"Blade Runner" is an autobiography written by British cardiac surgeon Stephen Westaby. Similar to his previous work "Open Heart," it introduces many of the cardiac surgeries he performed, but adds some of his personal experiences and views on the National Health Service (NHS) in the UK.
The book describes how an injury from a rugby match caused damage to parts of his brain, resulting in a loss of control over his personality, a willingness to take risks without caring about others' opinions, and a diminished capacity for empathy. While this affected his interpersonal relationships, it enhanced his career in cardiac surgery, allowing him to handle surgical procedures more calmly than others. The book mentions that many cardiac and pediatric surgeons experience similar situations; having a normal level of empathy makes it difficult to face heart patients, child patients, and their families calmly. This is actually contrary to most people's impressions, as some are motivated to become doctors because of their strong empathy. However, facing various life-and-death situations daily poses a significant psychological challenge, and if one cannot regulate this well, they may collapse. Doctors like Stephen Westaby are often driven by a sense of adventure and achievement; adrenaline is their motivating elixir, and cases that are more difficult and challenging are more appealing to them. If one's psychological endurance is poor, it is better not to choose to become a doctor, especially not a surgeon, as this can harm both the doctor and the patients.
The book frequently criticizes the NHS, primarily for being overly controlling, with some outsiders evaluating and managing doctors, wasting a large amount of management funds, leading to a shortage of essential medical equipment and healthcare personnel. Free healthcare sounds great, but in reality, there is no true free service; the costs come from taxpayers and health insurance fees. No country can efficiently use public funds, so the scope of public fund usage should be minimized. However, the reality is that departments or units receiving public funds will try every means to expand their use, inevitably leading to a shortage of public funds. The typical government response is to increase the money supply and raise taxes, which essentially shifts costs more onto ordinary people, often amounting to robbing the poor to benefit the rich. I believe that public healthcare and public education are still necessary, but the scope must be controlled to avoid creating a situation of universal or de facto monopoly. Instead, they should serve as a foundation for the healthcare and education markets, ensuring that those who cannot afford medical or educational expenses have basic access to healthcare and educational opportunities. Most people should still choose suitable health insurance or educational funds through the market. Although this may seem unfair to the poor, fairness does not mean everyone should be brought down to the lowest level. Most people have to wait a long time to see a doctor, and many can only choose average public schools. Society needs differentiation; as long as everyone has the opportunity to become wealthy, there is no need for everyone to maintain the same standard of living.
The healthcare and education industries are not like other industries; they cannot fully rely on market competition for self-adjustment, especially since these two industries relate to people's health and future development. Government regulation is necessary, but this does not mean the government needs to take over everything. If the government manages the prices of medical equipment and drugs, it will inevitably create a vast space for corruption. What the government needs to do more is to formulate policies and strictly punish violations of those policies.