Здравствуйте! It’s 1972 and you’re in Russia, in case you were wondering. So I understand you want to buy a car? Here, take this brochure. It shows you all the cars on offer. No – you haven’t misread it – you can have a Lada, or a Lada, or a Lada. Which would you like? The Lada? Excellent choice. But please, take your time over the decision, there’s no rush – getting any of the fine range of shoddily-built cars will take a wait upwards of five years.
And therein lies the problem of monopolies. They allocate resources inefficiently and react poorly to customer demand. When you’re the sole provider of a service, there is little incentive to provide a decent service to your customers. By privatising firms, you make once publicly funded, clinically obese organisations compete on a for-profit basis with other firms and, ceteris paribus, the service improves. It’s pretty basic stuff.
Why, then, do people fight so passionately for the last few state monopolies today in Britain? This weekend, UK Uncut have organised the ‘occupation‘ of 30 high street banks in protest of proposed NHS reforms. Ignoring the fundamental flaws (PDF) of many of UK Uncut’s arguments, it is unclear why they demand the perpetuation of a health system that fails the population of various accounts.
The NHS is, as of last year, the third largest employer in the world. Britain, by contrast, only has the world’s 22nd largest population. Perhaps this discrepancy is due to the fantastic healthcare we receive? Alas, no: compared to other similar countries, it under-performs in a wide range of key areas, notably cancer survival rates (PDF).
Sadly, these statistics are not merely academic – they describe real-life outcomes that have irrevocable consequences to the people involved. For every percentage point that the NHS under-performs, people die. For every vested interest in the NHS protected against patients’ interests, people die.
To end on a personal experience: I went to hospital a few months ago. I spent 11 hours sitting in a waiting area, without any food or drink facilities, sporadically being told that I might be seen soon. Eventually I was seen. Thankfully I was okay. However, given the choice, would I go back to this hospital? No. Do I have a choice? No.
Much of the problem lies in the public’s ‘it’ll do’ attitude towards the NHS. In my own minor experience it did'; but nothing more than that. We should all demand better.