Stephen Hawking Has Not Yet Been Murdered by the NHS

There are, I think, two essential truths in international health policy. No-one sees fit to copy the National Health Service and no-one sees fit to copy the American system. Still, for all that we need NHS reform (hardly a surprise since just about every health system is under strain and needs tweaking), the picture of the NHS given by some of the people opposed to Obama’s health plans is, well, not hugely accurate. Take, for instance, this Investors Business Daily editorial which claims that:

People such as scientist Stephen Hawking wouldn’t have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.

Everyone* has jumped on this and, quite reasonably, had some fun with it since, alas, it seems as though the writer is unaware that Professor Hawking is, um, British. Now it’s possible that Hawking has private medical insurance, but as recently as April this year he was admitted to Addenbrooke’s hospital in Cambridge. Which is, I believe, an NHS hospital. And last time I checked, Hawking hasn’t been bumped off by some heartless NHS bureaucrat. At least, not yet.

Lord knows, the NHS has its problems and, yes, there’s a degree of rationing. But there’s rationing in just about every system. It just depends on how that rationing is organised and, to some extent, whether its existence is admitted. Ability to pay = rationing too. Equally, by any historical standard (different, to be sure, from international standards) the NHS actually, for all its cumbersome bureaucracy, performs pretty well. Could it be run more effificiently and cheaply? Almost certainly. Does it, on balance, offer a decent, though not world-beating, service for the money we spend on it? Probably.

The relevance of the NHS to American health care plans seems pretty limited anyway since, as best I can tell (though I try not to pay too much attention to these things) Obama doesn’t actually plan on copying the NHS.

Fundamentally, however, the difference between the systems is psychological. In Britain you worry what will happen when you fall ill; many Americans worry about what will happen if you fall ill. Will your insurance cover you? Often (but not always), yes it will and the best American care probably is better than the best British care, but there’s a greater psychological security to the British system. That’s probably worth something too. In other words, many Americans find themselves fretting about healthcare even when they’re perfectly healthy. That’s a psychological burden people in this country (and many others), don’t have to worry about.

As Stephen Hawking might also attest.

*By everyone I mean: Ezra Klein, Kevin Drum, TNR, TPM, Jay Bookman, Yglesias, Paul Krugman, Wonkette and doubtless many others.