Following recent public health guidance from NICE, the Government are apparently planning to encourage GPs to prescribe boilers, insulation and double glazing to vulnerable patients. I am pleased to say that, if this scheme goes ahead, it can only mean we’re nearing ‘Peak State’ and that the collapse of the current political system is imminent.
The plan is an example of warped solutions from simple observations. This scheme hopes to address the issue of increased ill health from poor living conditions, including poor heating in winter. There is evidence that poor living conditions affects respiratory health, and that some conditions make patients more vulnerable.
The proposed solution, however, is clumsy socialism. It is often said that ‘GPs are best placed to… (do certain tasks)’ but simple economics shows that doesn’t mean they should do that job. I am the fastest typist where I work, but my comparative advantage is in being a well trained registered GP, so it makes sense for my slower secretary to do this work. There will even be inevitable claims that the scheme reduced hospital admissions but these schemes are almost always flawed by selecting the highest risk patients whose hospital visits will inevitably revert to the mean, through natural fluctuations in chronic disease or through death, thus making the intervention look effective.
Worryingly, the guidance includes the recommendation to ‘Record assessments and actions in the person’s notes or care plans. Make this information available to other practitioners, while respecting confidentiality.’ We already know how hollow the aspirations to confidentiality are and, coupled with the trend for integration of health with local authorities – see the ‘Devo Manc’ plan, this could see a disturbing development of a full person record, not only recording your health, but your housing, employment, heating, social habits etc. Would this record be a source of control? Would a local authority cut your health cover if you don’t spend enough on heating from one of their preferred suppliers?
The ‘right’ to health is the largest Trojan horse that perpetuates statism in our current world and, as health needs are rising exponentially, due to ageing and scientific development, tying health to the state will result in an inevitable further expansion of the state. Think of the things that influence health: jobs; food; drink; drugs; housing; activity levels; happiness. The current trajectory would give the state carte blanche to interfere further with all of this.
The paradox, of course, is that the more the state intervenes, the lower these determinants of health fall, and the worse the health outcomes. Even if one were to believe in redistribution, the most honest form of redistributive theft is to give people a handful of money rather than specific services, as they will spend it far more efficiently than the state ever could.
Of course the inefficient state will eventually bankrupt itself on this path, but there is much damage that can be done along the way. Solving the politics and economics of healthcare must be a priority for those who strive for individual liberty.