The price of life


"How can the NHS put a price on life?" – that the Daily Mail's take on the news that four life-prolonging drugs are to be denied to kidney cancer patients on the grounds that they are not "cost-effective". It's hard to disagree with the Mail (or Cancer Research UK, for that matter), especially when you hear that these drugs can double a patient's life expectancy, and are considered "the biggest advance in the field for 20 years".

Unfortunately though, putting a price on life is precisely what Britain's National Health Service does. It is simply the nature of the beast. Taxpayer funding puts a budget ceiling on healthcare, and with rising life expectancy, technological advance, and no constraint on demand, that budget ceiling is never going to be high enough. As a result, a tax-funded system like the NHS inevitably and unavoidably rations care, either through waiting lists or through not offering particular services.

Clearly, this presents a problem. The best solution would be to allow the market to take over healthcare, letting the price mechanism match up supply and demand, and using taxpayers' money only to subsidize those unable to pay their own way. But there seems to be no political appetite for that.

Nonetheless, there are a couple of things which could make the current system more tolerable. Firstly, introducing limited user charges for NHS services (as in Sweden) would constrain demand for services and free up capacity. Secondly, allowing patients to pay privately for additional services (like new medicines or treatments) without losing their entitlement to NHS care would be fair, humane, and would encourage the development of an affordable 'NHS-plus' private insurance option – giving many more people access to the very best care.