Friday 4 October 2013

In a State?

The current impasse in the US highlights the essential difference between them and us. We have had a National Health Service free at the point of access since 1948. Despite the best efforts of Obama, they have fought tooth and nail against such a move. Their passion has now brought much of the Public Sector to a standstill as neither side shows any sign of giving way. Make no mistake, this battle is one of ideology. In plain terms, the US is the biggest advocate of the "nothing for nothing" attitude. If you want a service, you pay for it. Not for them the totalitarian doctrine of the State. As our own NHS lurches from one crisis to another, the day fast approaches when the really big debate needs to take place. Is the current NHS sustainable in its present format or will we now have to face the reality of paying for it on an "as you use it" basis? It seems inevitable that it can't continue in its current format and has become a bit of a political football as our leaders seek to avoid the burning issue. In the US you have to put your hand in your pocket but the service is arguable far superior to our own. It begs the question why we haven't pursued such a route sooner. When we all go to vote in 2015, the battle lines are clearer than at any time since the late '80s. Vote Labour for State or vote Conservative for Enterprise. It really is becoming as stark as that. One reason why the US has been so reluctant to adopt Obama Care is the obvious connotation with the Communist State. Since the emergence of Communism in the aftermath of the Great War, the US has always sought to remain as ideologically opposite as it can. That looks set to continue since the majority are perfectly happy with the status quo. What will be interesting is to see how our own leaders decide to address the problem that has now been gnawing away at them since the 1980s. Making GPs work longer hours is simply avoiding the real issue. The average renumeration per patient is about £30 as things stand in GP land. Compared to our cousins abroad, that is chicken feed and can't very well be sustained indefinitely. Something's got to give..

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