There exists in England today a sometimes uncaring, often unresponsive and typically disrespectful health care system. This system, as well as other global socialized systems, not created in regard to the patient's best interest, continue to be considered as worthy of emulation by many in the United States government. This continues to be a very much ill-advised initiative. The latest "buzz" in health care is "evidence-based medical practice." Well, let's examine the evidence:
There is little question but that the American health care system is
Perhaps value is being received
because longevity and quality of life
have progressively increased and patient satisfaction remains high. There is
also little doubt, however, but that we could do
a much better job of improving service and decreasing overall cost by replacing HMOs
with MSAs (Medical Savings Accounts) and getting serious
about a paradigm shift to a truly preventive
The British prescription for health care continues to be typified by the phrase "Take A Seat." There is a remarkable complacency among a population which readily accepts the notorious British National Health Service (HNS) waiting lists for necessary hospital treatment. As the 20th century ended there were 1.12 million ever-suffering souls patiently waiting for needed hospitalization. This appears to be the price for "free care. One usually gets what one pays for. There is no doubt but that disabled Americans would be a great deal more impatient regarding their desire for prompt quality service than our British cousins.
The British Health Service continues to announce that the official list
of those waiting for care is shrinking. This is simply not so;
what has happened is that waiting lists to get on waiting lists have been
created. After waiting to be seen by a family physician a British
patient incapacitated with a spine problem may have to linger for more than
a year to see a specialist. It is up to the specialist to determine
the urgency of the case and to order any specialized tests. After the wait for the tests and the results (often a
process of months) the next wait, of about a year, for surgery begins.
Are things getting better? As of May, 2001 all indications were that
the British National Health Service continued to "languish from
bureaucracy, demoralization and capricious medical fads" (clearly not
a formula for success). ( Lawlor S: Britian's
Nationalized Medicine Needs Doctoring, The Wall Street Journal Europe, May
Socialized health care systems typically address the best interests of the state rather than the individual. The urge by these political entities to cling to unworkable and discredited policies is the stuff of legend. Tight financial controls in Japan have kept their medical costs to about 7% of their Gross National Product (GNP). The Japanese, however, also only get what they pay for. In the United States in 1996 26,200 patients were treated with defibrillators as a life-saving device. Japan (with half of the United States' population) treated only 100 such patients because such devices are rare in Japan. Many other important medical devices such as cardiac stents and other sophisticated implants are also not usually available. Because of artificially low, government mandated, physician fees the Japanese medical profession has had to turn to other means of generating income by owning their own hospitals and being their own pharmacists. In many countries today reasonable medical care is only available through the process of "black money" being passed "under the table."
Socialized systems do have some redeeming features which are worthy of emulation. In the Russian medical care system "feldchers", who are similar to "junior" doctors are used to replace more expensive fully-trained physicians or specialists. The Russian availability of free basic care for infants and children is certainly an important part of any valid health care system.
Every health care system in the world differs.
One can perform a quick assessment of a health care system by determining
their degree of
Restrictions, Regulations, Delays and the level of
disrespect directed to patients. The next assessment is that of the degree to which the system is
oriented to the patient's best interest. Quite frankly the Burton
has not yet seen a health care system, primarily oriented to the patient's
best interest, which also "makes sense" from the economic
standpoint. Americans are remarkable, we preach to the
rest of the world about the merits of the free enterprise system and the
importance of serving the patient's best interests but we are often guilty
of ignoring our own rhetoric. The real sadness is that common sense
programs which reflect the patient's best interest, allow for latest
technology, are a "true"
health care system, and are cost-effective actually exist. These programs are based
on genomic screening, early detection and appropriate preventive
care. At this time no health care system has yet implemented such a
common sense approach .