Danny Dorling and one of his disciples have decided to tell us how good Finnish health care is compared to our own dear National Health Service – that wonder of the world that it is. And they’re right, there are things about that Nordic system which are better than our own and policies we should adopt.
The most obvious being that we should abolish that National Health Service:
According to the OECD, Finland spends a slightly lower proportion of its GDP (9.5%) on health than does the UK (9.7%). Finland can do far more with that money partly because doctors don’t need to be paid as much as they are in the UK, since housing costs are lower. For every 10,000 people in Finland, there are 32 doctors employed, compared to 28 in the UK, and there are 40 hospital beds for every 10,000 Finns, compared to 26 in the UK.
How excellent. But they are rather missing the two bits that really are different. The first is that there are copayments. You pay – real money, from your wallet – to see a doctor. And you get charged a hotel fee in hospital. Modest amounts, certainly, perhaps 15% of the costs of actually providing those things. But not free at the point of use, one of the things which reduces consumer demand.
And then there’s the absence of a national system. Taxes are raised locally to pay for care locally. This means that everything is subject to what I’ve called Bjorn’s Beer Effect. The thing being there are very few national, universal, health care systems:
There are indeed national health care systems out there–but they tend not to be single payer. And there are single payer systems out there, or close enough at least–but they tend not to be national. Which is something that we really ought to be thinking about, no?
Such a system will also be subject to what I’ve called Bjorn’s Beer Effect here before. If Bjorn is the bloke who sets your tax rate and Bjorn is the guy who decides where the money is spent, then in a community of 6,000 to 30,000 people you’re going to know, or at least be able to find out, where Bjorn has his Friday night snifter. Which is going to put the fear of God into Bjorn as he spends your money: but also means that there’s one human individual to explain to you, forcefully if need be, why you can’t have what you’re not willing to pay the taxes for.
That is, to make the NHS like the Finnish health care system we’ve got to abolish the national bit and start charging for it too. Which, amazingly, isn’t what Danny Dorling and his acolyte tell us. Wonder why….