Why Andrew Simms is a lying scumbag

The latest of the NEF Mythbusters has Andrew Simms talking about health care costs.

He uses this chart:


And then says that if we have markets in the NHS then we will inevitably move out to the US position.


Hmm. Actually, as you can see, the NHS is below that trend line. We\’ve a worse money/lifespan trade off than the average. Which means that the NHS is, for whatever reason, less efficient than the average system (and that average does indeed include that horrendous outlier of the US).

Which means that perhaps we might want to think about which systems provide better than average outcomes and try to copy them?

Roughly the same information presented in another manner:


Now, eyeballing that we can see that Spain has a better trade off than the NHS does. Australia and Sweden do. New Zealand does.

Hmm. Anything we can say about the health care systems in those countries? Could it be that they all have internal markets in them? A mixture of state, charitable, for profit private providers?

Would that be why Andrew Simms hasn\’t bothered to label most of the countries that are above average in his chart? Because, you know, he\’s a lying scumbag?

And if we are to take efficiency of health care spending as being our guide, shouldn\’t we thus be copying Singapore? Which, roughly speaking, tells you to deal with your own fucking health care out of your savings. Only if you\’ve got something seriously wrong, cancer, been scraped up off the road after a car tramples you, that sort of thing, does the government then pay for you.

But no, obviously better to scare the bejabbers out of everyone by lying to them.

Well done Mr. Simms, well done.

58 thoughts on “Why Andrew Simms is a lying scumbag”

  1. This is just about the biggest problem with discussing healthcare in the UK: people who cannot conceive that there are other ways of doing it besides the US and British systems, whereas the true issue is that both are ghastly, and there are much better ones existing in the world.

  2. The only decent thing ever put into effect by British politicians was the National Health Service. A rarity – ‘apart from natural catastrophe, all the bad things that happen to mankind are caused by politicians.’

  3. What’s odd is that he actually publishes the evidence that shows that the NHS is not the most efficient health care system in the world, and that other systems are demonstrably “better”, and yet doesn’t seem to suspect that his readers will be able to work that out for themselves.

  4. “The only decent thing ever put into effect by British politicians was the National Health Service”: but they did it in such a stupid way – contrast it with the better overseas alternatives.

    To be fair it may be that it was cocked up because the Labour Party was so late to adopt the policy of having an NHS – later, that is to say, than the Conservatives and Liberals – so that it presumably hadn’t been remotely thought through within The Party. Or maybe it was just that Bevan was a dim, Stalinist ragbag. Dunno: it was before my time.

  5. @John Problem

    John, do you work in the NHS? It seems to exist mostly for the benefit of the employees, after all.

  6. On the basis of the NEF chart, we should go to the Japanese system – which is universal insurance + competitive non profit providers. Except we know that life expectancy is not just a result of healthcare. The Japanese are busy rejigging their system too.

    The NHS does a pretty fair job in general and a very good one in others – it is lousy in some areas. Could it improve? Yes. Will the reforms bring improvement… not so much.

    NEF veracity: low

  7. Anyone fitting a trend line, especially a linear one, to that chart, should have painful things done to them.

  8. To judge from a posting below ,there is not much hope of British business paying a living wage, even when bribed by Ed Millibands’s scheme apparently,so how are people to pay Singapore style for their own” fucking health care out of savings?” British business should thank their lucky stars for the NHS otherwise they would have to pay their workers enough to cover BUPA fees, and at the farthest reaches of free market fantasy,school fees and private fire insurance (the type where you pay your insurance but get burned out by your uninsured neighbours setting the whole street on fire). Stroll on!

  9. I don’t think we know how much the UK spends on healthcare.

    We may know what the NHS spends but we don’t know what it spends on healthcare.

  10. @DBC Reed

    You must have missed the bit where A&E and cancer are dealt with by the govt?

    If the major things are taken care of, the price of health insurance would be fairly low – anyone who smokes* could afford it, for instance, and ironically would be less likely to need it.

    *I know it’s illiberal of me not to want to pay for everyone else’s B&H/Golden Virginia.

  11. I wonder if healthcare spending has much correlation with life expectancy.

    Drains, clean water, diet, education, feminism, education, lifestyle, pollution, family circumstance, grandparents, choice of vacuum cleaner, the weather at time of birth are all confounding variables and probably still more important than waiting times at A&E or whether you go private or not.

  12. Of course we are assuming that the biggest correlation is between life expectancy and health spending. The average diet in the UK and US does not compare favourably with those of many nations. There is an argument for diverting some health spending towards education to improve diet and lifestyle. more money

  13. Interested

    “If the major things are taken care of, the price of health insurance would be fairly low”

    The problem is how do you decide what the major things are and who makes the decision ? It’s usual to reference cancer here because it’s what most people are afraid of, yet there are many other debilitating and expensive conditions, I should declare an interest here as I have one of them. Once you accept that the state will be paying for some major illnesses then it becomes hard to deny that payment for others.
    Which is not to say that the NHS is the solution, I was discussing this yesterday with a family member who works for the NHS and went some way to persuading her that nationalising health had been a mistake.

    Tim adds: The usual way of dealing with this is to say, well, go get your treatment. And if it costs more than 10% of your annual income then the govt will pick up the tab.

  14. @Thornavis

    Yes, understood. We could look at it the other way by excluding things, or we could have a list (aaarrrggghh) of definites, maybes (to go to some sort of committee (aaarrrggghh, again, but I can’t think of any other word) and nos; it wouldn’t be simple, and there are obvious issues with Tim’s percentage of income approach too, but the current NHS has quite a bit of bureaucratic fat which might be trimmed out of it and applied to this question.

    The bottom line, it seems to me, is that the NHS has become an employer rather than a health service, it’s hugely expensive, not all that efficient and can’t really go on like it is.

    That and the pensions system are going to kill us all if nothing changes.

  15. DBC Reed: Bog-standard socialist bollocks.

    If your leftist crap was worth tuppence then those great shitholes the USSR, North Korea and China under Mao would have been paradises of health care–instead of the fucking Soviets rushing to German santoriums during the Hitler pact rather than take a chance with Soviet “care”.
    Chris Mounsey some years ago costed private healthcare and unemployment insurance for himself and found both of them cheaper and better value than the states thieving despite being a small market because most can’t afford private after the state rip-off.

    As for the NHS James Bartholemew notes in his book (The Welfare State We’re In) that the founding of the NHS was not attended by legions of claims that ordinary people were not getting medical care or were getting poor medical care pre-welfare state. The only complaint raised was a 6 week waiting list for Rhuematism treatment. Rather the left peddled the line that the system of private and charity mxed was “unplanned” and would be much improved by central planning.

  16. Well said, Mr Ecks.

    And DBC Reed forgot that if we had the money that the state steals from us in taxes, we ‘d have the money to pay for all these things.

    (And if he doesn’t agree with that, how does he think the government is paying for it?)

  17. @newboilerman
    Interesting how you lump the UK & the US together. My, agreed limited, experience of US cuisine – staying in an Italian-American household in Brooklyn was of a diet not much different from the Mediterranean supposedly so advisable. The time we were guested out it was Vietnamese home cooking. Then there’s been a couple of American girlfriends, over this side. One Mexican-American one of Polish ancestry. I always thought tacos or stuffed cabbage were healthy eating. So what exactly is the US diet that’s supposed to be so lethal?
    The UK I’ll give you. The Brits know FA about food & FA about cooking. The native passion for Indian, a cuisine that doesn’t actually exist, says everything. But what is the country supposed to do apart from getting a new population? (Although, to be fair, it is attempting to do exactly that)

  18. Don’t forget that arguing with an NHS proponent is rather like arguing with a Religious fanatic – indeed its arguably that in the increasingly secular UK, the near – universal acclamation for it as ‘the envy of the world’ is the closest thing the country has to a state religion.

    The reductio ad absurdum of this was when attempting to argue with a colleague of @RichardJMurphy’s and postulating that the Norwegian healthcare system might be worth examining as a potential model to emulate, I was told that anything other than total state control ‘verged on the fascist’. A label which my correspondent confirmed could be applied to Denmark, Sweden and Finland as well. No doubt any denizens of those countries on this blog will be pleased to know that the admiration they received from the likes of Toynbee and Murphy is no doubt tempered by disgust at their valuing pragmatism over ‘pure’ ideology.

    I am surprised that anyone is expressing amazement that the latest ‘Mythbuster’ is anything other than an exercise in misleading statements that would have warmed the heart of the late Joseph Goebbels – what did you expect? Don’t forget also that Murphy’s paper in this series has yet to come – I, for one, cannot wait….

  19. @BiS

    I accept that US home cooking can be everything you sy that it is. However, did you ever eat at a restaurant, or even buy a sandwich at a lunch counter? A ham sandwich is 2 slices of bread with a whole pig between the bread slices. A normal restaurant portion contains enough nutrition for one person for an entire week. I worked out that starters are about the same size as a large european portion of food. Eventually, I just ordered off the child’s menu.

  20. Don’t forget that arguing with an NHS proponent is rather like arguing with a Religious fanatic – indeed its arguably that in the increasingly secular UK, the near – universal acclamation for it as ‘the envy of the world’ is the closest thing the country has to a state religion.

    The other is British television. Get into an argument with a fan of British television, and you hear how Casualty running uninterrupted for 20 years reflects well on the BBC; that Britain leads the world in “costume dramas” (as if any other nation gives a fuck); and that British television is “far superior” to that of any other country – but only the BBC and locally produced stuff, what’s on Sky doesn’t count because they only buy stuff in and don’t produce stuff in-house.

    I must say, I’d be more convinced that British television – and the NHS, for that matter – was so good that foreigners actually praised it, or at least foreigners who aren’t from African and Asian basket cases.

  21. @Diogenes
    Would a refugee from Jewish East London in NooYawk resist the opportunity of arguing the correct spelling of beigel at a deli counter. But FFS, what’s the problem? Have you done nouvelle cuisine? Mice could starve. What’s wrong with VFM? There ain’t some guy with a gun to your head insisting you eat it all. Well only in Jersey.

  22. Tim N, I second two of your thoughts. First, that there are places other than the US and the UK we can look at (no idea what we would conclude, but we could at least look).

    Second, British TV, or anything else in which British xxx (insert your own, TV, Army, NHS, advertising, oil standards) are the best. Not knocking any of the above, or other examples, but with (Wikipedia) 193 UN member states, it is quite difficult to be the best at anything. Not that we should be defeatist, just acknowledge that in any field, there is probably at least one country worth plagiarising.

  23. >The other is British television.

    The BBC and the NHS are the two British institutions that I loathe so much I can barely prevent myself from frothing at the mouth. The BBC isn’t very important in the big scheme of things, and the NHS is fairly important, but there are still other things that it would be more important to abolish first if I were suddenly dictator. Still, though…

  24. What that chart tends to suggest is that:

    – for per capita healthcare expenditure above $2000 there is little or no correlation between expenditure and life expectancy

    – countries with expenditure below $2000 tend to have lower life expectancy. (This need not be cause and effect: poor people generally have lower life expectancy.)

    – healthcare in the USA is stupidly expensive.

    If we can’t detect from these data a benefit from spending more money, it’s implausible that we could detect a benefit from adopting a different healthcare structure.

    So, other than telling us we don’t want to be like Hungary or the USA, there’s nothing to see here.

  25. @boilerman

    If it’s all the same to you, I can do without more of my money being funnelled to people who want great big fuckoff research grants and PR budgets so they can tell us that eating fresh fruit and jogging is healthier than eating cake and smoking.

    People in this country who live unhealthy lifestyles do so because they’ve chosen to. Not because nobody has told them about the alternatives.

    Too much of our money is already spent nannying us about our lifestyle choices. It’s a load of old cock. Most people, it seems, would rather 75 years of good living, than 80 years of salad. This fetishising of life expectancy needs to stop. Everybody dies.

  26. @Micheal Jennings:

    The BBC and the NHS are the two British institutions that I loathe so much I can barely prevent myself from frothing at the mouth.

    Why deny yourself?

    I don’t.

  27. @Bis

    you were the one who brought up the “unhealthy” diet meme.

    No, you do not have to eat it all but, were you never given hell by parents for not eating all your food, as a child? That guilt still applies to me. You give me 4 times too much food! Just cut down on the portion sizes…..feed the world

  28. We also have an endpoint fallacy here, since health is rather more than just life expectancy. A long life missing a leg (or other organ) is worth less than one with. Heck even missing a few teeth is worth a major reduction in quality of life.

  29. Bloke in spain, my experience of American cuisine was not as good as your. Admittedly it was limited to just Florida, but I see a wider range of different types of food in the UK than over there.

    One experience was quite telling. We holidayed near the end of the season, and when we popped into a TGIFridayI the waiter was surprised when I asked for the optional broccoli to go with my fish. This was the first time he had someone order that all season.

  30. As for the health system in Australia you can expect up to a year on a waiting list for joint replacement, doctors with indifferent english and barbaric attitude to suffering (“not my department”) And a churn them attitude in the emergency department.

  31. I’m glad I live in Japan *smug*. The health system seems to work fairly well here. Hospitals are clean, modern and well equipped. Staff are friendly and helpful. It’s no problem getting to see a local doctor. My dentist did an amazing job re-building a busted crown. Cheap too.

  32. SMBL
    My experience, visiting a country for a short period like a holiday gives very little idea what the locals eat. Spain, where I am, is a very good example. We shop & eat either Spanish or it’s South American variant. It’s food we see in the small, cheap back end of town restaurants we prefer but much less in the places tourists eat. Occasionally I take LaC to a “just like home cooking” Britcentric place for the comedy value.
    The vile stuff is part of the reason my last indigenous Brit g/f was somewhere in my mid 20s & I married a foreigner.
    On the other hand, like TTG & others, sod all this 5-a-day, state sponsored diet terrorism. The fundamental problem’s too few women in the UK learn how to cook (& as a result too few Brits know how to eat*), so it’s not going to make much difference what ingredients you force on them.

    *Difficult to explain that one. It’s to do with the way the palate’s educated. Bringing kids up on spaghetti hoops & fish fingers & the rest of it encourages a taste for bland, over-sweetened food.

  33. You think you ‘v egot it bad – my liberal friends see that and think we (the US) should jump over to a UK style healthcare system.

    The ignore Switzerland, Australia, and even Singapore since those are *more* free market than what we have over here – and really that’s what bothers them, the “free market” part.

  34. Diogenes // Apr 29, 2013 at 5:35 pm

    I can attest to the “large” portion sizes – I am not a small man (6’1″ and, uhm, over 200 lbs) and I can not finish a meal at most restaurants.

  35. And I’m lucky – where I live I can afford to jump across the border to Mexico for minor stuff which I pay cash for at a 1/4 or less the cost of seeing an American doctor.

  36. And I’m lucky – where I live I can afford to jump across the border to Mexico for minor stuff which I pay cash for at a 1/4 or less the cost of seeing an American doctor.

    Heh! I was wondering where this was all heading until the final word. 🙂

  37. Heck even missing a few teeth is worth a major reduction in quality of life.

    But you have to take into account the improved banjo-playing abilities which serve to compensate.

  38. Mr in Spain, I must say I appreciated your comment about too few women in the UK learning how to cook. The fact that everyone else ignored it made me grin even more.

  39. I know it’s a fallacy but, primarily from my experience of friends and acquaintances, there is a line that goes something like ‘You’re born with either a 50 year body or an 80 year body’, and no matter what – diet, lifestyle – this is your destiny. That said, diet and lifestyle will probably impact heavily on your quality of life during your last decade. I guess you have to ask yourself whether the effort and self-denial is worth it. “If I knew I was going to live this long …”

  40. @Mr Ecks
    Many thanks for providing me with a testimonial to shore up my left-wing credibility. “Bog standard socialist bollocks” should do nicely, for someone who wanders off into such dodgy areas as LVT and democratising the creation of money.
    None of the comment here, mainly concerned with food and television!, deals with the substantive issue: that the British private sector cannot circulate enough in real wages to cover people’s food , rent and mortgage bills let alone BUPA. Have n’t you heard of working tax credits by which the State (watch out for the knock on the door in the small hours!) subsidises employers to pay crap wages. Just like the Speenhamland system (not that the techie clientele on here work in a historical dimension).
    BTW if you abolish most taxes in the UK, house prices will go up as a private tax on residential land values.So there you go.

  41. BiS & Lud,

    The point about teaching kids (not just girls) how to cook is not lost on me. I know how to cook, my mum taught me well when I was very young. Plus supplied me with loads of recipe sheets for my time in Uni. My wife isn’t too bad, but I dread what kids now-a-days are being taught. The stories we heard from our nieces about cooking involving the making pizza and other simplistic stuff just horrified us.

  42. Surreptitious Evil

    Mr in Spain, I must say I appreciated your comment about too few women in the UK learning how to cook.

    I do the cooking because my mother-in-law taught Mrs S-E nearly everything she knows about cooking.

    Making a decent pizza is actually quite an extensive exercise, particularly with the base (one I personally don’t bother with). Merely heating one is triviatics.

  43. “Plus supplied me with loads of recipe sheets for my time in Uni…”
    It’s a start. But cooking’s a bit like a language. Its techniques are like a grammar. The ingredients are the words & the herbs n’spices, punctuation. Once you have the technique you can borrow ingredients from other cultures & even compose entire sentences in foreign cookery.

  44. Most UK-ites were never taught to cook, they were taught to heat food through. For just long enough at just high enough a temperature to make sure the meat is tough but colourless all the way through.

    This led to an incident recently of a visitng pensioner relative of mine sending back the best pork loin chops they would ever have had (German cuisine does excel at one or two things – ok, one thing) because they correlated an extremely mild central juicy sanguination with not being properly cooked.

  45. @ #49 DBC Reed
    When I was a young graduate on £1100 p.a. I could afford to take out a BUPA subscription to make sure that if I needed some treatment I could have it scheduled to avoid my professional exams. I did feel slightly guilty because my family had taken a decision in 1948 to support the NHS and quit BUPA when I stopped taking exams
    You claim that is impossible for people paid more (even after adjusting for inflation) than I was to afford BUPA. NO. They just don’t want to do so. They prefer to spend their money on other things.

  46. @ #53 JamesV
    When you say “Most UK-ites were never taught to cook” are you limiting UK-ites to boys attending state schools? In my day basic cooking was required of public schoolboys and most mothers taught their daughters to cook (a minority also taught their sons).
    However a standard warning was that pork needed to be cooked thoroughly so your pensioner relative may have been responding on the basis of stuff drilled into him/her by the Ministry of Food in the 1940s.

  47. @ #18 Mr Ecks
    Prior to the foundation of the NHS, there was a lot of health provision by charities and by facilities funded by Friendly Societies and the like but that did not provide universal coverage. The low level of complaints may reflect the differential between what people expected and what they received rather than between what the Guardianistas now expect and what people received in 1947.

  48. John77: The complaints or lack of them did not come from the ordinary British person but from the Socialist advocates of what was to become the NHS–ie the Labour Party in their 1943 pamphlet ” National Service for Health”

    DBC Read–The classic socialist sneer. A man is happily doing his job, you run up, kick him in the balls and while he writhes in agony on the ground you stand there shouting “This bloke is a fucking waster–he’s not doing his job, etc,etc”
    The vile scum of the state thieve half the country’s income, urinate most of it against the wall, debase the coinage, meddle endlessly in economic matters, pass bullshit laws that cause huge misallocation of wealth and generally turn the nation into a statist/socialist/corporate socialist shithole and then you label this mess of your own turds as “capitalism” and complain that it is all fucked-up?.

  49. nef has now deleted all the posts pointing out that Andrew Simms is wrong while maintaining his original post.

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