I think that American government bureaucracy will maintain a marvelous sense of efficiency when it comes to running health care for everyone. Unfortunately, the sense in which I’m using “efficiency” doesn’t have any direct relationship to people getting well. It’s going to be more about the numbers that bureaucrats can trot out in front of Congressional committees and occasionally to the public to show said efficiency. The actual care provided under such a system will be quite another matter.
In the past I’ve anticipated a three-pronged approach that will tighten up, as it were, the performance of an American system of “universal” care.
First will be a wide-ranging program of eugenic “editing” for the unborn, where “therapeutic” abortion will be “highly recommended” not just for potentional cases of Down’s syndrome and genetic disorders of that level, but for many other “costly” and troublesome conditions that might afflict the human being after it leaves the womb. Juvenile diabetes will certainly have to be considered for “therapy,” if and when pre-natal tests are available for it. But genetic predisposition to heart disease, various cancers and other big, costly killers will certainly need to be looked at for “therapy,” lest they burden the system.
Why gum up the works of the system when a simple test and some minimally invasive suctioning can provide that ounce of “prevention” so famously less expensive than the pound of cure? We want a healthy population, don’t we?
Second, at the end of life, the “right to die” will need to evolve very steadily into the “duty to die.” The elderly will, I predict, come to view a trip to a hospital as a certain death sentence and begin to resist being removed to one for any reason. That will of course require that legal instrumentalities be firmly in place to force them to go. (We wouldn’t want to have news stories about elders preferring to just die at home in their own time rather than go to a “universal” hospital and be put straight on the euthanasia ramp. That kind of publicity would damage the reputation of the system!)
Third, in between the weeding out of the unborn and the culling of the elderly, care will need to be carefully rationed, particularly for those with chronic conditions that haven’t been caught at “phase one” and are so costly to treat.
All of this is necessary to keep those who are healthy very satisfied with their “universal” coverage. After all, that’s the target market, the healthy, who will be so pleased and reassured to be protected. As long as they are healthy, how generous it will all seem.
Fortunately, we have the well-tested National Health Service of the Mother Country, the U.K., now smoothly humming along through its 61st year of steadfast health care, to guide us in our quest for a truly efficient “universal” system. For instance, we don’t want our nurses acting out like this:
Latest news in the exciting saga of Britain’s socialized medicine is that a nurse, Margaret Haywood, aged 58, has been struck off for the crime of exposing neglect and mistreatment of elderly patients at the Royal Sussex Hospital on a television program. It was found that because of this: “It would not be in the public interest for her to be able to practise as a nurse.”
“Struck off” is the British term for getting fired from your job for cause. The responsible bureaucrat explains:
Linda Read, chair of the panel responsible, said: “Although the conditions on the ward were dreadful, it was not necessary to breach confidentiality to seek to improve them by the method chosen.”
If one were to say about the British NHS that it specializes in the “old ways” of care, one would not be far from the truth. In fact, some of the care in that system takes you back a good century and a half:
It had already been established that filthy conditions in British hospitals have been the cause of many deaths. The Daily Telegraph wrote in 2007 that in the hospitals run by the Maidstone and Tunbridge Wells National Health Service Trust staff told patients suffering from diarrhea to “go in their beds.” Between 2004 and 2006, 90 patients there died from Clostridium difficile, and the disease was a factor in the death of a further 241: “Were it not for bad nursing, bad medical attention and bad administration, none of these patients need have died. Indeed, they would not have contracted C. diff. at all unless they had gone into hospital. So, after 150 years’ advance of education, technology, prosperity and science, we have lost what Florence Nightingale taught [about cleanliness].”
That’s the great thing about a government run system: according to the government running it, it’s a wonderful thing, and if you want to work in the system, you had better get that part straight. Because you can’t go running to the government to help you straighten the situation out.
Hit the link for the rest of the piece.
I think that America will find methods of efficiency in its “universal” system that will far outclass the Brits, and that many of these health problems will be eliminated before they show up on crowded wards.