NHS: Not Perfect But Far Better Than The US Model

Every day seems to bring another story of how the greed of corporations, many of which seemed to have secured a cartelised or a monopolistic position, is distorting the economy and society. The credit crunch was stimulated by corporate greed, but the high bonuses that leading members of Barclays Bank are receiving while so many of us are without work or are losing our houses, have shown, it is not they who are paying the price. The clearest flexing of corporate might in the world at present is the concerted oppositon by health insurance companies in the USA to prevent President Obama introducing a free health care service in the USA to cover the 46 million Americans who have no health cover. That represents about 1 in 6 Americans who lack access to any health care that is not charitable; it is equivalent to the population of Belgium, Spain and Poland put together and is more than the number of adults in the UK. In addition, as many people who buy health insurance in the USA find it does not cover them if they develop a serious illness nor for existing conditions. Unsurprisingly life expectancy is lower in the USA than the UK, there are fewer only 70% as many hospital beds per head of population and infant mortality (i.e. children under 5) is 9 per 1000 compared to 6 per 1000 in the UK. Out of a population of 304 million, that means over 910,000 more children die each year in the USA than would be the case if they had the UK system. This is despite the fact that the UK only spends 8.3% of its GDP (Gross Domestic Product) on healthcare compared to 16% in the USA, which suggests Americans are getting a more costly but less efficient service. In the UK, sometimes hospitals get overloaded but we do not have the situation as often occurs in the USA where an ambulance has to drive from hospital to hospital trying to find one that will take their uninsured patient. British hospitals need to have an increase in capacity and staffing, but never turn people away no matter what their nationality or background, simply because they lack the right insurance.

There are a number of sickening elements about the opposition to Obama's plans. One is that they are being portrayed on a moral basis. This is that somehow state control will lead to 'death panels' deciding when people have to die. This happens now de facto anyway, when families can no longer afford to fund keeping their relative alive. However, in the twisted US morality, ability to afford determining life expectancy is right, deciding on life expectancy depending on quality of life, is somehow wrong. The lie about 'death panelss' can be seen easily if you simply look at the fuss that has arisen in the UK about people even travelling to Switzerland for assisted suicide let alone any consideration of it being permissible in the UK. To conjure up this lie is just a scare tactic and to associate it with reference to British healthcare is offensive. Of course, Americans never consider any other country's viewpoint, so any indignation in the UK or Canada is dismissed as nothing.

The anti-public health care lobby in the USA has drawn support from the religious right who say they want freedom, whereas in fact they want to control people's lives far more than so-called 'big government' does, getting down to controlling their behaviour behind closed doors as well as in public. They lie and say public health care will lead to the elderly being advised every five years when they should end their lives. This is perverse fantasy dreamed up by companies wanting to kill any legislation that they feel would even minutely dent their income. To liken the NHS to approaches adopted by Hitler and Stalin offends not just British people now but also the memory of those who died opposing Hitler and Stalin, among them, Americans. Rick Joyner, a US pastor, has said that if Hitler and Stalin had had health care systems like the NHS it would have made it easier for them to kill millions of people. He forgets that they still killed millions of people and yet the NHS has kept millions of people from dying and suffering over its 61-year history. How patronising is that attitude to the people of the UK to think that we would sit by with a system that did us such harm for so long? Which plaent is Joyner referring to? Clearly not the one he is actually living on. These Americans are so arrogant that they somehow even seen decent, Christian Britons as imbeciles.

What gets me is that Obama's package is primarily aimed at those people who currently do not have health insurance, so why is it any concern of the companies that these people receive a service provided by the state? In that typical arrogant American way, they get offended even if anyone considers thinking differently to their assumptions. In addition, as the sub-prime mortgage fiasco proved, they always hope they can penetrate into those sectors of society not currently buying products from them, however risky or unsustainable such penetration is. Do they not understand that if these people could afford health insurance they would have bought it? They are offended that the state might provide a rival to them in getting health cover to these people, however remote the chance of them ever affording health insurance. US corporations, despite the anti-trust laws of the past, have become so used since the 1980s of having no limits to their activities that to see anything that intervenes in an area of the market, even one they are currently absent from, is an anathema to them.

The second sick thing about the opposition to health care proposals is how these people have attacked the public health care systems of the UK and Canada. Again, being Americans, they believe they have a right to make judgement over anyone else's system and yet not be judged themselves (refer back to my comments on the USA seeking exemption from war crimes laws). They portray the National Health Service (NHS) as somehow an evil system and inherently wrong in its philosophy and behaviour. Living in the UK, I know how clunky the NHS is. It is far from perfect, but ironically a lot of the problems it is currently facing, especially over hygeine in hospitals, stems from the situation created when the Thatcher government of the 1980s tried to move the service in the direction of the US model. If the internal market and competitive tendering for services, including cleaning, had not been introduced, then many more people would be alive today and the NHS would be in a better state. The reason why health in the general population is better in the UK than the USA is because of the NHS. It is not simply about treating people, it also does excellent work in preventative information too, to try to reduce the impact of the health challenges of modern living such as obesity, alcohol and tobacco consumption. The NHS is not perfect. I think it needs massively more funds. I would fund it to the extent that prescription charges introduce in 1950 could finally be scrapped and the care was free to everyone at point of use. The cap on National Insurance was taken off far too late. Everyone needs to pay towards the service and in accordance with their wealth. It is no argument to say that they will not use it. If the rich like they can see it as an insurance that their cleaner will not drop dead or that if they hit someone in their car while speeding, they will not get charged with murder because their victim will live.

I am glad that Gordon Brown, John Prescott, Lord Darzi and the trade union Unison are taking a strong stand against the Americans 'slagging off' (in Lord Mandelson's phrase) the NHS. I despise Mandelson, but am glad he is adding his weight to the defence of our health service. The maverick Conservative MP, Daniel Hannan, who feels that the NHS is an excessive burden on the UK, has a right to his opinion, but it is one that should be strongly contested, ridiculed even. The opposition to Obama's proposals is terrible, immoral and will lead to deaths. We cannot tell how many Americans have died unnecessarily because this opposition prevented Bill Clinton's 1993 health proposals being put into action, let alone the countless lives that have been blighted. This is about people's lives in exchange for profits, well not even that, in exchange for the imagination of profits that could be made and the fight to stop anyone involving themselves in that. Of course, Americans, especially on the extreme right, who feel under pressure now Bush have gone, feel they have the right to tell not only Americans but the whole world how to live. This leads to the deaths of not only Americans but people across the globe. The NHS is not perfect, but it is far, far better than the system the USA has. The American right profess to believe in God, but their god wants health care to be inaccessible to millions of people who will suffer as a result and prefers that people make bigger and bigger profits than care for others. Whoever their god is, he is not the God that millions of Americans and others believe in. Non-Americans need to stand up and tell Americans to stop using what we have done well as a weapon for their own perverse arguments. Britons are proud of the NHS and the vast majority want it improved not scrapped. Any American who falls ill in the UK can go to an NHS facility for emergency treatment, the reverse cannot be said of Britons in the USA. Of course, that does not matter to these opponents of Obama's proposals, they care about no-one, not even other Americans, just their potential to make money. May the NHS prosper and grow and be a model for decent, truly moral people to look to, rather than misuse as a tool for greedy objectives.

How Does Liberal Humanism Survive in the Age of Fundamental 'Truths'?

This might seem overly philosophical and to some extent represents the fact that my brain seemed to wake up after falling into disuse over the weekend. I thought of a lot of things to blog, but given my poor memory have forgotten most of them, bar this one, but I hope they will come back to mind, probably when I am driving down the motorway and can do nothing about it. Recently at the company I work for I was interviewed by a woman and the only recording device she had was her mobile phone. The first time I have seen an hour's recording captured that way. Anyway, today's posting was prompted by a review in 'The Guardian' newspaper on Saturday of 'The History Man' by Malcolm Bradbury (1975; TV series 1981 - I actually sat behind the author once in a cinema, a nice man, appeared very much as you would expect). A lot of the review was about the economical writing of the book and the focus on the outward perception of things rather than any concern for inner thoughts. However, the part that provoked my thinking was the novel's exploration of the weakness of liberal humanism with, to quote, 'its built-in tolreance and self-doubt' in the face of 'those convinced they have a monopoly of the truth'. When it was written Marxism (represented in the book by the 'hero' Howard Kirk, a university lecturer in sociology) seemed to be the prime source of those who felt they had the monopoly on the truth. Soon after though came two more sources to eclipse the Marxists - the New Right and Religious Fundamentalists. These are the two broad groups who seem to challenge liberal humanism today.

Now, I know for US readers anything called 'liberal' seems dirty, sordid, corrupt even. The USA is the only country in the English-speaking world where you can insult someone by calling them a liberal, maybe because they have more of the truth monopolists of both the New Right and the Religious Fundamentalist categories than anywhere else. For the rest of us, liberal humanism is what marks out life in the early 21st century from that of the early 20th century. It seeks to protect us from the random nature of life which can lay low even the most wealthy and wreck the lives of anyone else less rich. In particular it encourages us to have a 'safety net' for people made vulnerable through disease, poverty, old age, war, ignorance, bigotry and so on. It also tries to stop the spread of violence, corruption, narcotics, etc. reducing us all to barbarians. It makes war seem like something to avoid and embrace instead getting along with people and respecting them. Of course it is a constant battle and one that in many parts of the World is being lost, but that does not mean there is any reason to give up the fight.

People may argue that liberal humanism appeared at the time of the Enlightenment in the 18th century, but it has been around lurking in the background for many millenia. In Ancient Rome you had slavery and gladiatorial fights but you also had the chance for manumission and the grain 'dole'. In the Middle Ages there was constant warring and narrow-minded attitudes and persecution from churches but there was also alms-giving, hospitals and concepts of chivalry (however idealised they may have been) that sought to dissuade people from abusing the poor, slaughtering prisoners and raping women.

Yes, liberal humanism does embrace self-doubt and tolerance. If it did not embrace tolerance then it could not exist, it would not embrace humans and humanity in all of its diversity. To have any feeling for humans obliges you to be tolerant. As to self-doubt, I would argue that it is not really doubt, rather it is self-questioning and self-verifying. You may argue then how does it verify that what it is doing is correct, and certainly approaches can be contested. However, surely it is better to actually seek to verify your actions rather than steam ahead dogmatically. In addition, the truth monopolists are not free from doubt and in fact are often fearful of defeat, part of the motive for driving them on. Take one example, the Nazi regime in Germany. The Nazis argued their empire would last 1000 years, yet on the other hand they were so fearful of the Jews that they felt they had to wipe them out. Yet, in turn, they thought the Jews were weak compared to the Aryan race and corrupt, so you might ask them 'why do you fear these people if they are so weak compared to you?' Thus, to say that fundamentalism lacks self-doubt is wrong. Every revolutionary body or fundamentalist religious group has a tendency to fragment which may show confidence in oneself, but doubt in the self of the broader grouping as it previously existed.

Liberal humanism is certainly under threat, possibly because it is hard to sell the necessary positive image when there seem to so many fears. The threat of nuclear war which it seemed able to address has now been replaced by the threat of terrorism (though of course it has been around for decades, it has just started to be used in a much more aggressive way as a threat) and ironically environmental damage which requires liberal humanism to effectively address. The fact that liberal humanism is still alive at all, reflects the huge leap in communications of the past two decades. Without the internet I imagine we would be living in much more authoritarian times. It is no wonder that dictatorships such as China and Singapore (until it found it was too expensive to continue doing) censor their people's access to the internet. The shift of the post-war consensus, notable in the UK towards the so-called Thatcher Consensus, but common across the Western world with the rise of the New Right in the 1980s matched by similar rise of authoritarian attitudes in many Muslim states made it easier to make the step to the next stage in the 2000s which is a rapid erosion of civil liberties, ironically in the name of protecting freedom in the face of comparatively small threats which have been exacerbated by bigoted, aggressive moves in the first place. In this world it is now normal to accept detention without trial for a month or even years (once you reach Guantanamo Bay), the use of torture by even low-level soldiers, invasion of countries to secure resources, greater control of movement of people and a general sustained hysteria.

How can liberal humanism survive? To some extent by becoming devout. It might seem weird to say 'yes, I am a devout liberal humanist'. Whatever people might say, in fact that is not contradictory with saying 'I am also a Christian/a Muslim/American'. All gods love the people they oversee so any worshipper should love humans too. Religions and the American constitution tend to praise mercy and respect for people and it is there in the Bible, Koran, Torah, US Constitution if you look no matter what people might tell you. The key thing is to see what the key tenets are of liberal humanism. They are few and are easily applicable in many circumstances, it is just that all decent people have to keep saying them loud and proud. The key aspect is to treat people like people. Even to treat people like animals in this age of increased rights for animals, would be a step up in many places in the World. Do not torture, do not detain without charge, do not make people homeless, do not deny them drugs you can afford to give them, do not deny them food you throw away in vast quantities, do not kill or harm someone because they look different from you or follow a different view, let people meet, let people speak, let people travel. Everything we expect for ourselves is the minimum we should allow others.

I passed two postcards in people's windows over the past few months. One showed a refugee family behind a barbed wire fence, with the text explaining how they had fled to the country portrayed to escape repression only to step into repression. The other showed the Statue of Liberty against the Stars and Stripes, and said that the USA that person believes in would never torture people. Liberal humanism is not weak and people need to see that. It is a far better counter to fear and danger than any amount of repression and authoritarian attitudes. What will destroy it is people believing it has no tenets and that it is already dead. The bulk of you know what the World needs because for most people it is what they, as a human like all the rest of us, needs.