Snow

I remember seeing this cute little meme posted, without irony, on facebook a couple years ago.

Clearly the fact that the picture highlighted the failure of a state program escaped the OP.

More seriously though, it's hard to see how the removal of snow would pose any problem for the private sector at all. Some entrepreneur (or community serviceman reprisenting a nonprofit organisation) comes round the neighbourhood and asks if people are willing to contribute however much (or little) would be necessary to insure them against heavy snows. If necesseary, the organisation could draft a contract which says if the necessary amount of people to fund the program is not reached, the people who agree do not have to pay.

Everyone who does pay up gets placed on a register, and gets a nice big siver snow-flake medallion to put on their mailbox or gate to show off to their neighbours that they have contributed. If some people can't afford to pay they can be offered a discount rate, or perhaps they could be included on register in return for agreeing to volunteer for the snow removers should their help ever be needed.

If people choose not to buy into the system, when the snow falls eventually come, the company will drive by houses that are not on their register and don't have a snow medallion on display, or they will bill them out of pocket for a far larger sum than the original insurance fee to clear their driveway, offsetting the costs for everyone else. Perhaps they will think better in future. Even so, they will not necessarily be stranded - they can pay the neighbours children to take shovels and clear it like in the old days.

Problem solved.

Similar arrangements could be made for other services considered "public goods", like municipal garbage removal. For things like street lighting, which are near impossible to exclude those who do not pay for provision of, the medallion system would allow neighbours to apply social pressure to free riders without applying the use of coercion to subtract funds. Those who don't have theirs on display might attract disapproving looks, or have people round saying, "hey man, you are taking money out of everyone's pocket, when everyone pays, everyone pays less." With the technology we have today, it would be easier than ever to apply pressure to those who shirked the responsibility of sharing in the costs of local services they benefit from. The local shop could choose not to serve them and they may need to drive further to the supermarket which will not be worth the hassel of not buying a medallion. Their neighbours could choose not to allow them to collectively buy other services unless they paid in, meaning they would have to make their own arrangements which would prove costlier than choosing not to cooperate.

Libertarians! You can't beat Something with Nothing!

Here is a decent presentations on Libertarian Strategy and Psychology by me.

The NHS is a False Prophet

According to a recent article in The Guardian by Polly Toynbee, The NHS is our religion in the UK and that's why the conservative government can't destroy it. Of course, the Conservative government has never actually tried to destroy the NHS. They haven’t even reduced the amount spent on the NHS. They haven’t even halted increases in healthcare spending. The only thing they have done is reduced the rate at which spending is going to continue to increase.

Before the National Health Service was created in Great Britain, our nation was a world-leader with an unrivaled record in making major medical breakthroughs. People came from all over the globe to study medicine, and to be treated in the UK. Dr. John Snow proved that the source of cholera epidemics was the water supply in London. Edward Jenner pioneered a vaccine for smallpox in rural England, and Sir Almroth Wright one for typhoid. Sir Humphrey Davy, also a Briton, first suggested the use of nitrous oxide as an anaesthetic in 1800. Sir Joseph Lister pioneered the use of antiseptics in operations in 1865 using impure carbolic acid, saving countless people dying from infections after surgery. Alexander Flemming, the Scottish physician discovered Penicillin in one of the charitable hospitals in London in 1928. Howard Florey and Ernst Chain, brought it to fruition working in a laboratory in Oxford in 1941.¹ Britain had established the best record in the world for achieving major medical advances and had just developed the landmark drug of the 20^th century, as well as playing a leading role in 5 out of the 7 leading medical breakthroughs between 1750 and 1948 when the NHS was established.² Britain is no longer a leader in medical advances. Despite its costliness, nepotism, and other flaws, America’s private system has taken the lead.

Britain has less of the latest equipment and the old equipment is often being kept beyond the time when it is safe.³ If a private company was using out of date intensive care machines and x-ray machines, obsolete cancer care equipment, and operating tables over twenty years old – double their safe life span – the champions of the NHS would no doubt be clamouring for more government oversight and regulation. When government agencies are culpable, they are more or less given a pass on public outrage because they are perceived to be acting in the public interest rather than for profit.

In the UK we cannot compete with cancer survival rates in the US. A 2011 report demonstrated that the average cancer survival rate was 71.18% in the USA as compared to 54.48% in England.⁴ Our healthcare may be free at the point of service, but fewer of us survive it. It is costly in terms of lives. In fact, the BBC recently ran an article that reported “patients ‘dying in hospital corridors’.”⁵ In one month 300,000 patients were made to wait in emergency rooms for more than four hours before being seen, with thousands more suffering long waits in ambulances before even being allowed into the emergency room.

The sad reality is that in the UK or Canada people die waiting in line for what would be quick and routine medical treatments in the US. In Britain a shocking 4 million people languish on waiting lists according to official sources⁶ up from a 7 year high of 3.4 million in 2015 as reported by The Guardian, a left-leaning newspaper,⁷ and this in a population of scarcely over 65 million. At current trends this number is set to rise above 5 million in 2019 unless we do something to reverse them.⁸

In the UK you could turn up to an emergency room with an appendix about to burst and still be asked to wait overnight before they find you a bed. One patient reported that a lack of treatment rooms led hospital staff to examine her for gynaecological problem which had left her in severe pain and bleeding in a busy corridor, in full view of other patients. Such humiliating anecdotes could be dismissed as embarrassing one-offs were it not for the shocking fact that as many as 120 patients per day are being attended to in corridors and waiting rooms, in the public areas of hospitals, and some even dying prematurely as a result. In the first week of 2018, over 97% of NHS trusts in England were reporting levels of overcrowding so severe as to be “unsafe.”⁹

25% of British cardiac patients die waiting for treatment, and an investigation by a British newspaper found that delays in treatment for colon and lung cancer patients have been so long that 20% of cases were incurable by the time they finally received care.¹⁰ 193,000 NHS patients a month wait beyond the target time of 18 weeks for surgery.¹¹ According to the OECD Britain has the lowest number of doctors per thousand population in the advanced world.¹² A chart displayed in James Bartholemew’s book The Welfare State We’re In in 20 documented that while only 1% of patients of patients in the USA had to wait over four months for surgery, while the number was 12% in Canada, 17% in Australia, 22% in New Zealand, and a shocking 33% in the UK.¹³

Where free-at-the-point-of-entry resources are limited older patients are viewed as a drag on the system – especially since they require the most frequent care which costs much more. The average 65-year-old costs the NHS 2.5 times more than the average 30-year-old. An 85-year-old costs more than five times as much.¹⁴ Although a third of all diagnosed cancers in the UK are found in patients seventy-five and over, only one in fifty lung cancer patients over seventy-five receives surgery, and the NHS does not even provide cancer screening to patients over the age of sixty-five.¹⁵

The government can make waiting lists look shorter by denying patients services outright because those who have been refused services will no longer appear in statistics. If someone’s disease proves fatal because they failed to receive treatment in time, the government figures appear more cost effective because instead of having to budget for a series of expensive surgeries, they have a deceased person on their hands who will not rack up a whole lot of medical accounts. It’s not to say that anyone is perniciously trying to kill off patients, but with pressure constantly mounting for officials to show meaningful improvements, the incentive to coldly take advantage of manipulated statistics “for the greater cause of saving the NHS” will always loom. It is, after all, our religion. In one interview, prominent columnist Dr. Dalrymple reported “Managers going around the wards telling the doctors who they thought ought to be discharged. They had no medical training or knowledge. But they would try and influence the doctors to discharge patients quickly… This is a problem, of course, wherever the person paying for the care is not the patient himself… But where you have one giant organization that decides everything the hazard is even greater.”¹⁶

The failings of socialised medicine are invariably blamed on budget cuts and a lack of funding by advocated of the NHS who are used to expecting medical services to be paid for by the government. The assumption is that if we were just spending more money none of this would be happening. The thing is, we are spending more money than ever before already.

In fact, the budget of the NHS doubled in real terms between 1995 and 2015¹⁷ and now waiting lists are longer than ever! This is because the shortages and inferiority of services are not caused by a lack of funding in the first place. They are caused by how we are choosing to pay for healthcare.

If you are interested in receiving and advanced copy of my eBook Why Healthcare in America is so Expensive, please email me at frequency528@hotmail.co.uk to let me know.

1 Tooley, J. (2004, 2013) “The Welfare State We’re In” p106-109

2 Tooley, J. (2004, 2013) “The Welfare State We’re In” p109

3 Tooley, J. (2004, 2013) “The Welfare State We’re In” p131

4 https://www.pop.org/cancer-survival-rates-far-worse-in-great-britain-than-u-s/

5 Triggle, N. http://www.bbc.co.uk/news/health-42572116

6 https://fullfact.org/health/four-million-hospital-waiting-lists/

7 http://www.dailymail.co.uk/news/article-3158591/Hospital-waiting-lists-seven-year-high-3-4m-need-treatment-6-000-forced-wait-year-operations.html

8 https://www.theguardian.com/society/2017/may/03/nhs-annual-health-budget-increases-conservatives-ifs

9 Pickering, G. https://mises.org/wire/patients-are-%E2%80%9Cdying-corridors-britain%E2%80%99s-socialised-health-system

10 See DiLorenzo, T. J. (2016) “The Problem With Socialism” Chapter 9. p96-97

11 https://www.theguardian.com/society/2017/jan/13/193000-nhs-patients-a-month-waiting-beyond-target-for-surgery

12 http://www.dailymail.co.uk/news/article-2533698/Britain-just-2-71-doctors-1000-people-fewer-Latvia-Estonia-Lithuania.html

13 Bartholomew, J. P126

14 Triggle, N. (2017) "10 charts that show why the NHS is in trouble" BBC News, Health

15 See DiLorenzo, T. J. (2016) “The Problem With Socialism” Chapter 9. p101

16 Gunn, C. and Dr Olsson, P. R. (2015) "Wait Till It's Free." Gunn Productions LLC, Waco, Texas. p67

17 Author Unspecified (2015) “Health Spending”, The Institute for Fiscal Studies.

Why do Markets Work? Public vs. Private