What U.K. health scandals tell us about Obamacare

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Most Americans don’t know anything more about Britain’s National Health Service (NHS) than what they saw during the opening ceremonies of last summer’s London Olympics: dancing nurses and smiling children bouncing on spotless hospital beds. But recent healthcare scandals paint a less flattering portrait:

  • Alarming reports of doctors and nurses using drugs to hasten the death of terminally ill patients and killing patients who were seriously ill or mentally challenged but not dying by denying them food, water, and medicine were confirmed by a government-commissioned review. That review, chaired by Julia Neuberger, found that poorly trained and uncompassionate healthcare professionals were misapplying guidelines (called the “Liverpool Care Pathway for the Dying Patient”) intended to help make the final days of terminally ill patients as comfortable and dignified as possible and using the guidelines as an excuse for poor care.
  • As many as 1,200 patients died needlessly over a three-year period at two hospitals managed by the Mid Staffordshire NHS Foundation Trust because of what a government-commissioned report chaired by Robert Francis described as “appalling care.”
  • As many as 13,000 patients have died needlessly since 2005 at hospitals managed by another 14 trusts because of “fundamental breaches of care,” according to Jeremy Hunt, Secretary of State for Health. Those trusts were reviewed because of Francis’ report on the Mid Staffordshire scandal.

These scandals should warn us what happens when the government takes control of healthcare:

Healthcare decisions are ultimately made by politicians and government bureaucrats, not patients and their doctors. Patients are given the care the government thinks they should have, not necessarily what they want or need. British doctors and nurses have been treating end-of-life care guidelines as a check-the-box exercise, not asking patients or family members whether that’s what they want or changing course if patients or family members object.

The government puts its financial needs first, not the patient’s desires or best interests. The British government has been giving hospitals financial rewards for increasing the number of patients put on end-of-life care, a type of care that clears beds needed for other patients and reduces the government’s expenses. The Francis report described hospitals in the Mid Staffordshire trust as a “culture focused on doing the system’s business,” not caring for patients.

Doctors and nurses become so focused on following government-ordered treatment guidelines that they lose compassion for their patients. Healthcare providers forced to comply with political targets and financial constraints can easily lose their moral compass. There have been heartbreaking accounts of patients desperately sucking at sponges used to moisten their mouths because nurses refused to give them water. The family of one patient put on end-of-life care said they were told that if they wanted to give their loved one anything to drink they’d have to soak a paper towel in the toilet and let her suck it. The initial Francis report found that the most basic elements of care were neglected. Patients were left lying in soiled sheets. Patients weren’t washed for as long as a month and were left sitting on the toilet for hours. Food and drinks were left out of patients’ reach. Pain relief was provided late or not at all.

When there’s a problem, the government’s first instinct is to cover it up. British government officials covered up complaints about poor care to avoid having to acknowledge bad news that could hurt their electoral prospects. The recent scandals were investigated by the government after Conservative Party leader David Cameron replaced Labour Party leader Gordon Brown as Prime Minister.

People become conditioned to believe that only the government can solve their problems. British officials have promised to come up with new rules to make sure these scandals don’t occur again. When those rules don’t work or cause other problems, they’ll propose still more rules. Britain’s NHS celebrated its 65th anniversary on July 5 and still can’t get things right. There’s no reason to believe that things will be different in the United States, even if you somehow believe that our government officials are more skilled and intelligent than British officials.

It’s arrogant for government officials to think that they can encourage innovation and allocate resources better than the free market.