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Notes -
British healthcare is not run excellently: https://www.thetimes.co.uk/article/maternity-payouts-twice-cost-of-care-times-health-commission-svdhsjhqk
https://unherd.com/2020/09/lets-be-honest-the-nhs-is-awful/
https://www.themotte.org/post/829/friday-fun-thread-for-january-12/178889?context=8#context
If the country was governed well, everything would improve, health included. There are ways to do more with less. They could've managed HS2 properly for one thing. And when was the bureaucracy replaced?
They can’t manage HS2 properly for the same reason that California can’t built HSR or that infrastructure projects in all Anglo countries cost 5x as much as they do anywhere else, namely common law and restrictions on eminent domain that allow more challenges and more legal action. Only parliament can solve it but they don’t want to because the people don’t want it; Boris Johnson proposed planning reform and people in deep-blue Tory constituencies flipped to the Liberal Democrats in protest at the idea that local small town councils would no longer be able to veto any construction. Not really a bureaucracy problem.
The NHS is awful because the UK spends much less, both absolutely per-person and as a proportion of GDP, than other wealthy nations. Everything is done at the cheapest price, because of the tax/spend conundrum I discussed. The people won’t accept more taxes and won’t accept privatization, so there it is. Again, it’s a people problem, not a state problem. The compromise that the UK has (mediocre public services and moderate taxation levels) is one the public have selected. There are no administrative solutions, no magic sauce in the bureaucracy that can fix it. It’s just basic math. Either taxes go up or services get worse, the public will accept neither.
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