In the US this summer everywhere I went the second thing people said upon finding out I was British (after ‘thanking’ us for Dancing With the Stars) was to ask about the NHS. The debate over healthcare reform is raging in America.
The debate is raging here too it seems as evidenced by the article ‘National Socialist Health System?’ in the last London Student. Like many contributions to the debate, it contained some fallacies.
The first fallacy came with the assertion that the controversy over nationalizing 1/7th of the American economy was “essentially manufactured and delivered by some of the most toxic elements of the American right-wing press.” I spent two weeks in Minnesota, one of the most social democratic states in the US (the only state never to vote for Reagan). Contrary to the articles assertion, the people quizzing me about the NHS were not raving right wing lunatics but ordinary Americans understandably concerned about the vitally important question of what happens when they get sick.
Next the article referred to the “46 million Americans without any health-care cover whatsoever”. First, the figure of 46 million contains 35 million who could afford insurance if they wanted to but choose not to. They may be young, sporty, don’t drink and smoke. Like a man who lives on top of a mountain doesn’t take out flood insurance, these Americans decide the chances of them needing healthcare are so small it’s not worth the cost.
Also the author didn’t mention Medicaid, the government insurance scheme for Americans on low incomes. Medicaid spent $204 billion in 2008 and will be bankrupt in the next decade.
The article mocked the “Freedom to suffer and to die prematurely due to inadequate health-care access”. But this sarcastic freedom doesn’t hold up. For example, for all cancers 66.3 % of American men and 63.9 % of women survive more than five years. In Europe just 47.3% of men and 55.8% of women survive that long. Breast cancer mortality is 88% higher and Prostate cancer mortality is 604% higher in the U.K. Neither do these treatments bankrupt poor families. Out-of-pocket expenses by American patients are 12.6% of national health spending, lower than in Germany, Japan, Canada and most of Europe.
Finally the article said that the NHS does not have “Orwellian death panels or bureaucratized guidelines on the worthiness of treatments for various categories of people”. This ignores the existence of the National Institute for Health and Clinical Excellence (NICE). This is the body which decides whether the NHS can afford this or that treatment, such as memantine for the treatment of Alzheimer’s disease and various drugs for treating renal cell carcinoma, both of which NICE refused to provide as not being “cost effective”.
American healthcare is clearly not perfect. Florida Congressman Alan Grayson said 44,000 Americans (out of a population of 300 million) die each year as a result of not having health insurance. But neither is ours. Leading oncologist Karol Sikora estimated 10,000 cancer deaths (out of 60 million) in the UK every year because we have the NHS as opposed to another, more efficient system. Discussing these issues makes you a concerned citizen, not a foaming nutcase.
(Printed in London Student, vol 30 issue 3, 19/10/09)