Friday, 14 August 2009

In defence of socialised medicine

In the United States, on significant area where Barack Obama has departed from the path set by Bush II - indeed most US Presidents before him - is on the issue of healthcare. His healthcare reform bill, whilst not quite approaching the level of public health care offered in Britain, canada, and most of the rest of the industrialised world, represents a significant move for the poorest in American society.

In the United States, according to estimates by the Centres for Disease Control (CDC), 54.5 million people were uninsured for at least part of the year in 2006. The Center on Budget and Policy Priorities (CBPP), meanwhile, projects the amount of uninsured as rising year-on-year. The Institute of Medicine states that "lack of health insurance causes roughly 18,000 unnecessary deaths every year in the United States. Although America leads the world in spending on health care, it is the only wealthy, industrialized nation that does not ensure that all citizens have coverage."

That is why Obama's commencement, in March, of public consultations on health care reform represented such a landmark moment. In the US, health care is a for-profit industry, with the average $2 trillion dollars spent yearly amounting to nothing more than public subsidy for private enterprise. Thus, in spite of the level of money spent on health care, the World Healh organisation ranks the US at #37 out of 190 health systems internationally. That a baby born in El Salvador, which until March this year had a government which spent the 1980s using death squads to murder its dissident citizens, has more chance of survival than one born in Detroit is an inescapable indictment of the US system.

In this context, the hysterical reaction to the bill by Republicans and conservative Democrats is absurd. Sarah Palin's Facebook rant that a reformed system is "downright evil" and that the result will be an America where "my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care" smack of scaremongering nonsense.

Now Daniel Hannan, the Conservative MEP most famous for his YouTube tirade at Gordon Brown, has joined the debate. He told viewers of Fox News that "I wouldn’t wish [the NHS] on anybody." "We’ve lived through this mistake for 60 years now," he said, insisting that the British National healh Service "has made people iller [sic]" because "we have very few doctors." Hannan, of course, is a "free-market" dogmatist who praised Iceland's "blue-eyed Sheikhs" for staying out of the EU and for its willingness to "cut taxes and regulation, and to open up its economy." The wisdom of these measures became apparent recently when, in the wake of the recession, the Icelandic government completely collapsed.

Hannan's comments on the NHS are similarly nonsensical. There are, of course, problems with the NHS, but these are due in a large part to the creeping privatisation of the system in recent years, as well as the long-term effects of a massive neglect of it by the Thatcher government in the 1980s. Hence, the lax cleaning standards that gave rise to "superbugs" like MRSA and C-difficile can be traced back to an outsourcing of cleaning contracts that began in the 1980s, with the majority of nurses that cleaning be brought back "in-house;"

May McCreaddie, a nurse from Glasgow, said: "There has been an increase in hospital infections and decline in cleanliness. It is quite simple."

She said private cleaning firms did not have the public sector ethos of in-house teams and there was higher staff turnover which contributed to poorer performance.

"We know what works we have been there before, we have had them. They are called ward domestics, they are an integral part of the team."

Another significant problem with the NHS is that too much money is spent on the bloated bureaucracy at the top rather than the vital staff at the bottom. This, too, is a recent development, with the result that dentists' appointments, glasses, and prescriptions now have to be paid for where once they were free. The cause, once again, is outsourcing and creeping privatisation.

So, Hannan and other "free-market" dogmatists can talk down the NHS, pointing to problems caused by privatisation as "proof" of the folly of socialised medicine and public health care, but it doesn't change the facts. Other public health services, where care genuinely is free at the point of delivery, expose the flaws of their arguments. That 96% of Cubans say that health care is available to everyone and are highly satisfied with the level of care received, with a longer average lifespan and lower infant mortality rate than the United States, is just one example that speaks volumes. And that's in one of the poorest countries in the world, devestated by half a century of an illegal US trade embargo.

We should remember, too, that rejecting public health care does not mean a reduction in taxes. For all their talk of a "free market," honest economists know that such a version of capitalism is unviable - which is why it hasn't existed since the Wall Street Crash. What we have instead is a system akin to fascism, where public funds feed into private profits to the tune (for the US health industry) of $2 trillion a year, as the poorest in society die for lack of access to treatment.

This is why the distortions of screaming reactionaries in America need to be rejected, as do any moves to privatise and destroy the health service any further in Britain.