There’s a new book out: “Dear NHS, 100 Letters to say Thank You.” 100 letters, 100 contributors, some of them very famous – Paul McCartney, Malala Yousafzai, Emma Thompson,
Ricky Gervais and many others – well, 96 others.  Each has submitted a story of their experience of being admitted to hospital under the auspices of the NHS and the wonderful care they received.

Public health and private health

What got me thinking was that none of the contributors was short of a few bob, yet they had not been treated under the private system.  If anything speaks of the treasure that is the NHS, surely that does.

In NZ we have a similarly excellent public health service together with a separate private system.  The doctors are one and the same.  The care is first class under both systems.  The difference is in how quickly you get treatment.  Either you go in the queue and wait your turn or you elbow your way to the front of the queue, waving a fistful of money.

Getting to the front of the queue

It’s interesting that if we were literally queuing, let’s say at something like a ticket kiosk, or a bank, or anything else at all, we would strongly object to some ratbag pushing to the front.  We would be the ones using our elbows – and our voices – “Hey, get in line!  What the hell do you think you’re doing!”  Depending what sort of queue, the jumper would be in danger of being wrestled to the ground and given a few swift kicks.

Why do we quietly accept that those with a bucketful of bucks have some kind of right to get ahead of us in the queue for the most important thing of all – health care?  How did we get conditioned to quietly accept that it’s OK to push to the front? We know it’s not OK in any other context, but it’s OK when it comes to being treated for what’s wrong with you, even if it’s something really serious like the crippling pain from a hip or knee that needs replacing.

Stand up and be counted

It’s a well-known fact, an indisputable fact, that when private care comes along, public care goes downhill.  There are many reasons for this.  One is that those who can afford private care are the very ones who have power and confidence, the ones who don’t put up with their needs being shunted aside.  They are the very ones we need to stand up for the rest of us and scream about inadequacies in the public health service and insist on improvements.   The rest of us have less time, clout and nous to stand up for better service.

When the ones with the money and the power don’t care about public amenities because it’s nothing to do with them – they will be seen privately – public health suffers. The queues get longer, the staff more overworked, the demands on them greater.  Many will seek to join the private sector, and that degrades public health even further.  It’s a downward spiral.

A subsidy too far

Recently there is a proposal that those who pay for private health insurance should be subsidised by the government.  This is the worst idea of all.  It would reward people for abandoning our precious, wonderful public health service.  It would make it cost less for people to go to the private sector, and the public sector would enter an even steeper decline.

Everyone should read this new book about the NHS, so that they come to understand how wonderful a top class free hospital service is for every person in our country and what a terrible loss it would be if funding should be diverted to the private sector, to cater exclusively to the needs of better-off people.

Health as a business

People should also read about how the medical system works in the USA.  If you get sick there, you’d better have private insurance.  But what is seldom understood is that insurance runs out.  I met a professor whose wife had cancer.  He had insurance courtesy of his university position, but after some months of treatment, the limit was reached. Then he turned to their savings, and after that, the house had to be mortgaged.  Do you say to your wife “Honey, we can’t afford any more treatments.  Sorry about that”.  When they were bankrupt, I believe the state stepped in at last.

This is not an uncommon story.  When I visited a hospital in the USA a staff member told me that when insurance ran out, patients were put out the front door.  Hospitals there are businesses, not charities nor are they publicly funded.  They treat you for as long as you can pay.

I hope those who advocate for subsidies for private insurance are fully educated about what happens when a public system such as ours and the NHS, go down the drain.