The president ought to have known better. He thought he was making an obvious observation that “the NHS is going broke and doesn’t work” and that socialised medicine is “really bad”.
Little did he realise that he was committing the worst sacrilege perceived in Britain as such. For the nation has channelled its religious fervour previously reserved for God into the conduit of the NHS.
Actually, this is only an ersatz of religiosity, in the Christian sense of the word at any rate. For western Christianity encourages, indeed demands rational thought. However, NHS champions, including Mrs May and her Health Secretary Jeremy Hunt, not so much use as abuse reason in defending this Leviathan.
They’re proud of the NHS because it’s free at the point of delivery. But in colloquial usage, only the first word of this description is enunciated clearly. Hence this is the only word our comprehensively educated masses hear. Our health service is free.
Now imagine, one could say to them, that you want to buy a sofa costing £500. But rejoice: you pay nothing up front. The sofa is free. Of course there’s the small matter of your having to cough up £5,000 at the end of the year, but let’s not talk about such incidentals.
One could venture a guess that most people would insist that they’d rather pay £500 now than £5,000 later. They might even accuse the salesman of cheating. And yet those same people proudly describe the NHS as free, even though the logic of its financing is exactly the same.
Having lived in the US for 15 years and in Britain for 30, I can compare the two systems. As a sickly sort, I used the US system a lot, including for major operations. When I was in employment, medical insurance was a standard part of the package. When I was between jobs, I picked up the cost of the premiums myself.
Yet at no time did I pay 12 per cent of my income for medical care, which is the proportion charged by HMG in national insurance ‘contributions’. This before topping it up with private insurance, which in Britain is essential for anyone who needs first-rate medicine and can afford it. Free medical care seems dear at the price, wouldn’t you say?
Mrs May rebuked Trump’s assertion that the NHS is going broke by saying that the expenditure on it is at a record high. That may be, but it doesn’t at all contradict being broke.
No one would object to describing as broke a man whose liabilities exceed his assets, but who nevertheless continues to borrow vast amounts. Then why not apply this term to the NHS? It’s largely responsible for our huge budget deficits and trillion-plus public debt. Not only is it broke, but it’s beggaring the country for generations to come.
Mrs May and Mr Hunt counterattacked by boasting that any Briton can be treated regardless of his bank balance. The implication was that in America only the rich – or the lucky possessors of insurance policies – can get medical care, while the poor die in the gutter with greedy medics looking on with indifference.
This ignores the US public medical services of Medicare and Medicaid that look after those who are too old, too poor or too unemployed to have medical insurance. In fact, the US government spends more as a proportion of GDP on public medicine than the UK does – this although only less than 10 per cent of the US population are uninsured.
I visited friends in American hospitals financed by Medicare and Medicaid, and they’re in no way inferior to anything the NHS has to offer. And what do you know, male and female patients are kept in separate wards, not herded together as they are in Britain.
Nor do I recall having to wait for a GP appointment or hospital admittance in America – never mind waiting a fortnight for the former and over a year for the latter, periods that are standard in the NHS and getting longer. Neither do Americans ration medical services, something that’s routine in the UK.
Mr Hunt is proud of the fact that “healthcare for everybody [is] delivered at half the cost of the US system”, but that pride would only be justified if we received the same level of service. Yet we don’t, not by a long chalk.
However, it’s true that the US system is far from perfect. After all, perfection is only attainable after the Second Coming of Christ, and even then not by everybody.
Stripping the issue of totemistic adoration and nationalistic pride, we should identify the aetiology of imperfections in both systems and analyse them rationally.
Then we’ll see that, to use the medical parlance, the NHS problems are systemic, while the US ones are symptomatic. The former are caused by the intrinsic nature of things and therefore aren’t correctable. The latter lend themselves to relief, if not easily.
The main reason American medicine is too expensive is American litigiousness. Like some primitive African tribesmen who see every death as somebody’s fault and swear vengeance, Americans are encouraged to blame medics for their health problems and sue.
Hence in my day, 30 years ago, a Manhattan GP had to pay over $100,000 a year in malpractice insurance premiums, and consultants paid much more. These numbers must have grown exponentially in the interim. And the same applies to hospitals and pharmaceutical companies, which spend billions fighting, and often losing, legal action.
That’s why exactly the same treatments may cost more in the US, although, what with contingency legal fees becoming popular in the UK, the gap may soon narrow. We tend to learn things from the Americans, except those that are worth learning.
NHS problems are caused by the very nature of a giant socialist enterprise increasingly less dedicated to treating patients than to promoting egalitarianism. The NHS provides yet another proof, if any are still necessary, that it’s possible to achieve universal equality only at the lowest common denominator.
All socialist enterprises are unwieldy bureaucracies breeding sinecures like rabbits busily copulating in the field. The NHS reinforces this observation by systematically replacing frontline medical staffs with useless administrators, who function similarly to the Soviet nomenklatura of my childhood.
History shows that such setups can’t be reformed. The only way is to wipe the slate clean and start from scratch – possibly by losing the first letter in NHS and moving the other two closer towards a mixed system used in the US and most other Western countries.
Conversely, the drawbacks of the American system are extrinsic to it, deriving largely from a plethora of litigation, most of it unreasonable. This sort of thing could be corrected by reforming laws, although the mechanics of this could be devilishly difficult.
Mr Trump had in his sights not so much the NHS as his political opponents who hold it up as a shining example to follow. But taking a shot at them, he hit the NHS by ricochet – and put his bullet right in the bull’s eye.
Let us be quite clear that 94 percent of NI contributions pay for state pensions. Apart from that, I agree with everything that you wrote – especially your comments on the parasitic ‘nomenklatura’ in the UK and the absurd payouts to what are clearly litigious insurance fraudsters in the US. I would think that 12 percent of of income would scarcely provide for a decent private pension. As for health insurance, the NHS is funded mainly from consolidated revenue so that the punters never actually know what proportion of their taxes are paying for it because the auditor general has to rely on figures supplied by the treasury that cannot be assumed to be independent of its political masters.
I’m not sure about 12 per cent of one’s income over a working life not providing a decent pension. I suppose that depends on the size of the income. What I am sure about is that state pension definitely doesn’t provide a decent pension – barely enough to keep body and soul together, and not at all in London. And of course the NHS isn’t just financed out of the 12 per cent – it takes more than that to become Europe’s largest employer. Exactly how much it takes, and where all the money is coming from, we’ll never know. That’s another arresting feature of socialist Leviathans: they are secretive, operating strictly on need to know – and we don’t need to know.
“Mrs May and Mr Hunt counterattacked by boasting that any Briton can be treated regardless of his bank balance. ”
Or in the case of the 50,000, or so who had their operations cancelled this January, because of ‘flu’…Not treated, regardless of his bank balance.
The NHS is a crock and the claims made for it are absurd.
Will be treated. The question is WHEN!
“This ignores the US public medical services of Medicare and Medicaid that look after those who are too old, too poor or too unemployed to have medical insurance. In fact, the US government spends more as a proportion of GDP on public medicine than the UK does – this although only less than 10 per cent of the US population are uninsured.”
The Veterans Administration health care system too. Forgot that one. For ex-soldiers. And the care is pretty good. Among that 10 % without insurance the bulk of which are young people who are in the prime of health and don’t need constant medical care. American hospitals by law too are not allowed to refuse service to a person from lack of insurance. They MUST treat you.