A death a day


Do we really want nationalized health care? Every time I read about another country’s centrally controlled system –France’s, Canada’s, or Massachusetts, for example, our partial free-market system looks just fine by comparison, for all its problems.

Via the Heritage Foundation, we read about the latest From Britain’s National Health Service. As the Times reports, an award-winning hospital treats its patients to Third World conditions:

A catalogue of failings

Lack of staff

Receptionists with no clinical training assessed A&E patients, and were responsible for checking them in the waiting room. From September 2005 to March 2008, A&E operated with two senior doctors, not three. For months there was one emergency consultant, making 24-hour cover impossible. The trust relied on senior doctors not specialising in emergency medicine, or middle-grade doctors. In one fortnight there was no consultant or middle-grade night cover.

Patients in pain

Patients suffered without treatment for hours. A senior doctor told of a patient with a broken elbow that pierced the skin who had no pain relief for four hours. A patient with a history of heart problems waited for 40 minutes. Patient alert buzzers could sound for 40 minutes unanswered. Families said that help with feeding was minimal and some patients drank water from vases.

The target culture

Staff said that there was “pressure, pressure, pressure” on them to meet the four-hour A&E waiting time target. Doctors recounted occasions where managers asked them to leave seriously ill patients to treat minor ailments instead so that the target could be met. One was asked to leave a heart-attack patient being given life-saving treatment. Nurses left meetings in tears after being told that jobs were at risk after a target was breached. Patients were “dumped” into wards near A&E so the target could be met. This led to delays in X-rays and increased risk.

Poor equipment

Lack of training on cardiac monitors meant that some were switched off. Some nurses alerted to an alarm on a machine were unaware of what it meant. A resuscitation trolley was not checked for seven months, with items missing and drugs out of date.

Read the whole thing. The article quotes people involved in the hospital and the investigation as blaming the bosses, which is true as far as it goes: their conduct was reprehensible. But the fact is, as Heritage points out, that the top-down system itself creates incentives for meeting management and budget goals first, usually at the expense of patient care:

This reveals, yet again, the fundamental flaws with top-down national health care systems, and, indeed, with excessive top-down control in all areas of life. First, the more responsibilities the bureaucrats at the center assume, the more targets, mandates, goals, and requirements they push down the system. But by trying to control everything, a top-down order ends up controlling nothing, except the flow of paperwork: the more it tightens it grip, the more humanity slips through its fingers. Second, a centralized system incentivizes people to be more concerned with managing the system than with managing their jobs. And when their job is making life and death decisions, that’s a recipe not just for failure, or even for expensive failure. It’s a recipe for inhumanity.

Nationalized health care is rationed health care, which means some people will get turned away. And yet, this is the very kind of system the Obama-Pelosi Democrats want to impose on us.

No, thank you. Not talking

LINKS: More from Dr. Paul Hsieh — America doesn’t need a ‘health care czar’


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