Nick Pickles’s blog

The NHS is an easy target if you can get health insurance. But the whole point of it isn’t to provide a comparable service to those who can - it’s to provide a service to those who can’t.

I disagree with Republicans on a lot of things, but I agree that big government puts pressure on individual liberty. But when they, joined by people like Dan Hannan, start banging on about the NHS being some socialist invention that is all a big mistake, it exposes a side of them that is feckless, out-of-touch, self-important and utterly foolish.

Hannan criticised the ‘poor survival rates’ of the NHS. They may not be perfect, but for the 45m Americans with no healthcare, the survival rate for treatable illnesses is much, much worse.

Absolutely, the NHS could be run more efficiently. 500,000 managers is too many even for an organisation that employs 1.5m people. But an inefficient NHS hospital is still preferable to a system where 1 in 10 children are born without access to healthcare.

I don’t remember where, but I once read someone argue that ‘insurance is legalised extortion’ and I still like that definition. The higher the risk, the higher the premium. The higher the cost of treatment, the bigger the incentive for the insurance company to try and avoid paying.

Anyone who watched with scorn as the British MOD tried to block higher compensation awards to soldiers should take a look at the lengths health insurance companies go to in order to establish the treatment isn’t covered by a policy.

Now what about Obama’s plan?

The NY Times economix blog takes the argument about it becoming an enormous, socialised reform to pieces quite brilliantly and is well worth a read. One point worth noting is this: $1.6 trillion (the current plan’s cost over the next decade) is only about 1 percent of the amount of G.D.P. that America can reasonably be expected to produce in the next decade. Not exactly crippling.

As the same blog points out, the Millman Index (a good guide to healthcare costs) estimates the cost of heathcare insurance for a family of 4 to be $16,700 this year.

Next year, it goes up. Infact, current estimates show that between 2001 and 2010, the cost will have doubled.

Healthcare insurance, like most insurance, is inherently unfair. If you have a pre-existing condition, a family history of an illness, or a job that exposes your body to higher risk (ie manual labour, industrial plant work) they you’ll either struggle to get covered or it’ll cost a fortune. Yet these are the people who need care the most.

There one area the NHS can learn from the insurance system - if you don’t take care of yourself, your premiums go up. This is one area I think the NHS does need to start to take notice of. As people live longer, and yet live unhealthier lives with scant regard for the consequences, the NHS cannot be a blank cheque. Obesity in particular can be picked up early in life and addressed before it leads to huge burdens on the public purse.

As the NY Times estimates, health care insurance could end up costing a family bringing in $80,000 dollars around $36,000. That’s 44% of the family income gone before tax, food, housing or tuition.

The NHS isn’t just good on a social level - it’s good on an economic level too.