Why the UK Is Ditching Socialized Medicine


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There is more than a little irony attached to the Obama administration’s determination to pursue socialist, EU-style “solutions” to America’s problems, even as the European Union is coming to grips with the bitter realities such socialism produces. And while Greece and its financial problems receive some media coverage in the United States, there is a much bigger story flying under the mainstream media radar: in Britain, Prime Minister David Cameron has introduced a bill seeking to partially privatize the National Health Service (NHS). Why? Because the British government is “hoping to avoid a Greek-style financial meltdown.”

The system’s defenders are upset. The Times of London is reporting that Health Secretary Andrew Lansley is in the eye of the storm. “Andrew Lansley should be taken out and shot,” said an unnamed “Downing Street source.” “He’s messed up both the communication and the substance of the policy.” The source further contended that Lansley was “a disaster” and “a law unto himself.” The British Medical Association and the Royal College of Nursing also want the bill withdrawn, as do members of the Royal College of Pediatrics and Child Health, the Royal Medical Colleges, including the Royal College of GPs. Unions, including the Royal College of Midwives, want to “kill the bill” as well, while Labor Party leader Ed Miliband accused Mr. Cameron of failing to listen to the experts.

Cameron refuses to back down, insisting there’s too much bureaucracy in the system, and that it interferes with patient care. “If we were as good at treating cancer as the average European country, we would save 5,000 lives a year,” he contended. He further noted that reform will create “a fair system that stops the private sector from picking off contracts and the public sector from providing an inflexible monopoly.” Yet he insisted that “health care for all, free at the point of use, unrelated to the ability to pay” will remain the animating features of the system.

Such euphemisms are at odds with reality. Last November, the NHS’s Hinchingbrooke Hospital in Cambridgeshire, running at a loss of $8 million a year on revenues of $143 million, was given over to Circle, a private health care company. Circle was brought in to cut bureaucracy and improve efficiency, and it is the first private company to take over an entire British hospital. Earlier this month, an NHS “watchdog” at the National Institute for Health and Clinical Excellence (NICE) ruled that a breakthrough drug used to extend the lives of men with late-stage prostate cancer was too expensive to be included in the system. NICE makes calculations based on the “cost of the drug to the NHS according to the number of men likely to be treated.” NICE will pay for some end-of-life drugs for rare diseases. But the current, though unofficial, threshold for QALY (quality-adjusted life year) drugs has been $80,000 for renal cell carcinoma. “Therefore the £63,200 ($101,000) cost per QALY for abiraterone would still not be deemed a cost effective use of NHS resources,” said a NICE statement.

Such rationing–and it is rationing–is nothing new. A 2011 report revealed that independent medical providers were experiencing a growing number of patients choosing to pay for their own care after having treatment delayed or denied altogether by an NHS primary care trust (PCT). A survey of 101 influential industry figures revealed that 34 percent believed “budgetary pressure in the NHS” was the principle cause. At the annual meeting of the Chartered Society of Physiotherapy (CSP) earlier this month, members contended that they were “increasingly being asked to make decisions based on financial rather than clinical reasons and to ration their care,” further noting that such rationing “was on a scale that had never been seen before across both acute and non acute NHS services.”

Last November, such rationing reached a scandalous level. A study by the Co-operation and Competition Panel (CCP) revealed that Primary Care Trust (PCT) heads were imposing arbitrary spending caps, denying patients treatment for procedures such as hip replacements and cataract removals–and that waiting times for services were being deliberately extended “so that patients would go private or die before they were seen” to slash costs. Secretary Lansley was furious. “For too long, Labour turned a blind eye to unfair practices within the NHS which harmed patients,” he said. “No right-thinking person could possibly understand how anyone could delay a patient’s treatment unnecessarily. If patients need treatment, they should get it as soon as possible, and where they choose.”

“As soon as possible” is yet another euphemism. Brits have a legal right under the NHS Constitution to start their hospital treatment–within 18 weeks after a referral by a GP. Yet referrals require diagnoses, and the wait for those is increasing as well. The Guardian reports a 92 percent increase compared to last year in the number of people waiting more than the NHS’s recommended six-weeks for a diagnostic test at an NHS hospital. In other words, even under optimum conditions, people suffering from afflictions such as heart disease and cancer will face more than a five-and-a-half month wait before getting the treatment they need.

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  • sedoanman

    We must imitate Europe in everything except correcting errors.

  • Don Kosloff

    Any service or product that is offered “free at the point of use” will be wasted by the vast majority of users.

  • WarPossum101

    Ideologues is right. When Obama took office, the first thing he and the Democrat-controlled congress did was pursue the monster health care bill. All other priorities, like the wars and the tanking economy, were deferred while the Democrats launched their banzai charge for free doctoring. Seemed to me, with everything else that was going on at the time, that the Dems were using their "mandate" not to address glaring issues but to rush through an item on the ancient Progressive agenda.

  • George Peyton

    "That’s not ideology. That’s insanity."

    Most big government efforts are.

  • Ghostwriter

    I have a newspaper article from my local newspaper about a family of English immigrants. Apparently,the parents worked under the British health care system. They moved to America to get AWAY from that system and start new lives here. I wonder what they would think about Obamacare? Their opinion would be the same as Sally Pipes.They would say,"We've seen what government health care is like. Why would you or your president want that?"

    • stuart Parsons

      Anyone in Britain can obtain private healthcare by paying an insurance company. The British family you referred to could have done this.

      The vast majority of us Brits are happy with our National Health Service. It aint perfect, but we do not have 40, 000,000 without any healthcare and hospitals do not have to check our credit rating before they can treat us. Any goverment that made serious a serious attempt to privatise medical care in the U.K, would soon be the ex-government.

      I am 82 and have reached that age because of our heallthcare system. Without it I would have been dead 20 years ago.

      We are amazed at how much Presidential Candidates have to raise in order to be elected. In the U.K a reasonable limiit is place on the amount a candidate is permitted to spend, thereby creating a reasonably level playing field for all candidates. Its called Socialism…….. oops I.m sorry I mentioned a dirty word.

      • Ghostwriter

        Mr. Parsons,the reason socialism has a bad name in this country is that it doesn't work. It has never worked anywhere. Most Americans see that. And don't blame immigrants to America for spreading lies about socialized medicine and scaring Americans to death that their freedom might be in danger. We've heard stuff like this and not just from immigrants. We've heard about this from experts on those same systems. Oh,and by the way,the British family in the article were doctors THEMSELVES.
        Americans have heard about socialized medicine in places like Great Britain and Canada. Those are similar to what is called Obamacare is promising,Mr. Parsons. Can you see why we're so nervous?

    • Ghostwriter

      What's going on here? Why are my comments not being shown?

  • johnnywoods

    Obummer is so arrogant and stupid that he believes he can make socialized medicine work, even though it has failed everywhere it has been tried, just because he says so. And of course he has the support of Harry the Red and Nancy Palooka, neither of which are towering intellects. I guess that is what we get for electing Socialists and Communist to high office in government.

  • http://www.newenglishreview.org John MJ

    The British NHS is absolutely wonderful. Were it not for my country's system of free healthcare based on need I would not be alive today and therefore I would not be paying the high taxes that successful businesspeople such as I pay everywhere. I was struggling to get my business off the ground and broke some years ago when I became ill with a life-threatening disease. I was treated in four efficient and immaculate modern NHS hospitals by professional surgeons, and others. Recuperation was also superbly provided by the NHS. I have needed drugs every day since then and those, have been provided to me by the NHS at a price that I can afford now and initially, when I was still stony-broke, free of charge. I know many other people who owe their lives and their subsequent happiness to the free at the point of use treatment as needed NHS. Not all run companies or are wealthy but all are grateful for such a civilised solution to the nations health problems. Needless to say I am a fervent supporter, in my own country, of free at the point of use healthcare paid for out of the public purse and, as a taxpayer, I am more than willing to contribute my share to the public purse to pay for it for myself and for others.

    • reader

      That's not what I hear from refugee Brits, all of whom say that NHS is horrible. Long, sometimes fatal wait time and terrible quality. I'm not even mentioning dentistry – the proof is in the putting (just open your mouth, John, will you?). And so is the Swedish health care system, by the way.

      • http://www.newenglishreview.org John MJ

        I think you are being misled by a tiny minority who may have had a bad experience – such things happen in any large organisation. I have spoken with many people who have had NHS treatment – remember, our ordinary family Doctors who are most peoples' first, and only, contact with the NHS are also free – and they are all alike in singing the praises of the NHS. I've never needed to avail myself of the free dental treatment that is available on the NHS but my partner has had to and was very pleased with the results as is his current private dentist. In my area emergency dental appointments are available free for anyone 24/7 just by calling the correct number and one of the people who work for me blessed this facility just before Christmas when her own, private, dentist refused to treat her until mid-January because he was going on holiday and said he couldn't afford to arrange locum cover! Incidentally, the dentist in question was going skiing in the USA.

    • Susan

      I have a friend that lives in the UK and they HATE their healthcare plan. She had an aunt that needed surgery so she was put on a "waiting list"…while she was waiting, she passed away. That would not have happened here in the US under our present health care. Why do you think so many Canadians come to the US for their surgeries, etc??? They hate their plan and know they will get the care that they need here in the US.

      • http://www.newenglishreview.org John MJ

        Susan,
        That shouldn't have happened even in the NHS and if it did and the aunt passed away due to whatever illness had originally placed her on a waiting list then it would have been investigated by the Police and the Coroner's Office as well as being the subject of an internal investigation in the NHS's own controlling body for the area in which it happened because it would have been deemed manslaughter due to negligence and the Hospital and the aunt's Consultant would have been in deep doo-doo.

        I must also point out that no-one is forced to use the NHS. Private clinics exist all over the UK and they always have done. Why didn't your friend pay for the aunt to go private if so little was thought of the NHS.

    • http://www.newenglishreview.org John MJ

      By the way the US people and government spends over $8,000 per person per year on healthcare which is about 18% of GDP, whereas the UK government spends out of general taxation about $3,500 per person per year, and the figure for private spending is not known but is reckoned to be miniscule, and this is about 5% of our GDP. Our total spend is about 170 billion dollars from the public purse, but the total spend in the USA from the public purse at federal, state and local levels is an estimated 1.9 trillion dollars – and another trillion dollars is spent from private sources such as corporations. Life expectancy in the USA is 50th. in the world, which is below most developed nations and some developing nations. It is well below the average life expectancy for the UK and the European Union generally. So, are you getting value for money?

      • http://www.newenglishreview.org John MJ

        It is difficult to measure the efficiency of healthcare systems. The NHS, like other healthcare systems, has never consistently and systematically measured changes in its patients’ health. As a result, it’s impossible to say exactly how much the nation's health improves for each pound spent by the NHS.

        In the UK life expectancy has been rising and infant mortality has been falling since the NHS was established. Both figures compare very favourably with other nations. Surveys also show that patients are generally satisfied with the care they receive from the NHS. Importantly, people who have had recent direct experience of the NHS tend to report being more satisfied than people who have not.

        • Forest

          $8000 hasn't been spent on me… EVER. I haven't been to a doctor in 4 years and I like it that way. Now I will be forced to buy health insurance (even though I don't ever want to go to a doctor) or pay a penalty. Fortunately since I cannot find work (and no I'm not on unemployment because I was self-employed before Obama changed some rules) my penalty will be considerably cheaper than insurance…..

  • dirt

    Looks like the Brits has some wisdom in this particular area!

  • Fearless

    When reporters asked the Prime Minister of Australia about his private health care insurance he replied he did not have any and he would go to the hospital and get treatment like everyone else. Nationalised health care works reasonably well here.

  • http://ampatriot.blogspot.com/ C.R.

    I don't think they understand–American Marxists are not innocent–they want to wreck the USA–like Europe is wrecked! They are quite insane!

  • Ghostwriter

    What's going on here? Why are my comments not been shown?

  • Ghostwriter

    I've been trying to respond to Mr. Parsons,but none of my comments seem to be showing up. Why?

  • M Harris

    "people suffering from afflictions such as heart disease and cancer will face more than a five-and-a-half month wait before getting the treatment they need."

    This is utterly untrue. The majority of patients with serious illnesses are seen within 2 weeks. The NHS has never been more popular – and at 9% of GDP as opposed to the shocking 16% of GDP wasted by the US healthcare system – it's efficient too.

    • Ghostwriter

      M Harris,Americans like me have heard a lot about socialized medicine. We don't want it here. We've heard about the long waits and the deaths from lack of treatment that are common in places like Great Britain and Canada. The NHS might seem like something we might copy,but it won't work. It has NEVER worked anywhere. Americans want to choose their own healthcare. That won't be possible under Obamacare. In fact,the more we find out about it,the less we like.
      Americans don't want something like the NHS here. We already have enough problems with healthcare,we don't need any more.

      • http://www.newenglishreview.org John MJ

        Rubbish, Ghostwriter, it works very well here. Come over and spend some time with me and I'll show you. The vast majority of us are perfectly satisfied with what is an extremely modern and efficient system that delivers good healthcare from cradle to grave – and our life expectancy is, as I said in an earlier comment, much higher than yours – and delivers it at a fraction of the cost that your system does. M Harris's post and my earlier posts give you the statistics on that. Whatever horror tales some maundering journalist has cooked up to retail to you and give you a little frisson of fear over your breakfast table are just that: like Mr Twain's death they are greatly exaggerated. When I was seriously ill my treatment started five minutes after my diagnosis which was made ten minutes after arriving at the hospital – that is the norm for seriously ill people, NOT whatever idiotic scare stories you may have had retailed to you. A streamlined modern NHS delivers great healthcare to a population of approximately sixty million at a fraction of the cost per person that the USA achieves.

  • http://www.mrinvestor.org sell DFW house

    Your comments are simply not shown because they have been send for review by the moderator..

  • Michael

    Cameron/Lansley's reforms do not apply to Britain, but only to England, in the other countries of the UK (Wales, Scotland and Northern Ireland), there are no changes to the system.

    Has so called socialized medicine failed as some here say? What does the data tell us? In the US, life expectancy was 78 years in 2007 in the US, 80.6 in Sweden (health service funded out of taxation), 79.9 in France (social insurance) 78.7 in the UK. Infant mortality was 6.4 deaths per 1,000 live births in the US, 2.8 in Sweden, 4.2 in France and 5.0 in the UK. That's not the entire picture, healthcare costs less per capita in all three European countries than in the US.

    So higher costs and worse outcomes in the US. These are averages, but there is also evidence of greater inequities in health across social groups than in Europe. The rich may do better, but the poor (and particularly the unsinsured do much worse.

  • Eugene

    Very disappointed to find this article so full of falsehoods.
    I'm an American who has been living in the UK for many years and my view on socialized medicine has done a 180 since I came here to work. My experiences with medical treatment here have always been excellent. I've never had to wait long to see my doctor. When I had a hip operation I saw my doctor, had x-rays taken, saw the specialist surgeon and had the operation all over about a two month period. I could have paid to have the operation performed privately, but the only difference is I would have had a private room instead of a shared room in the ward.
    Further, I had a resurfacing of the joint rather than a hip replacement, which is less invasive and damaging to the body. I have learned that doctors don't like performing resurfacing operations in the US because they make more money with the full hip replacement. In the US, doctors provide service to maximize their profit, not to necessarily provide the best and most appropriate service.
    There has never been the slightest hesitation to provide treatment, help, or medication in my experience. That includes when I became ill when in Belfast, asking for a second opinion for osteonecrosis at Edinburgh Royal Infirmary or using their emergency service at Foresterhill Hospital in Aberdeen.

  • http://twitter.com/fantasia_fairy @fantasia_fairy

    I'm an American living in the UK who has experienced the NHS first hand. The NHS saved my life, they caught a borderline cancer that if left would have developed into an aggressive cancer that could have ended up killing me. I was treated in an new modern hospital, with a top notch surgeon. I had a private room, and stayed three days with excellent care. I could not fault them on anything. I thank god every day that the NHS was there for me when I needed them the most.

  • Lyle

    The NHS is the most popular institution in the UK, despite the increasing private involvement that the majority oppose (http://www.bma.org.uk/ap.nsf/AttachmentsByTitle/PDFnhssystreform2007/$FILE/48751Surveynhsreform.pdf). 51% of people agree that the NHS “in general” provides a good service, but 92% of hospital in-patients described their stay as positive (http://www.dh.gov.uk/en/FreedomOfInformation/Freedomofinformationpublicationschemefeedback/Classesofinformation/Communicationsresearch/DH_4129933?IdcService=GET_FILE&dID=16549&Rendition=Web). This suggests that much of the dissatisfaction is with out-patient and social care, two areas with high private involvement. Remember that even with these “reforms” that the current goverment are pushing through, NONE of them involve removing the NHS Constitution, the legal mandate for the Secretary of Health to provide comprehensive healthcare, and most importanly, tno government will EVER “ditch” the principle that helathcare should be free at the point of need. Any government that did so would be forced out of power immediately.

  • Tommy

    Lyle said it all. This article is complete BS

  • Shane

    Lyle seems to be disconnected with reality.

    The reality of private systems under a single payer insurer is that it is a cluster-fuck and a half. It will save the British government money, but it will send quality of care through the floor, just as it has done in America.

    The problem with single payer systems is a fundamental lack of patient financial responsibility. To illustrate this point – just look at the state of rental vehicles and the stereotypes they carry across virtually all societies. This is the mentality of everyone who is ‘insured’ by healthcare. Any time they are over-billed for a service (necessary or not), they say: “Thank God I am not responsible for paying that.” Any time they are told to wait in line – they say: “Well, my insurance doesn’t cover out-of-network as well.” Or – in the case of single-payer, they wait in line or they don’t get treated.

    When patients are spending their own money on GP services – patients who wait in line will find another practitioner who is open for business. Patients who pay out of Health Savings Accounts have an incentive to question the necessity of surgeries, to investigate the cost/effectiveness of treatments, and to scrutinize the bill they receive.

    Private practices often treat insurance companies and governments the same. A radiologist will walk by and review a patient’s flow chart, scribble on it a bit, and charge for a full visit. The patient receives the bill, praises insurance (private or government) and signs to send it off to the insurer. Insurance companies will scrutinize bills and haggle with the billing department (often settling for far lower than the stated bill). Governments often have fixed rates (since they cannot afford the manpower to haggle with hospitals) and often have deadlines to pay those bills by (in the U.S. – all Medicare must be paid within 30 days of billing receipt – which is why $100 billion a year are lost to fraud).

    The government’s fixed rates are often impossible to break even with (in terms of operating costs). HemoDialysis patients on Medicare are a net operating loss to any company that accepts them. Perhaps at a state of the art Hemo clinic designed specifically to operate on as few staff, little power, and with the most maintenance-free machines possible could break even with Medicare’s pricing – but good luck. On the flip side – Private insurance is billed far higher than necessary to turn a reasonable profit to cover for the medicare patients (which is a billing standard applied to any hemodialysis clinic irrespective of its number of Medicare versus Private insurance payers).

    Fully single payer systems are simply a cattle drive with requests and denials. Doctors are underpaid and overworked and they leave the system – further burdening the system and causing the waiting line to increase.

    This is precisely why Healthcare in America is such a bipolar experience. In terms of surgery and critical care – there is no better place on the planet. I’ve been to more than a few countries and seen what kind of care is available to people and how those people treat their healthcare system. The number of Americans with practical access to replacement surgeries and advanced imaging diagnostics is astronomical by comparison to other nations. People of all income brackets can be the recipients of this care.

    Where the U.S. falls behind is in general practitioners. There are many factors that have led to the endangering of the GP in the U.S. healthcare system – but it can largely be summed up by too many regulations compounded with too many ‘customers.’ The amount of schooling required to become a GP is nationally enforced, but far more than what is necessary. The inflation of education costs (also driven by government ‘investment’) begins to directly impact what a GP can reasonably be expected to work for.

    With rapid expansion of patients on medicare and many people starting to shift to private insurance plans that pay for routine check-ups (the logic burns the mind) – GPs began to deal with underpayment for services and long waits before private insurance would approve the expense of a GP. All of this with new GPs facing increased amounts of student debt that is essentially required to become a licensed GP.

    Over-regulation of medications also factored into this. A doctor (or GP) must write a prescription for a wide range of drugs that could be just as easily prescribed by a pharmacist, also more than qualified to diagnose symptoms and make referrals (who would likely stock herbal and simple remedies if legally allowed to do so). In many cases – patients still go to a GP to get a prescription for an over-the-counter drug.

    Patients unnecessarily pile up at the GP’s office, effectively underpay him or pay him months after the fact through insurance (during which time he still has to make payroll for his staff and make payments on his student loans). The GP closes his doors, goes back to school to become a specialist, and goes to work making two or three times as much money with more manageable patient load.

    It’s similar under single-payer systems – except the doctors have to apply for jobs rationed by the government. You don’t get to go back to school to become a specialist that isn’t necessary. You just quit and find something else to do. Governments with that mentality also tend to have a pretty effective nanny state in place – so lower income is a perfectly acceptable tradeoff to less of a headache in a dead-end job.

    So, yes, Lyle – of course the British Government is going to keep its NHS ‘constitution’ that it is the responsibility of the government to provide comprehensive healthcare to its citizens.

    The delusion is that a government -can- accomplish such a thing.

    All power that a government has comes from the people it claims to represent. It can do nothing that the people could not do of their own accord, and it has nothing that the people do not have. Any time a government claims it will do something for its people; it must, by virtue of physical law, confiscate the means to do so from its people.

    And, Lyle, it is completely unnecessary for a government to have a principle of healthcare being free at the point of need. You will find that most healthcare providers throughout the world carry a mentality of: “Treat first, worry about pay later.” There are entire hospitals in the U.S. that are run off of charity (and nothing but).