Conservative MEP Daniel Hannan has been causing his party headaches by attacking the NHS on American television. The position this has earned him as a darling of the American right is ironic, given that Barack Obama is not proposing a British-style system but instead one closer to the Singaporean model that Hannan himself favours. But let's take a look at his criticisms.
First and foremost amongst these is that the NHS offers a relatively basic standard of care, at least compared with the more lavish insurance packages in the States, with longer waiting times for elective surgery and lower survival rates for prostate cancer. Some of his examples are questionable - a recent Commonwealth Fund study found that Americans endured longer waits, and the US's high prostate cancer survival rates appears to be an artefact of its more aggressive screening catching more harmless cases of this disease and then scoring them as successes (after all, Britain and America have virtually identical numbers of deaths from prostate cancer per population as opposed to per diagnosed case).
But regardless, the fact is that Britain spends about 60 percent less per capita on health care than America. Given that figure, our statistics are something of a triumph for our system, and certainly do not discredit it. Yes, our low-cost approach means that some treatments are not covered and we have what Hannan calls "rationing by queue". But this is a strange objection for a free market, small state conservative to make: it amounts to complaining that the NHS is not a generous enough benefit. Shouldn't such a person be glad that the state provides only the basic level of care that most would buy for themselves, leaving the choice to purchase more with the individual? It is important to remember that, despite the implications of some American critics of NHS "rationing", one does always have this choice if one can afford it (though the NHS does sometimes withhold treatment from those who buy treatments and services it does not offer, a cruel and pointless practice that Hannan rightly criticises). In this respect, our situation is not so different from that in America, despite Hannan's claim that "if the decision [as to whether you get a particular treatment on the NHS] goes against you that's it".
In the passage from which I earlier quoted Hannan, he asks: "If supporters of the status quo were truly confident of their case, surely they would extend their logic. I mean, why shouldn’t the state allocate cars on the basis of need, with rationing by queue?" Yes, the NHS is explicitly redistributive, and whether you agree with this will depend on your ideology. But those who do can reasonably argue that health care is a better target for redistribution than transportation. It alleviates suffering rather than providing positive goods, and this leads to greater improvements in people's lives (including those of the disadvantaged) without interfering with incentive structures in the same way. And, as already mentioned, the level of care provided by the NHS is something almost everyone would buy if they could afford it, so taxing for it does not rob people of a choice they would in practice take advantage of.