Arguably, the single most powerful person in the U.S.
health care system is the Administrator of the Centers for
Medicare and Medicaid Services (CMS). As the head of a federal
agency that directs the flow of nearly $1 trillion per year
through our medical system and effectively dictates quality
standards for the nation’s hospitals, nursing homes and clinical
laboratories, this bureaucrat’s influence reaches far beyond the
bounds of his statutory authority. Moreover, that influence will
be considerably augmented by ObamaCare. Thus, the American public
should be alarmed that President Obama has nominated Donald
Berwick to head CMS. Berwick is a blinkered ideologue with an
abiding admiration for Britain’s National Health Service (NHS),
and the significance of this for the future of U.S. health
care can hardly be overstated.
The NHS is no public-private hybrid. It is a full-fledged
socialized medical system. Yet Berwick has written,
“I am romantic about the National Health Service; I love it…
All I need to do to rediscover the romance is to look at
healthcare in my own country.” That the President has nominated a
man with such views to run CMS is a clear signal that he intends
to lead us out of what Berwick calls “the darkness of
private enterprise.” This is disturbing, and not merely because
it constitutes yet another broken campaign promise. The health
care system about which Dr. Berwick is so vocally “romantic” has
been an unmitigated disaster for the average Briton. The NHS, the
good doctor’s paeans notwithstanding, is a
third-world operation that employs Soviet-style central planning
to produce terrible care and worse outcomes.
The quality of care received by NHS patients is nothing
short of scandalous. Indeed, it provides consistent fodder for
Britain’s tabloid press, and more “respectable” media of all
political stripes regularly carry NHS horror stories. For
example, the BBC — hardly a hive of free-market zealots — has
run a series exposing routine neglect of elderly patients in a
major NHS hospital. “Undercover Nurse” revealed
that patients were often in agony due to improperly administered
pain medications, hungry because nurses ate their food and, in a
couple of cases, actually dead for extended periods before anyone
noticed. Obviously, this series resulted in enormous
embarrassment for the NHS. What was the government’s response? It
fired the nurse who assisted the BBC in bringing these
disgraceful practices to light.
In addition to sheer neglect, NHS patients are often
subjected to incredibly unsanitary conditions. The Daily
Mail
reported one case in which “serious hygiene breaches” were
still rampant in three hospitals where such conditions had
previously killed ninety patients. The most serious of the
continuing hygiene violations were “related to the
decontamination of equipment in the endoscopy units.” The
equipment was, in other words, frequently reused without being
sterilized between patients. At another NHS facility, a patient
stopped his surgeons from performing a procedure because he
smelled a rat — literally. The rodent in question was
decomposing in the ceiling tiles of the operating room.
Incredibly, hospital officials encouraged him to go through with
the procedure because the rotten rat presented “no infection
risk.”
Ironically, these horror stories of patient neglect and
unsanitary conditions involve the “lucky” NHS patients — those
who actually receive care of some kind. Many British patients
never endure such conditions because treatment is denied outright
as too expensive. Last year I
wrote about Jack Rosser, a South
Gloucestershire resident who had been diagnosed with
advanced kidney cancer. Although Rosser’s doctor had prescribed
the drug Sutent, knowing that it would add years to his patient’s
life, the NHS decided that it “was not worth the expense.” The
NHS calculated that the ROI on Rosser’s life was simply too low
to warrant the investment. Luckily, an anonymous American
benefactor was so moved by Rosser’s story, which had been widely
reported in the media, that he
donated the money to pay for the pricey cancer drug. Sadly,
most British cancer patients have been less fortunate.
Which brings us to the dismal health outcomes that
socialized medicine has brought to the average Briton. The NHS is
run by health care bureaucrats who, like Donald Berwick, regard
the free market as ethically dubious and economically
inequitable. Yet the “morally superior” and “fair” medical system
they have created for the U.K. produces results that give new
meaning to the epithet, “Perfidious Albion. As David Gratzer
recently
pointed out, “British cancer outcomes don’t just
trail U.S. results; they rival those of Eastern European
nations.” This isn’t hyperbole. A 2008
study showed that cancer survival rates in the
U.K. don’t come close to those of the United States. American
men, for example, have an 80 percent better chance
of surviving prostate cancer than do their English counterparts.
The study revealed similar disparities in comparative survival
rates for victims of breast, colon and rectal cancers.
Such disparities are by no means limited to cancer victims.
Heart patients subjected to the tender mercies of the NHS also
fare poorly. The Telegraph
reports that British heart attack victims are much more
likely to die after being admitted to a hospital than similar
patients in the United States and other developed
nations: “Around 6.3 per cent of patients who have suffered a
heart attack have passed away within 30 days of entering a
British hospital — significantly higher than the 4.3 per cent
average.” And, using a measure much-beloved of government health
care advocates, the life expectancy of the average Englishman
does not compare well to other European nations: “British life
expectancy is much lower than our nearest neighbours. Men in this
country can expect to live to 79 years and six months, against 81
years in France.”
So, if the NHS provides awful care and produces atrocious
results, what precisely is it about the system that Dr. Berwick
“loves”? The answer can be found in one of his most widely
publicized statements: “Any healthcare funding plan
that is just, equitable, civilized and humane, must redistribute
wealth from the richer among us to the poorer and the less
fortunate.” In other words, what he loves about the NHS is that
it “spreads the wealth around.” For Berwick, the treatment a
health care system provides and the resultant medical outcomes
are far less important than its ideological foundation. By
nominating such rigid ideologue to run CMS, with its
enormous power and gigantic budget, the President has revealed an
agenda that has nothing to do with health care. And, if
confirmed, this man will do real damage.
