Natalie Solent

Politics, news, libertarianism, Science Fiction, religion, sewing. You got a problem, bud? I like sewing.

E-mail: nataliesolent-at-aol-dot-com (I assume it's OK to quote senders by name.)

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Wednesday, March 06, 2013
Healthy life expectancy is shorter in the UK than abroad

People in the UK enjoy fewer years of good health before they die than the citizens of most comparable European countries as well as Australia and Canada, a major report shows.

The health secretary, Jeremy Hunt, said Britain's performance was "shocking" compared with that of other countries, and called for action to turn it around by local health commissioners, who are about to take up their new responsibilities.

The UK ranked 12th out of 19 countries of similar affluence in 2010 in terms of healthy life expectancy at birth, according to a detailed analysis from the Global Burden of Disease data collected by the Institute for Health Metrics and Evaluation (IHME) in Seattle.

Despite big increases in funding for the NHS in recent years and many reform initiatives, the UK was in exactly the same place as in the league table for 1990, according to the IHME report, published in the Lancet medical journal.

Emphasis added. The report's authors, and the Guardian article from which I quote, are at pains to say that
the problem is only in part to do with hospital care – much of it is about the way we live. Our diet, our drinking and continuing smoking habits all play a part
In other words, Britain's relatively poor average life expectancy partly is to do with NHS hospital care, but they would rather not say so. As for the remainder of the problem that is not caused directly by the failings of the NHS, I wonder if the report's authors have considered the possibility that the "despite" might be a "because"? Why do the British do worse than other nationalities of similar wealth when it comes to living an unhealthy lifestyle? It is no answer to just say "culture"; why is our culture as it is? Have we always been thus? We have a long tradition of getting drunk, I grant you, but my impression is that the British were not considered any fatter or any more drug-addled than comparable nations a few decades ago... before 1947, let us say for the purposes of discussion.

It is often said that one of the great blessings of the NHS is that it has lessened the fear of illness. The fact that they do not have additional worries about costs or insurance does come to those already worried about illness as a huge relief, and NHS-sceptics like me have to engage with that, sometimes in our own lives. So let us do so. I submit the hypothesis that a certain amount of fear of getting ill is salutary - both in the general sense of producing a beneficial effect and in the more specific, and original, sense of promoting health.

Naturally, I speak here of averages over a large population. Many illnesses cannot be avoided by human action; that is what insurance is for. When considering any one individual, I doubt that when making the many small bad decisions that have the cumulative effect of making him or her unhealthy, "hey, I don't have to worry about paying for healthcare" often comes consciously to mind. But, like the proverbial mills of God, the mills of incentives grind slow but they grind exceeding small. In some countries those many small decisions take place under the shadow of "I might end up with a bill for this". In Britain they do not. My hypothesis might go some way to explaining Britain's anomalously poor average health. Something must explain it.

By the way, I shall take it as read that every human being has a perfect right to eat, drink, smoke and inject as he or she pleases. I shall also take it as read that the authors of the report and 95% of its readers wish to deny others that right. If the hypothesis above is correct, Britain has set up a system that, besides the inherent wrong of being based on coercion, removes one of the incentives for people to take care of their own health. How to solve that? More coercion, of course.