Minette Marrin ranted absurdly against Michael Moore’s new film Sicko, in the Times Online.

Apparently, Michael Moore made the unarguable point that the NHS is free. (Well, almost free, except for prescription and dentistry charges) Free at the point of delivery. Provided according to need, not according to the ability to pay. That’s the principle.

For the benefit of Americans, that means, for example, that you don’t face bankruptcy at the same time as major illness.

Being sick is bad enough in itself, surely. Free access to competent medical treatment isn’t just one of the best candidates for recognition as a universal human right. It even makes perfect common sense socially, given that the healthy aren’t normally mad-keen to catch TB from the untreated poor.

The infinite superiority of free medical care was made eloquently clear by Richard Titmuss decades ago in The Gift Relationship: From Human Blood to Social Policy , original updated 1997, LSE Books.* Titmuss showed that the properties of altruism and social responsibility, on which UK blood banks depended, actually produced a product – blood for transfusion – that was of better quality than that available from US blood banks. (People who sold their blood tended to be hungry, diseased, alcoholic and/or drugged. People who willingly gave blood tended to be healthy. Well, d’uh.)

Moore seems to be making a similar, but updated, point that free healthcare is better for the vast majority of consumers, is cheaper and more effective. (We are English. We aren’t supposed to need telling that.)

It’s hard to see how free health care could seem like a bad thing to anyone except the executives of medical insurance companies. (Not even to doctors, given that they do pretty well out of the NHS and can also run unfeasibly profitable private practices.)

In England, we complacently take the National Health Service for granted. We whine constantly about specific local problems. Plenty of people (including us) rant about crazy high-level decisions to spend billions on computerising bits of it. But, we genuinely cannot imagine what it would be like to live without it.

Well not so Minette Marrin. Her piece has the title “Quack Michael Moore has mad view of the NHS“

Quack? So Michael Moore’s film is peddling crystal aromatherapy for cancer then? I assumed from the reviews that it was about the horrors of US healthcare and the merits of alternative ways to provide it. Silly me.

She claims that Moore showed a rosy view of the NHS, apparently by showing a clean and efficient hospital.

You would never guess from Sicko that the NHS is in deep trouble, mired in scandal and incompetence, despite the injection of billions of pounds of taxpayers’ money.

Well, I can only assume that her definition of “deep trouble” is subtly different from mine. Even without referring to years of targets- and cost- and privatisation-driven policies that have been imposed on the NHS (spot the misdirection, yes, I did mention them) I would say that the NHS may face a few problems

These tend to be problems talked up out of all proportion by a biased media, but, wait, that’s what she’s accusing Michael Moore of doing.

Nothing undermines the principle that our NHS is so superior to the US health care system that it can look mockingly over its shoulder at US healthcare and say “Call that a health care system?” Then give a sarcastic laugh.

Even Minette has to acknowledge this, after she’s brought up a selection of NHS failings: prevalence of hospital infections; loss-making NHS trusts and GPs who don’t provide out of hours healthcare.

None of these problems mean we should abandon the idea of a universal shared system of healthcare. It’s clear we would not want the American model, even if it isn’t quite as bad as portrayed by Moore.

I think that is too grudging and it’s way too late to unsay what she’s already said.

The issues she mentioned are all issues of policy. They do not in any way relate to the wider principle of free universal health care. It’s as if Micahel Moore said he liked your house. You say “I hate it”, listing things you hate – like the creaking doors – without considering that this might imply that you believe you would be better off homeless.

* See, I can reference, though granted it’s not Harvard system. The British Medical Journal has a full reference. There’s a Wikipedia article on Richard Titmuss, if you are interested in post-WWII social policies