Ration or reform?


In Monday’s Times, Libby Purves suggests that NHS rationing is something that we should all get used to. Purves plucks examples out of the air as to where further rationing could be employed:

- IVF should be funded because it is not life-threatening.
- Drunkards, smokers and addicts should be required to get clean before any emergency treatment.
- Stomach-banding should be subject to co-payment in arrears since you’ll be eating less.
- Life-extending (as opposed to palliative or Alzheimer’s) treatments should cease at 85.
- Breadwinners and parents of young families should get formal priority with cancer drugs.
- An age should be introduced beyond which heart surgery is not offered.

Purves does not suggest that any of these policies should be introduced, but is showing that these are areas in which we could potentially ration healthcare. I’m not surprised she is vague in her policy suggestions. People being denied treatment -  who have paid in taxes throughout their life for the inefficient and failing NHS - but happen to smoke, be fat, have chosen not to have children or be past a certain age, is simply unfair and frankly missing the point of the problem.

Given that this is the state of healthcare in this country, is it not therefore time for us to think about healthcare reform instead of rationing? As Michael Tanner argues in The Grass Is Not Always Greener. A Look at National Health Care Systems Around the World:

Those countries with national health care systems that work better, such as France, the Netherlands, and Switzerland, are successful to the degree that they incorporate market mechanisms such as competition, cost-consciousness, market prices, and consumer choice, and eschew centralized government control.

Just to be clear. Tanner does not include the British healthcare system in this list.