There is some support in the United States for “solving” America’s health care problems with a state-run health system like Canada and European countries have. Fortunately, although there might be a lot of support for a generic health care system like this, such support tends to vanish when people start seeing the details (e.g. HillaryCare).

British paper The Telegraph had a story back in September about a study comparing the performance of the UK’s National Health Service with that of the United State’s mishmash of private, semi-private and public system of hospitals. The difference was quite striking,

Patients who have major operations on the National Health Service are four times more likely to die than Americans undergoing such surgery, according to a new study.

. . .

The results showed that just under 10 per cent of the British patients [in the study] died in hospital after major surgery, compared with 2.5 per cent of the American patients.

What would explain such a high difference in mortality? Are British surgeons and nurses less competent than Americans? Do Americans use technologies that the British don’t have access to?

Part of the difference in mortality rates is explained by a feature of most nationalized health care systems — the increased waiting period from diagnosis to surgery.

The joint study, carried out by University College London and a team from Columbia University in New York, found that patients in Britain who were most at risk of complications after major surgery were not being seen by specialists and were not reaching intensive care units in time too save them.

The other part is due to cost-cutting measures in Great Britain when it comes to post-op care. Quite simply, in the United States someone undergoing such an operation would be treated in post-op by another surgeon and an anesthesiologist, typically in a critical care unit.

Prof [Monty] Mythen . . . said: “In The Manhattan hospital, the care after surgery is delivered largely by a consultant surgeon and an anesthetist. We know from other research that more than one third of those who die after a major operation in Britain are not seen by a similar consultant.

“In America, everyone would go into a critical care bed — they go into a highly monitored environment. That doesn’t happen routinely in the UK.”

Which brings up my other pet peeve about nationalized health plans proposed for the United States. Advocates of such plans frequently blast HMOs for interfering with the doctor-patient relationship by dictating what doctors can and cannot offer their patients. But a nationalized health system would simply substitute a single entity — the federal health agency — for the various HMOs. Call it the mother of all HMOs.

The trend in countries that have nationalized health care is not some utopian health care system where doctors get to treat patients regardless of cost. Rather it is a system where health care is explicitly rationed by state and/or national health care agencies and health care decisions are completely subsumed to the need to control costs.

Source:

US surgery safer than under NHS. Thair Shaikh, Telegraph (UK), September 7, 2003.

I absolutely love the headline on this story from The Observer from October 5,

Police fear they are losing control of gun-crazy Britain

Now wait a minute — starting in 1998 Great Britain banned the private ownership of handguns and forced everyone who had registered a handgun to turn their weapons over to the state.

And yet, according to The Observer, gun crime has doubled since the Labour Party came to power.

Apparently, as best I can tell, criminals aren’t abiding by the law and are obtaining weapons illegally — imagine that. The nerve of some people.

Not to worry, though, the government apparently has a plan. They’re talking about mandatory minimums for illegal possession of a gun. I’m sure that will accomplish what the ban on guns hasn’t.

Source:

Police fear they are losing control of gun-crazy Britain. Tony Thompson, The Observer, October 5, 2003.

The BBC reported on an odd trend in British medicine today — there are too many female doctors. One of the central planners of Great Britain’s medical system touched off a controversy by suggesting that medical schools might have to start discriminating against women in order to boost the number of male doctors.

The problem with female doctors goes to the heart about debates over why men earn more, on average, than women. Female physicians in Great Britain end up working significantly less than male physicians do. According to statistics from the Royal College of General Practitioners, female physicians work an average of 24 years versus 31 years for men.

What are they doing during those 7 years? They are temporarily leaving the profession or entering part-time work, probably to accommodate other priorities such as raising children.

Add to that the fact that about 60 percent of students in medical school are women, and the result is an almost certain shortage of doctors in Great Britain during the next decade. The government says it will find a way to scrounge up 2,000 extra physicians, when the British Medical Association estimates that at least 10,000 more physicians are needed.

So, should medical schools in Great Britain start discriminating against women? Of course not. The problem here has nothing to do with gender and everything to do with Great Britain’s National Health System.

In the United States, the health care system deals with shortages through the free market. For example, over the past several years there has been a pretty marked shortage of nurses. Competition for available nurses has driven nursing salaries higher, in turn enticing more people to become nurses. Eventually the number of nurses available will meet or exceed the demand and nursing salaries will likely level out and likely decline in some places.

Much of Great Britain’s health care system is controlled and centrally planned by the state. The National Health System is perpetually short of cash and cannot afford to pay market rates for doctors. This means that talented doctors open up expensive private practices or else go into other fields or emigrate to other countries. The result is the shortage seen today which the British Medical Association wrongly associates with simply a decline in the number of men seeking to be general practitioners.

Source:

Medicine ‘may have to favour men’. The BBC, April 8, 2002.

I guess I’m just too much of a law-and-order right winger. This story is even more disgusting than the teenagers who terrorized the family. A man in Great Britain lost his temper with a 22 month old girl he was babysitting because she had an accident while being potty trained.

So, of course, he turned on the tap until the water was 96 degrees celsius, and held her under it. The girl was burned over 32 percent of her body. She almost died, and has had 13 operations over the last six months.

The man received a 6 year jail sentence. An improvement over the hooligants who received such mild sentences for terrorizing that family, but come on — somebody who would stick a toddler under near-boiling water from a tap needs to spend at least 10 to 15 years in jail. That’s as good a demonstration as I can think of that this person is incapable of living in society.

How the hell does this happen? Two 17-year olds and an 18-year old in Great Britain target a family because they know the mother and father have learning disabilities and committ a series of crimes so disgusting (warning, this is genuinely disgusting even though no one was killed) that the trial judge describes it this way,

It is quite beyond the pale of normal understanding. I have many years of experience on the bench and criminal bar and although I have been concerned in more serious cases such as murder, I cannot remember any quite so revolting and degrading as this one.

Which means, of course, that rather than through the book at these two, one of them just had his sentence reduced from 24 months to 18 months. Almost as disgusting as the crime.

The European press often lambastes the United States for treating violent minors as if they were adults. Better to do that, though, than see this sort of monster back on the streets after only 18 months. No wonder crime is such a problem in Great Britain these days.

Great Britain’s National Health System has no choice but to privatize some medical treatment options if it is to survive. That was the conclusion of a recent report put together by representatives of the British Medical Association, the Royal College of Nursing, patients, private health providers and other stakeholders.

Barring some sort of privatization, the rationing which already exist informally within the NHS will have to be occur formally in order to avoid bankrupting the system.

Great Britain faces the same problem that all socialized medical systems face. When the cost of medical treatment is free to the end customers, the demand for medical treatment is extremely high. Since resources are not unlimited, something has to give.

Great Britain, like most socialized health care systems, keeps costs down informally through extremely long waiting periods. Surgical procedures that might take two or three months at most to schedule in the United States can keep a patient on waiting lists for a year or more in Great Britain. In addition many advanced treatments and expensive medications that are considered routine treatment in the United States are simply not available in Great Britain because they are simply too expensive.

But the bottom line is that delaying procedures and limiting treatment options has merely forestalled the day of reckoning. Without massive funding increases — which is a nonstarter politically — the system is in trouble.

And this is the system that folks such as Ralph Nader say the United States should adopt. No thanks.

Source:

Rationing ‘only option’ for NHS. The BBC, February 7, 2001.