You should manage your health. You should have the power to choose whichever option serves you best. The power over your health -- your very self -- should be in your hands. … What we desire is liberty. The freedom to choose. Domain over our own bodies. Ourselves.
Liam doesn’t share this view, but he does wonder about the dominant UK attitude to healthcare:
I know lots of people who have bigger houses than I do. Nicer clothes, better cars and more exotic holidays. … I also know some who do considerably worse on all these things. As a society we’re largely comfortable with those disparities. …
The reason for that comfort, it seems, is that on all these fronts some sort of acceptable minimum is in place. … We’re comfortable with the lottery of life provided nobody falls too far…
So why are British voters so distinctly uncomfortable with ‘safety-net’ provision in healthcare? Why can’t the focus of our debate be the adequacy of that minimum level to which everyone is entitled regardless of their means? Instead our debate (and the language we conduct it in) is focused on the ‘top end’ of healthcare provision and discussions around why everyone can’t have the best available treatment.
Two thoughts: first, I think we all do actually accept that resource constraints mean that the NHS can never provide the very best care to everyone. In fact, it falls a good way short of that. Yes, there’s political rhetoric that suggests perfectibility (as there is in most policy areas), but that’s hard to take seriously other than as a gesture towards ongoing improvement.
Second, Liam does have a point. Nigel Lawson wasn’t far wrong when he called the NHS Britain’s “national religion”. The thought of a ‘basic minimum’ level of healthcare makes us fearful of how low that might be in a way that the thought of having a basic minimum level of material possessions doesn’t.
The reason can actually be found in the quote from Prell: your health is about “your very self”, so poor healthcare is an existential threat while relative material poverty, however damaging, typically isn’t seen that way. It’s not about what we have, it’s about who we are, and I think that explains a lot of the resistance to treating healthcare as a commodity. The British public are likelier than Prell to favour the state over the market in this case.