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William Beveridge: His 1942 report recommended the foundation of the NHS

Jim Buchanan, who won the 1986 Nobel Prize for Economics and who died earlier this year, once made a very curious remark to me. "I really admire your National Health Service," he said. Not in itself curious, perhaps, but from an American economist, sometimes described as "Chicago School" this regard for "socialised medicine" seemed odd. When I asked him why he admired it, his reason was even odder: "Because it kills people," he said.

Though there was an element of Swiftian irony about this comment, it was not mere sarcasm. Jim was at the time an elderly man and philosophically he was a utilitarian. What he meant was that in the NHS decisions are taken about priorities which take into account many criteria, including "quality of life", whereas programmes in the USA are based on the assumption that, if you are entitled to medical care at all, you are absolutely and equally entitled to state-of-the-art treatment. The economic consequence of this is that the US spends the same proportion of gross domestic product on Medicare, which primarily serves the over-65s, as the UK spends on health.

Actually, until I became a pensioner my personal interest in the health service was cheerfully minimal. I was a healthy chap from healthy stock who had literally never missed a day's work in his life. (OK — I was an academic, so read this as meaning I always turned up for things I was supposed to turn up for.) My most serious problems were sporting injuries and it was one of these which started my present saga. A chronic shoulder injury required surgery. The pain after the operation was worse than expected and an iceberg tip of evidence emerged which led to further tests and the discovery that I had a "teeny weeny" bit of prostate cancer as the nurse kindly put it (though the pain and the discovery were not directly linked). And then further tests which discovered other problems "down there" (I have an image of Les Dawson mouthing these words as I write them).

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