But the NHS were trying…

I was impressed that the libertarian press was sticking the boot into the mainstream media, Labour and the NHS in an apparently co-ordinated effort today. The City AM editorial made the point nicely and Guido backed it. It is vital to ask why one story – Libor or horse meat – is getting more press than another – the large scale failure of NHS hospitals. This is how bias is revealed.

The question is powerfully raised, but I don’t like the answers. Guido simply highlights that the difference exists, and points to the equine story as a distraction, and so made no contribution on this point. Heath gets it wrong by highlighting “double standards”, but there is a totally consistent standard that is being applied.

The NHS is set up to help the poor get healthcare. The poor, having better things to worry about, tend not to be the people doing all the shouting. For that we have Polly-Toynbee-style trustifarians with smart houses and cushy jobs writing daily columns, not filling sandwiches nightly in factories.

What the shouting in favour of the NHS is usually about is that the NHS helps others. Not the speaker. Everyone except the speaker who is alright-actually thanks-for-asking. That the NHS failed to care for 1200 people, resulting in their deaths is regrettable but the NHS was trying to do good. It was trying to help others, not the speaker and not the NHS either. The fact that the NHS is a lose-win deal makes it virtuous. The NHS and everyone who pays for it lose and the patients win; that’s the point. Were NHS staff greedy, self-absorbed, evasive and dishonest? Almost certainly, but they are part of a larger project aiming for a lose-win outcome.

Meanwhile, meat manufacturers and bankers exist to help customers. Customers who pay them money. Their normal mode of operation is rationally self interested: a win-win. Such sustainable trades are morally neutral at best, but eyed with suspicion. Are those win-win outcomes really fair? How come one party has more buildings and employees?… hmnn…. In this context the greedy, self-absorbed, evasive, and dishonest minority tip the scale and the result is an anger which is unmitigated by any appreciation for a larger virtue.

The standard then, to spell it out, is nasty unpleasantness on one side balanced with lose-win altruistic contributions; and the NHS is seen as a massive charitable program. It might very well be avoiding criticism due to bias and short-termist point scoring by the left, but the NHS is supposed to be forgiven, it’s trying and that is good enough. That it might be trying something unsustainable and foolish is not part of the analysis. The problem is that the whole moral analysis is flawed, and that is why this blog keeps returning to the point that to win we must change the terms of the moral analysis.

  16 comments for “But the NHS were trying…

  1. Feb 12, 2013 at 9:22 pm

    I’m a libertarian, and I’m having trouble grasping your point. I think I see what you’re saying, but the public won’t. So, much better to take the Heath / Fawkes line perhaps.

    • Feb 12, 2013 at 9:33 pm

      That’s okay. I’m not saying we stop taking the Heath / Guido line. I’m saying that basic moral analysis is flawed as we need to address that as well. Objectivists would say address it first, as the primary, but it’s a proper mind bending thing so “as well as” will have to do.

      How to actually articulate that a moral code is broken in a short editorial though, that’s the problem, and I obviously need to work on it too.

      Ayn Rand had to repeat herself many times and took 1100 pages to do it – in small print too.

  2. Richard Carey
    Feb 12, 2013 at 9:24 pm

    Perhaps it’s in part due to the establishment parties all supporting the NHS. They all embrace its socialistic nature and structure, and buy into its mythology. To attack the NHS thus would be to attack themselves. Obviously the left won’t do this, as they proclaim the same ideology, and the right keep quiet in case anyone notices that they are just as much centralising statists as their opponents. Also, I don’t think the government would have a clue how to reform the institution in any meaningful way, even if it wanted to.

    The only politician who I recall attacking the NHS in principle was Dan Hannan, and he did that on US television, although it got reported here, but he’s only an MEP.

    If you cast your mind back to the Olympics, you’ll remember the opening ceremony. NHS worship is one of the tin gods we are supposed to worship in the modern age.

    • Feb 12, 2013 at 9:34 pm

      What I’m trying to address is: why is it a tin god in the first place?

  3. George Mulberry
    Feb 12, 2013 at 9:40 pm

    ‘meat manufacturers and Libor rigging bankers are helping customers’ eh? How is deception and faud helping customers?

    Surely the whole point of these scandals is that these organisations were acting in their own self interest against the intrests of their customers (maximisation of profit above all else regarding libor + hoursemeat, not sure what the NHS workers motive was but def not putting patients first)

    • Feb 12, 2013 at 10:21 pm

      The purpose of those organisations is to help customers, for money. The fraud is self-evidently a bad thing but isn’t their normal method, as a group anyway. I’ve edited the article to clear that up.

      As to self-interest, if they are being self-interested then they are doing a bad job of it.

  4. Paul Marks
    Feb 12, 2013 at 9:48 pm

    I love the term “the libertarian press” – it may be with outlets such as City AM and Guido (and so on), that one really is developing.

  5. James Rigby
    Feb 12, 2013 at 10:47 pm

    The reason the NHS is a “tin god” is because there are people alive today who remember the benefits it brought about when it was created. They told their children that it saved their lives (and it may well have done – or perhaps it was advances in medicine), and they then told their children. Perhaps when the NHS was created it was a generally good thing – but then over the decades it turned into the monster we have now. As we all know, no state organisation ever stays small and focussed. The argument to be used against those who claim it is the envy of the world is to point out that the world is so envious that the only other comparable systems are in Cuba and North Korea (and I’m not entirely sure about the latter).

  6. Tim Carpenter
    Feb 12, 2013 at 10:59 pm

    Well, you know what they say about belief – it allows one to stop thinking about how the world works.

    Belief in the NHS means one can ignore how it is funded, how it operates, what it provides.

    The NHS is systemically dysfunctional. We have to break the false dichotomy of NHS or “privatization”, which is just, in effect, outsourcing.

    It is going to be tough.

  7. Feb 13, 2013 at 4:11 pm

    What a bunch of ranted, rancid codswallop – and even that’s too good for it.

    • Feb 14, 2013 at 12:04 am

      That’s a useful contribution.

  8. Mike Fowle
    Feb 15, 2013 at 2:49 pm

    If the Staffs hospital had been private, it is not difficult to imagine the media response. Labour MPs and shadow ministers would be queueing up round Broadcasting House to utter vacuous soundbites – profit before safety, greed before compassion etc. There would probably have been an earnest discussion on the BBC – have private hospitals a place in the NHS? But because it is the NHS everybody seems to be bending over backwards to make excuses and bury the story. Ironically, such things are far less likely to happen in a private hospital because the media are far readier to find fault, and there is choice – so that if the patient/customer is unhappy they can say so and go elsewhere. Because they are paying they do not feel obligated but expect proper treatment. There is this strange notion that people in the private sector are motivated solely by profit; those in the NHS are not. (Despite the senior executives who make a horlicks of one post and slip quietly into another just as well or better paid.)

  9. Lawrence
    Feb 27, 2013 at 9:38 am

    Actually, I don’t buy your argument. In theory, the NHS is trying to help people, and at the level of nurses, doctors, consultants, I know that the vast majority do try their best. The problem comes with the trusts, NICE, PPC’s and all the shenanigans that come along with party-led political appointees, meeting targets and spinning the pro-Labour/anti-Tory story constantly. When these unaccountable, unfireable incompetents take actions that result in the deaths of the very people you are defending above, then the BBC should come down on them like a ton of bricks. But they don’t. “Because the NHS are trying to help.” This has cost 1500 lives so far in just one area, and you better believe there are far more as the figures get investigated!
    Versus the horse meat scandal. Dishonest, yes. But not a single death so far, and never will be.

    While on the subject of BBC bias, compare :
    – LibDem Clegg lying vs the Bicycle story – top story for weeks, on radio, TV and web
    – Phone hacking – no damage caused = judicial enquiry vs Jimmy Saville – hundreds of underage rapes over decades, massive institutionalised coverup = internal BBC enquiry, the results of which are heavily censored.

  10. Feb 27, 2013 at 5:18 pm

    It’s getting even worse ! We are increasingly told that the NHS’s failings are a function of society’s lack of love for it. Therefore any good the NHS does is in spite of society while its failings are because of society.

  11. Mar 1, 2013 at 2:01 am

    For every person the NHS fails I am sure that there are just as many who are failed by their insurance, which give the promise of covering them for every eventuality, but being a business run for profit will of course try to get out of paying for as much of their healthcare as possible.

    Personally I love the NHS. It has saved my life. I have cancer, and looking around the blogs it is clear that I am much better off being that ‘poor person’ in the UK with cancer than in the US.

  12. Paul Marks
    Mar 1, 2013 at 2:02 pm

    Medusa Jordan.

    I hope you are not treated in the same way my mother was in the NHS – in relation to her cancer.

    My late mother. The British record on cancer is not good. Hopefully you are the exception that proves the rule.

    By the way – the old line that before Medicare and Medicaid (introduced in 1965) poor people with cancer were kicked out of American hospitals because they could not pay, is not true. Few American hosptials were ever “run for a profit” (mostly they were charitiable or religious) – it might have been better if they had been.

    Even in the 1950s the United States did not really have a free market health system (such things as licensing and FDA regulations distorted things), but it was something like a free market in the 1950s. In modern times health care in the United States (contrary to the nonsense that is so often taught) has been GOVERNMENT DOMINATED. Half of all spending which forces up costs – just as government backed student loans have exploded tuition costs in universities. And the great web of regulations (mandates and so on) have forced up costs (and actually harmed care).

    Obamacare (of course) finishes the process – over the next couple of years American employers will drop health cover (and pay the fines for doing so) because Obamacare will push up health costs even more. Most people will be forced into the government “exchanges” where crony “private providers” will be paid by the government. In theory it will be different from the NHS – but, in practice, much the same (i.e. equally bad – if not worse).

    You should also look into the work of Jon Huntsman (senior) on cancer.

Comments are closed.