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Opinion | Niall Ferguson

Guns are America’s blind spot; in Britain, it’s health care


We live in a small world. There are in fact just two degrees of separation between you and someone who attended the concert in Las Vegas last Sunday at which Stephen Paddock killed 58 people. That is because you are reading my column and my son’s nanny was there with a group of her friends. (Luckily, she left before the shooting began, and none of her friends was hit. Spattered with the blood of others, but physically unscathed.)

One of many pathologies of a small world is groupthink. I arrived in London shortly after the Las Vegas massacre. I encountered unanimity, right across the political spectrum. Americans are crazy, I was repeatedly told. How can you live in a country where such things are possible?


Now it is true that America has a gun problem, but it is not quite the problem most Britons imagine. As the London Times pointed out last week, more Americans have died from guns in their own country since 1968 than have perished in combat in all the nation’s wars (including the Civil War). On average between 2011 and 2014, guns were linked to 34,000 deaths a year in the United States.

But such figures are deceptive. More than half of those 34,000 deaths were the results of suicide, not homicide. All week, the media have been publishing exaggerated statistics on mass shootings (“477 Days. 521 Mass Shootings” — The New York Times, which defined a mass shooting as four or more people injured or killed in a single event). But defining a mass shooting as a single attack in a public place in which four or more victims were killed, as Mother Jones does, I count 91 public mass shootings across the country since 1982, in which 760 people have died.

That is still an unacceptable death toll, to be sure. Also troubling is the trend in the direction of more frequent massacres and larger death tolls. Yet we need to be clear about the nature of the problem. Britons are amazed to be told that three quarters of Americans don’t own a gun at all. Just three percent own half the guns. Stephen Paddock possessed 42 firearms, 23 of which he took to Las Vegas. He is one of a very small proportion of American population that takes advantage of flaws in US law to amass large numbers of guns. This state of affairs is not what the authors of the Second Amendment had in mind.


Will anything change in the wake of the Vegas massacre? At most, bump stocks, which effectively convert semi-automatic weapons into automatic ones, will be banned. Otherwise, I expect very little to change. Gun control has for years been a deeply partisan issue, favored by Democrats, opposed reflexively by Republicans.

So does all this mean that Americans are nuts? Well, let’s keep the gun problem in perspective. Of the 2,596,993 total deaths in the United States in 2013, 1.3 percent were related to firearms. For some reason, the same people who say, “You are more likely to be killed in a road accident than by a terrorist,” never say: “You are more likely to be killed in a road accident than by a firearm.”

Yes, Brits are far less likely to die from gunshot wounds than their American cousins. Generally speaking, according to World Health Organization statistics for 2015, the American rate of mortality from interpersonal violence is four times higher than the British. Americans are also 10 times more likely to die from cocaine use, and between two and three times more likely to die from drug abuse, poisonings, and intentional injuries. The American way of death is relatively violent. This is another way of saying that the United States is more like Latin America than Western Europe.


In any case, the Brits have their own idiosyncrasies when it comes to death. In 2015 they were five times more likely than Americans to die of the lung cancer known as mesothelioma, nearly three times more likely to die of oesophageal cancer, twice as likely to die of stomach cancer, and nearly twice as likely to die of prostate and bladder cancer.

These figures are in line with a variety of studies showing that Britain is not the best place in the developed world to be diagnosed with cancer. Between 2000 and 2007, for example, the average adult five-year survival rates for patients diagnosed with nine types of cancer were lower in the UK than the European average. Meanwhile, according to a 2012 study, cancer patients in the United States “lived longer than in the EU, and these survival gains were not due to more aggressive screening of US patients,” but to the higher expenditure that characterizes the American system.

And yet the National Health Service is an institution so beloved by British voters that woe betide the politician who does not pledge to preserve it.


True, a growing number of Americans are persuaded by single payer enthusiasts such as Vermont socialist Bernie Sanders. But most Republican voters don’t want to know. According to one recent poll, only 28 percent supported a single payer system.

Maybe, as Hillary Clinton said, Republicans really are just a basket of deplorables who are nuts to prefer the National Rifle Assocation to the National Health Service. However, when I tell conservative Americans how British friends of mine have been treated after being diagnosed with cancer — one who had a breast tumor was told to take her usual summer holiday as there was a queue for treatment — here’s what they say:

Brits are crazy. How can you live in a country where such things are possible?

We do indeed live in a small world. And yet we all—Americans and Britons alike—struggle to see ourselves as others see us.

Niall Ferguson is a senior fellow at the Hoover Institution at Stanford University.