Nationalized Health Care

September 3, 2009

Here’s a very interesting read from the UK’s Telegraph about the realities of government run health care.  Just a wee bit sobering as our Administration, whose proposed plan already includes “end of life counseling,” looks to European models:

In a letter to The Daily Telegraph, a group of experts who care for the terminally ill claim that some patients are being wrongly judged as close to death.
Under NHS guidance introduced across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.
But this approach can also mask the signs that their condition is improving, the experts warn.
As a result the scheme is causing a “national crisis” in patient care, the letter states. It has been signed palliative care experts including Professor Peter Millard, Emeritus Professor of Geriatrics, University of London, Dr Peter Hargreaves, a consultant in Palliative Medicine at St Luke’s cancer centre in Guildford, and four others.
“Forecasting death is an inexact science,” they say. Patients are being diagnosed as being close to death “without regard to the fact that the diagnosis could be wrong.  “As a result a national wave of discontent is building up, as family and friends witness the denial of fluids and food to patients.”
The warning comes just a week after a report by the Patients Association estimated that up to one million patients had received poor or cruel care on the NHS.

Read the rest.

6 responses to Nationalized Health Care

  1. This is a denial of patient’s rights and something medical ethicists would have a field day with.Being in the medical field and seeing people suffer by being treated with chemotherapy,etc when it is futile, I am an advocate for a person’s right to die should they desire no further treatment. Over sedating people who might have a change in condition is a big issue. At least for now in the US we have living wills and healthcare powers of attorney to convey the patient’s wishes.

  2. Steve,

    I am sorry to say Steve, you have the wrong facts. The administration does not have a health care proposal only the congress thus far has put forward any bills. The end of life issue which was about the right to consult professionals on this topic was withdrawn in committee.

    Many of us already consult our lawyers on this issue and utilize health care proxies and wills that direct options for end of life issues.

    There are a number of web sites you might consider viewing to gain the facts before you offer your views that seem to ignite unwarrented and needless passions on subject matter not in evidence. Shame on you……..

  3. Fanfare, I appreciate your point of view. I’ll happily rebut over the weekend. Just wanted to let you know I read your post.

  4. Fanfare,

    Let’s begin with the premise which I think is valid: health care in the US needs addressing. The question is, how much must be changed and in what manner? Personally, I believe much more simple and less intrusive plans exist, beginning with addressing the nightmare of non-competitive insurance companies.

    Interestingly, EVERYONE of my doctors (5 of them) have expressed dismay at what the Administration (sorry, it is the Administration’s plan that serves as the basis of the bills being proposed – more on that later) is proposing. Each of them has said to me to expect rationing – as it exists in every governmental administered health care plan in the world.

    Finally, let me add that I try to see politics through Christian eyes – rather than Democratic or Republican eyes.

    Now, this is a quick response – much more will follow – that I pulled from my “health care” file on my computer. These are generally non-partisan resources, though not all will be – and I will quote both sides (ex., Camille Paglia, Obama fan, below):

    1. It is Obama’s plan. One source amongst a myriad noting this: Fact Check.

    2. Fact Check: Despite what Obama said, the House bill would allow abortions to be covered by a federal plan and by federally subsidized private plans. As a Christian I find this appalling.

    3. Fact Check: The bill does offer end-of-life services: The accepted definition of end-of-life planning means thinking ahead about the care you would like to receive at the end of your life – which may include the choice to reject extraordinary measures of life support, or the choice to embrace them. For instance, the National Library of Medicine describes end-of-life services as “services [that] are available to help patients and their families deal with issues surrounding death.” Personally, having the agency providing my health care “helping” me make end of life decisions – particularly the State (any State) is chilling.

    4. Multiple sites note rationing will be de facto and is de rigure. One example, Camille Paglia (an Obama advocate, though not blinded by the light) in Salon Magazine wrote: “Face it: Virtually all nationalized health systems, neither nourished nor updated by profit-driven private investment, eventually lead to rationing.”

    5. The CBO has already said – and been proven right – that the Administration’s cost assessments were fanstasmic. Fortune tells us the same thing. Obama’s health plan no bargain: Fortune Magazine

    6. Liberty Counsel, a nationwide public interest religious civil liberties law firm does a nice line-by-line walkthrough of the 1000 page plan.

    7. Finally, John Mackey, CEO of Whole Foods offers a spectacular analysis and alternative to “ObamaCare.”

    I stand by my post – unashamed and unbowed.

  5. I have ALS. I also have filled out the paperwork with my lawyer for end of life decisions. Those decisions are based on the way I perceive Medical decisions will be decided. Now I read the DNR “do not resesitate” patients at Memorial Hopital during Katrina were given high doses of meds to end their lives when the going got tough. I signed a DNR but I didn’t intend it to mean I should be discarded like the Katrina patients. Now all this talk about changing health care and medical proceedures. I need to rethink what I’m signing.

  6. Thanks for your fact checking. A few thoughts:

    1. Good resource!
    2. Clearly, the government due to its political focus on plurality makes such decisions based on the current law, and not moral bases.
    3. the plan FINANCES end of life services, but presumably it is physicians or professional counselors who actually provide them. One could suspect the motives of those hired by “the plan,” but then one would also have suspect the motives of the physicians and related professionals working for private insurance who daily make decisions regarding whether services are “medically necessary” (and hence covered) by their company’s policy.

    4. De facto rationing occurs now in that not everyone can afford insurance, and also see 3 above. I if what one is hearing is that more affluent individuals who currently are able to afford everything are worried they will get thrown in to the same bin as the less affluent. While the “walking in the shoes of another” idea is not scripturally based, maybe something of the “Do unto others. . .” applies?

    5. This if course is the big problem. My conception of some of this was that comprehensive coverage of basic preventive care for all and an ability to dictate terms to providers/ pharmaceutical companies based on large subscribership would help bring costs down, but such arguments are obviously based on the idea that such a comprehensive plan could be run efficiently (!) and that it wouldn’t cause providers to decide it wasn’t worth it. Having worked in the Boston academic hospital setting during the initial HMO vs. hospital partnership/networks “dynamic” (and in a way having been on the other “side” of reducing costs via reducing reimbursement by fiat, I acknowledge the complexity and potential unintended consequences of such a strategy.)

    6. OK, this will take some time to digest.

    7. Thanks for sharing that; I actually like that analysis very much and the idea of allowing for “high deductible” policies (to cover those who would otherwise opt out of insurance) is very interesting indeed. I would however add that there should be some provision to still incentivize preventive care as an at least theoretical mechanism for trying to avert later costly and catastrophic illness.

    Also, the one hole in the idea of treating health care as a responsibility rather than a right is the question of what to do for children even if their parents are not responsible in this regard.

    It may well be that the recent talk in the Obama administration about walking back the idea of a completely government run plan is a tacit acknowledgement of particularly the cost issue (again, while the political talk is uncompromising, one hopes that on both sides the walk is based on more realism and rationale).

    As an alternative, I read this other editorial by Peggy Noonan where she suggests a middle ground of simply expanding Medicare to allow people other than those over 65 to qualify as a substitute “government-plan-of-last-resort:”

    http://online.wsj.com/article/SB10001424052970204619004574320743837417378.html

    Of course, there was already the question of how much we could afford to finance the looming Medicare/Social Security “bubble” before the economy tanked. But compared to the other proposed government plan, that might seem paltry. But obviously I don’t have numbers, and don’t know if anyone has considered calculating them.

    Interestingly, a sidebar note to such a thought is that relatively little has been made by at least tentative efforts by a joint HHS/DOJ strike force to reduce Medicare/Medicaid costs by cracking down on fraud:

    http://www.hhs.gov/news/press/2009pres/06/20090624a.html
    http://www.reuters.com/article/domesticNews/idUSTRE55M76R20090623

    Probably because the estimated savings and estimates of fraud are seemingly elusive:

    http://www.politifact.com/truth-o-meter/statements/2009/aug/27/tom-coburn/coburn-says-20-percent-every-medicare-dollar-goes-/

    (parenthetically I agree this raises the spectre of even greater fraud opportunities in a large automated government-run program)

    No definitive answers, just some thoughts on what to look for/be careful about regarding “reform” geared toward insuring the uninsured and reducing overall healthcare costs.

    Kyu