May an expat weigh in on the future of the National Health Service in Scotland (Poll:
NHS is the key to win female vote for Yes, News, August 17)? The health service is the last that should be a for-profit enterprise.
The United States is a stark and sobering case study of the pitfalls of privatised medicine. We spend $9000 per capita on healthcare, by far the highest in the world. In 2012, total health care expenditures were some $3 trillion, fully 17.5% of the total US gross domestic product. Yet we rank abysmally low globally in terms of life expectancy (50th of 220 countries worldwide and, more significantly, 27th of the 34 advanced industrial nations). The US leads the developed countries in incidences of heart and lung disease, infant mortality, and sexually transmitted diseases. In all, the world's richest nation suffers at least 50,000 unnecessary deaths per year simply through inadequate healthcare provision.
For upper-income Americans, healthcare is excellent, in terms of available screening, diagnosis and treatment. The reason for the glaring gap between money spent on research and treatment and the population's state of health is the lack of affordability of healthcare for lower-income families (by some measures, 40% of Americans are uninsured or under-insured, and President Barack Obama had a long, bitter fight to bring in what is mockingly referred to as "Obamacare" - the Republicans are committed to overturning it). This lack of fairness and access is inevitable in a system geared to maximising profits over quality of care.
The commitment to a social contract that is under dire stress in England, and to which the Scottish Government seems committed, is a compelling reason to vote Yes. I say to Scots: be afraid, be very afraid, of a for-profit health system.
David C Speedie
Senior Fellow
Carnegie Council for Ethics in International Affairs
New York
Why are you making commenting on The Herald only available to subscribers?
It should have been a safe space for informed debate, somewhere for readers to discuss issues around the biggest stories of the day, but all too often the below the line comments on most websites have become bogged down by off-topic discussions and abuse.
heraldscotland.com is tackling this problem by allowing only subscribers to comment.
We are doing this to improve the experience for our loyal readers and we believe it will reduce the ability of trolls and troublemakers, who occasionally find their way onto our site, to abuse our journalists and readers. We also hope it will help the comments section fulfil its promise as a part of Scotland's conversation with itself.
We are lucky at The Herald. We are read by an informed, educated readership who can add their knowledge and insights to our stories.
That is invaluable.
We are making the subscriber-only change to support our valued readers, who tell us they don't want the site cluttered up with irrelevant comments, untruths and abuse.
In the past, the journalist’s job was to collect and distribute information to the audience. Technology means that readers can shape a discussion. We look forward to hearing from you on heraldscotland.com
Comments & Moderation
Readers’ comments: You are personally liable for the content of any comments you upload to this website, so please act responsibly. We do not pre-moderate or monitor readers’ comments appearing on our websites, but we do post-moderate in response to complaints we receive or otherwise when a potential problem comes to our attention. You can make a complaint by using the ‘report this post’ link . We may then apply our discretion under the user terms to amend or delete comments.
Post moderation is undertaken full-time 9am-6pm on weekdays, and on a part-time basis outwith those hours.
Read the rules hereComments are closed on this article