Socionationalised Healthcare

I'm back!  But let's not linger on that for too long, let's dive straight in.

I’m getting a little tired of the term “socialised healthcare”.

I pay some attention to American media – at least, more than the average Brit – and as I’m sure most will know, they’re having a bit of a to-do over the so-coined “Obamacare”.  As you can probably tell, I’m understating just a tad today.  Considering when I say “little tired” I mean “frustrated” and when I say “just a tad” I mean “downplaying like Tim Henman on a bad day”.

What I want to know is: why are they having this debate?  The US Government already provides its citizens with basic healthcare insurance, Medicaid and Medicare, each serving particular demographics (those in poverty and the elderly), but no program currently exists where citizenship is the only eligibility test.  Currently, and with few exceptions, most of Europe provides its citizens with some form of universal healthcare; that is, paid for through taxation.  Even Mongolia has a (admittedly fragile) health service.

Living in the United Kingdom for so long and taking advantage of that wondrous part of our social system led me to be quite amazed later in life that some countries, even in the Western world, did not have a similar setup.  Even playing Grand Theft Auto, I just assumed the deduction of about $100 every time I accidentally blew myself up because I was spending too much time worrying about not hitting the cars coming the other way and not enough on the angry mob boss chasing me with a machine gun was a game mechanic to prevent players from seeing it as a free-of-charge safety net.  Now I know that if a real American gets into a similar situation, not only will they have to pay to get stitched back together again, but likely a whole hell of a load more than one hundred Jeffersons.

Of course, health insurance does exist, but I’m not a fan of the ethics of insurance as it is let alone paying a private company a few quid every month so that I don’t have to worry if my arm falls off.  Sure, I’ll worry, but only for the few seconds up to the point that I remember, ‘No, wait… definitely paid my premiums this month.  Now you can call the ambulance.’

My point is this: healthcare provided by the government should not be referred to as “socialised”.  Whatever the true etymology of the word in this context, it implies that it is inherently socialist in nature, and brands itself as part of some Marxist notion of governance.  We don’t refer to our other emergency services as “socialised policing” or “socialised fire and rescue”, so why healthcare?  What is it about medicine that sets it apart politically from the other tax-fuelled forms of public health and safety?  Any Brit reading this might think, “well, we do.  Numpty,” but this is more a message to Americans.

There may be a good, rational, sensible reason why this distinction is made, but I’ve yet to hear it.  Mind you, I’m also yet to hear any decent explanation for the inclusion of medical care in the budget, yet I’ve assumed that’s the case because the rationale seems so blindingly apparent.  The concept of government is not to take your money: there’s a reason it exists.  It’s a beacon of what civilisation ultimately defines itself upon, and until humanity evolves mentally to the point where we are capable of communicating en masse and ad hoc to make informed, universal decisions we have to rely on government as a means for this communion of leadership.  And, along with the definition of government, no matter how anarchic or libertarian you are, this includes certain responsibilities and duties.  The safety and security of its populace is a major one, and they sometimes take this to hyperbolic extents, especially in Europe where we have felt the effects of socialism more pertinently following the end of the Cold War.  Take defence, for example.  We call it “defence”, but it’s really an “offence”, based on the huge amounts of money that we pile into making sure we can hit any location on the planet from any other point on the planet with a first strike weapon that harnesses the power of the atom.  Even the notion of something as simple as the aircraft carrier carries connotations of an attacking capability.  Which makes the British acquisition of a supercarrier somewhat counterintuitive: why in the name of the Gods do we need a ship capable of carrying half the Fleet Air Arm, when we have plenty of perfectly good land-based airfields from which to deploy them?  The only reason an aircraft carrier exists is to provide a mobile platform for amphibious, international warfare.  It is a relic of the Second World War that persisted because of the possibility of a third.

Sorry, I think I intruded on a different topic (and blog) there.

Nationalised healthcare makes as much sense as a nationalised police force, or a nationalised fire and rescue service.  The USA had a police force to some effect (no matter how ineffective or corrupt, or both) over two hundred years ago when libertarianism was a driving philosophy of the Old West.  I find it odd that in the modern day, a poor American might get burgled and the police will investigate for free (relatively speaking), but if they get stabbed they have to pay for damage incurred, or seek financial assistance from elsewhere.  I know there are plenty of charities about that help with that sort of thing, but I take the philosophy that charities are the cogs that support a mechanism until the manufacturer makes a new cog.  By that I mean we should constantly seek to make charities redundant: cure cancer (Macmillan and others); provide better care for war veterans (British Legion); and even assist Third World populations in developing infrastructure, which would hopefully eventually make them largely self-supported within a greater trading and interactive community (a whole bunch).

To wish for all those things is perhaps naively optimistic, but I only say it to illustrate a point to all the conservatives saying, “there’s the emergency room” or “plenty of charities can help them”.  It’s ridiculous rhetoric of course because charities rely on donations and they are not consistent – they can only help up to the point that they have money coming in from the generous.  But as a society, we should be being generous anyway, by making it a part of our tax and revenue.

We provide the preventative measure for criminal activity: the police force.  In cases where the preventative measure fails, we have the reactive: the Criminal Investigations Department (CID).  We also provide the preventative measure for natural occurrences that can cause material damage, and also as an extrapolation cause physical damage to the human: the fire and rescue service.  Where they fail, the same service seeks to react.

Here in the United Kingdom we also provide perhaps the most important of measures for public health and safety.  The National Health Service.  It provides inoculations and viral treatments and prescriptions to prevent illness, and where those fail or are irrelevant, we have the same service to react to broken bones or disease.  The whole thing seems perfectly logical.

So, right-wing America, you don’t want nationalised healthcare?  Far be it from me, a lowly Brit, to question your obscure liberty-but-only-where-us-holding-the-picket-sign-thinks-it-should-be political philosophy, but if you really plan on seceding from the United States of America, do you think it is therefore ethically consistent to maintain a tax-funded police force and fire service?

For the Brits amongst us, I want to use this same blog as a means to demonstrate the reason why we should not be even contemplating privatising the NHS, even to minor degrees.  The problem is not that healthcare costs too much - although an argument could be made that the pharmaceutical companies make it so - it is that the NHS is a bureaucratic mess.  Although I try not to make it a habit of criticising Blair's government too much, they were big fans of introducing bureaucracy in the organisations it exercised control over.  The NHS has suffered as a result of this.  Its management is flawed, and I was making this argument before various investigations began to reveal corruption in the regional trusts.  I am reminded, as I write this, of a fantastic A Bit of Fry and Laurie sketch:

https://www.youtube.com/watch?v=k6CkltzGAxY

Good day.