Making me iller: an open letter to Daniel Hannan


Dear Daniel,

As I said yesterday, you and the other fundamentalist libertarians in the Tory Party pose a real threat to the Cameron project.

I say this not because I want the Cameron project to succeed – quite the contrary. But if it does succeed in winning the election with you and your like as cuckoos in the nest, the consequences could be devastating for the majority of people who do not share your narrow set of values.

I want to take you up on your comments about the NHS. Quite simply, you are completely wrong.

The NHS does not make us iller. Life expectancy is, in fact, higher in the UK than in the US. In fact, for most chronic, debilitating and life-threatening illnesses, care in the NHS is as good as that which one would receive in the US, and we have broadly similar healthcare outcomes.

We get all of this for less than half the cost, per capita, of healthcare in America. Put simply, Americans pay more – far more – for a service that is the same if you are covered, and substantially worse if you’re not.

This is because – contrary to what you think – markets don’t function well in healthcare. I’m not saying this because I’m some kind of paleo-Marxist with an exe to grind: the nature of health as a good which we consume is very different to everything else.

I don’t need an expensively educated, qualified professional to run expensive tests to tell me how much brie I want to buy, or how many pairs of cufflinks I want, or when I want to buy a new lawnmower. I do, however, need a large and expensive medical infrastructure to tell me if I need to take certain pills, or emark on a programme of surgery or treatment.

The market deals with this badly: costs soar, and needless overprovision results in massive waste and price inflation. Insurance based systems are little better: adverse selection problems are endemic, and the insured must also bear some costs even for the rudimentary treatments handed out in Emergency Rooms to the uninsured, if they cannot pay.

Of course, there is another very good reason why we have an NHS: because, by and large, people do care if other people get sick and die of preventable illnesses. But, as a socialist and democrat, I can see why you – a headbanging, right-wing libertarian fundamentalist – might not agree.

Fair enough. But I don’t see why you fail to acknowledge why a publicly provided system is actually economically efficient, as well as arguably morally required.

Best wishes,

Vote Red Go Green

I will edit this post later this evening, when I’ve had a chance to dig out some long-since-forgotten links to academic articles about the economics of health care.

EDIT: I’ve put a couple of links in: apologies if some of them are slightly frustrating, but it appears that you can’t read a lot of academic journals unless you’re within a university network. Which I’m not, unfortunately.


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3 Responses to “Making me iller: an open letter to Daniel Hannan”

  1. alunephraim Says:

    There’s also the issue of administrative overhead. Sounds dull, but is actually a very good reason for running a health service on Solidaristic principles rather than an insurance system (of any kind).

  2. CharlieMcMenamin Says:

    Why just focus on the NHS? let’s not forget his seminal contribution to international economic analysis

    “In the ten years that I have been travelling to Iceland, I have watched an economic miracle unfold there.”

  3. Sean Says:

    Do you have any evidence that life expectancy in the US is shorter specifically because we have the NHS? There are all sorts of lifestyle differences (diet being the biggest) that could account for the discrepancy also. Secondly there are differences in statistical sampling between the countries. For example, the US shows a higher level of infant mortality than many European countries because many still-born infants are simply not included in european statistics that are in the US.

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