Though Cowards Flinch

During his recent visit to London, Rudy Giuliani took the opportunity to attack “socialized medicine”, criticising the National Health Service as “not only very expensive” but also “increasingly less effective”. He went on to compare the survival rates for prostate cancer patients in the United States and Britain. As 82% and 50% respectively, it would seem a damning remark about the NHS – if one were to stick one’s head up one’s arse, that is.

A few quick points. As a undeniably wealthy individual, I am sure Giuliani enjoyed the very best of medical care available to American citizens when he suffered from cancer. But then, I would expect healthcare to be pretty bloody decent when you concentrate your resources on those who can afford to pay for it. The top of a pyramid undoubtedly offers a very pleasant view. The minor problem of 40 million Americans without health insurance coverage was an apparently unimportant statistic quickly disregarded by the Republican primary candidate. The fact the United States actually spends more on its wreck of a health service than Britain with its universal coverage was similarly dismissed.

But then, good healthcare costs money. In a brief flirtation with the truth, the PR guru, Max Clifford, once remarked that “if the British people want a first class health service, they need to learn they’ll have to pay for it”. Truer words than most politicians dare to use. The difference between the two countries is that, while American money (including public money in the form of federal subsidies etc.) is spent on unnecessary duplication, bureaucracy and the needs of the privileged few, “socialized medicine” serves the public interest: medical care on the sole basis of clinical need; equal access; a professional, as opposed to commercial relationship between patients and doctors; and an end to needless fear of health expenses.

And let’s not forget what all this “expense” i.e. the trebling of the NHS budget under Gordon Brown’s period as Chancellor, has brought us. Tens of thousands more doctors and nurses have been trained. Dozens of new hospitals have been built. Waiting times for operations and Accident & Emergency treatment are down. More operations are performed each year and more are successful, resulting in fewer deaths. Let’s just repeat that: resulting in fewer deaths. But no, the expense is what’s important. It takes only a rudimentary understanding of the English language to conclude from this that “expense” is, in fact, increasingly more effective. Perhaps Giuliani’s concerns have more to do with his devotion to the interests of insurance companies and the ideal of free market competition than the needs of his would-be electors? Say it ain’t so, Rudy.