Socialised medicine strengthens illness

February 16th, 2010

Ambrose Evans Pritchard wrote in The Telegraph:

[…] David Cameron views the NHS as sacrosanct, but that is precisely what must be cut. It is anachronistic that you cannot obtain prescription drugs without going through a doctor — wasting everybody’s time — as if doctors these days reach a better decision in two minutes than well-informed patients with an acute self-interest in getting the matter right.



Later in the comments, he retracts and says this is ‘silly’ but it in fact is not silly at all, and is perfectly reasonable and sensible on several levels.

First of all, there is no reason why the state should be able to interpose itself between me and the manufacturer of anything that I want to consume, wether that be paracetamol (there are regulations restricting how many packs you can buy at one time), beer (when and where you can buy it and in what measures), bowls of fruit (selling by the bowl is illegal) or anything whatsoever. It is my absolute right to buy anything that someone wants to sell to me. Period.

They say that “A man who is his own doctor has a fool for a patient”. I have an absolute right to be a fool and to medicate or immolate myself as I see fit. Any compromise in this regard instantly turns me into the property of the person who makes and enforces the restrictions on what I can or cannot do to myself.

There is another aspect to this that should also concern everyone; state collectivised medicine (what the americans call ‘single payer’) reduces the efficacy of antibiotics and strengthens the lethality of pathogens.

Drug companies exist to make a profit. In a socialised system of medicine where all pharmaceuticals are either free or heavily subsidised, medicine has no real price. When you are prescribed antibiotics on the NHS, their value to you is zero. You have no incentive to finish the course since you did not have to pay for them. These drugs are also overprescribed because they have no value; they are ‘free’.

This lack of real prices and subsequent over prescription has the unintended consequence of creating what are now known as ‘superbugs’; deadly and highly resistant strains of infection that are immune to the battery of antibiotics at the disposal of doctors.

If there were no subsidies of antibiotics, the drug companies, knowing that overprescription would kill the market for these drugs in the future (no one would buy antibiotics that no longer work), would raise the price of them until people took them seriously, in both meanings of that phrase.

Getting a course of antibiotics would no longer be a simple matter of asking for them and then being handed them for nothing. If a course of antibiotics cost £200 the buyer would be reluctant to purchase them without great consideration; she would think long and hard about wether or not the symptoms she was suffering really indicated that the application of a course of antibiotics was necessary, rather than paracetamol or whiskey and lemon, because there would be a real cost to saying ‘yes’ to them. Also, when the need was determined to be real, you can guarantee that the course would be finished on schedule; medicine that costs that much would not be thrown away half way through the course; everyone who bought antibiotics would finish them. We know that people failing to finish courses of antibiotics adds to the problem of strong strains of pathogens; market driven pharmaceutical supply would solve this problem. The manufacturers of antibiotics would have a vested interest in reducing the use of these drugs so that they can keep selling them in the future. The way things are now, wether or not the antibiotics work they can sell them to the state, ad infinitum, no matter what the future consequences are.

This is only one benefit of people being freed to buy any medicine they like over the counter in a free market. Many people die from adverse reactions to pharmaceuticals; whatever that number is, it will fall dramatically once medicines have a true market price. The pharmaceutical companies would still make huge profits, because the prices of these medicines would be market based. Over consumption of pharmaceuticals would drop dramatically, since people would not be able to eat them like candy.

Take another example; people with hypertension. A woman with essential hypertension can be put on three or more drugs to control it, and receive these drugs ‘for free’. Once you start taking them, the current wisdom is that you are on them for life. If these drugs had a market price, they may constitute an unacceptable long term financial burden, forcing the patient to adopt lifestyle changes to reduce her blood pressure. It also may be the case that since so many people suffer from hypertension, the cost of medicines that treat it would be driven down until they were as cheap as aspirin, especially the drugs that are now patent free. Who knows? What we do know is that in those two scenarios, the patient is better off; in the first, she has a disincentive to begin a course of medicines that she will be hooked on for the rest of her life, in the second, those same medicines that she becomes dependent upon are cheaper than bottled water thanks to the free market.

Involuntary collectivised medicine, i.e. socialised medicine run by the state, is a bad idea with many unintended consequences that are bad for health. It destroys freedom, harms patients, makes disease worse, causes people to be coerced away from natural remedies and should be completely abandoned for a 100% voluntary free market in medicine and pharmaceuticals where the state has no part whatsoever in its operation, regulation, administration or anything of any kind.

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