American health debate

In an editorial in the newspaper, Investor's Business Daily, it was claimed: ' People such as scientist Stephen Hawking wouldn't have a chance in the UK, where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.' An astonishingly ignorant thing to say since Stephen Hawking lives in the UK and survives!

Professor Hawking - who is British, and who as recently as April was treated in an NHS hospital, Addenbrooke's hospital in Cambridge - quickly rubbished the claim. 'I wouldn’t be here today if it were not for the NHS,' he told the Guardian. I have received a large amount of high-quality treatment without which I would not have survived.'

Last week Chuck Grassley, the most senior Republican on the Senate finance Committee, claimed Ted Kennedy would be left to die untreated from a brain tumour in the UK because he would supposedly be too old for treatment. However he admitted he had no evidence to back up his wild claim.

'I don't know for sure,' said Grassley. 'But I've heard several senators say that Ted Kennedy with a brain tumour, being 77 years old as opposed to being 37 years old, if he were in England, would not be treated for his disease, because end of life – when you get to be 77, your life is considered less valuable under those systems.'

Andrew Dillon, chief executive of the National Institute for Health and Clinical Excellence (NICE), told the Guardian it was utterly false that Kennedy would be left untreated in Britain: 'It is neither true nor is it anything you could extrapolate from anything we've ever recommended to the NHS.'

I respect the fact that Americans must chose their own way of paying for health care, but I wish they would do so without publishing falsehoods about the NHS. Having now received 6 months treatment from the NHS I have very little criticism of it. I may be in a more privileged position than most people using it, but my observation of fellow patients does not suggest that my treatment is exceptional. I am receiving exactly the same treatment for my cancer that I would get in the US, and should it be unsuccessful, there are second-line options available even though they are not yet NICE-approved for first line. (NICE does not hold the stranglehold over practice that its critics suggest). There are dangers in jumping in with unproven treatment options. A good example would be Bevacizumab which on the basis of early results seemed to offer improved survival in colon cancer. It was adopted in many countries including Holland, yet more recent results presented at the American Society for Oncology this year demonstrated no therapeutic benefit, just extra toxicity. I am glad I have not been given it.

My treatment has been free at the point of consumption, though I have paid enough in taxes over the years. The ward where I receive the chemo is light and airy with a fine view over the lake. The nurses are cheerful and caring. I have the Oncologist's mobile phone number. I never have to wait. I was offered a second opinion with the leading specialist in the UK for this disorder, or with whomever I would rather see, at no extra cost. I was offered a choice of hospitals to receive my treatment, though naturally I chose the one that is 5 minutes drive away since it is equipped with the latest CT and MRI scanners for which there is no waiting list. In my diagnostic work up there was no delay and I was examined with state of the art radio-scanning equipment.

When I was an in-patient having surgery there were some minor quibbles about silly rules that Health and Safety regulations had forced upon us, though it wasn't so much the rules as the over-zealous interpretation of them by junior members of staff, that was the problem.

Because there is no billing, no third-party payer, no checking on financial status, no local negotiation, no restrictions on which provider goes with what payer and for many other reasons, the cost of bureaucracy in the NHS is much less than in insurance-based systems. Government interference is always a bind, but the essence of the NHS has always been its local nature. Local people make local decisions. I spent a lot of my time in the 1980s and 1990s making those decisions for the benefit of local people. I am now benefiting from the decisions I made then.

The Labor government dislikes the unevenness of the NHS. Some areas are better or worse than others. One correspondent has suggested that Glasgow is as bad as Moscow - but that is because the people there live of whisky, cigarettes and deep-fried Mars bars. The NHS has no responsibility for that.

The idea that we would be better off being treated by vets is laughable. Anything difficult is treated by lethal injection, unless there is money in keeping the beast alive.

Normally, I would go along with Caveat Emptor, but in health care there is so much misinformation that the buyer is not qualified to know what is best for him. Even those with a medical education make wrong choices. As a result there is a huge malpractice industry in the US. My best prescription would be for everyone to have a family doctor who is concerned with the welfare of that particular patient. The NHS provides one for free to everyone. They are not always the shiniest knives in the box, but they are usually more honest than the TV ad or the specialist who sells his wares on a fee for item of service basis.

But my main point was how much the cost of the American system was to the taxpayer, When you consider the cost of Medicare, Medicaid, provision for children, the VA, NIH, CDC, health insurance for government employees, tax breaks for employers, the cost of the FDA, research grants to universities, etc the cost is more than the UK government spends for the whole of the NHS.