The Brick Wall

 The Brick wall

    I suppose it is the same for most retired folk, but it seems to me that the world in going to the dogs, going off the rails. If we continue in this direction we are heading for an impasse. To make the image more visible I will call it a brick wall.

    Take for example our UK National Health Service. It seems to be running out of money and giving less and less satisfaction. I wrote about this in 2013, a period of austerity following the banking fiasco of 2008 and the 2010 election that produced a ConLib coalition. I was then arguing against austerity cuts and calling for an increase in taxation 'specifically for the NHS'.  A call subsequently made by others.

    In a similarly outrageous companion piece I expressed my alarm at 'mission creep' of the NHS. New expensive tools and therapies are constantly being developed. Since the NHS was conceived, we have developed CT (1971) and MRI (1977) scanners, kidney (1960), liver (1968), and heart (1968) transplants, in vitro fertilization (1977), and now gene therapy (2023). There is no foreseeable limit to the development of more and more costly therapies. (Thus, there are 19,000 other protein-coding genes, all mutating at the standard rate of 1/100,000,000 to 1/1,000,000,000 per generation.) A billionaire could have his genome repaired every year, but that service cannot be available to all. 

    Deciding where to stop repairing a failing human being and to let nature take its course opens up a new area of ethics, into which we have barely taken the first tentative step. Or rather, deciding the point at which it is not the responsibility of the state to fund the repair work (which can perfectly well proceed with private funds, if those are available). I suggested, in 2013, that the state's responsibility might be deemed to cease when the patient reached the age of 70. (I now wonder about suggesting the age of 80 years.)

    In January 2025, when I reached the age of 83, I found I wanted the surgical repair of bilateral inguinal hernias, and found myself queuing at the local NHS hospital. Very straight-forward, my sister-in-law reassured me; absolutely routine. Yet the NHS could not find a bed for me. I was scandalised that the (free) NHS, to which I thought of myself as being loyal, was failing so lamentably. 

    After waiting 4 months I remembered (with some embarrassment) my earlier conclusion that it may not be sufficiently in the state's best interest to spend public money repairing a 70 year old citizen, let alone an 83-year-old. Due to my persistent good fortune, I had plenty of money in my "re-roofing fund"; indeed, it was totally untouched. So I went private, and got both sides done in the same operation for a cost of some £4500.

    My updated suggestion, therefore, is that the present system may not be so bad. Perhaps GPs could give a stronger hint to well-off, elderly, patients that they could quite honourably jump the queue, and have a private bed if they were prepared to pay. They could think of it as a voluntary contribution to the coffers of the NHS. 

    It is marvellous to find that the majority of citizens in Britain are willing to spend public money to help less-well-off citizens. But public money is largely other people's money. It would be even more to the nation's credit if there were some citizens willing to go over and above the average donation, and voluntarily to forego their fair share of the public benefits. 

    (Comments are welcome to: cawstein@gmail.com)