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The British National Health Service

2009 August 26
by Gordon Reid

What follows is from an article in “The Church Times” by The Revd Dr Giles Fraser, who is about to become Canon Chancellor of St Paul’s Cathedral, London (Well done Her Majesty or the Bishop of London, or whoever appointed him!). It expresses what I have been feeling lately since President Obama began to try to remedy what must be one of the most shameful gaps in so-called “Christian America”.

He writes: “The NHS (National Health Service) has been coming  in for quite a bit of bashing these last few days. Barack Obama’s health-care reform has unleashed a barrage of Republican indignation against our health service.

Apparently, the NHS is a form of fascism and, according to Sarah Palin, it has what she calls “death panels”. Of course, it is widely recognised that Mrs Palin may not be the sharpest knife in the drawer, but this is ignorant and cynical beyond compare.

According to its Republican critics, the great crime of the NHS is that it rations health-care. When a drug is incredibly expensive, the NHS has to decide whether it represents value for money. If not, then such a drug will not be made available.

To me that makes perfect sense. To spend millions of pounds on drugs that make little difference is like flushing taxpayers’ money down the lavatory.

Of course this means that sometimes the NHS will say, no, some treatments are not going to be offered. That’s how it should be.  Yet the people who make these tough decisions are the ones that Mrs Palin has branded “evil”.

If the NHS is so terrible, why do so few people go private in the UK? If the NHS is so terrible, why do we have a higher life-expectancy in this country than in the United States, and, on most measures, can expect roughly similar health outcome from our different arrangements?

The biggest difference is that the US spends a heck of a lot more on its sick for a similar result. Sure, it isn’t taxpayers’ money. But someone still has to find it, and that often means the poor employer.

The reason that the US throws all this money away is that they have an insurance system that encourages people to seek medical interventions at the drop of a hat. So they buy all the expensive equipment and are forever being scanned and examining themselves. But they don’t live any longer or get appreciably healthier.

And, worst of all, the poor find they cannot afford to go to a doctor. Now that is sick.”

Well said, Canon Fraser. God bless your new ministry in St Paul’s.

I would add that, from my own pastoral experience, I know how valuable to recovery it is for a sick person to have no worries about how they will be able to pay for their treatment. Families are not beggared by long-term treatment and there is no unseemly rush to minimize the time spent in hospital because of the cost. Not to mention the fact that most UK doctors will still make house-calls. The NHS is by no means perfect, but only a lunatic fringe in the UK would try to abolish it.

8 Responses leave one →
  1. Paul Goings permalink
    August 26, 2009

    “The fact [that a sacrificial reading of the death of Christ] is a disgusting idea, and morally degenerate, is obvious to all but those indoctrinated into a very narrow reading of the cross.”

    That Fr Giles Fraser?

    • August 26, 2009

      That may well be the same person, but just because I approve of one thing a priest says, it doesn’t mean I will approve of everything he has ever said. But of course in the passage you quote, he may be referring to the theories of Our Lord’s sacrifice as placating the vengeful wrath of a fearsome God. That doesn’t sound like the one Jesus called Abba, Father.

      • Paul Goings permalink
        August 26, 2009

        Quite right on both counts, Father. Being wrong about some things doesn’t make you wrong about everything. And there are plenty of soteriologies which are un-catholic and even abhorrent. But my impression of Fr Fraser is that he goes quite beyond anything that I could view through the lens of charitable interpretation. This is the context for the quote that I offered above:

        http://www.guardian.co.uk/commentisfree/2009/apr/11/christianity-easter

        Thus, to rejoice that he had been given any cure, let alone being made a Canon of S. Paul’s, is not something I could do.

  2. August 26, 2009

    Yes, I see what you mean: he goes too far. Just because there are abhorrent views of sacrifice doesn’t mean that the sacrifice of the Mass, identical with Christ’s self-sacrifice on Calvary, is not a true and beautiful fact.

  3. Dave permalink
    August 27, 2009

    Father, please don’t fall into the trap of both parties and only be able to see the beam in another’s eye.

    The NHS has problems, our system has problems. Trading one for another may or may not be an equal exchange. I haven’t made up my mind on the issue, as I, like most of our congressfolk, have not read the entire bill. I have honest concerns with some of what I have (and have not) read in the bill itself.

    The real issue, for me, is how to pay for it. My understanding is that the British Government is going broke, and we are headed that direction. This year we will spend upwards of $30,000 in government spending on each American family if divided equally. How much federal did you pay last year? I came nowhere close to meeting the $30k spent on us, and we are firmly in the middle class. There just are not enough rich folk and corporations to pay this each year.

    Is health care a moral question? Absolutely. Should folk receive it, and should the poor have the same quality of care? Absolutely. Again, how to pay for it without breaking the bank is the deeper issue. Having my children start their working careers with federal debt that is unsustainable is also a moral question.

  4. August 27, 2009

    “The NHS has problems, our system has problems. Trading one for another may or may not be an equal exchange.”

    True, but rather misses the point:

    http://welshjacobite.blogspot.com/2009/08/health-care-ignoratio-elenchi-rules-ok.html

  5. September 10, 2009

    In all the discussion about committees making health decisions, I have not heard one person address the crucial issue: If a government panel/policy, etc, makes the decision, even if it is based upon the most unassailable general principles, it takes the decision away from the patient, the one whose health is at issue. This violates the principle of self-ownership, on which so many American traditions are based. The other day, Sen. Barbara Mikulski took issue with the GOP’s description of such decision-makers as “bureaucrats.” She retorted that these so-called bureaucrats are well-regarded scientists at the NIH and other supposedly respectable institutions. But I would answer–and this is key–that even scientists make mistakes, and in a highly controlled health care system, the patient has no recourse against a decision he disagrees with. In a free market health care system, he can always get a second opinion, or simply offer to pay for the treatment he wants. Whether or not it is economically justified is up to him, since it is his money. This is the real point of the criticism pointed at bureaucracies deciding which treatments are “worth it” and which are not. This error is based on the false paradigm of objectivism and fails to take into account, among other things, the uniqueness of each given situation.

    And yes, America is going broke. In fact, for all intents and purposes, she already is. If China wants to take her over, they don’t even have to invade. All they need to do is call home all the money she owes them.

    I won’t for a minute claim that our health care system is all peachy. I myself have some unpleasant paper work from my generally excellent provider on the desk next to me, and I’ve heard many horror stories from relatives in the field. But we’re dealing with a caricatured debate, one that is mostly ad hominem and not striking at the roots of the problem. The Democrats and Republicans line up behind their respective battle slogans, and then the hilarity ensues, and all of us are stuck dealing with the disastrous outcome of this circus.

    Sorry this comment is so long.

  6. September 10, 2009

    Dear Michael,

    In the British health system, it is always an option for someone to opt for a private insurance and choose whatever doctor or surgeon or medicine he wants. As in America, he will have to pay for this , usually through private insurance. I doubt if the millions of Americans who have no health insurance at the moment would mind being told which doctor to go to.

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