Saturday, 7 July 2007

The NHS is a rip-off

Giles Whittell

Remember the name Chainsaw Rick. I have added the chainsaw bit, but you will see why. He appears in a so-called documentary that has not yet secured a British distributor but will spawn an awful lot more about Rick when it does.

The film is Sicko, a two-hour take-down of the mighty US healthcare industry directed by and starring the potato-faced Michael Moore (he of Bowling for Columbine, Fahrenheit 911 and subject of too many right-wing diatribes to count). In it, Rick is an uninsured sadster who loses two fingers to a chainsaw and has to talk hard cash with an accountant before his general anaesthetic. It’ll be $12,000 to reattach the easy finger, he is told; $60,000 for the pair. Rick goes for the budget option.

Fully half of Sicko is devoted to envious glimpses of better-run, more equitable and more compassionate healthcare systems in other countries, such as Canada (where another power-saw victim gets all five digits reattached for nothing) and Britain, where Moore would clearly choose to live if he didn’t have such an avid following and such comprehensive health insurance at home.

“Keep your British health system,” he told one of our reviewers after a screening on Skid Row in LA. “Never get rid of it. It’s a wonderful thing.” He has also made the mistake of calling British healthcare “free”.

Let us be clear: Michael Moore is amiable, fearless and funny, especially when provoked. He is also a brilliant film-maker who has transformed his genre in the US, where documentaries now pack out cinemas from coast to coast.

You can take this as official. I have met him and liked him and am entirely trustworthy. The same cannot be said of Moore, of course. He is routinely denounced as a misleading, self-serving propagandist by critics who fail entirely to grasp that these are his great strengths.

When Moore barged his way into General Motors headquarters, and American culture, while making Roger & Me in 1988, it was about time. Here at last was a booming, populist, shamelessly blinkered voice from the American Left to answer those that had boomed unanswered from the Right throughout the Reagan years. Small wonder that he found a far-from-fringe constituency and became embarrassingly rich.

Moore’s European critics, in particular, continue to misunderstand his challenge and his audience. They delight in exposing his crafty way with “facts”, as if the corporate interests he attacks weren’t just as crafty. They worry that the millions of Americans who pay to see his output might actually believe everything he says, as if, being Americans, they lack the power of critical thinking. And they forget that many of those millions of Americans do in fact, quite reasonably, share Moore’s view that GM ignored its social responsibilities when Japanese competition hit home; that Kmart never had any business selling lethal handgun ammo to kids; and that when Charlton Heston raised a rifle in defiance a few days after the Columbine high-school massacre, he was a berk.

Moore, by contrast, was the man-grizzly who stood up to the idiot president of the NRA and lived to tell the tale. He was my hero. But now he has started spouting nonsense about the NHS, and he should know it’s nonsense, and know that we know.

It goes without saying that healthcare on the NHS isn’t free. But just how unfree it is gets too little attention. We pay for it through our noses, every month.

Next year’s NHS budget will be about £104 billion. That’s roughly £1,733 per man, woman and child. Multiplied by four for a typical two-child family, then divided by 12, that equates to median monthly family healthcare expenditure of £577, or $1,155 in American money. I can buy some very respectable US health insurance for $1,155 a month. In fact, on a quick and painless stroll through the website for Kaiser Permanente, a leading nonprofit US healthcare provider, entering my basic family details and the Beverly Hills zipcode, the most expensive family policy I can find that does not depend on contributions from the state or an employer costs $400 less than the sum Gordon Brown currently chooses to spend from my taxes, each month, on the NHS.

Being honest, I must add a few hundred to my US bill to cover “deductibles” and the portion of my US taxes going to federal schemes like Medicare and Medicaid. But I must also cop to earning more than the UK average, which means I pay more than average for my NHS care; through the nose, as I say.

American roadworks tend to be adorned with signs announcing, “Your Tax Dollars at Work”. There should be signs saying “Your Tax Pounds at Work” at the entrance to every NHS hospital and surgery, and whenever “at work” fails to describe what goes on inside them, taxpayer-patients should whinge like hell. They may not like it. They may not think it British, but nothing else is working and in the meantime they are being royally ripped off.

Really? But aren’t waiting lists down, as Mr Blair used to tell us every Wednesday? I would refer the Right Honourable gentleman to a recent ruling by the Canadian Supreme Court in favour of a man who sued to be allowed to buy insurance to speed up an operation. “Access to a waiting list,” the court found, “is not access to healthcare.”

Forty-seven million Americans are uninsured. This is a problem. Several million more are inadequately insured. Another problem. But that leaves more than 200 million fully insured Americans who’ve never heard of waiting lists. I envy them.

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