The NHS: Dogma vs. experience

BELFAST, Northern Ireland—While the Obama administration offers life support to its Affordable Care Act, in the UK a growing number of people are asking whether it’s time to pull the plug on the National Health Service (NHS), which is in critical condition.

For many years the UK media have carried stories that not only bode ill for the future of government-run healthcare, but also continue to serve as a “code blue” warning to the U.S. as to what might be in our future if we decide to go down that road.

Writing in The Daily Telegraph under the headline, “It’s time to make difficult decisions about the NHS,” columnist Judith Woods says, “The NHS, dying on its feet for decades, is in a critical state. The promised injection of cash may stabilize it temporarily, but the chances of a full recovery are nil.”

She is not alone.

A headline in The Guardian, declares the NHS “on the brink of extinction.”

While in America there are concerns about an insufficient number of younger people signing up for Obamacare, in the UK among the latest causes for concern is a plan that The Guardian writes “… would only see new drugs licensed for NHS if judged to be a benefit to wider society.”

Does this sound like a close relative of eugenics? Let us not talk of “death panels,” or should we? In the UK, the National Institute for Health and Care Excellence decides whether new medicines should be approved. Might it someday also come down to some official deciding who gets treatment and who doesn’t? Changing the name of the decision-making entity doesn’t alter the intent, or the outcome.

Already, according to the Daily Mail, citing a report by the European Commission (EC), “Britain has fewer doctors per person than nearly all other European countries.” There are just 2.71 doctors for every 1,000 people. The EC reports the UK ranked “24th out of 27 countries in the EU, behind some of the poorest countries, including Bulgaria, Estonia, and Latvia.” General practitioners are paid 1,500 pounds (about $2,500) a shift to cover nights and weekends in overburdened ERs. Can one see this crisis looming on America’s horizon as the current supply of doctors proves inadequate to treat a flood of new Obamacare patients?

What’s more, stories about incompetence and corruption within the NHS, once the exception, are now common. “Blood donors turned away by clinics’ incompetence,” says a headline in the Daily Mail.

The NHS was supposed to reduce the number of people who seek treatment in emergency rooms. Instead, the BBC reports, some patients visit them as many as four times a week. Citing data from 183 sites obtained under the Freedom of Information Act, BBC News writes, “… nearly 12,000 people made more than 10 visits to the same unit in 2012-13. A small number of those—just over 150—attended more than 50 times.” The same has proven true for Obamacare. Obama said that coverage would result in fewer ER visits, when in fact studies already show that the newly covered are visiting ERs more frequently.

An editorial in The Daily Telegraph says, “The NHS is cursed by a devotion to dogma.” People have come to expect “free” care and the cost of “free” is breaking the system. The editorial recommends everyone visiting a GP should be required to pay 10 pounds ($16) to “discourage those with minor ailments” from making a trip to the ER.

Dr. Mark Porter, chairman of the council at the British Medical Association, has said that if the NHS were a country, it would barely have a credit rating. He warns: “A growing and aging population, public health problems like obesity, and constant advances in treatment and technology are all contributing to push NHS costs well above general inflation.”

If the NHS can’t be sustained in the UK, why would anyone believe an American experience will be different? The ACA, of course, is not nationalized healthcare (people pay insurance premiums, after all) but some think it could evolve into that.

If it’s a question of dogma vs. experience, experience should prevail. The UK experience with nationalized healthcare can teach America something.

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