Monday, March 21, 2011

Alternatives to the Lansley plan

One of the problems for those of us that oppose Andrew Lansley’s health reforms is that it’s hard not to sound negative. “Kill the Bill!” is not a constructive slogan. "Here's a better one!" might be more effective.

We need an alternative but most people (like me) haven’t a clue where to find one. Apparently, there are pretty good health systems in France, Holland and Switzerland, even the US system has its good parts. A cursory look at these - courtesy of good old wikipedia - throws up a few ideas about what kind of NHS we might ask for instead.

The main finding is that all those systems cost a lot more than the 7.7% of GDP we're used to paying. The chart above shows how cheap the NHS is compared to other systems (click here for more data).

Another is that no one has really cracked the problem of getting the efficiencies of competition without paying for profits and suffering from cherry picking, monopolies and other market failures. In general, the more competitive systems seem to cost more overall, which must be a puzzle for economists.

Here's what a few of the alternatives look like, in ascending order of cost, and some features we might look to adopt from them for ourselves.