In response to the
creeping privatisation of the National Health Service, a group of women from
Darlington have organised a 22-day 300-mile march from county Durham to
Westminster following the route of the 1936 Jarrow March. You can read about it here: http://999callfornhs.org.uk/. More on this later. Meanwhile some general thoughts on healthcare provision.
Access to healthcare is a fairly basic human need. So is having
food to eat and clothes to wear. In fact you might consider these even more
basic. But nationalising the allocation of food or clothing would be
soviet-style lunacy – much better for people to sort this stuff out for
themselves. This is what private enterprise is good at. So why entrust healthcare
to the government?
First because sickness is so unpredictable and potentially expensive that only the exceptionally wealthy could budget for it. To solve this problem capitalism provides insurance companies, which are motivated by profit to do three things: sell policies, deny claims and steer clear of sick people.
First because sickness is so unpredictable and potentially expensive that only the exceptionally wealthy could budget for it. To solve this problem capitalism provides insurance companies, which are motivated by profit to do three things: sell policies, deny claims and steer clear of sick people.
Secondly because although choice is a good thing, and simple
enough when it comes to shoes or sausages, options for treatment can be so
complicated, so finely balanced and of such uncertain outcome that they can be
baffling not only to the individual patient but to the individual practitioner.
We don’t need competing stallholders crying their wares and hiding their ingredients
and processes from each other, but a marketplace of ideas and information.
Thirdly because new drugs are constantly being developed
and sold by multinational companies with huge budgets for sales and
advertising. We need whoever’s passing them on to us to have some bargaining clout
and the means and motivation to conduct their own research on what works and
what doesn’t.
Fourthly because ill-health is sometimes catching, and its
causes, consequences and cures often have a social dimension. The profit motive
doesn’t offer much encouragement for competing providers to look beyond their
own potential markets and consider the larger picture.
And because, in the end, healthcare isn’t about selling stuff. Pile it high and sell it cheap might be a
recipe for success in the grocery business, but it shouldn’t apply to
antibiotics. It’s not about selling services either. In his preface to The Doctor’s Dilemma, George Bernard
Shaw expresses despair at the thought that ‘any sane nation, having observed
that you could provide for the supply of bread by giving bakers a pecuniary
interest in baking for you, should go on to give a surgeon a pecuniary interest
in cutting off your leg.’