The NHS, which we should all love and cherish, is safe for at least the next five years, thanks to the election of a Labour government led by Keir Starmer. This, I should add, is a simple matter of fact. The Labour Party founded the NHS back in 1948 and pretty well ever since then, on the rare occasions Labour returns to power, it has to first save and then rebuild it. This was especially true in 1997 after the 18 disastrous years of Tory government led by the evil Margaret Thatcher (if only there had been a hell for her to go to) and John Major and again now after 14 years of more Tory mismanagement and disinterest in the NHS under David Cameron, Theresa May, Boris Johnson, Liz Truss and Rishi Sunak. In both instances, Labour returned just in time. There are no guarantees the NHS would survive another term or more of another Conservative government, or worse a Reform UK Ltd government. If we still believe in an NHS which is free at the point of delivery, how can we persuade people that it’s in their best interests to maintain and sustain it? The answer is to bill people for their treatment.
“Woah!” you cry. “Hang on a minute. “One minute you’re arguing that we need to keep our NHS free at the point of delivery and the next you want to bill people for the treatment they received. Isn’t there a contradiction in all this?
On the face of it, of course there is, but what I am arguing for in this blog is not that people should have to pay a bill for their NHS treatment once it has concluded. They should simply receive a bill for what the treatment actually cost and how much they would have had to pay if the NHS didn’t exist, like in America.
The figures that follow are a rough average of what various aspects of the NHS cost the individual, but they make for fascinating, if not terrifying, reading. For instance,the average cost of the NHS per person in the UK is around £4100 a year. But let’s dig a little deeper into specific areas.
If you needed to visit an A&E department, you might expect to pay between £137 and £445, but that’s just for starters. If you ended up in A&E by ambulance, that’s another £417, so before you’ve had any treatment, you’re £900 out of pocket. A serious leg injury might set you back up to £67,000 whereas a minor leg injury might “only” cost around £1100 to treat. But what about other treatments?
What if you require chemotherapy to treat cancer? That will be worrying enough in itself, but a single round of chemotherapy can cost up to £30,000 in some circumstances. All the numbers I am quoting are approximate, mainly for illustrative purposes, but do you get the idea by now? Relying solely on private healthcare would not be cheap option for the individual. So, what happens in countries where no form of NHS exists. Take the USA where the healthcare system, if you can call it that, is entirely a private matter.
26 million people, some 8% of the population, are uninsured. When you consider that the cost of healthcare is around $25,572 for family coverage, that figure tells only part of the story. Over 100,000 million Americans have some form of medical debt and 66.5% of all bankruptcies in the US are due to medical debt. In numbers, anywhere between 500,000 and 750,000 people are made bankrupt every year in the USA due to medical debt compared to precisely no one in the UK. Are you getting my drift now?
It is at this point where I return to the politics of this issue. Where Labour, and to some extent the Liberal Democrats and the Greens, is unequivocal in its commitment to the NHS, the same cannot be said of the parties of the right. The Conservatives have been drifting to the right since 2010 and are now in a straight fight with the hard right Reform UK Ltd business/political party, controlled by Nigel Farage. Both the Tories and Reform UK Ltd believe in low tax, small state countries. Do the math. There is no bigger part of the state than the NHS. If you truly believe in a low tax, small state economy, the NHS has to go. Farage has admitted as much. The USA has relatively low taxes not least because they don’t have an NHS. If people really want that low tax, small state country, let them be honest and clear about what that means. The state, which includes health, defence, the environment (which already in an increasing mess), transport, education and all the rest of it, is funded by taxation. It’s a straight choice between quality public services and nothing. (It’s fair to say we’ve become an uncomfortable halfway house in recent times, but in general it’s one thing or the other. You pays your money – or not – and you makes your choice.)
Have your gallbladder out and the bill will come to £7250. A knee replacement? £11,000. A hip replacement? That will set you back some £13,000. Having a baby? Then don’t have a Caesarean section unless you have a spare seven grand knocking about. And don’t ask for prescriptions, either. 47 tablets of Metformin for Type 2 diabetes will set you back £1335, Sertraline (29 tablets) for your depression just under £1000 or Simvastatin (28 tablets) for your cholesterol is a mere £1700. The NHS covers all this, plus numerous incredibly expensive treatments because the basis of it is simple: we are all in it together. You receive treatment not on the basis of the size of your wallet, but your need for treatment. It is a simple matter of principle.
I hope I have made a vaguely coherent argument as to why we should be billed following GP visits, hospital appointments and the actual treatment itself, as well as helping to clarify in simple terms what a small state will look like. If people look upon the NHS as the state, which it is, then perhaps they may appreciate that the state itself is A Good Thing and not the obstacle to prosperity the siren voices of the right proclaim it to be.
This is not America, not yet anyway. In the coming years, Donald Trump may scale back health provision even further, if his threats to dismantle the government go ahead and there is no reason to suspect this won’t happen. Much evidence already exists to inform us what happens when a country has no national health service and that will be on the ballot paper for us at the next general election. In my opinion, a strong and well-funded NHS is a price worth paying for the greater good. And if we are made more aware of the cost and benefits of a universal system, free at the point of delivery, maybe we will think hard before tossing it all away. Because if we lose the NHS, we will never get it back again.
(Thanks to my friend Campbell for giving me the ideas for this blog.)
