Tuesday, July 31, 2012

The man with the muck-rake

BW3 praises the NHS in this post.

BTW, I have a lot of friends and family from the UK. I've lived and studied in the UK. I'm a bit of an Anglophile too. So I hope any remarks I make about the UK and NHS won't sound like an outsider criticizing someone's mom/mum or anything along those lines!

The Brits are fiercely proud of this.

I have to wonder why someone would be so "fiercely proud" of a gov't organization like the NHS? I'd be a bit perplexed if a fellow American told me he's "fiercely proud" of a gov't organization like, say, the IRS or FDA or Homeland Security. It just sounds strange to my ears. Maybe it's because I'm not from the UK.

And rightly so. A country can and should be judged by how it treats its least fortunate, weakest, and most vulnerable members of society. On that scale, America is a pretty selfish country.

1. Why should we judge a country by this standard? Should it be a country's purpose to help the least fortunate and weak and vulnerable? If so, in what sense and to what degree should they be judged? What about judging a nation by how it holds up against crime or national defense?

2. Related, don't private individuals and groups like churches and charities tend to do a better job helping the least fortunate in society than the gov't?

3. America is a country made up of Americans. From what I've read Americans are one of the most generous peoples in the world. I'm not talking simply about money either. I've read American conservatives including American evangelical Christians are especially generous. I think someone like Arthur C. Brooks has studied the matter.

4. Among the least fortunate and weak and vulnerable are infants in the womb. Although Roe v. Wade is current law, and although there's surely tremendous room for improvement, we also have a strong pro-life movement. Can the same be said about the UK?

It would rather have a universal right to have guns of all sorts than universal health care.

1. Why should health care and gun ownership be analogous to one another?

2. This assumes universal health care is a human "right" too. Is it?

3. Gun ownership (or perhaps the right to self-defense via guns) may or may not be a human right. But the right to bear arms is part of our Bill of Rights.

But let’s be clear its [the US health care system] patchwork and piecemeal compared to the British National Health.

1. I'm not exactly sure what BW3 means to imply by "patchwork and piecemeal."

2. But is the US health care system "patchwork and piecemeal compared to the British National Health"?

3. If it is, why should "patchwork" and "piecemeal" necessarily have negative connotations? On the one hand, I think the US health care system could be vastly improved. But on the other hand, I also think it may be good that we have such a diverse health care system. For example, a single centralized gov't entity can't dictate what doctors, nurses, and other health care professionals can and can't do. So I think it's possibly a good thing to be "piecemeal" in this respect, if this is along the lines of what BW3 means by the term.

No, its [the NHS] not a perfect solution to health care problems…. but it’s way better than what we’ve got. I for one would gladly pay lots more in taxes if it meant we had a truly comprehensive healthcare system for everyone in this country. I just would.

I'm sorry to say but that's quite unreflective.

We could debate how best to make that happen, but not, I think, that it would be the most humane thing for it to happen.

1. Why assume the NHS or universal health care is "the most humane thing"? As mentioned above, this assumes universal health care is a basic human right. Is it?

2. BTW, I wonder what BW3 thinks about stuff like:

"Government Control Leads to Denial of Care"

"Patients are denied high cost drugs by NHS trusts"

"NHS waiting list rise prompts government U-turn"

2. A lot of people might have the idea that U.S. hospitals are almost entirely private, and that private entails for-profit (and that for-profit is bad at least when it comes to hospitals).

While it's true most our hospitals are private hospitals, private doesn't necessarily mean for-profit. Let's look at how the numbers breakdown. U.S. hospitals can be more or less divided into three broad categories: non-profit; for-profit; and public aka government. According to the American Hospital Association (2010), there are a total of 5754 hospitals across the nation. Non-profit hospitals number 2904 or approximately 50% of all hospitals. For-profit hospitals number 1013 or approximately 18% of all hospitals. Local and state public/government hospitals number 1068 and federal public/government hospitals number 213 or approximately 22% of all hospitals. (The remaining 556 hospitals or approximately 10% of all hospitals are miscellaneous types of hospitals including prison hospitals, college infirmaries, and most numerous of all psychiatric hospitals.) In short, only 18% of all U.S. hospitals are for-profit hospitals.

As noted, these numbers are based on the most recent AHA data (2010). As far as I can tell, the AHA numbers seem to be on the conservative end. However, other organizations appear to have different numbers. For example, a University of Pennsylvania affiliated source (2005) cites the number of non-profit hospitals as 70% (not 50%) of all U.S. hospitals and likewise claims this 70% has been stable for decades.

If I'm not mistaken, most the non-profit hospitals were originally founded by religious organizations - predominantly Christian but also Jewish.

Of course, in addition to our hospitals, we have other health care providers such as private specialty clinics (e.g. surgical centers). These very often regularly work in tandem with hospitals. Unfortunately, I don't know the numbers of these other health care providers and so I can't compare them to our hospital system.

I'm not sure if military hospitals, VA hospitals, and hospitals for Native Americans (i.e. the Indian Health Service) are included or excluded from the non-profit, for-profit, and public/government numbers.

3. Even if we assume the NHS is more or less on the right track or workable (not that I do assume this), what may work in other nations like the UK may not necessarily work in the US.

4. Anecdotally, here is what one commenter (who favors universal health care) said about the NHS:

I am an American who has married a British national in the UK and currently live in the UK. Because of multiple health situations in the family, we have had frequent use of the NHS health system. This has helped me appreciate the goal of the NHS: to make sure no one is left on their own, but to provide care even for the poorest.

On the flip side, it has helped me appreciate the high quality of care available in the US. The NHS is NOWHERE close to it. Service in the US is much quicker, high quality, and is not strapped by huge government debts and cutbacks. Even elderly people are released here in the middle of the night to free up beds – they are really cutting back. Hospitals are generally clean, but not fresh looking like US hospitals. Capitalism may not be very Christian in the way it motivates healthcare in the US and I would be interested in there being changes, but I haven’t been impressed enough by the NHS to want to switch to that system. I would be more interested in how places like Denmark, Sweden, or Germany are set up. I hear that they are better, but I have no experience of that like I do in the US the UK.


  1. Doesn't the NHS pay for abortions? How's that "treat[ing] its least fortunate, weakest, and most vulnerable" thing working out for you, Ben?

  2. In addition to what Patrick and Paul have noted, here and here are a couple posts I wrote in 2009 about the alleged lack of care for the poor among Americans. We've spent trillions of dollars, shed a lot of our own blood, and sent out a lot of missionaries, for example, to help the poor and others in this nation and around the world. In some contexts, we could and should do more. But evaluating whether America is "a pretty selfish country" involves a lot of factors that Ben Witherington and other critics often don't address.