Tuesday, 14 August 2012

Paul Ryan is right about the NHS

The Times headline this morning shrilly exclaimed Romney's No2 savages NHS before stating Paul Ryan "has been sharply critical of the NHS, claiming that free healthcare distorts the democratic process".

What the Wisconsin congressman actually wrote three years ago was that “every time a tax cut is proposed, the guardians of the new medical-welfare state will argue that tax cuts would come at the expense of healthcare — an argument that would resonate with middle-class families entirely dependent on the government for access to doctors and hospitals.”

Paul Ryan was right. If we look at the arguments made in the past by British politicians it is clear that the NHS does distort the democratic process as politicians use it as a tool in their electioneering.

Remember Danny Kruger and his remark made ahead of the 2005 election that Britain's public services needed a period of "creative destruction"? This led to him standing down as a Conservative candidate. Anyone who has studied free-market economic theory knows "creative destruction" is all about making an organisation more efficient - not destroying it at all. Unfortunately, in the hot-house atmosphere of an election campaign, economic theory has no place it seems particularly when this might be applied to the sacred NHS.

The rebuttal by Labour highlighted this further with Alan Milburn claiming Kruger "had exposed the Tory agenda for £35bn of cuts to public services". Underlining Paul Ryan's point perfectly.

When arguments move on to actual policy ideas things get even more ridiculous with Gordon Brown saying ahead of the last election in 2010: "Let's be clear - the Tories might have a lot of warm words for the middle class - but the cold reality of their plans is to cut your benefits, cut your frontline services."

When Paul Ryan wrote "once a large number of citizens get their healthcare from the State, it dramatically alters their attachment to government" he was only half right; it also alters politician's attachment to that healthcare system as they become used to using it as a political weapon to bash their opponents with which then dramatically distorts the democratic process.

It what way was Paul Ryan wrong?


  1. Ignoring the question of whether you pay through tax or you pay through insurance premium we should ask ourselves this
    "Would you rather be treated in a UK hospital or a US hospital?"

    1. You cannot ignore how it is paid. If you have a pre-existing condition your insurance company will not pay, so your treatment will come out of your pocket (or your creditors, since healthcare costs are the biggest cause of bankruptcies in the US).

      And in reply to your question: US healthcare has a few islands of excellence amongst a sea of mediocrity, so for the average patient, they will get much better care in an average NHS hospital than in an average and mediocre US hospital.

    2. I have a pre-existing condition (conditions actually) and I am uninsureable in the commercial market place for those conditions, which are chronic but not life threatening. They are also increasingly low cost to treat. But, I can get cover for everything else except those conditions. In other words all that we might consider is that the State acts as insurer of last resort for people like me, but that I will be expected to cover myself for everything else.

      And the major issue in the US for healthcare costs is that it is highly proptectionits and highly regulated with huge vested interests.

  2. Ryan may have a point, but its a point that is much more valid about his country than it is about ours.

    Dont forget, their state-funded Medicaid and medicare provide partial coverage between them to only a few more people than the NHS does (around 85 million vs 62 million) and yet costs ten times as much. Add to that the crippling effect of health insurance costs to private citizens and businesses, and I would much rather have our imperfect system.


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