On Friday we met with the current Cabinet Secretary and head of all British Civil Servants (544,000 according to his count) Gus O'Donnell. After a brief, high school civics class-like presentation on 'what goes on at the Cabinet and Whitehall,' Mr. O'Donnell opened the floor to a few questions.
In case you've missed the theme, we appreciate and are intensely interested in how basic economic principles inform public policy. You can imagine our delight, therefore, when we learned that Mr. O'Donnell has a background in economics. With that in mind, we posed the following question: we asked, "how he employed his background in economics and understanding of incentives as the head of a notoriously inefficient bureaucracy?"
Reading the question in print, we understand how he might have taken that as a bit of an institutional dig. But it wasn't intended as such.
He proceeded to give a somewhat tedious and patronizing explanation--almost lecturing--on the differences between undergraduate and graduate economics (as though the laws of supply and demand stop after ones bachelors degree!).
Of course, he never really explained how they were different, simply insisting that they were so in order to establish his superiority. What he was really arguing came out when he applied his bureaucratic jargon to a practical example: the National Health Service.
Being the only American accent in the room, he probably understood that we were thinking specifically of Britain's socialized medicine when we asked our question about economic incentives. He explained that with no prices--after all, health care is free--there was no way to employ market forces to bring about any degree of efficiency whatsoever. The overriding principle, and my peers around the table nodded their heads, was equity.
Espousal of egalitarian principles is what all good socialists do. Never mind that everyone gets crummy health care, or that thousands die because cancer isn't diagnosed in time for treatment, or that thousands more wait in queues (brit-speak for lines) for basic procedures. None of this matters, so long as everyone's health care sucks equally.
And suck, it does. Think Walter Reed writ large.
Consider that since we've been in this country, we've had personal experience with two friends who needed medical treatment. Both reflected poorly on socialized medicine.
One friend knocked out all her front teeth and cut up her mouth very badly. Because of the inefficient bureaucracy that is the NHS, she had to wait three weeks before they could begin treatment and repair. Did you catch that? She was forced to wait, teeth presumably in a cup of milk, hidden away because she didn't want to go out in public, for 3 weeks before she could start on a series of procedures that would take longer than a month to complete. "That," as the Brits might say sarcastically, "is just brilliant." What makes this sucky sequence of events even suckier is that this friend doesn't even know any better. That's just how it is. Suckiness has permeated British expectations for their medical care.
Example number two is a friend who took a nasty spill off of his bicycle. His knock on the head was bad enough that a passing driver had time to stop the car, get out, and pick him up off the ground. In this friend's case, he wasn't able to see a doctor that day. The next day, when he turned up for his appointment, he discovered that they had scheduled him during a time when doctors were only seeing "emergency" patients. Finally, three days later, he saw a doctor who was able to properly clean up and bandage his various cuts and scrapes. As for any tests to determine damage to his brain as a result of his head injury and apparent concussion? Well, that would require waiting at least two weeks to see a specialist, and our friend just couldn't be bothered. How many Brits don't get the care they need because the line or wait is too long?
So far, the NHS is 0 for 2. And that's just our count. We hope we don't get injured or sick and have to rely on the NHS for medical care. We don't want to become another cautionary tale.
Sure, it's free--if you consider nearly 50% income taxes free (and with costs spiraling out of control, the tax burden is only going to grow)--but it sucks.
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