“the NHS is the one public service on which the political classes dare not ravage with market fundamentalism. ”

I wish that were true but it’s not is it. Whilst we haven’t seen the wholesale sell off of the NHS in the way the railways were there is more private involvement in the NHS now than at any time in history, more outsourcing, more casualisation of labour, more market philosophy embedded within it than ever.

The problem with the NHS is that it is not socialised enough – and that’s why it’s been a strange experience to see politicians like Gordon Brown trying to make political capital out of the ‘we love the nhs’ campaign when he has done more to introduce market forces into healthcare in this country than any other.

Yes but the basic structure remains sound: free at the point of delivery; treatment based on need not ability to pay. I have no doubts that if Nye Bevan was around today he would still recognise it as the National Health Service he helped to put in place.

Whilst there are criticisms to be made of this government’s policy towards the NHS, in terms of basic funding the situation has improved. Not enough, but Brown still deserves credit for that.

The thing is schemes like PFI deliver less and cost more. Outsourcing cleaning in hospitals means you get lower standards but you’re paying a middle man for the privilege. I give Brown credit for increasing the cost of the NHS – but there have been fundamental structural shifts in the NHS over the last twenty years that have undermined workers rights, and some aspects of patient care.

“the millions of uninsured American poor, the fact remains that there are lots of places in the world where people are much worse off – at least they have Medicaid”

Err, Medicaid is government health insurance for the poor.

Yes Tim, but they are “uninsured” in the sense of not being covered by the insurance companies. There’s no inconsistency or foolishness in that statement. (And you know it).

“Yes Tim, but they are “uninsured” in the sense of not being covered by the insurance companies. There’s no inconsistency or foolishness in that statement. (And you know it).”

By that measure then so is everyone over 65 in the US. For they are also insured by the govt under Medicare.

“The poor” are insured by Medicaid. Forgotten what the income level is now but it’s well above poverty level to be eligible.

By your definition above everyone in hte UK is without insurance, because we’re not insured by insurance companies but by the NHS.

I can see what you’re saying but it strikes me as being a very silly thing to say.

Yes Tim but it doesn’t cover enough, we’ve already had this discussion.

Anyway, onto the topic itself, I’ve been chided by Americans elsewhere as to why I’m sticking my nose in to debates about US healthcare and I came to much the same conclusion as you Josh and also the rather trite idea that a healthy America, means a better America and a better America is essential to a better world.

Now can we all hold hands and pray…

Actually, Josh, I do not believe that the USA is an appropriate political environment for a national health system simply because it is a neoliberal concensus on centre right.
The historical context in which the NHS developed was quite different both politically and socially,:- it was part of a social policy which was closely aligned to the post-war economic policy – Keynes/demand management/corporatism and the conditions were ‘perfect’ for a national health service to be introduced.
If the NHS was dismantled I doubt if it would emerge again. And because of the aforesaid reasons, this is why the NHS model is not adopted in other countries.

.
If the NHS was dismantled I doubt if it would emerge again.

I don’t really see what this hypothetical achieves. The entire point of this article is that it is not going to get dismantled.

James@9 I thought that I had made my point clear in that the NHS emerged at a particular time in history which was quite unlike the existing USA conditions and, by inference, the political conditions which now exist in the U.K.
My hypothesis was that if there was no NHS e.g. it became dismantled, it would not emerge again anywhere.
Surely the point of this debate is actually the controversy over Obama’s plan to introduce a national health system in the U.S.A rather than whether or not the NHS is going to be dismantled.

It has been priceless watching the moronic American brown shirt hoards on the right as they turn up at these health care debates and whine on about how they don’t want govt health care, totally oblivious to the fact that Medicare is ……………govt health care. Hilarious.

When this is pointed out to them, with the additional fact that all the wounded soldiers who return from war get govt funded health care, along with all those idiot , hypocritical Washington politicians who also get govt funded health care they say, “well I don’t claim to no all the facts, but I don’t want to live in Russia.” Stupid does not even begin to describe these sheeple.

Another interesting thing about this debate in America is that once again it reveals the total bullshit of the so called ‘right to life movement.’ They may want to save the fetus,but once it comes out of the womb and gets cancer “well fuck you, I don’t want to save your life,”

But The American right does victim status like no other in the world. They whine like the little tiity ass babies that they are. I see that the British Right wing has adopted this rather unappealing trait. Dale and Montgomeire have become real whiny titty ass babies when someone points out that they talk shit.

The Americans lost any right whatsoever to say that people should keep their noses out of American healthcare business once they used Canada and the UK healthcare systems in their attack ad’s.

So it is open to all to say what they like.

While you are very correct, Sally – the right have yet to come out and say what their proposals are so all can debate them.

Odd that keeping them quiet seems to confirm that they want a US style system – I know some who are very close to me who say that they do.

jb – The point of this article was that as it exists in Britain the NHS is something which will not be dismantled. It is simply too popular for the Hannan strain of Toryism to triumph in, that sort of view is a niche which the mainstream Conservatives will make a concentrated effort to isolate. Responding to this the point you made is to pursue a pointless counter-factual & to ignore the article altogether.

As it happens I do agree that the NHS came about under a set of unique circumstances (a cross-party consensus that one was necessary combined with the visionary drive of Nye Bevan, the greatest British politician to obtain power) but I don’t really see what that has to do with the article.

“As it happens I do agree that the NHS came about under a set of unique circumstances (a cross-party consensus that one was necessary combined with the visionary drive of Nye Bevan, the greatest British politician to obtain power) but I don’t really see what that has to do with the article.

I think the Conservatives voted against the setting up of the NHS. They only kept it going because it was so popular. Many of their own supporters love the NHS, but the political class of the Conservative party hate the NHS. Always have done.

The Observer today has a front page lead about other Tory MPs who want to destroy the NHS. They include that supercilious, goggle eyed twat Michael Grove. You don’t get more arrogant than him. Cameron’s claim that it is only Hannan , is bullshit. Many of his own front bench want to destroy the NHS.

.It would also interesting to know how many Tory MPS are taking money from the American health care companies who have a vested interest in destroying the NHS. I wonder if Conservative home is taking funding from these copmpanies. The companies have been pouring huge amounts of corporate money into Canada to try to destroy their system.

Sally – With regards the voting, I’m not quite sure (although I should be). As for support, though, there’s a quote from Churchill in 1943 where he says in so many words that he supports a “National Health Service…Free at the point of use”. This was a cornerstone recommendation of the Bevan report & all three major parties were signed up to the Beveridge Report (with the only controversy in that statement being whether or not you deem the Liberal Party in the mid-1940s “major” or not).

Like I said, I doubt that it would actually have happened had a lesser man than Bevan been in charge of health (and everyone of the era was a lesser man than Bevan, do remember). It took both boldness & imagination to devise the system settled upon (state ownership of the hospitals, an idea which seemingly emerged from Bevan’s own head). But the Conservatives were supposedly in favour, the electorate just decided that Labour were the best lot to implement the Report. Quite rightly.

As for Gove, yes, he is a loathsome oik. The thought of him in power disgusts & terrifies me.

Shit, that did not come out very clearly. Try again …..OECD Report.

Expenditure on health % of GDP

America 16%
France 11%
UK 8.4%
Singapore 3.4%

Life Expectancy at birth

France 81 years
Singapore 79.7 years
UK 79.1 years
America 79.1 years

Out of pocket spending by households as a % of private expenditure on health (Includes items not covered by insurance. E.g. some medicines or fees)

Singapore 93.8%
UK 92.1%
France 33.2%
US 23.9%

Expenditure on health per capita US$

America $7,290
France $3,601
UK $2,992
Singapore $1,228

Infant mortality per 1000 live births

US 6.7
UK 4.8
France 3.8
Singapore 2.1

Tim W,

“By that measure then so is everyone over 65 in the US. For they are also insured by the govt under Medicare.

“The poor” are insured by Medicaid. Forgotten what the income level is now but it’s well above poverty level to be eligible.

By your definition above everyone in hte UK is without insurance, because we’re not insured by insurance companies but by the NHS.

I can see what you’re saying but it strikes me as being a very silly thing to say.”

Why is it silly to point out that a person you are attempting to lampoon is using the word “uninsured” to mean specifically (and quite reasonably) “not insured by an insurance company”, when your attempt to lampoon them relies upon using the word “uninsured” in a different (equally reasonable, but different) sense meaning “not insured by any entity whatsoever”?

For by making that distinction, it would seem that your attempt to lampoon is clearly misplaced and therefore does not hit its mark.

It may well seem like “a very silly thing to say” to you, but that may well say more about you than anything else…

The point of this article was that as it exists in Britain the NHS is something which will not be dismantled

It won’t be dismantled, but it could be destroyed. It would take about 10 years: slight underfunding, but still with big headline budgets. Restructure it every two years to keep managers chasing their tails, but avoid any meaningful reform that takes account of technological and social changes. Make sure there are 5 headline stories each year about medical tragedies, and make sure those 5 stories are ones that can be naturally spun as inherent in the nature of the system.

Then, once it’s unpopular, sigh and say ‘we tried so hard to keep it going, but you can’t fight economics’.

Replace it with something more profitable.

You mean 10 more years?

Sally@14 – Although Churchill actually agreed with the NHS (he was a free marketeer), the political and social circumstances at the time literally ‘forced his hand’.
James@13 – I don’t disagree with you but the ‘consensus’ was tenuous to put it mildly.
The emergence of the NHS was enabled by a unique set of circumstances and I don’t want to underplay Bevan’s vision, but even he would have been unlikely to have got the NHS model agreed at any other time. That said, the NHS has become, to many people, more than just a state provider of healthcare, even Thatcher’s neoliberalism failed to change the views of the majority of the UK population, but it is not ‘natural’ Conservative territory. The ageing population and the healtcare provision which has been forecast, means that the NHS, in its’ existing form, is likely to be restructured in some way. And if the Tories win the next election, quite considerably.
soru@18 Spot-on

Someone mentioned that this thread is really about: Why the Republicans are bashing the NHS.

There are, arguably, two fundamental points to make for starters:

- The proposals for healthcare reform in America don’t amount to anything remotely like the NHS so we are left to speculate on just why are the Republicans bashing the NHS?

- Other west European countries have not adopted the NHS as a model but instead focus on social insurance schemes for healthcare costs without creating state monopolies of healthcare provision. By independent assessments, the healthcare systems of other west European countries rate better than the NHS in performance league tables.

Bob B:

The reason the Rethugs bash teh NHS is that they have idiotically assumed that NHS is in somewhy connected to Obama’s healthcare plan, when it is not.

The idea that just because other nations do not have the NHS model means that somehow the NHS is lesser, based on WHO stats only nations like France and Germany have superiour healthcare across the board in comparison to the NHS.

“based on WHO stats only nations like France and Germany have superiour healthcare across the board in comparison to the NHS.”

Umm, no, not really. You see, the WHO stats are composites, they measure not only the level of care but also the distribution and the financing. In fact, the majority of their measurement is about the equality (or inequality) of care and financing rather than the actual level of care.

The NHS is 14th in the level of health care.

The stats are here.

http://www.photius.com/rankings/world_health_systems.html

Um yes, I’m talking about looking at life expectency, infant mortality, number of doctors and nurses per patient, number of beds, cost of service and outcomes.

Also, to re-state something for the 18th time, the NHS is superiour to US care.

Cool.

” the NHS is superiour to US care.

Cool.”

Well, I have just shown you the WHO stats that prove that haven’t I?

As I’ve been saying around and about the place (ever since I first started looking up the statistics actually) the thing the US system is number 1 at is “responsiveness”.

And that’s what makes it so expensive.

Fuck off Tim, in a previous tedious debate with you I already dragged them out.

Is this baggsy the stats?

Fuck me.

As for responsiveness…heh, only if you’ve the money rude boy and the deductibles are not too bad and you’ve covered the premiums and you’ve no previous health issues.

I’ve no idea why you’re fighting the US healthcare’s corner but I’d choose your allies a little better in future.

Excellent digest of public debate over reform of US healthcare (IMO):

Misconception over key issues at core of debate
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/08/17/MNT4198FQ4.DTL&type=politics

Also worth reading on healthcare in America:

ObamaCare is bad news for Big Pharma, by Stephen Foley
http://www.independent.co.uk/news/world/americas/the-brutal-truth-about-americarsquos-healthcare-1772580.html

Try Paul Krugman on US healthcare reform:

“So where does Obamacare fit into all this? Basically, it’s a plan to Swissify America, using regulation and subsidies to ensure universal coverage.”
http://www.nytimes.com/2009/08/17/opinion/17krugman.html?_r=1

“Abusive, sarcastic or silly comments may be deleted”

MAY be deleted, I see. Comment 14 may need an edit (no need to delete)

The reason the Rethugs bash teh NHS is that they have idiotically assumed that NHS is in somewhy connected to Obama’s healthcare plan, when it is not.

I think that there is a possibility that they have chosen to focus specifically on the NHS, rather than any of the continental systems, because in many modern American movies the bad guys are marked, not by black cowboy hats, but by English accents.

Spank Owls:

Leave Sally alone!

hahaha…OK. What she wrote seems OK I just thought the description of Gove was not necessary; he can’t be that arrogant if he arranged a full (open?) meeting and “came clean” re the expenses etc and they all forgave him! Of course he could well be a twat…

Seriously, she’s mental but some of us love her a great deal.