This is the first in a series of blogs destroying some of the myths and misconceptions we all seem to have about public services. The subject? The NHS and the commonly held belief that it is a free service. It is not. It never has been and it never will be. Every single man woman and child who has ever had money has in some way shape or form paid a contribution towards the running of the service. Ah, you say. Not true, what about the single teenage mum on benefits, who has never done a days work, spending all of her benefits on fags and booze? How much tax has she paid? Well surprisingly, probably quite a lot. Alcohol and cigarattes are taxed to the hilt. When little Johnny and Gemima go to the sweetshop, 20p of every £1.20 they spend on sweeties, goes to the taxman in the form of VAT. If you give little Johnny a pound a week pocket money and he spends it on sweets and toys, £8.67 of what he has spent goes to the treasury every year.
Then there is the argument "I never use the health service, so why should I pay?". I doubt there is a single reader of this blog who hasn't benefitted from the health service. Most of us had innoculations as children, which have gone on protecting us. Diseases such as TB, Diptheria and Smallpox have disappeared (sadly TB is making a comeback). Some selfish parents do refuse to innoculate, but they are given a degree of protection by the fact that society in general has been, removing plagues of these diseases. The people who say they would rather take responsibility for their own health care and sod everyone else, neglect to acknowledge the fact that in the USA, people become uninsurable. What happens then?
In the UK we spend about 8% of our GDP on healthcare. The Americans spend 15%, yet we have universal coverage. It is true that there are some specialism, especially in the cancer field that we don't have, but for the average person in the street, you are far safer here. Why do the Americans pay nearly twice as much for a system which delivers far less to the man on the street? Because it is run by insurance companies and private hospitals. It always amuses me when right wing pundits say "I'd rather pay for my own healthcare" and cite insurance schemes. This is because in the American system, like our you don't. The healthy people in the scheme pay for the sick people in the scheme. It is like car insurance. I must have it by law. I have never (touch wood) had an accident, so I've paid thousands for nothing. If I did have a major accident, then the dynamics would change. I would become subsidised by everyone else. This is how healthcare in America works. The insurance companies make huge profits, which are paid as dividends to shareholders. That is where much of the money goes. Americans claim that their hospitals are more efficient, but a significant portion of the money is siphoned off to the shareholders of the insurance companies before it even gets to the hospitals.
The hospitals themselves are corporations. They make money by supplying services. Many tests are run, which would never get run here, purely to avoid the minute possibility of malpractice lawsuits. This ramps up costs (and profits for the hospitals). The difference between a taxpayer funded health service and a private health service is not that you only get what you pay for. It is that in the NHS, you will get treated. In a private health service, there are a million reasons why you may not. If you have ever had an break in and had to claim on your insurance, a loss adjuster comes around and tries to minimise your claim. The same thing happens in private healthcare. The companies are far keener to take the cash than pay it out.
Getting back to the point I made at the start of this blog. The NHS isn't free. We all pay for it. If a single man, who is a layabout and has never worked for a single day, has also never been ill, he will have paid a fortune into the NHS by the day he dies. He still pays VAT on most of his purchases, as well as duty on alcohol and cigarettes.
Another point about the NHS, which right wing comentators never mention is that it is good for business. Many multinational companies will locate in the UK, because there are no costs associated with healthcare for staff. In the USA, many people are tied into jobs they hate, because they need the medical cover supplied by the firm. This restricts peoples life options. Losing a job can mean losing healthcare benefits. In some major cities, such as Detroit, the death of the US motor industry, lead to the partial death of the city. People could not stay in a city without healthcare. That meant that by the time new industries were attracted to the city, the workforce had left.
We are blessed that the government after the second world war set up the NHS. For all it's problems, it is by far the best way to manage the nations health. Anyone who says otherwise, probably has a vested interest. During the last US election campaign, I was in America. Various republican figures would appear on the TV every single day, denouncing Obama and claiming he wanted to "introduce a socialist healthcare system like the British NHS". They would then claim the NHS was evil, didn't work and was hated. They would quote obscure right wing pundits (most of whom no one has ever heard of). In short, they would talk complete bollocks. I was chatting to one rather rabid, right wing American about the subject. I asked him what he thought of Margaret Thatcher. He was fullsome in his praise. I then asked if he realised that NHS budgets had massively increased in the period of her rule. He was quite taken aback. I then also pointed out that Winston Churchill had been a supporter, during his time as Prime Minister. I suggested that it was quite unlikely that the NHS was a "communist plot" as these two had not abolished it.
What Margaret Thatcher, Winston Churchill and every other Prime Minister since 1945 has known is that the NHS is the one institution that is sacred to the British people. Even the slightest hint that it may be dismantled is enough to end a political career. In some ways, I actually believe the Tories get away with many things, because in a Faustian pact with the British people, they leave the NHS alone. Whatever the truth of it, just remember, it is not free. We pay for it and we should be bloody proud of it to boot.
It would help if everybody with an NHS appointment actually attended it. Sadly 10% of out-patient apointments are not attended - often with no contact from the patient. This makes treatment less efficient and lengthens waiting times for those who do attend. Wasting your appointment costs the tax-payer (by whatever means) money, and can mean cuts in vital services. Don't be part of that problem.
ReplyDelete