UK-based The Daily Telegraph printed a story illustrating one of the dangers of socialized medicine. Based on a Freedom of Information Act request, the report demonstrates financial incentives were paid to National Health Service (NHS) hospitals to employ a controversial treatment, called Liverpool Care Pathway, for patients believed to be dying. The treatment can involve withholding diagnostic tests and “nonessential” treatments. In some cases “can involve the removal of hydration and nutrition from dying patients.”
In a sample, NHS hospitals were paid at least an equivalent of $20 million (£12.4 million), and potentially in excess of $32 million (£20 million) as an incentive for putting patients on the “treatment” course. As the debate over government’s proper role in healthcare in the US continues, this example from “across the pond” shows us exactly why Americans should be distrustful of a greater role for government in the healthcare sector of the economy.
We’ve heard the argument before. It goes something like, “well healthcare in the UK is so much better and efficient than here because they don’t give you medical services until you really need it.” Or so the argument goes.
The fundamental flaw for the pro-government approach to health care delivery is that politicians and government bureaucrats tend to see “healthcare” as a finite resource that must be distributed as “fairly” and as equitably as possible to the voting constituencies (or an even more cynical view, campaign donating constituencies). In dessert terms, government views healthcare as a cake and its mission is to decide who will get how big of a piece. We’ve heard ad nauseum from one presidential candidate about fairness. We’d like to point out that our founding documents, the Declaration of Independence and the Constitution, which describe the roles and powers of government does not discuss “fairness.” They do, however, mention “freedom.”
And freedom is lost in a government-controlled healthcare system. As seen in the bureaucratic machinations of the Affordable Care Act, an unelected, appointed group of bureaucrats serving on the Independent Payment Advisory Board will wield power (not subject to Congressional override) to determine anything from a list of accepted treatments to an overall “per capita funding level” in the event that the growth of medical payments exceeds targeted amounts.
Government fails to efficiently allocate resources because it is subject to political pressures. Would government mandates have lead to the creation of “minute clinics” now popping up in various pharmacies and discount stores across the US? No, of course not. Because rather than finding a way to more efficiently deliver service–and thus find a way to increase the size of the healthcare cake available to all, government is locked into its finite resource mentality of allocating scarce resources. It’s the incentive to reap the rewards of their innovation that has inspired US companies to research and develop new medical technologies–technologies that other countries benefit from (even those with socialized medicine). If the US turns to socialized medicine, who will be left with any incentive to develop new and life-saving medical innovations?
Sarah Palin is noted for coining the phrase “death panels” and was savagely criticized for it. But the reality is she’s far closer to the truth than those who attacked her for using the phrase to describe the future of government-managed care in the US. The UK health system uses a metric called “quality adjusted life years” to determine if a disabled or elderly patient will be eligible for various treatments. One of President Obama’s healthcare advisers, Ezekiel Emanual, is noted for his contributions to the Complete Lives System, which evaluates a patient’s future overall value to society in decisions of allocating healthcare resources.
Which leads us to our conclusion. If government is permitted to decide what treatments are available to certain patients, healthcare in the US becomes an entirely new proposition, not unlike the relationship many people have with their cars. When a car needs a new transmission or another expensive repair, many owners (excepting true car lovers!) either resort to a do-it-yourself option or often weigh the cost of a repair against how many useful years a car “realistically” has left. If the fix is determined to be more expensive than its worth, the car owner evaluates trade-ins or how to finance a new car.
This is the undeniable reality of government-managed care that we see coming via “Obamacare.” Government management of the healthcare system chases political rewards rather than economic ones. If a company finds a low cost and profitable way to deliver care via a minute clinic, patients win by finding a low cost provider, and the company wins by earning profits. But instead of engaging in this market-based behavior, the UK government established financial rewards to ease a patient’s passing and allocate scarce healthcare dollars to other areas. It kind of reminds us of another group, also from the UK:
(Warning: Strong Language at close of clip, but very funny!)