I'm afraid the doctors have this the wrong way around about the NHS


One of the joys of a market in things is that it's clear and obvious who it is who is the supplicant and who it is that is the boss. You check which way the money is flowing and you can tell easily: the person handing over the cash is the one whose wants, needs or desires are being catered to. That we don't have a market in the NHS is what causes logical failures like this:

Feckless patients who fail to take proper care of their health are to blame for a growing NHS crisis, doctors say. GPs said the public needed to take more responsibility for “managing their own health” instead of always turning to their local surgery. Rising patient demand means soaring numbers are struggling to even get through to their GP surgery to make an appointment, a recent National Audit Office report found. In total, around 6 million patients a year turn to Accident & Emergency department and walk-in centres because they have struggled to see a family doctor.

There's something Brechtian about this demand: that the doctors would like to elect a different population to cure and treat. But that's not actually the way that the treating should be going on. It might be masked, in that we pay taxes which then pay for the NHS, but it is still true that we are disposing of our cash on a service which we need, desire or want. The NHS is thus supposed to be at our disposal, not us at its.

What this means is that if we like the grape so much that our livers explode, well, treat us. Sure, tell us that our livers might explode if we do have that second bottle of port with lunch every day, but that's all you do get to do. Similarly with smoking and lung cancer, hamburgers and diabetes and so on. We are hiring you, keeping you in bedpans and nurses, with our money. We are the bosses and you, the medical professionals are, or should be, at our beck and call.

This is rather what Hayek was on about in the Road to Serfdom. That taxation as the method of payment is going to lead to that Brechtian position: that we the population should accord with the ideas of the bureaucrats rather than the proper relationship which is that the bureaucrats gain their salaries by serving us.

No, no one does want the US system of health care: but something more like the French or other European ones, where this relationship is properly pointed out would be an advance.

The NHS is there to treat us, not for us to live up to the standards of the NHS.