He was a charming, damaged, charismatic, fiercely intelligent, dissolute individual, who lived entirely on his own terms. As a professional gambler, it is unlikely he paid much if any tax in 37 years. He had no will, no funeral plan. He never did fill out the forms necessary to vote in the last election, or the one before that, as I discovered. He just hated forms. I could sympathise. Had he stayed in the US, it is – how you say – dollars to doughnuts he wouldn’t have got it together to fill out the forms, and would have had no health insurance. He considered the US system “absolutely unmanageable”.
However long this goes on for, they'll continue throwing resources at this individual and never show a single sheet of figures to any of his relatives. Not because they'll get anything back, but because this is what the NHS does. It’s free care for throat cancer sufferers who only gave up smoking four years afterwards, for drinkers who were told 35 years ago that if they didn’t quit drinking they’d die. Free care for American immigrants, for jerks and gents. Free care for parents whether they showed up or not. Free care for guys who tried to try. Free care for the only father I will ever have.
So here comes the TANSTAAFL argument: I don't think anyone argues that what the OP describes is a "bad thing"...in fact, I think it's probably the dream scenario that people optimistically assume is the case before they have their first encounter with an emergency room.
But the reason why it doesn't happen is because of cost, plain and simple. And to be concerned about cost is not just the domain of greedy insurers and fat cat cost cutters, but of reasonable people who understand that preventive care is less dramatic than end-of-life care, but is surely as deserving of resources and attention. And both types of care rely on the same limited pot of funding.
It's easy to be emotionally invested in the personal case of a man who is lucky enough to have a loved one so eloquent with words. But what about the hundreds, thousands of routine cases that are treated by NHS with a protocol governed by cost limitations, limitations that will inevitably be imposed by the decision to give blue-chip treatment to the untreatable?
These routine cases don't pull at the heart strings because it is the nature of the human mind not to realize/dwell on how an exam/procedure not scheduled two years ago is the main factor in the chronic disease one suffers today. And yet these people are just as deserving of optimal treatment as OP's Bill. The way that OP judges the value of healthcare, though, means that the Bill's will get a greater share of a finite set of resources. Is this really the way an optimal healthcare system should work?
This is not to say that the U.S. or any other system is currently better than the NHS. It's just to point out that fashion in which the OP (positively) judges the NHS is susceptible to being ignorant of the problems that occur earlier in the pipeline of health.
"But the reason why it doesn't happen is because of cost"
The most peculiar part of the whole situation is service cost and individual personal wealth is never an issue WRT national military "defense" or police coverage or fire department coverage or admission into a church or the (admittedly failed) K12 education system or EPA enforcement or OSHA enforcement or ... thus the real question is why cost should be a concern almost exclusively for sick care. My point being that you need to convince not merely that cost is an issue, but that cost should only be an issue for healthcare specifically.
I think we have happily gotten over the idea of needing insurance company plaques on your building in case of fire, and soldiers rarely defend only the rich parts of cities.
Note that there are a few townships that provide emergency services free to residents for the first /n/ visits per year, after which some fees are assessed. If you are not a resident, you may receive a bill if that area's emergency services dispenses care or transports you to a hospital.
But the nice thing about a publicly financed health care system is that early interventions become much more likely when people aren't forced to make decisions like "Should I spend my paycheck getting this lump in my breast checked out or should I spend it on groceries for the family."
Exactly. My mom is dying from terminal breast cancer and she avoided going to the doctor for more than a year for chest pains because she had anxiety issues and was too worried about the financial aspects to confirm whether it was anxiety issues or something more serious. It had to turn from chest pains to shortness of breath before she finally set aside the cash to get it checked out. Turns out the breast cancer had metastasized and ended up in her lung, bones and liver by the time they diagnosed the cause. By that point the cancer in her lung was the size of an orange.
Similar case with my uncle and colon cancer. The anxiety of knowing made the situation worse.
For most of us, the money can be attained, as evident by the electronic devices littering our homes and offices.
Related, I've found that many young people don't want to know what their credit card or bank balance is, for fear of seeing how little money they have left (or saved).
The problem with the TANSTAAFL argument in this case is that the NHS is far cheaper than the American alternative. It is also far superior at providing preventative care than the American alternative.
As an example of preventive care offered by the NHS. I am registered with a local GP who I hardly ever see (because I don't need to). Two years ago I received an SMS message from them because of my age (over 40) to come in for the NHS Health Check (http://www.nhs.uk/Planners/NHSHealthCheck/Pages/NHSHealthChe...).
The test involved a bunch of basics (weight, exercise, blood pressure, etc.) and two blood tests (for cholesterol and blood sugar level). They will repeat this every five years.
I do not think the NHS is the greatest possible system (in fact, I preferred the French system when I lived there), but by many measures it is good.
Indeed. The US private sector and the US federal government EACH spend more per capita on health care than the UK does. And yet we rank behind the UK on virtually every health statistic that they bother to track.
In 1993 Republicans did an interesting analysis. They found that Clinton's health care plan would work, and would be popular. If it passed, they believed that Republicans would be losing national elections for a generation. But they also figured out that if they derailed it, then they could turn fears about it into a potent election issue. They did, and it was. They tried the same thing with Obama's plan. Whether the other half of their prediction comes true is yet to be decided.
Not only that, but as Dean Baker never tires of pointing out, if the US only spent as much as other rich countries do on health care (countries that get better health outcomes), it would have huge budget surpluses rather than deficits.
You are exactly right and often times the ability to derail a reform plan in the legislature costs it support not only by seemingly discrediting it in the political process but also forcing reform advocates to support a concrete bill that has real consequences while opponents don't need to offer anything and can attack consequences of the bill passing out of context. No one is sure it will pass, so invariably some members waver and the bill is watered down to guarantee support, at which point it becomes compromised and rather ineffective which once again discredits reform.
Its interesting in the post-1945 election in the UK very few voters strongly supported the NHS but once it passed it developed bipartisan support. The chances of a party taking every house of congress a supermajority in the senate and the presidency to have the ability to move legislation is incredibly small in our system as compared to a parliamentary one. I'm not suggesting that our system is always worse but in this instance it certainly is.
> "They found that Clinton's health care plan would work..."
They found nothing of the sort. Did you even bother to read their analysis at your link? You can disagree with someone without misrepresenting their motives.
Just for the record, I'm not saying NHS is worse than American healthcare. I'm just stating that its possible, in a hypothetical system, in which an efficient and fair allocation of resources will bring about end-of-life care scenarios that are less ideal than what the OP describes. And that its also possible that ideal end-of-life care will end up hurting others (through a disproportionate allocation of resources) and doing so in a way that is hard to dramatize (until it's too late).
This is a tension that keeps effective health care reform from moving forward, but it's still a tension that should weigh as heavily in a debate as an emotional appeal.
Of course it's cheaper - the NHS is actively controlling prices. That of course means that doctors get paid less, patients wait longer for certain types of treatments or are denied other types outright, and people do are not granted unlimited resources to fight death at their end of life as they are in our system. You can't just say it's cheaper as a blanket endorsement without analyzing exactly why it's cheaper.
Yup. You can happily pay for private insurance, or pay out of pocket for private care, and you'll be able to get all the drugs that the NHS thinks are too expensive for the benefits they bring, or surgical procedures that are considered experimental.
So why all the hate for socialized medicine? If the rich(er) folks want to have access to the most exotic care, they can still have it. Meanwhile, people who can't afford basic care today will get it. Come on, America.
He was a charming, damaged, charismatic, fiercely intelligent, dissolute individual, who lived entirely on his own terms. As a professional gambler, it is unlikely he paid much if any tax in 37 years. He had no will, no funeral plan. He never did fill out the forms necessary to vote in the last election, or the one before that, as I discovered. He just hated forms. I could sympathise. Had he stayed in the US, it is – how you say – dollars to doughnuts he wouldn’t have got it together to fill out the forms, and would have had no health insurance. He considered the US system “absolutely unmanageable”.
However long this goes on for, they'll continue throwing resources at this individual and never show a single sheet of figures to any of his relatives. Not because they'll get anything back, but because this is what the NHS does. It’s free care for throat cancer sufferers who only gave up smoking four years afterwards, for drinkers who were told 35 years ago that if they didn’t quit drinking they’d die. Free care for American immigrants, for jerks and gents. Free care for parents whether they showed up or not. Free care for guys who tried to try. Free care for the only father I will ever have.
So here comes the TANSTAAFL argument: I don't think anyone argues that what the OP describes is a "bad thing"...in fact, I think it's probably the dream scenario that people optimistically assume is the case before they have their first encounter with an emergency room.
But the reason why it doesn't happen is because of cost, plain and simple. And to be concerned about cost is not just the domain of greedy insurers and fat cat cost cutters, but of reasonable people who understand that preventive care is less dramatic than end-of-life care, but is surely as deserving of resources and attention. And both types of care rely on the same limited pot of funding.
It's easy to be emotionally invested in the personal case of a man who is lucky enough to have a loved one so eloquent with words. But what about the hundreds, thousands of routine cases that are treated by NHS with a protocol governed by cost limitations, limitations that will inevitably be imposed by the decision to give blue-chip treatment to the untreatable?
These routine cases don't pull at the heart strings because it is the nature of the human mind not to realize/dwell on how an exam/procedure not scheduled two years ago is the main factor in the chronic disease one suffers today. And yet these people are just as deserving of optimal treatment as OP's Bill. The way that OP judges the value of healthcare, though, means that the Bill's will get a greater share of a finite set of resources. Is this really the way an optimal healthcare system should work?
This is not to say that the U.S. or any other system is currently better than the NHS. It's just to point out that fashion in which the OP (positively) judges the NHS is susceptible to being ignorant of the problems that occur earlier in the pipeline of health.