American Elephants


In Britain, the NHS is Starving its Patients. Are We Next? by The Elephant's Child

We frequently include stories here about Britain’s National Health Service.  Britain has had socialized medicine since just after World War II. Some call them “scare stories” and so they are. Many Britons like their National Health Service, and feel that they get good treatment.  The scare stories are compelling.  Why do we include them?  Britons hate it when we use their NHS as a bad example; and they, in turn, use their idea of American medicine as a bad example.

Much of health care is routine and minor. You can’t judge health care by the occasional broken arm or deep cut.  Most anyone can fix it. You have to judge health care by the very sick,  the elderly in failing health, the difficult diseases, and the chronic disease. The well don’t need health care. So the real customers for health care are probably in poor health.  And the question of quality becomes how do we care for those in poor health?

The goal of socialized medicine is to give good health care to the poor — those who cannot pay the usual cost of good health care.  The theory is that they will save enough money elsewhere to afford to give good care to the poor.  But are we talking about routine care for healthy poor people, or the care for poor people in poor health?

There is an assumption that “preventative care” will prevent people from getting any condition that is expensive.  This is nonsense. Diagnostic medicine is expensive.  A single blood draw may result in a whole battery of tests.  Machines like MRIs and C–T scanners cost a fortune.  A diagnosis usually begins with a symptom and the attempt to discover the cause of the symptom. Running tests on people who have no symptoms is not usually cost-effective.

What about the modern epidemic of obesity?  A few years ago, they changed the standards for what was called obesity to include more of those people who had never been called obese before.  Voilá, and “epidemic” of obesity.  The same thing happened with diabetes.  They lowered the standards sharply to include more people, and there was suddenly an “epidemic” of diabetes.  The intent was to get more people treated early, but the idea that everybody had better stop eating Big Macs or anything that tasted good was probably misguided.

The Wall Street Journal today has a postcard from the NHS. In 2007, 230 patients died of malnutrition in British hospitals, the latest year for which figures are available.  Age UK, a monitoring charity, says “the true figure may be much higher” due to under-reporting.  In 2007-2008, 148,946 Britons entered hospitals suffering from malnutrition and 157,175 left in that state, meaning that hospitals released 8,220 people worse-off nutritionally than when they entered.  In 2008-2009, that worse-off figure was up to 10,443.

The problem is not insufficient food.  It is individualized mealtime assistance.  The constant scarcities created by socialized medicine, and the constant drive to cut costs leaves nurses with more responsibilities and less time.  It is not, the Journal points out, a Labour problem or a Tory problem.  It is a single-payer health-care problem.

It is a problem of bureaucracy. Anyone who has worked in an organization of any size recognizes that the bigger the bureaucracy, the greater the problems.  Group think doesn’t work. And the more remote the bureaucrats from the actual sick person, the worse the system will be.   Examine this chart (click where noted to enlarge) and note the stubby yellowish star in the lower right-hand corner.  That represents you the sick person.  All the rest of the bubbles and squares and rectangles represent not individual people, but bureaus, who are making decisions about what treatment you get and whether their decisions will allow you to live or die. Not you.  Not your doctor.  Hundreds and hundreds of faceless bureaucrats.

Democrats are facing a nationwide backlash.  Democratic congressional candidates have a new message for voters.  We know you don’t like ObamaCare, so we will fix it.  Do not believe them. Endless tinkering does not fix anything.  It is a single-payer health-care problem.  It does not work. The inevitable result is the NHS — which is what the ObamaCare people want.  They have said so.

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