Now that the battle over the nationalization of U.S. health care is fully engaged, with the outcome to be determined by whether or not the Republican Party controls all three branches of the federal government after Jan. 20, 2013, it’s worth casting a look elsewhere to see what might be in store for us if the GOP’s effort fails.
Progressives are more than fond of telling Americans how this nation’s health care system is a failure, with millions left uncovered by formal insurance and with the “poor and needy” continually left behind in the quest for a doctor’s attention outside of an emergency room.
And they are even more fond of pointing at the health care systems of other nations, saying that countries where medicine is primarily or entirely a creature of the state are far more efficient and effective than our own.
So, let’s ignore the fact that our own system of nationalized health care for the elderly, Medicare, reimburses doctors far less than the cost of the care they provide, shifting costs over to private patients and driving more and more physicians out of the system. Medicaid, the program that provides care for lower-income families through grants to the states, has also swelled far beyond projections.
And let’s ignore Medicare and Medicaid’s unfunded mandate for care, which was projected last March by the Senate Budget Committee to cost up to $82 trillion by 2075 — exceeding total projected tax revenues now used for all purposes — once the effects of Obamacare are figured into the equation.
Let’s look instead at one of the more well-established programs of socialized medicine abroad that our deeply caring leftists continually bring up as object examples of how medicine could and should be provided.
I refer to Britain’s National Health Service, a system implemented after World War II that has endured — and grown — to this day. If there is a sacred cow among government programs in Britain, the NHS is it. Even Prime Minister Margaret Thatcher, who was fully aware of its problems, was never able to address them in any meaningful way.
Today this paragon of medical provision is the object of headlines such as “Why NHS Is On The Critical List,” in the July 1 Sunday Express. Staff Writer Neil Hamilton begins his account by noting that “Twenty-one NHS regional trusts (out of 151 primary care trusts, which administer health care in a given area) face financial meltdown, with combined debts of 130 million pounds ($204 million). One, the South London Trust, is already bankrupt.”
Hamilton continues: “The NHS is the last Soviet-style nationalized industry. It gobbles up a sixth of Government spending and is exempt (from cuts) because it is such a political hot potato. Before global warming it was the nearest thing we had to a substitute religion.”
One reason is because it is so huge: “With 1.7 million employees, it is the fifth-largest employer in the world, behind the U.S. Department of Defense, the Chinese military, Walmart and McDonalds. It costs us 125 billion pounds a year ($196 billion).”
Americans used to huge federal expenditures may not think that’s a terrible amount to spend, but as the author notes, that “equates to 80 percent of all (British) income tax revenue.” That works out, he says, to $12,500 a year for the average family.
And perhaps this will sound familiar: “The NHS is in a pincer of rising patient numbers and relatively fewer workers to pay the bills.”
But, at least the care is top-notch, right? Let Hamilton give an example: “Recently I had to have a three-day heart monitor strapped to my arm to check my heart rhythms. It was a five-minute job but took 57 days to get an appointment. By the time it arrived, I had survived so long there was no need!”
And he adds, “The NHS does not provide an equal service to all, but instead treatment depends on where patients live, their income, age and, crucially, who they know.”
Pay special attention to this next sentence: “The many appalling scandals of mistreatment of the elderly are a national shame.”
Though Americans may never read about them, the British papers are full of such stories, far too many to be merely anecdotal. In July, an independent oversight agency, the Care Quality Commission, issued a report on care for the elderly in 100 facilities that concluded, as one online site digested it, “More than half of NHS hospitals fail to meet optimum needs for care for the elderly. A fifth are so bad they are breaking the law.”
Deficiencies noted including putting call bells out of the reach of patients, failing to feed them for extended periods, letting them lie in their own waste for hours (and in some cases, days) and failing to give disabled people needed help to eat even when meals were provided.
The government plans to implement a rule soon in which patients with non-acute conditions can be treated in private hospitals at public expense if they have been waiting more than 18 weeks to see a doctor.
Hospitals claim a lack adequate funding, but apparently there are many ways to cut a health care budget.
One of them was disclosed, and all of Britain was truly stunned, when a prestigious physician, Dr. Patrick Pullicino, a consultant neurologist and professor of clinical medicine at the University of Kent, said in a speech to the Royal Society of Medicine in London in June that, as the Daily Mail newspaper reported, “NHS doctors are prematurely ending the lives of thousands of elderly hospital patients because they are difficult to manage or to free up beds.”
Pullicino was referring to a national treatment protocol called the Liverpool Care Pathway (LCP), designed “to come into force when doctors believe it is impossible for a patient to recover and death is imminent.”
The plan “can include the withdrawal of treatment, including the provision of water and nourishment by tube.”
Thus, patients are either starved or dehydrated to death.
About 130,000 people placed on the LCP die every year in British hospitals (29 percent of total system patient deaths), but Pullicino says that “far too often elderly patients who could live longer are placed on the LCP, and it has now become an ‘assisted death pathway’ rather than a care pathway.”
And he cited “pressure on beds and difficulty with nursing confused or difficult-to-manage elderly patients” as factors, the Daily Mail reported.
“If we accept the LCP,” Pullicino told his fellow doctors, “we accept that euthanasia is part of the standard way of dying … ”
And he concluded, “Very likely many elderly patients who could live substantially longer are being killed by the LCP. Patients are frequently put on the pathway without a proper analysis of their condition. … The determination in the LCP leads to a self-fulfilling prophecy.”
Now, it’s not the case that all other nations have health-care systems as bad as the British example. Both the Swiss and the Germans have public-private systems that appear to satisfy their citizens and keep costs within limits, although those citizens pay substantial taxes for their coverage.
And, let’s not forget, they are Swiss and German.
But if we want to see where our health-care planners intend to take us, we should remember they have touted Britain’s NHS to the skies.
However, a system where tens of thousands of people are forced every year into a “pathway” where food and water are optional treatments may not be one we want to imitate.
M.D. Harmon, a retired journalist and military officer, is a freelance writer. He can be contacted at: firstname.lastname@example.org