that has achieved an amicable compromise between ensuring healthcare will be available to every citizen with affordability ensured, and people having to take responsibility for their own actions. If, as I have just argued, the NHS is inefficient compared to alternative systems, why are the public and politicians so united in support for what is seen as a treasured national institution? Is it simply that the public are ignorant as to its alternatives and politicians are obliged to reflect public opinion, and therefore would public opinion change if everyone read this essay? Or is it that there is something intrinsically good about having a free healthcare for all that I have overlooked? It could be the case that the non-economic benefits public peace of mind, in not having to fear the financial burden of illness, outweighs any drawbacks of economic inefficiency. Another factor is the risk involved; all experimental economic reforms involve risk, normally risk of affecting unemployment figures, inflation rates or growth in GDP, however reform of the NHS has the potential to risk peopleÊs lives. Furthermore, we can take a look at the recent experiences of Andrew Lansley, until recently the health secretary, who looked to abolish the primary care trusts in order to reduce the NHS budget. As a result he faced a huge public backlash with campaigns including the slogan Âthe NHS is not for saleÊ 9 and was subsequently moved to the post of Âchief whipÊ as his position of health secretary became untenable. This event will act as a warning for politicians and in particular, health secretaries in years to come; that the public will always be opposed to reform to their treasured health system, no matter whether they understand the reforms (as unquestionably the majority of those campaigning against LansleyÊs reforms had not studied the Health bill in detail themselves) and therefore radical NHS reform is only likely to damage oneÊs long
interventionist elements; to find some middle ground between soviet style communism and an absolute free market, in which there is no redistribution of income or state provided services, I would claim that a healthcare system does too. The nation which I see as a model healthcare provider is Singapore. It has a unique system, based upon a scheme called ÂMedisaveÊ which uses compulsory savings, subsidies and some government provision which ensures that it is affordable to all, yet care is not free, which prevents the abuse of universal healthcare systems. Additionally there is ÂMedifund which is in place for those who cannot afford to save up themselves to ensure that the poorest in society do not go untreated. They spend four percent of GDP on healthcare compared to the UK spending around eight percent, and in the WHOÊs national healthcare system rankings it was placed 6 th in the world (compared to the UK being ranked 18 th ) 7 . Therefore, although I believe that the NHS has delivered a fantastic service since its conception, the same level of healthcare could certainly be delivered on a more economically efficient and fairer basis. The Singapore health systemÊs website states that they have Âa financing system anchored on the twin philosophies of individual responsibility and affordable healthcare for allÊ 8 . The UK only achieves one of these objectives, which in my opinion is its major short coming. In a time in which the government is struggling to balance its books, the NHS is the largest public expenditure and a reduced healthcare bill is unquestionably in the national interest. Although I do not believe we should attempt to totally copy Singapore in the reforms that I believe are needed, we should take the lead from what I believe is the only system 7 http://thepatientfactor.com/canadian-health-care- information/world-health-organizations-ranking-of-the- worlds-health-systems/ 8 http://www.moh.gov.sg/content/moh_web/home/costs_ and_financing.html
9 http://rapgenius.com/Mc-next-gen-andrew-lansley- lyrics#note-161372
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