We can all agree that America’s health care is an inefficient amalgam of private and public with at times anomalous and unfair results. But where the government provides almost half of the funding and drives the rest of the system through the tax system, such problems are inevitable. The question is whether increasing political control would improve the treatment of patients–which is, after all, the purpose of the health care system The answer to that question is no.
Unfortunately, increased governmental control almost certainly would put political before patient priorities. We certainly see that in Great Britain. Consider this astonishing story from the Daily Telegraph (it’s a couple months old, but I just came across it):
People arriving at Accident and Emergency departments with symptoms which could indicate the aggressive spread of the disease are waiting weeks for diagnosis and treatment while “routine” cases are prioritised.
Hospital managers told researchers that treating desperately sick patients more quickly would “reflect badly” on their performance against Government cancer targets which only cover those referred to specialists by GPs.
Doctors, patients groups and politicians were appalled by what one described as a “breathtaking admission” which confirmed their “very worst fears” about how far the NHS target culture has gone in distorting clinical priorities.
The point is not to demonize the British system. But obviously the NHS has to fulfill political targets and respond to bureaucratic priorities, which often have nothing to do with, or even actively subvert the objective of, providing quality patient care. And it is far harder for British patients to escape the system when it miscarries so badly.
We can’t afford to make a similar mistake here.