I didn't really know the figures for the US, although I was aware of an estimate that half the uninsured could afford it, they have just made the decision (as is their right) to spend the money on something else, or to save it up.

Thatsnews - don't joke. I bet if you looked up back issues they probably did give him a positive write up. Oh, well, if you want to know my opinion of journalists and their effort at research, it should be obvious from these articles!

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