Magazine article The Spectator

Thank God for the NHS

Magazine article The Spectator

Thank God for the NHS

Article excerpt

American healthcare makes our system look good, writes Ross Clark. But however revolutionary Barack Obama's health reforms are, Americans will still pay through the nose

Had I a more devotional attachment to free-market economics I suppose I would be joining all those Republicans condemning Barack Obama's health reforms. I have written enough about the failings of the NHS over the years to fill an entire symposium at a Washington think tank. How tempting, then, to echo the sentiments spewing out of Fox News, predicting US bankruptcy and state-sponsored euthanasia. 'Say no to totalitarianism, ' appealed Republican congressman Devin Nunes, not content with the charge of mere 'socialism' made by many of his colleagues. 'When you turn 65, hello death panels, ' predicted Rush Limbaugh, building on an earlier threat to emigrate to Costa Rica if the reforms were passed. The reforms, ventured Jim Quinn on the Clear Channel, represent 'the final nail in the coffin of the individual free human being. Once they own your body, they own everything.'

I'm sorry, but I just don't have the stomach for all this stuff. In fact, a large section of the Republican party has struck me in recent days as a complete bunch of nutters.

The more I read about US healthcare the more I find myself uttering words I would have thought impossible a week or two ago:

thank God for the NHS.

I am not convinced by the Obama reforms.

Even their supporters admit that it is going to cost US taxpayers $940 billion over the next ten years - before projected savings kick-in, if they do. It is just that no amount of free market ideology can blind me to the obvious: that the existing US healthcare system makes the NHS - in spite of its blundering, overpaid managers and its locum GPs flown over from Germany for a nightshift - look good value for money. It is hard to escape the conclusion that, for all the choice and competition in US healthcare, Americans are being ripped off.

According to the OECD (the Organisation for Economic Co-operation and Development), in 2007 Britons between them - taking into account private as well as state provision - spent $2,900 per head on healthcare. The Germans spent $3,600 and the French $3,601. Americans spent $7,290 - half as much again as the next highest country, Norway. But surely Americans must be getting what they pay for? Well no, actually: not as a nation they aren't. True, as they often like to boast, they have straighter teeth - or more accurately they have a better class of false teeth, as a good number of their perfect 'teeth' are really implants. And true the US shows up well on international comparisons of cancer survival rates - which are often quoted as evidence of the superiority of US healthcare. In the US, for example, 90 per cent of breast cancer patients are still alive five years after diagnosis, compared with 77 per cent in Britain and an OECD average (comprising 14 developed nations) of 81 per cent.

But cancer survival rates are spurious statistics which flatter countries with high levels of screening and scanning. In the US, where MRI and CT scans are twice as common as in other OECD countries, you are more likely to have your cancer diagnosed at an earlier stage of the disease, before symptoms become clear. Therefore, you have a better chance of surviving for five years 'after first diagnosis' - regardless of whether the treatment is effective or not.

If US healthcare were really so superior, then you might think life expectancy would be higher. But it isn't. The average American lives for 78. …

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