Dr John Crippen: A fair contribution at the point of entry

Dr John "Crippen", of NHS Blog Doctor, is a full time family doctor working somewhere north of London. He is grateful to Wat Tyler, of Burning Our Money, for detailed advice on health care finance.

Free at the point of entry? Free at the point of need?

The newspapers highlighted the tragic case of a young women, aged only 26, who died recently of bowel cancer. Assisted by family and friends she spent the last few weeks of her life begging and borrowing money to buy a private prescription for Avastin, a drug that her PCT (Primary Care Trust) would not fund.

Examples like this are legion. They make excellent journalistic copy. They are the tip of an iceberg that no politician to date has been able to acknowledge.

The facts are simple.  No country can afford to provide its citizens with all that modern medical technology has to offer.

Britain has been the health care miser of Europe, spending less than 7% of GDP on health. Tony Blair pledged to match the European average of 8%. We duly increased our expenditure from 7% to 8% of GDP but by the time we got there, the European average was over 9%. It is a moving target.

And who is to say that Europe has got it right? The USA spends a massive 15% of their GDP on health.

The total world health care spend is currently $3 trillion. For those who like their noughts, that is $3,000,000,000,000. It gets worse. Health care is the world’s largest industry, bigger even than defence, and it is growing at twice the rate of the world GDP. By the year 2100 it will account for…everything. The total world GDP will be spent on health care.

The choice is ours.

We can take control. We can abandon short-termism. We can stop tinkering around the edges. We can look at the radical changes that are needed to control this modern Leviathan.

If we do not take control, decent health care will eventually only be available for the rich. The seeds are already sown. It is happening in the USA. It is beginning to happen here.