Sunday, July 27, 2008

The Parable of the Toast: A Meager Reality of Nationalized Health Care

Sherman Oaks, California

U.S. media coverage of universal health care proposals tends to ignore the day-to-day realities of medicine in countries with socialized systems.

In this excerpt from Boris Johnson’s entertaining Friends, Voters, Countrymen (reviewed here), Boris recounts his explanation to the Henley-on-Thames Conservative Party Association Nominating Committee as to why, if selected as their candidate for Parliament, he would understand voters’ frustrations with the U.K’s National Health Service:

Asked about funding of the NHS, I told a positively glutinous story about toast in the maternity wards.

This homily concerns what happens if you accidentally eat your wife’s toast in the middle of the night, when she has just given birth, and your wife wakes up and says, I say, what happened to that toast? And you say, I’m afraid it’s no longer with us, or not directly with us ha ha ha; and your wife says, Well, what’s the point of you? Why don’t you go out and hunt stroke gather some more toast, as your forefathers did back in the olden days? And you go into the highways and byways of the maternity hospital, and I tell you, Mr Chairman, there are babies popping out all over the place; and then you find the person who is i/c toast, and you ask for some more, and there isn’t any more, of course, Mr Chairman, because you have had your ration, and when you move to open your wallet, you find that this is no good, either. You can’t pay for things on the NHS. It’s a universal service free at the point of delivery, delivery being the operative word, Mr Chairman, ha ha ha. And the whole point of the saga is that it ought to be possible for a well-heeled journalist, who has been so improvident as to eat his wife’s toast in the middle of the night, to pay for some more . . . And this is not as trivial as it sounds, because we need to think about new ways of getting private money into the NHS.

If you look at the countries that do better on cancer survival rates, and on coronary artery disease – countries such as Belgium, Germany or France – they do not rely on a monopoly state provider. They have a variety of systems – employer-based insurance schemes, employee-based insurance schemes, whatever; and they manage to spend more per capita on health, and to achieve better results, because they do not just rely on general taxation and spending – the first being electorally unpopular and the second being inefficient.

And if you want an example of the kind of thing on which we could start to spend our own money, without infringing the principle of universality – then I give you the toast!

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7:40 PM  

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