The National Institute for Car Exboblification


Imagine a world where the government provided us with our cars. It would purchase a set number of them from private producers and some rationing board, lets call it the National Institute for Car Exboblification, or NICE, for short, would be established to allocate them. NICE wouldn’t necessarily allocate them to those who want them the most, but by some arbitrary principle.

Imagine, now, that a brilliant new hatchback is produced; superior in every way to the currently provided hatchback. However, NICE decides not to supply this hatchback. ‘It’s too expensive’, the rationing body decries! ‘It may well be superior in every way, but you’ll just have to make do with the old model.’

Clearly, this method of allocating cars is a nonsense. Why, then, do we apply it to the allocation of far more fundamental goods?

As readers of this blog are no doubt aware, a real life NICE determines which drugs are and are not made available on the NHS. A remote, unaccountable board of technocrats takes decisions that massively alter the lives of the individuals and families that they affect; such as that made yesterday to not provide Avastin: a new bowel cancer drug that could effectively treat 6,500 people a year.

In the allocation of drugs, as in the allocation of cars, the market does a better job than a rationing body. Removing rationing enables people to make better-informed choices. The medicines that one receives wouldn’t be determined ad hoc by NICE, but by an informed choice made in advance after a full consultation of health insurance options and their prices. One could object here that the poorest might struggle to purchase a decent plan. Yet is this really worse than the current system, where NICE denies them access to treatments in the first place? Also, there is no reason why, in a freer system, the government couldn’t step in to help the poorest purchase plans that meet a pre-defined standard.

It’s time to abolish NICE and wean our healthcare system off the wartime rationing mentality that has dogged it since its inception.