[Suggestion: watch this full-screen in HD!]
According to the National Bureau of Economic Research, the Great Recession ended almost two years ago, in the summer of 2009. Yet we’re all uneasy. Job growth has been disappointing. The recovery seems fragile. Where should we head from here? Is that question even meaningful? Can the government steer the economy or have past attempts helped create the mess we’re still in?
In “Fight of the Century”, Keynes and Hayek weigh in on these central questions. Do we need more government spending or less? What’s the evidence that government spending promotes prosperity in troubled times? Can war or natural disasters paradoxically be good for an economy in a slump? Should more spending come from the top down or from the bottom up? What are the ultimate sources of prosperity?
Keynes and Hayek never agreed on the answers to these questions and they still don’t. Let’s listen to the greats. See Keynes and Hayek throwing down in “Fight of the Century”!
Suffice to say, I’m with Hayek…
(H/T: Davy at The UK Libertarian)
The healthcare systems of Europe can be classified into two distinct models: the Bismarck model and the Beveridge model. Bismarck systems have been described as a “social insurance” model. In these systems, there are multiple different insurance organizations that exist and compete with one another. These insurers are organizationally independent of the healthcare providers in the country. Under the Beveridge model, the financing and provision of healthcare are handled with-in one organizational system. Financing bodies and providers are either wholly or partially contained within a single organization. Britain’s National Health Service, the Nordic countries’ medical systems and Canada’s Medicare system are all examples of the Beveridge model.
Throughout the history of the ECHCI, healthcare systems based on the Bismarck model have been shown to outperform the Beveridge systems. The larger Beveridge systems—Canada, Italy and Great Britain—have consistently been ranked near or below the middle of the indexes. These results strongly suggest that the separation of insurers from providers and the provision of consumer choice are important principles for the development of high-performing healthcare systems—especially in medium- and large-sized countries.
The top-line results of the 2010 index were as follows (p14):
Despite all of the additional billions of pounds that has been sunk into the NHS over the past decade, in terms of the customer perspective the UK resides only 17th in the list of nations compared; indeed of the ‘big’ EU countries only Spain falls below us.
Is it worth pointing out that Netherlands (#1), Germany (#2), France (#4), Switzerland (#5); Austria (#6); Luxembourg (#8) and Belgium (#10) – i.e. 7 out of the top 10 – all have ‘Bismarck’-type healthcare systems?
While I agree with those people who are loudly proclaiming that we need to ‘save our NHS‘, based on the results above I would strongly suggest that they may well be looking in completely the wrong place for the solution…
UPDATE: Dr Michael Fitzpatrick asks “Save our National Health Service? Why, exactly?” over at Spiked:
I have generally found it a useful rule of thumb in medical politics to assume that if the British Medical Association (BMA) opposes something (like the NHS in its first decade), then there must be something good about it. If, on the other hand, the BMA has decided to campaign for something (like coercive measures against smokers and drinkers), then it is unlikely to be worth supporting. Now that the BMA has come out against the Lib-Con reforms, I have to look again to see if I have overlooked some progressive content.
Here’s a healthcare-related story to smile about:
Researchers at Osaka University in Japan set out to determine whether music and laughter interventions would reduce blood pressure in one of two situations: immediately after listening to music or laughing and after three months of one-hour interventions that took place once every two weeks.
The scientists signed up 79 people between 40 and 74, who were randomly assigned to one of three groups. Thirty-two listened to music, 30 were assigned to a laughter group, and 17 neither listened to music nor participated in laughter sessions.
After three months, researchers say blood pressure significantly decreased, by nearly 6 mmHg, among those who listened to music. It decreased by 5 mmHg among those who took part in sessions designed to make them laugh.
When put in the context of ~10 mmHg blood pressure reductions observed with pharmaceutical monotherapies, shouldn’t we perhaps be prescribing music and laughter for those with mild to moderate hypertension?
Including these ‘therapies’ would at least make new Phase III hypertension clinical trials more fun wouldn’t they…? 😉