In health care, 2013 was a year of great irony. In the United States,
the Obama administration bullheadedly forged ahead in advancing the
most controversial and expensive law in recent memory, the deceptively
named Affordable Care Act.
The law, opposed by a clear and consistent majority of citizens,
immediately caused millions of Americans to lose their health insurance
along with their choice of doctor and hospital, and millions more to pay
far higher insurance premiums.
While the focus has been on the embarrassing roll-out that, at a
minimum, demonstrated both the incompetence and the poor judgment of
this administration, the true harm of this law is still to come as new
government authority over U.S. health care dramatically increases.
Concurrently, Britain’s National Health Service (NHS), the paradigm
of government-controlled health care, turned 65 years old in 2013 and
officially entered senior citizenship.
The NHS received its review by the British press this past year on an almost daily basis.
Headlines blared across the UK, endlessly documenting scandalous
patient care, shameful waiting lists, catastrophic hospital practices,
and financial debacle.
Directly undermining those who advocate for an even stronger role for
government in U.S. health care, the British press has instead been
documenting the disgraceful state of the NHS.
Despite what Americans are led to believe about nationalized health
systems, including the claims that everyone is insured and care is free
under such systems, the facts about what’s really important in health
care --- actual medical care access and quality -- showed the harmful
impact of government control on health care.
One critical distinction generally lost amid the naïve but passionate
backers of nationalized insurance is the difference between being
insured and having access to care.
Despite the chest-thumping that everyone is insured, U.K. citizens
relying on the NHS experience unconscionable problems with access to
care, problems not even remotely found in the U.S.
How poor is access to care in socialized systems like the NHS? Access
problems are so widespread that the government was compelled to issue
England’s 2010 “NHS Constitution” in which it was declared that no
patient should wait beyond 18 weeks for treatment.
It is noteworthy enough that the UK government felt so much pressure
from the systemic failures of its NHS that they were forced to issue
“rights” to patients about receiving medical care.
But should it not bring chills that the government of free people, in
the 21st century, had the authority to define those rights about
seeking and receiving personal medical care? And even more Kafkaesque is
the government’s boldness to define lengthy target times and then to
claim that standards have been met. Indeed, designed to propagate the
illusion of meeting quality standards, the government decreed that
targets were met, even if patients waited a full four months after the
diagnosis was made for treatment to begin.
What is the current status of access to care, now that the rights of NHS patients to medical care were enumerated?
At the end of June, the number of people waiting in England to start
NHS treatment was 240,000 higher than the same time last year.
NHS England figures for July showed that 508,555 people in London
alone were waiting for operations or other treatment to begin — the
highest total for at least five years.
Almost 60,000 more patients were waiting for treatment at the
capital’s 34 NHS hospitals than one year ago. According to NHS data
released in August, hospital waiting lists soared to a five-year high,
with almost 2.9 million patients with a known diagnosis in the queue for
treatment.
In Wales, the number of patients waiting more than nine months for
hospital treatment in November had more than doubled in six months. The
Welsh government also reported their NHS is still failing to treat 8 to
13% of the most urgent cancer cases within 62 days – two full months
after diagnosis.
Even given a laughably long leash of an 18 week standard, the number
of patients not being treated within the target of 18 weeks soared to
39,145 — up 16 per cent on the previous month -- in London alone.
The BBC discovered even more scandalous news back in February --
many patients initially assessed as needing surgery were subsequently
re-categorized by the hospital so that they could be removed from
waiting lists to distort the already unconscionable delays.
Royal College of Surgeons President Norman Williams, calling this
“outrageous,” publicly charged that hospitals are cutting their waiting
lists by artificially raising thresholds.
Though long proven by facts documented by the UK government and in
scientific journals, these shocking waits for care, whether for
specialist appointments, heart surgery, stroke treatment, diagnostic
scans, or cancer care go virtually unreported by the U.S. media.
Ironically, U.S. media outrage was widespread when time to
appointment for Americans averaged 20.5 days for five specialties in
2009. Escaping American media coverage was that those requests were for
healthy check-ups in almost all cases, by definition the lowest medical
priority.
It remains unreported that the U.S. wait for routine check-ups was
significantly less than for sick Brits needing heart surgery (57 days),
or Canadians with “probable cancer” of the gastrointestinal tract (26
days) or proven GI bleeding (71 days).
Even for purely elective routine physicals, U.S. waits are shorter
than for seriously ill patients in countries with nationalized
insurance.
The disgrace of nationalized insurance systems extends far beyond limited access to care.
Comparing data for cancer, heart disease, and stroke, the most common
sources of serious illness and death in the U.S. and Europe, and the
diseases that generate the highest medical expenditures, we see the
overt failure of the NHS and its socialist relatives compared to the
U.S. And the same bottom line is true for the most important chronic
diseases that portend long term morbidity and mortality, including high
blood pressure, diabetes, and high cholesterol.
All have better access to care and better treatment results in the
U.S. than in the U.K., proven by studies in the world’s leading medical
journals.
Adding to those undeniable facts is a long list of inexcusable
scandals in NHS hospitals that were repeatedly discovered, investigated,
and catalogued with promises of change this past year.
These outrages were epitomized in 2013 by the Staffordshire Trust
debacle, where
between 400 and 1,200 neglected and abused patients died
in squalid and degrading circumstances, where patients were left so
thirsty that drinking from the pots of watered plants was necessary.
Although unreported here in the U.S., the 2013 Francis report about
Staffordshire NHS hospital, containing more than one million pages and
64,000 documents, and costing British taxpayers about $20 million,
caused outrage even for those wedded to government-controlled health
care.
While forcing the resignation of the NHS chief, the report more
importantly officially called out the insidious negative culture in the
NHS, involving a tolerance of unacceptably poor standards and patient
neglect , a preoccupation with cost-cutting, targets and processes while
losing sight of its fundamental responsibility to provide safe patient
care.
Yet, the greatest deception of all about NHS-style socialized
medicine, the silly canard that it provides “free” health care for
everyone, was visible for anyone interested in facts in 2013.
The cost to British patients and taxpayers for their dismally
performing NHS has been enormous and has increased by 94 per cent in
real terms between 1999-2000 and 2009-2010. And even in the face of such
outrageous money-wasting as reported in September that millions of
non-existent “ghost” patients were registered at NHS surgeries costing
taxpayers £750 million over five years, Secretary of State for
Health Jeremy Hunt intransigently argued against any restraints on
the 2014 NHS budget of £114 billion ($175 billion), despite its shameful
performance and lack of accountability.
And that cost still does not prevent a growing number of British
taxpayers from looking elsewhere for medical care. About six million
Brits now buy private health insurance, including almost two-thirds of
Brits earning more than $78,700.
According to The Telegraph, the number of people paying for their own
private care is up 20 percent year-to-year, with about 250,000 now
choosing to pay for private treatment out-of-pocket each year.
Isn’t it notable that more than 50,000 Britons travel out of the
country per year and spend £161 million to receive medical care due to
lack of access, even though they are already paying for their NHS
insurance?
Despite all of these realities, just as in America, many in positions
of power refuse to accept the facts and continue to deceive the public.
Even the hard-hitting 2013 Staffordshire report still insisted near
the top of its list of summary points that “the NHS is a service of
which the country can be justly proud, offering as it does universal
access to free medical care, often of the highest order.”
In a truly offensive effort to further manipulate the public about
their failing system of socialized medicine, the NHS in London
separately spent even more taxpayer money -- almost £13 million, or
about $20 million -- on public relations in the last three years, as
reported by the BBC.
Eerily echoing that disgraceful waste of hard-earned taxpayer money,
our own Obama administration will spend about $684 million, as cited by
the Associated Press, mainly on a massive campaign to convince young
people to sign up for ObamaCare exchanges and purchase unnecessarily
bloated, highly expensive insurance they don’t need or want.
Finally, the system often heralded as the model for US health care
reform, offers access and quality of care so poor that Britain is now
experiencing a serious brain drain of their young doctors.
The NHS has become hugely reliant on doctors trained outside the UK.
An estimated 94,833 of the 259,719 doctors of all doctors registered
with the General Medical Council, 36.5% of the total, are from foreign
medical schools. And what is the solution to the disastrous waiting
lists and disgraceful care in the NHS in the face of a considerable
outflow of UK medical professionals?
The U.K. government is now considering sub-contracting operations to private firms from other countries.
Is anyone in the U.S. government watching this socialized medicine debacle unfold?
Yet, the stubborn pursuit of an overtly failed system like the NHS,
where government controls medical care, is the model for ObamaCare, so
the inexorable progression towards what we see in the U.K. should be in
the minds of American voters as more components of the law unfold in
2014.
Ultimately, the only way out is for taxpayers and all U.S. citizens
who care about choice, access, and quality of health care to make their
voices heard.
Thankfully, another election is approaching.
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