Praesidium

Sunday, September 02, 2007

NHS and Postcode Lotteries, Again

This is becoming a recurring theme (e.g. here, here and generally), but while regional differences in NHS provision may violate the principle of generic consistency, postcodes aren't a lottery. Nonetheless, BBC are repeating the fallacy again.

In fact, since you can change where you live (like religion, but unlike skin colour), it could be argued you can move to reflect the healthcare provision you desire (or require), although this might lead to local NHS decisions affecting house prices - which would be like allowing rich parents to buy good school places through purchasing houses in local catchement areas (see the Brighton case).

If postcodes were assigned by lottery, then this would seem a perfectly rational way of rationing scarce treatment/drug supplies. As it is, if we want to end the unequal treatment of people with the same conditions, it seems our only option is to do away with decentralized decisions, so the same NHS policy applies to everyone.

It seems those bringing this challenge don't even understand the notion of scarcity. "The Department of Health said... [trusts] should not refuse to pay because a drug is too expensive." So, if it would cost the NHS £20 million to keep me alive - albeit poorly - for an extra six months, is that something they should do? You could buy Fernando Torres for that...

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