Health Care

The final assessed essay that I have to write for my first year at Goldsmiths is for the Political Economy and Public Policy Module, and from the range of questions provided I have chosen to answer the one about health care in the UK and who should decide on its funding.

Health care spending is one of the largest areas where British taxpayer money goes, and so how it is spent is a highly contentious issue; people, obviously, want to get the most for their money. The down-side, though, is that how much is spent on what is ultimately decided by politicians.

Churchill said that, "it has been said that democracy is the worst form of government except all the others that have been tried." I happen to agree with this. Democracy is inefficient, prevents a government from doing what's in the best interests of the people and generally fails at most things. This is seen perfectly in health care.

Politicians have to battle between getting the best value for money and satisfying the irrational voters who are being driven by emotion rather than economic sense. Everyone can see the point of not paying massive amounts of money to extend an 80 year old's life by a couple of years, but this stops when the 80 year old is their parent - then no cost is too much. And so politicians, who are constantly thinking of re-election, are forced to make decisions that are not in the best interests of the country and its people.

For this reason MPs are among the most ill-suited people to decide on health-care spending. Doctors, economists and other people with relevant experience but, most importantly, no democratically given right to decide should be the ones to decide. This does not necessitate making it an entirely un-democratic process: the experts who manage how the money health care is granted should be chosen by the democratically-elected government (which, in Britain and especially with the coalition government, is an issue for another day), however beyond that they should sod off and leave the chosen ones to make rational, cost-effective conclusions. As they have no major concerns about job-security they will be able to make these decisions without worrying about the consequences.

Too much at the moment is decided by MPs. The Chancellor should decide how much money is to be spent on health care, set down some vague guidelines if they want to (got to keep them busy so that they don't kick off), but then it should be left to pros in the NHS and some economists where money should actually be spent, thus ensuring that there will be the greatest benefit for at least a reasonable cost. Unfortunately in this system, some people are denied health care (as already happens), but the public purse is not infinite, and sometimes there is simply no way around it.

"Eat right, exercise regularly, die anyway."

- Author Unknown