The healthcare fog

Mr Obama is to be applauded for trying to improve the healthcare system in America but the inevitable strongly opinionated debate about his proposals seems to have thrown up more heat than light and has now regrettably moved to Britain. Our own ignorance of the US system – I was surprised to learn that 50% of healthcare in the USA is provided by the state and that since 1986, federal law has required all hospitals which receive federal money (just about all of them) to provide emergency care to any patient who turns up – and their complete ignorance of our system has meant unwarranted criticism flying across the Atlantic and a peculiar nationalism, even describing itself as patriotism, growing in defence of our own, 60 year old healthcare system.

All this seems unfortunately to have obscured any useful debate. Despite the fact that I don’t want the American system in Britain – Obama doesn’t want it in America, either – I don’t think the NHS is without room for improvement. I had always been brought up to believe the NHS was the best system in the world and that foreigners were unfortunate not to have it. The first time I went abroad, it was to Switzerland, I was understandably nervous. But far from there being children with rickets and tubercular beggars wheezing in the streets, the Swiss looked healthy and prosperous, without the aid of a state owned healthcare system.

We should look at what other countries do. I think the government could farm out much of its own risk. For example, we pay monthly (through our wage packets) to cover an indeterminate healthcare need. That is insurance by any other name and insurance is best handled by insurance companies. I don’t see why the state needs to own almost all of the hospitals – they should be run by private hospital companies. I think it absurd that a millionaire gets the same free treatment as a pauper: anyone who can afford to pay should be pursued for the money.

The government should confine itself to the principle that everyone gets treated, irrespective of income. It should leave healthcare to healthcare professionals. And if we can improve our system by borrowing from other countries, let's do it.