Kill Obamacare, or U.S. healthcare will suffer same fate as Britain

A colleague of mine, a Conservative MEP, was cremated last month. Except he wasn’t: the hospital had released the wrong body to the undertakers. A second funeral has just been held with his actual remains — though, of course, nothing can be done for the family of whoever was cremated in error.

We take such incompetence for granted; it doesn’t make the news. Even when something happens that is atrocious enough to generate headlines — the latest scandal being what an official report calls a “systemic cover-up” of baby deaths in a hospital in North West England — no one calls for the system to be overhauled. The truth is that, after 60 years of a state monopoly in healthcare, most of my countrymen are unable to imagine any alternative.

It’s a vivid demonstration of what Milton Friedman called “the tyranny of the status quo”. In most fields of life, Britons lean toward the free market. Our political culture is Anglosphere rather than European, in the sense that even Leftist politicians have to cloak their schemes in the language of liberty and enterprise. But when it comes to the National Health Service, the reverse is true. Every party has to guarantee that the NHS budget will continue to rise, whatever the other austerity measures. No party will contemplate an end to the state monopoly.

Which is why this is probably America’s last realistic chance to ditch Obamacare. Several aspects of it are being challenged in court, and the GOP has rallied behind an alternative plan — the one advanced by Representatives Scott, Flores and Roe — understanding that there is no point in attacking a policy unless you have a better one to put in its place.

Many American conservatives fondly assume that, as the cost and contradictions of Obamacare become clear, voters will turn against it. But that’s not how it works. People are change-averse by nature. We cling to familiar mediocrity rather than risk the unknown. This is especially true when interest groups arrange their affairs so as to benefit from the status quo.

Physicians, for example, were among the strongest opponents of the nationalization of British healthcare in the 1940s; now, they are among its keenest supporters. A similar shift is underway in the United States among the big pharma companies, who love the idea of doing cosy deals with officials controlling vast budgets. Whole new bureaucracies are springing into existence and, as Upton Sinclair liked to observe, “it is difficult to make a man understand something when his salary depends upon his not understanding it”.

Healthcare engages us emotionally. British people will often say things like: “I won’t hear a word said against the NHS: it gave my Auntie Nora her new hip”. Of course, it’s the clinicians concerned who replaced Auntie Nora’s hip, but leave that aside. The odd thing is that they maintain this attitude even when things go horribly wrong.

In 2013, a report into a Mid Staffordshire Hospital showed that 1200 people had died needlessly. It made for disgusting reading, in every sense. There were reports of people left lying in blood and urine, elderly patients left unassisted in toilets for hours and other things too nauseating to write about.

Twelve-hundred people. Imagine any other institution causing so many deaths. Suppose a corporation killed 1200 of its customers through negligence. Directors would go to prison and the company would likely close. Yet, more than any multinational, more than any bank, the NHS, with its 1.4 million employees, really is “too big to fail”. When abominations like those in Mid Staffordshire are exposed, people rally round. “Let’s work together to improve our NHS instead of undermining it,” they say – which is, of course, a polite way to shut down the argument.

Obamacare isn’t a precise copy of the British system. But there is one parallel on which its exponents are relying, namely the conflation of their healthcare model with the people who work in it. The chairman of the body in charge of overseeing care quality in Britain recently put his finger on the problem:

“The NHS became too powerful to criticize. When things were going wrong, people didn’t say anything. If you criticized the NHS — the attitude was ‘how dare you?'”

Having been on the receiving end of that attitude more than most, I’ve noticed that it comes from two quite different sets of people. First, there is a knot of hardline Leftists, many of them in public sector trade unions. These are the types who pour out furious abuse online, who harassed my elderly mother after I had criticized the system, who drove the Mid Staffordshire whistleblower from her home. They will back the NHS, whatever its failings, because it is the only part of the British state that operates on socialist principles: contribution by ability, distribution by need, total government control.

Then there is the wider constituency: people whose personal experiences have been satisfactory, who have found NHS staff to be friendly and helpful, and who therefore see criticism as ungrateful. People in this second constituency have no ideological attachment to a state monopoly in healthcare. They simply remember that their doctors and nurses were, for the most part, good-natured, and that their treatment went well. This second constituency has been passively conscripted by the first.

I can see precisely such an alliance taking shape in the United States. You now have an alternative model before Congress, one based on individual freedom, property rights and increased competition. This is your last chance to strangle Obamacare at birth; flunk it, and you won’t get another.

Dan Hannan is a British Conservative member of the European Parliament.

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