Stanley Feld M.D.,FACP,MACE
Sometimes, in order to believe a certain ideology, some smart people take the position of not wanting to be to be confused by facts.
Countries with socialized medicine have said their citizens are happy with their care. Therefore, this is the evidence that the U.S. should have a socialized medicine system.
Less than 20% of a nation’s population experiences the healthcare system at a moment in time . The 80% who are not sick are happy because they feel secure. If they got sick they believe they would receive free medical care. The result is the majority of the population under a socialized medical system likes the system.
This Is A FACT (TIAF)
Dr. Donald Berwick former acting head of CMS and author of Obamacare wrote, in a personal letter to “Senior Government Officials and Senior Executives of the National Health Service in England after doing a review of the NHS.”
“You are stewards of a globally important treasure: the NHS. In its form and mission, guided by the unwavering charter of universal care, accessible to all, and free at the point of service, the NHS is a unique example for all to learn from and emulate.”
Dr. Donald Berwick added, “redistribution of wealth is the very essence of a compassionate healthcare system for all.”
I disagreed with Dr. Berwick in an earlier blog. I said citizens responsible for their own health, healthcare and healthcare dollars are essential ingredients for a cost efficient healthcare system.
Patients are the primary stakeholders. Patients must be actively responsible for their health. They must have a moral and intellectual responsibility for their own health as well as a financial incentive to be responsible for themselves.
They must have own their healthcare dollars, have the freedom to make their own healthcare choices and have access to care.
The government must create educational vehicles to help patients make the correct choices.
The government must provide financial incentives for people to make those choices.
Medical care and medical decisions made for patients by a bureaucracy has historically failed to control costs or provide efficient and compassionate medical care.
Socialized medicine run by bureaucrats has failed in England. Medical care consumes more than 50% of England’s GDP.
This Is A Fact (TIAF)
Medicare is wonderful for people over 65 years old. Seniors could not buy healthcare insurance from a healthcare insurance company. The healthcare industry had not figured out how to make money from these people so they disqualified them.
This Is A Fact (TIAF)
Medicare and Medicaid provide no incentives for patients to take care of their health.
Chronic diseases are ineffectively managed. The complications of chronic diseases consume 80% o f Medicare’s healthcare dollars. If chronic diseases were managed properly the complication rate from chronic diseases could be decreased by at least 50%.
This Is A Fact (TIAF)
Many patients do not have the incentive to take care of themselves . They leave it up to the system to take care of them.
Unfortunately, it has be demonstrated that a government controlled system creates ever increasing bureaucracies and cost inflation.
This Is Fact. (TIAF)
Most all of the nation’s attempts to control healthcare costs in the past 50 years have failed. (Price control of the 70’s, HMO’s, Managed Care, PPOs.)
These systems had to be abandoned. Nevertheless, healthcare policy wonks continue to give the same advice and make the same mistakes. The policy wonks’ advice is to institute greater government controls over medical care.
This Is A Fact (TIAF)
A recent report about England’s hospital conditions in Mid Staffordshire has emphasized the defects in England’s 60 year socialized medicine experiment.
The report only covers hospital inpatient defects. It does not cover the many defects in outpatient services.
5 February 2013 to the Secretary of State.”
1. For many patients the most basic elements of care were neglected.
2. Calls for help to use the bathroom were ignored and patients were left lying in soiled sheeting and sitting on commodes for hours.
3. Patients felt afraid and disenfranchised.
4. Patients were left unwashed, at times for up to a month.
5. Food and drinks were left out of the reach of patients and many were forced to rely on family members for help with feeding.
6. Staff failed to make basic observations and pain relief was provided late or in some cases not at all.
7. Patients were too often discharged before it was appropriate, only to have to be re-admitted shortly afterwards.
8. The standards of hygiene were at times awful, with families forced to remove used bandages and dressings from public areas and clean toilets themselves for fear of spreading infections.
9. These healthcare conditions caused the deaths of an unknown number of patients.
Robert Francis QC Inquiry Chairman who wrote the report covered a wide range of system failures. I will only highlight the key failures contained in the 500-page report. This report was mandated by the House of Commons.
These defect are occurring throughout the entire NHS system. The NHS is not as glorious as the Obama administration or Dr. Berwick’s has idealization the NHS to be.
"The trust board did not listen sufficiently to its patients and staff or ensure the correction of deficiencies brought to the Trust’s attention."
The NHS bureaucracy did not put patients first. It put the various levels of bureaucracy in charge. Bureaucracies deaden incentives and lose focus on who is the main stakeholder in the healthcare system.
"The trust failed to tackle an insidious negative culture involving a tolerance of poor standards and a disengagement from managerial and leadership responsibilities".
"This failure was in part the consequence of allowing a focus on reaching national access targets; achieving financial balance and seeking foundation trust status to be at the cost of delivering acceptable standards of care."
Appropriate statistical reports and collection of reports are more important that appropriate patient care.
Robert Francis goes on to outline how the bureaucracy puts measurements first, not patients.
None of the bureaucrats want to take responsibility for what is going wrong. Finger pointing and blame shifting is an occupation in the British healthcare system.
"The NHS system includes many checks and balances. These checks and balances should have prevented serious systemic failure of this sort."
"There were and are a plethora of agencies, scrutiny groups, commissioners, regulators and professional bodies, all of whom might have been expected by patients and the public to detect and do something effective to remedy non-compliance with acceptable standards of care.
For years that did not occur."
We are falling into the same trap with Obamacare. It might sound good to some. It will not work judging by the experience of others.
Unfortunately, the Obamacare’s model is the British healthcare system. I do not think the traditional media should praise it. The traditional media should publish the facts of history.
The traditional media should call for the repeal of Obamacare.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone