Sunday, May 31, 2009

Questions Answered Re: NHS

(Originally posted by my husband on NRO - The Corner)

Re: Is Socialized Health Care Popular in the U.K.?

Some very interesting questions, Pete. Here's my go at answering them.

1. How popular is the NHS? The polls suggest it is not as popular as people think. This poll for the Daily Telegraph (I am unsure of the date, because I can only find reference to it on the Daily Mail web site, and the Mail does not datestamp its articles, but its clearly pre-2006) suggests that 4 out of 10 would go private "if they could" and that two-thirds are unhappy with the NHS service. However, when faced with a choice between the NHS and other systems, a slim majority prefers the NHS.

2. Does David Cameron or any other conservative want to reform the NHS? Ever since it became a big issue during Mrs. Thatcher's ministry, conservatives have been declaring that "the NHS is safe in our hands." There was a brief attempt to introduce a "patient's passport" during one of the leaders between John Major and David Cameron, but that policy has been dropped and the "safe in our hands" policy is now back. However, the two brightest lights in the intellectual wing of the Conservatives, Douglas Carswell MP and internet megastar Daniel Hannan MEP, have a comprehensive reform package outlined in their essential work, The Plan: Twelve Months to Renew Britain. Since the expenses scandal, the political pendulum has certainly been swinging their way.

3. Why isn't there a groundswell against it? I have never seen a poll that drills down into the bedrock to ask just why people like the idea of the NHS, but I suspect it is a combination of three things: a confusion between "free" and "free at the point of use," a failure to appreciate that general performance is much better under other health systems, and an attitude to risk that wants a low-cost remedy in the event of catastrophe. If people did appreciate that other systems are better, the other two considerations might change. However, all Health Ministers of all parties have constantly repeated the refrain that the NHS is the "envy of the world." I hope that will change under a Conservative government and a more realistic assessment will be given to the British people.

Incidentally, the splendid British think tank Civitas has a useful collection of tables relating to NHS performance and comparisons with other health systems. This is the direct link to the one comparing the NHS to U.S. insurance.

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