First published on FrontPage Magazine.
By Enza Ferreri
In light of the ongoing ObamaCare debacle, it can be interesting to see how a state-run national health system free for all, like Britain’s National Health Service (NHS) – Obama’s favourite model -, has failed to deliver.
The UK is one of the few countries in the world – mostly concentrated in Europe - to have completely free universal health provision. It sounds cuddly and comfy, but, like in all utopias and fairy tales, reality is a different matter.
The NHS is Britain's sacred cow. No party, if it wants to be elected, can scrap it or reform it in any real sense. All parties have to recite the mantra: "The NHS is safe with us. We are ring-fencing the NHS".
In 2009, British Conservative MEP Daniel Hannan, interviewed on Fox News (see above video) about the impending Obamacare, warned Americans that the NHS is a “60-year-old relic” and claimed he “would not wish it on anyone”. Hannan was then condemned back home as “evil”, “unpatriotric” and “a traitor”.
Former Chancellor Nigel Lawson said that the NHS is “the closest thing that the British have to a religion”. And Labour politicians managed to create a climate in which this institution was considered sacrosanct, untouchable by criticism.
But it’s becoming increasingly impossible now to keep that pretence.
The NHS, born on 5 July 1948, is the first system of free universal medical care ever established. The 1942 Beveridge Report, influential in founding the UK’s modern welfare state of which the NHS is part, was conceived and implemented during a special time, when the population was not only ethnically and culturally homogenous, but also feeling like a great family, bound together by the heroic struggle of WW2.
The fundamental principles of the NHS, then as now, have been: 1) services provided free at the point of use; 2) services financed from central taxation; 3) everyone eligible for care (even people temporarily resident or visiting the country).
According to Treasury figures, NHS spending almost doubled in real terms from £57 billion in 2002/03 to £109 billion in 2012/13, and is forecast for £129 billion in 2014.
Britain spends 18.5% of its annual budget on health, the second highest expenditure.
The NHS has always been beleaguered by problems and cash crises, and needing reform.
All “reforms” attempted through the years have only amounted to internal changes and restructurings - giving similar bodies different names. The current “reform” is no exception. Crisis has always been the NHS’s permanent condition.
Its original ideal is too expensive even in the best conditions and, with health care becoming more costly and population ageing, the conditions are going to worsen.
But more money doesn’t mean better care. Department of Health reports admit that, despite significant and consistent increases in funding, hospital productivity has fallen.
A study in the prestigious Lancet of health data over 20 years in 19 countries shows Britain lagging behind in 12th place.
The BBC reported on the research:
Many deaths happen because the NHS is not good enough at preventing people getting sick or because treatment does not rival that seen elsewhere in Europe, says Mr Hunt who is responsible for health policy in England.By cancer survival rate comparisons, the NHS is one of the worst health systems in the Western world, even overtaken by former European communist countries.
The remedies are worse than the ills. After having created problems and produced terrible results, governments, to save their face and not risk losing votes, try to find band-aid solutions that make things even worse.
One instance of that is setting targets, which has led to patients being neglected to meet them:
Another example occurred at Mid-Staffordshire NHS Trust, where over three years from 2005 between 400 and 1,200 patients died needlessly as managers ruthlessly cut costs — particularly nursing numbers — to meet targets the Labour government laid down to win ‘foundation’ hospital status.This is by no means an exceptional case. Inquiries follow scandals and are followed by new horror stories.
Doctors were diverted from critically-ill patients in order to deal with less serious cases to meet the target of discharging all patients from Accident & Emergency units within four hours of admission.
Vulnerable patients were left starving, in soiled bedsheets or screaming in pain. Some became so dehydrated they drank from flower vases…
Apparently, the [Francis] report will damn not just the Mid-Staffordshire management but a ‘culture of fear’ from Whitehall down to the wards, as managers became fixated on meeting targets and protecting ministers from political criticism.
Countless families in Mid-Staffordshire have been left grieving for loved ones who were, in effect, killed by the National Health Service.
Top public health officials, from the Health Secretary Jeremy Hunt down to Medical Director of NHS England Sir Bruce Keogh, have acknowledged that in many cases patients were abused, neglected and bullied, and have expressed serious concerns about the service at some NHS trusts.
In July of this year, 14 trusts were found to have unusually high mortality rates. In August, up to 42,000 deaths a year due to kidney failure were linked to dehydration in patients who were not given water by NHS staff. In September, it was discovered that 13,000 every year die of sepsis because of delays in diagnosis and treatment – negligence which also costs the NHS more money. In October, we had: the previous Labour government was accused of a pre-election cover-up about hospitals with higher-than-normal death rates, “with inspectors finding blood stains on floors and curtains and badly soiled mattresses”; NHS doctors were discovered to have been routinely giving performance-enhancing drugs to patients to “enhance their recovery rates”; and NHS managers getting hundreds of thousands of pounds in redundancy just before being given other NHS jobs – this was due to the latest NHS “reform”, which is simply a reshuffling. In November, it was found that NHS dementia patients were left hungry for hours and not given medication at the right time; a £200 million NHS fraud scandal was uncovered, with patients illegally claiming free services, and dentists, agencies and firms working for the NHS committing fraud and sending false invoices; 19 more hospitals were investigated over their links to allegations of sexual abuse by late TV celebrity Jimmy Savile, making a total of 32; it was discovered that the NHS spent nearly a fifth of its budget for maternity services on clinical negligence insurance in England in 2012, nearly £500m; there was news that Colchester hospital has been fiddling with patient records to improve its waiting times for cancer treatment, with potentially life-threatening consequences. In December, it’s been disclosed that up to 170 operations are cancelled at the last minute each day by NHS hospitals for bed shortages, faulty equipment and lack of staff.
This is just a sample, in no way a complete record. Not bad for less than a half year’s work.
A former London correspondent for Time sounds very reassuring:
Health care was more psychically seamless in the U.K. Nobody worried about going bankrupt if they got sick.Nobody goes bankrupt individually, but everybody will go bankrupt with the rest of the country because the NHS and the whole welfare state are taking Britain to the verge of economic collapse, with an unsustainable and growing national debt.
Tim Kelsey, a director at NHS England, the central body in charge of the health service, warned in July:
We are about to run out of cash in a very serious fashion... our analysis will disclose that by 2020 there will be a £30bn funding gap in the healthcare system. [Emphasis added]Senior NHS doctors and managers said that up to 20 hospitals across the country may have to close to save the NHS from financial ruin.
Although the American system of employer-provided medical care is different from the British system, comparisons of the latter with Medicare, Medicaid and Obama’s “vision” for public healthcare can be made. When healthcare is mostly paid by a third party, there’s little incentive to economize on it, and as a consequence expenditures rise dramatically. Late US economist Milton Friedman would call the NHS a plan for the “socialisation of medicine”, flawed like all government programmes to control social fields.
Two weeks ago, during a visit to Vladimir Bukovsky, I asked him if he thought that looking after the health of a whole country is a task a government can be efficient at. He replied: "There are very few things that governments are efficient at".
Interestingly, the US has always been used as a bogeyman to scare Europeans into believing that they need universal healthcare. Look at what happens in America, where there is no state-run health system, Leftists and media say.
However, that the question "Are you insured?" asked in US hospitals is caused by lack of free healthcare for all, European-style, is far from the truth. It was free medical care provided by employers during the war - to attract workers at a time of price and wage controls - that led to the current situation in the US. Most Europeans have never heard of the existence of Medicare and Medicaid, and believe that Americans who can’t afford insurance are practically left to die.