The United Kingdom’s National Health System is one of the most prominent socialized health care systems in the world. It’s also falling apart because of the way it taxes doctors — in more ways than one.
According to a report last week in the U.K. Daily Mail, 585 “surgeries” — the word used in the U.K. to refer to doctors’ offices — have closed over the past six years, affecting 1.9 million British patients.
That number is accelerating, too. In 2013, only 18 surgeries shut down. Last year, the number was 138, with the closures affecting 500,000 patients, the Daily Mail reported.
Overall, the NHS lost 441 general practitioners in the past year. As September, according to a U.K. Guardian report, there were 11,576 vacancies for doctors in the system.
So, what’s responsible for this? It’s not just the fact that there are fewer doctors for an aging population, leaving long wait times for appointments and overworked general practitioners. It’s also the fact that a tax designed to soak the rich has instead been soaking the doctors.
“The [British Medical Association] has warned that growing numbers of GPs and consultants are taking early retirement or cutting back on work to avoid hefty pensions taxes which make it uneconomic to continue practicing,” the Daily Mail reported.
“Retiring GPs often create a domino effect by leaving remaining colleagues with more work, who in turn become demoralized and quit. The problem has been compounded by the fact that more doctors are now working part-time.”
Conservatives say no one should be surprised.
As Ben Johnson, a senior editor at the Acton Institute for the Study of Religion and Liberty, a Michigan think tank, wrote in a piece at the Foundation for Economic Education, the system itself — “a Byzantine labyrinth of rules and regulations impossible for most people to navigate” — makes the result inevitable.
Because of the sytem’s requirements, he wrote in an aritcle published Saturday, doctors who don’t retire could end up actually paying the NHS to work for it.
“In brief: NHS doctors have no choice about whether, or how much, to contribute to their public pension. Physicians must contribute up to 14.5 percent of procedures deemed ‘pensionable pay,’” Johnson noted in an article published Saturday.
“Citizens may also have a private pension plan. But since deposits are tax-deferred, the government slashed the annual limit on contributions from £255,000 ($323,244) in 2010-2011 to £40,000 ($50,705) in 2014-2015. There is also a lifetime pension limit of £1,055,000 ($1,337,344).”
Here’s a longer explanation of the problem from one of the people affected by it:
“To further complicate matters, a penalty kicks in on anyone earning an ‘adjusted income’ of £150,000 ($190,143) annually — but that amount includes earnings and any growth in the pension plan (which is impossible to foresee),” Johnson wrote.
“That can cause doctors to exceed government-mandated caps and see their income taxed at 40 to 45 percent. In some cases, they end up paying the NHS to work.”
So, the end result is simple: They don’t work.
Of course, this is just one country and involves a very specific problem, but it emphasizes the general issues surrounding socialized medicine.
Government bureaucrats simply cannot effectively manage the health care, employment and retirement decisions of millions of individuals patients and physicians — not in the United Kingdom, population almost 67 million, and not in the United States, population almost 330 million.
And then there’s the fact that high taxes are necessary to keep schemes like the NHS afloat. The system’s cost has risen to over 7 percent of GDP from under 3 percent in its early days, according to the U.K. health think tank the Nuffield Trust. Even with that, the NHS is facing significant shortfalls — and part of the problem is the fact that its running a deficit due to lack of staffing.
“An underlying deficit of £4.3 billion ($5.45 billion), driven in part by reliance on expensive agency staff, does not point to a robust or resilient health service,” Tom Sandford, director of England’s Royal College of Nursing, said last year, according to the Guardian.
This isn’t even going into what happens if the NHS deems your cataract surgery “non-essential” or other fun stuff like that. American health care may not be in a particularly great state at the moment, but it’s not because of lack of statist intervention.
If you don’t believe me, just look at the doctors in the U.K. who are throwing in the towel because they’re overtaxed in multifarious ways — all at the same time the country desperately needs more of them.
Truth and Accuracy
We are committed to truth and accuracy in all of our journalism. Read our editorial standards.