The truth about the NHS

Kristian Niemietz writes in The Independent:

Genuine question: what’s exceptional about the NHS?

The fact that it’s universal, that it provides care to everybody irrespective of ability to pay? Standard fare. All healthcare systems in the developed world do that, with the US system being the only major exception.

The fact that it is generally free at the point of use, with very little out-of-pocket spending? Nothing special either. Plenty of systems are, or where they have modest co-payments, they exempt people on low incomes and/or with high health needs.     

The fact that it offers modern technology and modern medicines? Meh. All healthcare systems in the developed world do that, and plenty of them are more innovation-friendly than the NHS.

The fact that it runs on compassion and solidarity, rather than self-interest? Give me a break. Of course it runs on self-interest. Let’s do an experiment: let’s cut doctors’ pay by a quarter or so and see how many of them would still turn up to work.

Now, if it delivered impressive outcomes, that would indeed be a reason to be proud of it. The Swiss have good reasons to be proud of their healthcare system. They have the lowest rate of (healthcare-related) avoidable deaths in Europe, possibly in the world.

The Dutch have good reasons to be proud of their system too. It is an exceptionally generous system which offers fast access to a broad range of treatments.

The Japanese and the Israelis have good reasons to be proud of their systems. They achieve phenomenally good survival rates for cancer and stroke.

And then there are the French, German and Belgian systems: not spectacularly good in any one particularly category, but consistently good across the board.

The NHS? Nearly always in the bottom third of the league tables, usually about on a par with the Czech Republic and Slovenia.

I’ve never used the NHS but don’t know that many people in the UK who rave about it. Most of them constantly complain about it.