“The Doctor’s Dilemma,” an article featured in a recent issuer of The Economist, discusses the outcome of a fortnight of frenzied debate about the state of the National Health Service (NHS). There are, apparently, two things that “everybody knows.” The first is that Britain spends too little on health; the second is that Prime Minister Tony Blair has promised a vast increase in health spending.
In America, socialists want to increase state control of medicine and base their argument on the two things that “everybody knows.” The first is that America spends too much on health; the second is that the current administration and candidates have promised a vast increase in government control of medicine. Although sold as cost containment, the experience in America is usually the reverse.
Perhaps a closer look at medical care in Britain is called for. Britain spends a much smaller proportion of its GDP on healthcare as compared with the United States, Germany, France, and Canada – but this may not be a problem inasmuch as life expectancy in Britain is as long or slightly higher than that in the United States.
Life expectancy measures, however, are a crude assessment of health. The relatively small amount Britain spends on health shows up as poor survival rates from some serious diseases – British women with heart disease are four times more likely to die from it than women in France are; British women with breast cancer have one of the worst survival rates in Western Europe. Patients in Britain are also subjected to long waiting lists for surgeries. Saving money takes precedence over patient comfort.
The poor record in heart disease and cancer and long waiting lists are not the only factors that contribute to making the NHS so cheap to run: a relative paucity of doctors and nurses in Britain, allied with the difficulty of getting access to specialist treatment, also keeps down costs. Britain has the lowest number of doctors per 1,000 patients among the G7 nations, and Britain has about half the number of beds per patient as France or Germany, and fewer nurses as well.
In most Western countries, public funds, taxes forcibly taken from citizens under threat of coercion, account for two-thirds of health-care spending. Only in America do private citizens control half of health care spending. We are the last hope on earth for optimum healthcare determined by the recipients of such care. Otherwise we will join socialist-government-controlled paternalistic schemes, such as the one a British doctor told me about: This year eye exams are in and teeth exams are out. Last year allergies were covered. Orthopedists are still waiting for the time when hips will be in bloom. One can never predict what a politician’s family is suffering from – which will then become next year’s priority disease.
What a shambles for our once noble profession. Are we on the goal line stance with the world watching the last hope for patient based medicine? Are we committed enough to place the medical football between the goal posts?