Ideological blindness is a terrible thing

Sonia Sodha, in The Observer, wants us all to know that the NHS really isn’t the national religion, that’s just a cheap jibe from Nigel Lawson. We may puff our chests in pride about it, fail to think rationally, but it’s not a religion, oh no.

She also tells us this:

The real story is this. Until 2010, the NHS had historically been given real-terms funding increases of 4% a year on average: not a sign of inefficiency, but of the fact that countries spend more on healthcare as they get richer, cutting-edge health technologies become more expensive over time, and ageing societies have more people who need more healthcare. However, over the past decade, the NHS has received the tightest funding settlement in its history, way below this average.

Health care is indeed a luxury good - meaning that richer folks spend more of their income on it, not that it’s a luxury only for the rich - but rational, rather than religious, observation also brings us to Baumol. Services become more expensive relative to manufactures as a society becomes richer. Because it’s much more difficult to increase labour productivity in services as labour becomes more expensive - labour becoming more expensive being a synonym for a place becoming richer.

This is true but the important thing is what do we do about it? Well, the way to improve productivity is more markets and more competition. This is a known economic result, it’s not some mystique being sprinkled across the debate by neoliberals or anything. Competition raises productivity over time. So, if we’re finding it hard to raise productivity in health care - we are - then we need more competition in the provision of health care. This is not less so because Baumol, or luxury goods, but more so.

But the NHS is indeed that religion, not something to be discussed rationally. A useful proof of that contention being this from Ms. Sodha:

Long-term data show just how efficient the NHS is. We spend significantly less per person than comparable countries such as Germany, France, Switzerland and Sweden. We have far fewer hospital beds a head, way below Germany, France and Austria, and fewer doctors and nurses a head than the OECD average.

Her own link to the evidence takes us to this:

Health and long-term care spending are above average, though hospital beds and the number of doctors and nurses are slightly below the OECD average

Spending more and getting less is known as inefficiency, non-efficiency, not as is claimed, efficiency.

But then that’s a mark of religious belief, isn’t it? Facts and reality have to be ignored, or at least twisted, to fit the extant belief system rather than theories adjusted to fit the universe.

These claims of NHS efficiency are as those American Bible parks where Adam and Eve pet dinosaurs. After all, we know absolutely the Earth was created on Oct 23, 4004 BC. Reality has to fit around that, obviously. To argue with Holy Writ is to be a heretic.