When it comes to healthcare, the British take huge pride in the NHS. Afterall, it is one of our national treasures that many people (myself included) are grateful for. However just like all systems, it has its flaws. It is only fair that systems, within the public sphere, are open to scrutiny otherwise nothing will improve. The NHS in particular however is often viewed in such a sacred way that any criticism of the NHS is usually met with fierce backlash. This view is also often conflated with a hatred for market based systems. However, I think there is a compelling argument to be made.
Before I get into the main bulk of the discussion, it is important to note that I am not bashing the NHS but it is good to look at alternative views. When it comes to healthcare, the classic case that has been made (and I think so far it rings true) is that there are three specific criteria when judging a healthcare system. They are ranked on universality, affordability and quality. No healthcare system currently in use, or used previously, has ever managed to achieve more than two of them. So let’s take a look at the healthcare systems in question. Often dubbed as the best in socialised universal care, the NHS is an integral part of the United Kingdom’s two-tier healthcare system. When we talk about privatised forms, we often talk about the United States. Despite this being true that it is a privatised system, it is not truly a free market, capitalist style system as it is heavily regulated but it is worth talking about.
Referring back to the 3 factors that dictate how good and efficient a healthcare system is, it is important to know where these systems stand.
The NHS has fantastic universality as it is available to everyone. It is affordable as each person in the system pays taxes that are in line with their level of income so the prices paid aren’t crippling to its citizens. The only one it doesn’t fulfill is the quality. I am NOT saying the NHS is horrific but when comparing things like wait times in socialised schemes to more privatised ones, it is often much lower in privatised systems. 5 year survival rates in countries like the United States for serious illness are much higher because of high levels of incentivisation and capital in the sector.
Flipping it on its head, the American style of healthcare has the best quality in the world, hands down. They are the leading research and developer for pharmaceuticals and medical equipment because of the money influx. The affordability is not there at all but if it were deregulated into a free market system we would see competition and prices drop so it would be affordable. It’s main issue is that it isn’t universal. Millions of Americans cannot afford healthcare in its current state making it beneficial for only the very rich at this current time.
The case for free markets.
The main problem with the NHS, and other socialised healthcare systems is that there is no incentive to become an NHS doctor. When healthcare is universal, it is effectively declared a ‘right’. When you declare things a ‘right’, more people feel entitled to it, therefore the demand increases. People spend so much money, time and effort into becoming a doctor only to find themselves being dictated the level of care they can provide and how much they can be paid according to a budget paid for by the taxpayer. This means doctors and nurses find themselves working extremely long hours, often understaffed and they don’t even have a financial incentive to offset the downside. The increased work hours is due to the declaration of healthcare being a right for everyone and therefore there is no concern to anyone in booking a doctors appointment for every minor problem. This leads to an unhappy workforce with quality standards slipping as everyone is working ridiculous hours just to fill the demand.
The main problem with the current United States healthcare system is that it is totally unaffordable to large swathes of the population. It is also heavily regulated and monopolised which contributes to the hiking up of prices for simple drugs like paracetamol.
A free market system (which is not what the United States has contrary to popular opinion) could help combat all these issues. Allowing a deregulation of the healthcare system and allowing it to fall into free market economy will (in theory) help the state of affairs. Competition from a whole host of private companies will inevitably drive down prices for everyone whilst still providing the incentive for people to go through medical school. Having a better incentive will mean more people to fill the demand leading to shorter wait times and better quality care from a satisfied workforce.
There would no longer be an inequality of taxation. Cheaper healthcare would be available to everyone so the middle and upper class wouldn’t be taxed through the nose for a healthcare system they are not using and the working class can still afford it. It would eliminate ‘freeloading’ and ‘medical tourism’ as an incentive to travel to the UK for free medical care is gone which will also reduce the strain on our services. The quality would not necessarily be affected. Private companies, no matter what the sector, have to have a minimum baseline of quality and safety in order to stay competitive. It would be a way of driving down costs while maintaining standards. This would eradicate the need for a heightened tax rate and allow greater economic mobility as people will have a higher disposable income as a result. This coupled with a greater satisfaction of the workforce, I believe, leads to a better system than both the US and UK have. The workforce will have less of a horrendous workload and shortened hours and more staff and removes the need to ration health care.
The free market system will definitely have its downsides and it probably isn’t perfect in practice. I think it is important however that we can freely open up conversation on the healthcare debate without casting assertions that people are uncaring and greedy with finance because they want lower taxes. I believe it is a topic worth discussing and we should be open to new ideas in all forms.