Monday, October 15, 2007

The immorality of socialized medicine

The spread of extremely dangerous disease in Canadian hospitals has received much publicity in recent years. In particular C. difficile and SARS have made headlines.

The medical professionals know a lot about these diseases, their causes and prevention. But a root cause of the problem, government monopoly healthcare, continues to be ignored.

It seems Britain has a similar problem with similar roots. This excellent column by Charles Moore describes the British National Health System. Change the names and it perfectly describes the situation in Canada:

The point our leaders are constantly making is not medical, but moral. It is that the NHS embodies organised altruism. It proves that we, as a nation, care for one another. It makes us "the envy of the world", and it makes us good.

Nevertheless, the basic proposition is not true. The National Health Service is not, morally, or in any other way, the best system of healthcare in the world. Indeed, it is morally defective at its very root, because it does not — cannot — put the sick first. Until this is recognised, it cannot be reformed.

The NHS is, with our state school system, the last major survival in this country of the idea of the 1940s that government can decide what is best for us and make sure that it is done.

We all know that a Minister for Industry could not possibly decide how many computers we produce or how many investment banks we should have. We all know that a Minister for Food could not wisely decree what vegetables should be sold in which shops.

But we cling to the idea that a single organisation employing 1.4 million people, with the GDP of an entire Scandinavian country, run by politicians, can meet our health needs.

Suppose Sainsbury's cold meat counter was found to have helped kill more than 300 people, would the company survive? Yet the NHS sails on, dealing death.

This is all, morally, wrong. It turns the patient from being the entity for which the service exists into a nuisance. Each new patient is just an added cost and each dead patient is an administrative convenience.

The NHS is run from top to bottom, and therefore, from top to bottom, it is bad.

My personal experience of conditions in our hospitals on several occasions over the past decade have reinforced my conviction that Mr. Moore’s analysis is correct. The worst experience was sharing a heart surgery recovery room in a dirty, decrepit old hospital with four or five other patients. While we have a new hospital now, cleanliness remains a serious problem as there continues to be outbreaks of C. difficile and who knows what else. No doubt the careless, dirty old practices followed the staff to the new digs. And the government certainly hasn’t given up its monopoly.



Raphael Alexander said...

I would be in favour of a mixture of socialized medicine with private medicine. Perhaps a low income exemption for people would alleviate the burden. We should also be careful not to offer so many medical benefits to refugees and immigrants who have not yet paid into the system in order to receive their medicare.

I am not, however, in favour of the Ontarian and British Columbian health taxes we are forced to pay on top of our taxes. With the added "premiums" I have no idea what they're doing with the rest of my thousands of tax dollars every year. Surely road maintenance and policemen cannot require that much taxation. I think our $14 billion surplus is proof of that.

Lemon said...

Definitely worth a link - great find

JR said...

Raphael, I agree that people with low/no incomes need help, perhaps subsidized insurance premiums. But I'd prefer to see government out of the healthcare delivery business altogether. They're inevitably conflicted or incompetent or both.

Brian, Thanks.