An Open Letter To My American Friends About The NHS

I did want today to write something about comics, and I’ve also got a playlist I want to post, but I felt compelled to write this after various news reports over the last couple of days. Unlike most of my writing (to which I retain the rights for various reasons, I’ve decided to license this piece as Creative Commons Attribution-No Derivative Works 2.0 UK: England & Wales License because I want people to share this by whatever means. I’ve emailed the following to as many of my USian friends as I can think of and have valid email addresses for (and at least a dozen who it turns out I *don’t* have valid email addresses for, if the bounce messages are anything to go by…):

I am writing to you because you are a friend of mine, because of various statements that have been made by American politicians and journalists about Britain’s National Health Service.

I do not like to try to interfere in American politics, because how you run your country is your own business, but your politicians have been lying, and they have been lying about me and my wife and many of our friends and relatives, so I feel an obligation to set the record straight.

Many of your politicians and journalists have been saying things like “Ted Kennedy wouldn’t get treatment for his brain tumour in the UK because of his age” (a Republican senator called Chuck Grassley said that). Sarah Palin said that in the UK babies with Down’s Syndrome would have to go before a ‘death panel’. And so on. I’m sure you’ve all heard many claims like this yourself.

These claims are lies, pure and simple. They’re not ‘opinions’ that people can disagree about, they’re not things that can be debated, they’re not honest mistakes, they’re out-and-out lies.

Many of you will know that I worked for the NHS for about three years. Some of you will also know that Holly, my wife, still does. Do we strike you as people who would work for an organisation that killed people? Your politicians and journalists are accusing us of being knowing accomplices to murder.

According to the CIA World Factbook, British people live on average seven months longer than Americans. Now, that doesn’t say much about either country’s health-care system, especially when you take lifestyle differences into account, but what you *can* tell from that is that we’re not killing our old people – you don’t get a high life expectancy by killing people!

The tiny grain of truth in all of these lies is that in the NHS, an organisation called the National Institute for Clinical Excellence decides what treatments the NHS will and will not pay for. It does this by measuring how much extra healthy life a given treatment will give a patient, and how much it costs – just like your insurance company does. All healthcare systems have a budget – no system can spend an infinite amount of money, after all – so choices have to be made. The difference is, in your system, the choice is made based on whether you can afford to pay for it. Here, the choice is made based on how much you need it. If you’re 77 years old, like Ted Kennedy, and you have a brain tumour, you’ll get treatment so long as there’s a good chance of it working and giving you a few more years of good life. If there isn’t much chance of that, the government won’t pay it, that’s all. Just like your insurance company won’t pay for expensive treatments that won’t help you, neither will the British government.

And no-one is stopped from paying for treatment if it’s not funded by the NHS. People in Britain can still get private health insurance if they want to and can afford it, and can ask for treatments that the NHS don’t provide. Mostly they don’t, because it works for most people.

I know at least one homeless person who has been given treatment for cancer – and he was homeless before the treatments, not because of them – in Britain, if you’re sick you will get treated, no matter how much money you have. And no matter how old you are, or how disabled.

One American news source recently said that Professor Stephen Hawking would be allowed to die over here, because of his illness. In fact Prof. Hawking has lived in the UK all his life and has nothing but praise for his treatment by the NHS. Sarah Palin says people with Down’s Syndrome would be refused treatment – that would be news to the people with Down’s Syndrome I used to work with, many of whom had had heart operations on the NHS.

On average, people in the USA spend twice as much on healthcare as people in Britain – and more than any country in the world. Despite that, according to the World Health Organisation, the USA’s health system is 37th in the world, while the British one is 18th.

There are plenty of faults with the British health care system – and I hope that your legislators learn from them and get you a better system than we have – but it works. We do not kill old people. We do not kill disabled people. If we did, then Holly and I , instead of working for the NHS, would be fighting against it with every ounce of strength we have.

There are arguments that can be made against our system, just as there are arguments for it, and if you agree with those arguments then that’s fine – I have no intention to change your mind here. I am just trying to let you know that I am not an accessory to murder, and that anyone who says I am is a liar.

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144 Responses to An Open Letter To My American Friends About The NHS

  1. pillock says:

    Give the arguments, name those who made them.

    Give the arguments, name those who made them.



    • bjm says:

      OK…well I just read that the incoming head of the CMA said some pretty foreboding things about Canadian Medicare.

      “We all agree that the system is imploding, we all agree that things are more precarious than perhaps Canadians realize”…maybe she’s a slanderer? Dont know…you tell me.

  2. bjm says:

    Hey, Andrew…I’m not stirring things up…I said “nah” in response to the other guy, who I felt was misrepresenting my view.

    My view is not that I am right about anything, just that Pillock’s defense of Medicare struck me as passionate but misdirected; and yes, he mentioned “slanderers” before he he went off on Candian politcos, so I don’t think I was being deliberately unfair, I just don’t know him like you do so I missed that point.

    And as for banning me, I commented earlier and was corrceted by you, and I was happy with that. I did misunderstand the QALY issue, and I’m glad you corrected me.

    No need to gang up…

    • pillock says:

      Let me lay this out for you, okay BJM? If you didn’t catch what I said about how who the “bad guys” are, if you missed it the first time and then skipped right over it the second time…that’s fine. But you are now in the shit because you are arguing Canadian politics with me, and you are TOTALLY floundering because you’ve made an assertion you just can’t back up. Now, if you were paying attention before, you’d know that arguing about this with people who DON’T know any better than what they’ve been UNFORGIVABLY led to believe pisses me off JUST to no end…and also I’m sure you’ll see that, after poking my head out after the longest while, I am NO WAY going to let you get away with just tossing off some shit about my country’s health care that isn’t true. You do see that, right? There’s no way I can wear this, not on this thread which is ABOUT how this can’t be worn. So what you need to say is: “okay, maybe I got a bit rattled, I guess there were crossed wires, I don’t actually know of any of those arguments, I was just hot under the collar.” Or: you need to put them right on the table for real, right now. If you have them, that’s one thing. If you don’t have them, that’s another. If you want to say this was a misunderstanding that is fine with me: more than fine, I would prefer it. But I can’t have you saying it wasn’t a misunderstanding, you know? NOT ON THIS THREAD, NOT AFTER I JUST SAID MORE ABOUT IT PUBLICLY THAN I HAVE IN YEARS. So understand my situation, if you would.

  3. pillock says:

    Uh-huh…so, would you care to reveal what her “pretty strong argument against the Canadian health-care system” is?


  4. bjm says:

    Well..this is her speech…lays out some more specifics:

  5. Hey, Andrew…I’m not stirring things up…I said “nah” in response to the other guy…

    Last time I checked, I had a name. It’s all over my post headers and everything.

    …who I felt was misrepresenting my view.

    If you felt that way, you could always try to convince me (and anyone else reading) I was misinterpreting you. Maybe by answering my earlier point about claiming the NHS to have “death panels” being slander by any reasonable person’s definition.

  6. bjm says:

    Her first argument is inefficiency:

    In the last 30 years, spending on health in Canada has increased to such an extent that it now devours almost half of provincial/territorial program spending.

    That is simply unsustainable.

    Canadians are not getting the bang for the considerable bucks that we are spending.

    In terms of value for money spent on health, we ranked last out of 30 countries. Patients wait for care at every level and many critical components of care – such as long-term care and pharmaceuticals – are not covered or are woefully under-covered.

    The wave of budget surpluses that allowed for roughly $100-Billion in federal money to flow to health care in recent health accords is not endless. When the current deal expires in 2014, will our economic outlook be so rosy? If not, what then?

    The issue is not how to do more with less. The issue is how to do better

  7. bjm says:

    I think that is her strongest argument against…financially, the system is unsustainable and something has to give.

  8. Andrew Hickey says:

    Whether being ‘deliberately’ unfair or not, you were and are being *actually* unfair – assuming bad intent, and claiming to know more about someone’s motivations than the person itself. That latter is in itself about the greatest insult there is, in my book. It is literally impossible to have a reasonable discussion if you go into it imputing motives to the other party that they deny.

    This isn’t ‘ganging up’. This is you coming into a place where the normal rules of polite discourse are highly regarded, and – deliberately or otherwise – breaking those rules. If you can’t make an argument without insulting others, or if you can’t provide evidence to support your argument, you *will* be called on it, and repeated instances of rudeness to other commenters *will* get a ban. That’s the way it is on this site, which is why even though the traffic levels are much lower than many other blogs, the quality of discussion in the comments is higher than almost anywhere else I know. That’s something I prize very highly…

  9. pillock says:

    BJM, none of that — not one word — constitutes an argument against the Canadian health-care system. Do you understand this point I’m making?

    • bjm says:

      I guess not. She’s saying that the system (as is) is unsustainable. Isn’t that an argument against the system (as is)?

      • pillock says:

        It is not. If she were arguing against the system, she would be advocating the dumping of the system (because it doesn’t work) in favour of another system (because it would).

        I notice Andrew’s jettisoned you, so I won’t go on to an empty room. But you might consider that this woman is not saying quite what you think she’s saying, in more ways than one.

        • pillock says:

          A hint would be to look at where the money that’s being spent in the system is going. Why are there waiting lists? Because of how much money we’re spending? Are Canadians harder to treat than Brits or Danes, is that the problem?

          You gloss over exactly what she glosses over, only she knows why she’s doing it. And so do I. You could as well, if you cared to find out.

          Okay, I guess I’m done.

  10. bjm says:

    Hy lk, thr r rgmnts gnst Cndn hlth cr. Nt vrybdy wh mks thm s cmmttng slndr, r n dt wh blvs th slndr. f ts nsltng Pllck t pnt tht t (nd ys, fl cmfrtbl nfrrng frm hs sttmnts tht h tnds twrds tht vwpnt), wll…nlcky.

    nd n, dn’t thnk thr r dth pnls n th K, Gvn, nd hd t g bck t fnd yr cmmnt d t th rpd-fr CPS LCK rspnss nd th wy ths cmmnts snk nd nw rll nt nw pg. ddnt s t frst tm. Hmblst plgs.

    nd snc thn, hv trd t cnvnc y tht y wr msntrprtng my vw, nd hv prvdd wht thght ws sfl vdnc. T spprt my rgmnt, whch wsn’t rlly my rgmnt s mch s pntng t smbdy ls’s rgmnt. ll knw bt Cndn hlth cr s tht t’s cntrvrsl nd thy sttch p hcky plyrs qckly.

    • Andrew Hickey says:

      “If its insulting Pillock to point that out (and yes, I feel comfortable inferring from his statements that he tends towards that viewpoint), well…unlucky.”

      Then I feel *perfectly* comfortable inferring from *your* statements that you’re a troll. Plonk.

    • pillock says:

      It is NOT COOL to say there are arguments, and not give the arguments. “Everybody knows it” doesn’t work when you’re in a room where most people disagree with you.

      What is unlucky is that you are trying to get out of this, and I am not willing to let you.

      Well…not yet, anyway.

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