Skip to main content


I reserve the right to be wrong.

I wrote the following as a comment on a website that was set-up in protest against back-door privatisation of the NHS. I don't agree with back-door anything, but do I agree that the NHS is literally the best healthcare system in the world? No!


The private sector includes individuals and households. 'Private sector' is actually a synonym for 'civil society', and civil society did just fine at providing for people's welfare until the Liberals legislated it into the ground in 1909.

This meant that by 1945 the government had induced (not intentionally) a breathtaking shortage of doctors since the BMA had negotiated minimum wages for doctors that were way above market rates and made seeing a doctor impossible for poor people, and becoming a doctor far more difficult, hence the sky high entry requirements today.

The NHS was created out of a necessity that the government itself had created, by legislating to change human behaviour several decades beforehand.

Even if poor people couldn't afford the fees of private healthcare providers, I'm willing to bet a doctor would see those most in need for free, as they did throughout the 19th and very early 20th centuries. And everyone was far less wealthy then, with a far vaster population living in poverty than is the case now.

You'd have to assume that all humans are moronic children, and will always be so, to believe that a centrally controlled, centrally rationed healthcare ecosystem is better than the free kind. If that's the position that prevails here, fair enough. It's not my position, but I'm not posting this message to be rude, I'm posting to introduce another perspective into the conversation.

And the Bevan quote above - "The NHS will last as long as there are folk left with the faith to fight for it" - is true because people like free stuff. That's it.

The fact that free at the point of use leads to breathtaking inefficiency, bad decisions by patients and staff, and enfeebles people's sense of personal responsibility is demonstrated empirically by the blithe overuse (in staff's eyes, not mine) of NHS primary care facilities by patients.

Centralisation also means you have no idea which services are incurring which costs unless you hire masses of admins to chase the actual healthcare staff around all day, thus replacing market accountability with record-keeping accountability.

Since record-keeping failed to save the Soviet Union, and is currently failing to save Laos, North Korea, Cuba and Venezuela, I'm inclined to think it is an inferior mechanism of accountability.

Yet another problem is that it takes out the contractual relationship between the healthcare professional and the patient, an element in human exchanges that has always been very useful, both for controlling cost and for keeping relationships civil.

If the two parties, healthcare profession and patient, can agree between themselves upon the terms by which care will be provided, I'm pretty sure that social justice that everybody carps on about will be more in evidence than in a monolithic bureaucracy with three letters on the front.

Abolishing the NHS would only make people worse off if all the other regulations that already existed before its creation were kept; state control over the number of medical school places and job posts; set budgets and targets every year; licensing of care practitioners including doctors and nurses; state approval needed to operate a hospital, clinic, medical/nursing school; franchising for services like the railways.

Avoid those pitfalls, and avoid back-door anything (I am opposed to back-door privatisation on the grounds that it is dishonest) and a more just and free and civilised and educated and advanced and affluent and fulfilled society beckons, and not so far off.


On the next Ecomony Blogtime; with all the flak from certain recent comments looming over his head, a certain Matthew Hayden 

Popular posts from this blog

So I was reading a piece on The Outline about identity politics when the author, Sean McElwee, brought up a survey he had penned and collated to establish how positions on economic and racial issues align;
Could Democrats win over racially conservative whites with economic populism? It’s unlikely, because people who oppose racial justice also tend to oppose liberal economic policies.  To test this, I created scales of economic and racial liberalism, using two questions that have been on the American National Election Studies surveys since 1972. One question asks respondents to place themselves on a one-to-seven point scale on government aid to black Americans, the other on a one-to-seven scale on guaranteeing jobs and income for all Americans. In 1972, only 54 percent of white Americans who took the racially liberal position (supporting aid to black Americans) also took the economically liberal position (guaranteeing jobs and income).  By 2016, 74 percent did. And in 1972, 77 perce…

What Lingos Are Most Similar to English, Though?

Commentaryism - The Death Toll of Capitalism

How many people have died because capitalism exists? How many would still be alive if it had never existed? Let's dig in!

We will take two approaches over the course of this blog post by looking at the the death tolls attributed to the word in its broad popular definition - everything socialists don't like - versus the toll that fits the definition offered previously on this blog.

By the same token I will not lay any outsized figures at any other mode of production's door except where that mode of production demonstrably caused the problem that killed people. It's political ideologies that really matter here, and this is where the first big problem with even trying to lay a specific body count before capitalism runs into problems - there is no political ideology called capitalism.

Now then, Alfonso Gutierrez says in a comment thread that "capitalism and free-markets have murdered billions of people" which is a risky claim at the …