Max the Cat has been to Michelle the vet this week for an eye ulcer — cost £45 (drugs), & £45 for 3 consultations. But why use the same system as a basis for Human healthcare? There’s been all kinds of blogosphere buzz around the US healthcare debate, some of it comparing our own National Health Service.
Like any system it has its ups and downs, its challenges and pitfalls. Amongst its personal ups as I have experienced them over 54 years are Dr MacArthur, our GP when I was 12. He was an old fashioned Scots socialist who refused to take private patients, and got me a hospital bed in 10 minutes at a weekend because I needed it. He saved my life, and would have been insulted to be offered money over and above his pay for doing such a thing.
Stephanie’s birth as an undiagnosed extended breach in a strange hospital (she arrived early and unexpected on Christmas night) was supervised by one of the finest obstetricians in the world, who gave Lucy the choice, then delivered her faultlessly without a C-Section, using an old midwives’ routine called the Burns-Marshall technique. Both these ace bits of effective medical care were delivered with nary a credit card or insurance policy between them, and I would take a lot of persuading that the kind of medical system we use for Max the Cat would have served us any better.
But if you’re comparing healthcare systems across whole populations, the big statistics are the place to begin. Make no mistake, a system which allows people to die earlier and risks more children’s lives, across a whole population is not as effective as one that delivers higher life expectancy and low child mortality. Efficient use of people’s resources is a bonus, given the inherent and spiralling costs of modern healthcare.
So here are the figures, and the comparisons for the UK, France, Singapore and the USA.
No system is free of glitches, failures and compromises, Every system is challenged by spiralling costs, but what works best is surely an empirical, rather than ideological question. It’s unfortunate that the US faces tough basc choices about healthcare at a time politics has been so snarky and partisan. The basic systems of medicaid and medicare was put together at a time there was a higher level of bipartisan respect and public service ethic. All good systems involve public and private elements, but the clever bit is in how they are belnded for the good of all. With any luck something can be done — why should US babies suffer three times the mortality rates of their counterparts in Singapore?