"Malaysia Prime Minister Mahathir Mohamad and the Sultan of Johor are seen in a blue Proton Saga... "When asked whether there is any tension with the sultan, Dr Mahathir said: “No, I don’t see anything because I went to see him and he drove me to the airport. I don’t want to comment on the sultans because if I say anything that is not good then it’s not nice because he is the sultan”"

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Monday, March 11, 2019

The NHS at 70

BBC Radio 4 - Moral Maze, The NHS at 70

"It seems Hitler was one of the NHS’s earliest fans. A copy of the Beveridge Report, the blueprint for what was to become the National Health Service was found in his bunker with a scribbled note ordering that if it were to become public, Germans should be told it showed how their enemies were taking over Nazi ideas...

The nearest thing to religion the English have, Nigel Lawson memorably said... But the experts say if you have most forms of cancer, have a heart attack or stroke, your chances of survival are lower here than they are in equivalent countries...

I think it's a great pity that the National Health Service has become like a religion, because it means we can't debate it properly. We can't borrow ideas from abroad, things that work...

‘The debate... rarely moves beyond discussing how its funded and I think that's just too technocratic. It’s inadequate to the task of really interrogating what we need now.’

‘Well, it's that whole structure of the NHS, it is essentially a government monopoly and government monopolies tend to be extremely wasteful. And one study was done showing that there were four times as many managers and support staff for the NHS than there are for a typical private hospital. In other words, huge numbers of highly paid people are employed. That money could be used in actual health care’...

'The man he introduced, Bevan, was a near communist who did it, not because he thought he could improve health care, but because he believed in collectivised solutions'...

'Most people can afford to pay a modest co payment for the cost of health care. I don't see why they shouldn't... I think they should do it as they do in most systems, even in places like Sweden and Norway and Denmark, which are always presented as role models to follow, even they have co payments for most forms of healthcare, quite modest, but there is some payment and that is some inducement to use healthcare more efficiently...

Healthcare services are traded now, it's just that we don't buy them in our role as individual consumers. But it's mediated through the political process. But it is clearly a commodity in the sense that it is being bought and sold. It's just that we have the state as the intermediary, and we can't deviate from the arrangements that the state makes for us'...

‘We have this idea that that we're all in it together, and the NHS is how we're all in it together. And rich people and poor people don't get different sorts of health care. And that actually is a very, that produces a solidarity in our society, which is crucial to our sense of identity.’

‘But that's also true in the systems that I'm describing. You may not be covered by the same health insurer, there is some difference there. But there is solidarity in the sense that if you can't pay for your premiums, then the government would pay it for you, you will be connected to a system which makes sure that everybody else has insurance. And they're not part of the same organization is, but it is universal. And that also creates the sense of togetherness... plenty of places, in the Netherlands and Switzerland and Germany and Israel and Belgium, they have competitive insurance systems and everybody is covered. And I'm pretty sure there is a sense of togetherness in the sense that they would also be proud that of the fact that nobody goes without coverage.’...

If you end up with that we love the NHS, this is what brings national togetherness, how on earth. Basically, you have a national myth that if you challenge it, you’re accused of wanting to fragment society and be lacking in care"
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