Starving Under Socialized Health Care
It's not been a good few weeks for Britain's National Health Service since it was dragged into the debate over plans to reform the U.S. health care system. After U.S. opponents of ObamaCare and domestic critics -- such as MEP Daniel Hannan -- highlighted problems with the NHS (some very real, others exaggerated) to warn against the dangers of socialized medicine, defenders of our state-run system rallied to its defense, dismissing the concerns of U.S. conservatives as scaremongering.
One of the biggest areas of concern for those who oppose increasing government control over health care in the U.S. is the issue of end-of-life care, a debate that's generally framed in terms of "pulling the plug on grandma" and "death panels." Since I wrote the piece linked above, several stories have emerged in the British press suggesting that, despite all the protestations to the contrary, under socialized health care the lives of thousands of elderly and terminally-ill patients are ended prematurely through a combination of neglect, incompetence, and misjudgments by doctors.
First up was a report by a body representing NHS patients, which claimed that hundreds of thousands of patients have received "neglectful, demeaning, painful and sometimes downright cruel" treatment. This included patients receiving inadequate food and drink and having operations repeatedly canceled and symptoms misdiagnosed. In many cases the failings contributed directly to a patient's death.
A few days later came a report which claimed that prisoners in Britain's jails have a better diet than hospital patients.
Then, a group of doctors wrote to a newspaper to warn that NHS guidelines designed to improve care for the terminally ill were in fact resulting in patients having their lives ended prematurely. The scenario is as follows. A patient loses consciousness due to the side-effects of drugs or because of dehydration. A doctor interprets the loss of consciousness as an indication that the patient is close to death -- and so food, water, and medication are withdrawn. No panels, no pulled plugs -- just an inevitable downward spiral ending with an officially sanctioned and apparently "natural" death.
As I have related in my previous piece, I have intimate knowledge of how the NHS works, or fails to work. On several occasions my elderly mother was admitted to a hospital from her nursing home after becoming semi-conscious, usually following some minor illness unrelated to the dementia that eventually killed her. Each time the doctors would explain that there wasn't much they could do, but each time the immediate problem turned out to be nothing more than dehydration.
Each time mum would come back to life, like the pot plant in ET, after a few hours hooked up to a saline drip.
On one occasion I remember the consultant coming around, spending about a minute assessing mum's condition, and proclaiming that "all we can do is keep her comfortable." The next day, one of the junior doctors working under the consultant was stunned to find mum sitting up in bed, talking to me, and drinking a cup of tea.
"Is she normally like this?" the doctor inquired. I took her aside and, doing my best to remain calm and polite, explained that, yes, this was what she was normally like when she had enough to eat and drink, and that I didn't feel the provision of proper nutrition came under the category of interventionist, life-extending care.
Leaving aside the complex clinical aspects of caring for the elderly and terminally ill, as the aforementioned reports testify the most serious failing of the NHS is surely the inability to adequately feed those under its care -- which at best makes recovery from illness more difficult, and at worst hastens death. Proper hydration is even more fundamental -- vulnerable patients can go a while with relatively little food, but they'll quickly succumb to dehydration which in turn causes them to stop eating and leads to a rapid deterioration in their condition.
The problem has been highlighted time and again in recent years, and each time health chiefs promise to take action but nothing changes.
Hospital food isn't great, but it's okay -- as long as long as you are able to eat it, and by definition many elderly and seriously ill patients are unable to feed themselves. Whether it's due to lack of numbers, pressure of time, or simple incompetence, nursing staff appear incapable of fulfilling the basic duty of feeding the patients under their care. A popular gimmick with hospital bosses is to bring in a celebrity chef to "liven up" the menus, but that's missing the point: you could serve up oysters, truffles, and lobster but it's not going to do Mrs. Jones much good if she can't reach it or can't cut it up.
My brother and I learned to schedule our visits to coincide with meal times so we could help mum eat. We often ended up helping other patients too.
So, more or less by accident, the NHS has developed a simple and very efficient solution to the "end of life" dilemma -- and you don't even have to be particularly close to the end of your life to qualify. You go into hospital, you receive inadequate care, and if the lack of care on its own doesn't kill you, the resulting deterioration in your health will be enough to persuade a passing doctor to hang the "Do Not Resuscitate" sign over your bed.
If you're old or terminally ill in Britain you'd better hope that you have someone to fight for you in your corner or, failing that, a living will and a good lawyer.
Of course, many of the problems that beset the NHS -- increasing centralization, consolidation, and cost-cutting leading to low staff morale and a diminution of patient care -- aren't unique to publicly run health services; large private health concerns can also be badly run. But those problems are exacerbated by the layers of bureaucracy, the lack of accountability, and the "it's not our money" attitude characteristic of public services.
While Obama and the Democrats may be backtracking on the "public option" just now, there's no doubt that, by fair means or foul, they want greater government control over health care -- with the ultimate prize being a single-payer system. Such a system may or may not resemble Britain's in its design, but you can be sure that it will fall prey to the same institutional failings. And the steady stream of horror stories from the NHS tells you where that leads.
There's no need to pull the plug on grandma when you can just pull the plate away.
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