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Archive for January 17th, 2023

I’m routinely critical of the many ways that government intervention has created an expensive and inefficient health system in the United States.

But there are countries where government causes even greater problems. So when I want to feel good about America’s clunky healthcare system, I look at the mess across the ocean.

The United Kingdom has a socialist health system. And it’s real socialism, with government running the hospitals and employing the doctors and nurses.

And this produces predictably bad results.

I’ve shared numerous horror stories about that approach (see here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, here, and here), but this report from David Parsley is so astounding that even some of my knee-jerk leftist friends may reconsider their support for big government.

Ukrainian refugees who travelled to the UK to escape the war are risking their lives by returning to their homeland to seek urgent medical treatments after giving up on the NHS. Due the NHS pressures and long waiting lists for procedures, Ukrainians living with families across the UK are taking the perilous trip back into a war zone where they are treated by doctors immediately despite Russian bombardments of their towns and cities. …Maiia Habruk escaped Kyiv last spring along with around five million fellow citizens and found a safe haven with a couple in south east London. But she returned to Ukraine in mid-December after failing to get the treatment she needed from her local hospital in Lewisham. …She decided the only way to get the treatment she believed she required was to make the 24-hour trip back to Ukraine, which includes a flight to Poland and a long and dangerous train journey to Kyiv. …Maiia, who witnessed almost daily bombing raids by the Russians while in Kyiv, knows three other Ukrainians in London who sought emergency health procedures back in their war-torn country due to the lack of availability of quick treatment from the NHS.

These people were engaging in cost-benefit analysis. They compared the risk of death, injury, or suffering from Russian bombs to the risk of death, injury, or suffering from languishing on a waiting list in the United Kingdom.

And they decided Russian bombs were the better option.

This disaster is attracting attention in other nations. The Wall Street Journal opined two days ago about the NHS.

The American left can’t seem to quit its desire for single-payer Medicare for All. So it’s worth noting that the United Kingdom, which already has a system resembling that socialist dream, is rethinking it amid another winter of healthcare misery. …Waiting times for ambulances for the most serious calls are getting longer, with the average response time reaching 10 minutes 57 seconds in December, compared to a target of seven. Once patients reach the emergency room, 35% now face waits above four hours… As of November, some 7.2 million patients have been referred for treatment but are waiting for it to start. Of those, 2.9 million have been waiting more than 18 weeks. The NHS considers itself a success if it starts treatment within that four-month window, which is the epitome of defining failure down. …Excess deaths in 2022 were the most since 1951, excluding the pandemic. …The U.S. suffers a chronic problem of healthcare financing but not of health-care delivery. Britain shows that with single-payer you end up with both. The U.K. also shows that single-payer’s biggest victims are low-income people who can’t afford to opt out.

Yet there are nonetheless American politicians who want to copy this failed system.

Allister Heath of the U.K.-based Telegraph has a grim assessment of his nation’s government-run system.

…the NHS is finished. It is broken beyond repair, ruining the lives of hundreds of thousands, and threatening the social fabric and economic performance of our nation. …this 75-year experiment in health socialism has failed appallingly, culminating in a surge in excess deaths, waiting lists that aren’t worthy of a civilised nation, inhumane strikes, intolerable delays for ambulances, explicit rationing… NHS spending is up 12 per cent in real terms since 2019-20; there are 13 per cent more doctors and 11 per cent more nurses, and yet the service delivered 5 per cent fewer treatments in the first nine months of 2022 than in the same period in 2019. …Its six pillars – that it is “free” at the point of use, the full state ownership of hospitals, its complete dependence on taxpayer funding, its supposed culture of altruism, its nature as a shared moral project uniting rich and poor, and its centrally planned workforce – are the very causes of its disintegration.

P.S. I can’t resist some closing comments about the politics of government-run health care.

The first story cited above includes these comments from left-of-center U.K. politicians.

Labour’s shadow health secretary Wes Streeting told i “Vladimir Putin is dropping bombs on Ukrainian hospitals, yet patients are travelling back to Kyiv rather than face NHS waiting lists. …Liberal Democrat health spokesperson Daisy Cooper said: “It’s a damning indictment of the government’s record on the NHS that Ukrainian refugees are returning to a war-torn country to access health care.”

Accurate criticisms, to be sure. But both Labour and the Lib Dems simply want to dump more money in the system.

But the so-called Conservative Party does exactly the same thing, as the Wall Street Journal noted in its editorial.

Former Prime Minister Boris Johnson in 2021 pledged an additional £36 billion over three years for the NHS and related home and nursing-home care, funded by a payroll-tax increase. Mr. Sunak and Chancellor Jeremy Hunt followed in November with another £3.3 billion a year for the next two years.

And Allister Heath made a similar observation in his column.

The Cameron-May-Johnson survival strategy was to “neutralise” the NHS by refusing to contemplate difficult reforms, genuflecting endlessly at its altar, prioritising it in every Budget, greatly boosting its funding after Brexit and worshipping it hysterically during the lockdowns; yet, in the end, it was the NHS that neutralised the Tories. Small-state, high-growth Toryism is incompatible with an unreconstructed NHS, with its need for ever-higher taxes. How long will the Conservatives continue to lie to themselves about this?

This is a good opportunity to revisit my “what’s the alternative?” argument.

Self-styled right-of-center parties have to choose whether to become tax collectors for the welfare state or whether to push for entitlement reform. There’s no other alternative.

P.P.S. There is one group of people who are net winners from the U.K.’s government-run system.

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