I am a believer in free health care for all, not simply for sentimental reasons but for economic ones. This is one of the reasons why I am happy to live in Scotland, which is (comparatively) supportive of its National Health Service.
The USA, through its health insurance schemes, which must necessarily provide for corporate profit margins, spends five times as much on health as does the UK - thus the average US citizen pays out three times as much in insurance payments (either directly or indirectly, where payments are made on an individual's behalf as part of wages) as a UK citizen does in that part of tax which pays for the NHS. A profit based, supply and demand service (which, to be fair, exists in several other countries besides the US, though that continues to be the worst offender) also runs into other problems. Most obvious among these is the horror of situations in which people who cannot afford insurance have no health care at all (or only a minimal amount provided by an extremely under-funded state body), causing a level of individual suffering which should surely be unacceptable in any civilised nation. The general ill health of the poor provides a breeding ground for diseases which then become which then become more dangerous to everyone. Yet worse still than this is the casual availability of antibiotics, frequently prescribed as a placebo by doctors who get paid for each prescription they write. Every time an antibiotic drug is used inappropriately, it facilitates the development of strains of bacteria which are resistant to antibiotics. These already present a potentially lethal threat to immuno-compromised people the world over, and as they develop and mutate faster than new drugs can be developed they present an increasing risk to the population at large. The irresponsible nations which encourage this practice are thus encouraging new plagues which cause suffering and death right across the world.
One advantage for those people who do have health insurance in countries like the USA is that their access to medical treatment is generally quick and convenient. A state maintained system will always experience delays, and will have to prioritise patients according to their needs and the cost of treating them. Many people find this abhorrent, but I see it as unavoidable - ultimately, a country's resources, however they are funded, will be limited. A socially responsible individual should see that most of the time (accepting that mistakes will occur on occasion) it is reasonable to wait for treatment for a comparatively minor ailment in order that those in more desperate straits might receive the best help available.
Treating citizens who become ill, or coping with the consequences of their untreated maladies (in time spent unable to work and time spent depending on the care of others who might otherwise contribute more to the economy) is obviously more expensive for a nation than preventing them from becoming ill in the first place. In the early 1980s, India provided a superb example of how a country can pull itself out of poverty and become a first world nation by investing in preventative health care for its population - its vaccination schemes and health education schemes have made a vast difference to the general fitness and capability of its people. This is an essential step for any country which wants to compete at the forefront of world economies, and nations which do not wish to lose their current advantages would do well to remember its importance also.
In the UK, the NHS provides free condoms for anyone prepared to go and collect them (they are available in a variety of locations - hospitals, family planning clinics and many charity offices). This costs money, of course, but in the long term it is likely to be much cheaper than treating those extra cases of HIV which might arise without such encouragement and facilitation of safe practise during sex. More controversial are the needle exchange systems available for intravenous drug users in several cities. Some feel that these clinics encourage users in the their addictions, but most anyone who has actually been addicted to a drug like heroin will tell you that when the desperate desire for a hit arises it will take a lot more than the risks from a dirty needle to make someone decide against it. Sharing needles is still responsible for a high percentage of the UK's new HIV cases.
The greatest tragedy of AIDS, on an international scale, is what is happening on the African continent, where in some places as much as seventy percent of the population is HIV positive. These are people who will gradually become unable to work, unable to support themselves; in many cases they will leave behind orphans, some of whom will be infected themselves; there is not just individual destruction here, but the destruction of whole economies, as the fittest, most productive people (who are usually also the most sexually active) are the first to be affected. Perhaps still more disheartening is the opposition encountered by some efforts to provide external assistance in the form of safer sex education and condoms. It is a tragic legacy of colonialism that even such politically significant figures as Winnie Mandela have denounced the use of condoms, calling them a white man's plot to stop Africans breeding, and arguing that sex and HIV are not connected.
Of course, there have always been people within Africa who have worked hard to combat the spread of AIDS, and these efforts ats are becoming increasingly well co-ordinated - but it is already too late to prevent an enormous level of social and economic destruction. This demonstrates the importance of educating people about health issues on a national scale all the time, in the hope of preventing such disasters before they happen. A civilisation which does not invest in the health of its people is doomed.
The most recent crisis in UK health education has concerned the measles, mumps and rubella vaccine (MMR) which used to be given to young children as a matter of routine, but which, since the publication of a single contraversial repost linking it to autism, has been rejected by thousands of parents. Their argument is that they should be given the option of having their children receive each part of that vaccine seperately. At first sight, it might seem that they have a good case - that all they want is choice - but the choice is a dangerous one. Where those vaccines are administered separately, they must be given several months apart, leaving children vulnerable to measles for a further six months at the age when they are most likely to contract it. For a vaccinated child, measles just means a couple of days in bed feeling miserable. In unvaccinated children, it can cause blindness, deafness, and even death. Since the vaccine does not work for every child who receives it, protecting children within society requires what is known as 'herd immunity' - it requires that a sufficient proportion of children be vaccinated to prevent the disease from spreading. Parents who refuse to let their children have the MMR vaccine endanger not only their own children but also other children whose parents may have been more responsible, and, further, every vulnerable immunosuppressed person in the rest of society. Measles is frequently fatal when contracted by adults.
Aside from the fact that no research has been done to prove any real connection between the MMR vaccine and autism (here it should be noted that existing autism usually becomes apparent in children at about the same age when they would normally be due to receive the vaccine), it would seem that much of the public's hysteria is based upon a misunderstanding of what autism entails. Most of those people who develop autism do not suffer to any noticeable extent; they may feel a little distant from other members of society, but they are perfectly capable of thinking and functioning and getting as much out of life as anyone else. Cases which result in extreme mental disability are extremely rare. Blindness and deafness caused by measles are much more likely to be seriously debilitating. Furthermore, autism is never fatal.
The crisis over the MMR vaccine is gradually beginning to resolve itself, albeit in a rather upsetting way, as an epidemic of measles among schoolchildren is frightening parents into getting their children immunised regardless of their former hesitations. The tragedy is that so many children have had to suffer in order to get the message across, simply because two generations had lived almost entirely free from dangerous infectious diseases, and had forgotten how horrific they could be. This is why it is essential that governments work harder to provide good general education with regard to such matters, and to anticipate these crises so that they are properly prepared to handle them.
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Last updated 7th December, 2005