Posted by gintstopgitprr on 11/06/09 4:47 PM [Newer: Operation Health Freedom: Tom Woods Transcript (Unedited)] [Older: Lesser Known Historical Figures #1]

http://www.youtube.com/watch?v=crZQyFlOYfY

Daniel Hannan:

The National Health Service was founded immediately after the second World War, it was conceived during the second World War, in 1944, and that's a very significant fact because it was the product of total mobilization. At that time the United Kingdom had rationing for food, it had identity cards, it had seized all the major industries for the war effort, it had conscripted the male population; there hadn't been such an enlargement of state power before, and there hasn't been one since. Every resource was mobilized for the contingency of defeating Nazism. 

Of course, since the war, most of these other things have eventually been undone. 

But we're left with one outstanding bit of wartime planning which is the idea of a healthcare system funded wholly out of general taxation and without any market mechanism with distribution according to need and rationing by queue. 

Why do we still have it 60 years on when in every other field we've moved away from government control, when we've privatized our airlines, our telephones, our trains and so on? Why do we have this one remaining bureaucracy that is unresponsive to consumer demand?  

I think part of the reason is that it is so large that it is very difficult to reform. 

I found this myself when I came here and remarked on a television station that it was not a good system if you took the comparators of survival rates and waiting times; you know we're not the worst in the developed world, but the United Kingdom does pretty badly. And this was immediately portrayed by the British left as an attack of the people in the system, which of course it wasn't, it was no such thing. 

But it makes it extremely difficult to have any serious kind of discussion as long as anything you say is then immediately portrayed as an assault on the doctors and nurses and cleaners and porters and all the other people in this system - who are of course, good and honest people, it's not by their choice that they're working in a system that doesn't always maximize their gifts. 

The other problem is that people are naturally conservative. And it's very difficult then for people to think that something could be better elsewhere, and this is especially true when people see people like Michael Moore coming from the United States and portraying an American healthcare system where people are regularly left without any medical attention because they're poor. 

There's this constant thing about people won't look at your medical card, they'll only look at your credit card.  So the combination of these things means that it is extremely difficult  to have any meaningful reform away from a system that is still run, as I say, on socialist lines, that is, contribution according to ability, distribution according to need, everything funded out of general taxation and without any payment. 

Even though, as I say, we're not doing very well, and I think the main thing I've found in the last month in the UK, the main differentiator, is whether people have lived in another country.  By and large, the strongest criticism of the NHS comes from people either who have lived in North America, or in another Western European country, or in another place of comparable wealth.

People who haven't done that, simply take queuing as a fact of life.  They don't think it's unusual to be told to come back 6 months later for an operation, or 3 months later, or whatever it is. 

I think that there must be a better way for us to organize our healthcare system. 

But in terms of the American debate; I don't think your system's perfect, no system in the world is perfect, mine has fallen. And I'm sure there are problems and the big insurance companies can be unresponsive; but the one thing that is by definition going to be bigger and less responsive than insurance companies is the federal government. 

And so rather than going in the direction of a nationalized system, something that has been rejected in every other field of public activity, you should be, it seems to me, going in the direction that I would like the United Kingdom to go in, with more control for the individual.  Personalized healthcare accounts, more responsiveness, more of a free-market which is what drives up standards. 

One final point.  It's always phrased, on both sides of the Atlantic, as necessary to have a system that will look after the poor. I agree. Of course, it would be inhuman in a wealthy country not to have a system in which those who are without means are deprived of good quality healthcare; but we  have to understand, that as in any other field, the poor will have their interests better served, if there is a system in which choice and competition have driven up standards for everybody.   The pushy middle class people who through their discernment are in a position to demand and secure better treatment,  thereby in the process also secure treatment for the worse off. I'm convinced  that a system where there is consumer choice, and where people have some control over what they do with their resources is going to be better both for the wealthy, and the less well-off.