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.