A Stitch in Haste

An ad hominem commenter to this post suggested that I know "nothing" about Britain's socialized medicine scheme, the National Health Services.

Oh, I know some things:

NHS trusts throughout the country are making sweeping cuts to services and delaying appointments in an attempt to address their debts before the end of March. Family doctors have been told to send fewer patients to hospital, A&E departments [i.e., emergency rooms] have been instructed to turn people away, and a wide range of routine procedures has been suspended.
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No patients [at York Primary Care Trust] will be given a hospital appointment in less than eight weeks, and none admitted for elective surgery unless they have waited a minimum of 12 to 16 weeks. Those treated quicker will not be paid for.

The trust also announced the immediate suspension of treatments for varicose veins, wisdom teeth, X-rays of the back, operations for carpal tunnel syndrome, bunions, arthroscopy of the knee, and grommets for the ear, among others.

Scarce resources must be rationed. If the rationing is not done by the free market (i.e., by patients, physicians, suppliers and insurers), then it will be done by politicians and bureaucrats. But it will be done.

And if your kid suffers hearing loss because the rationing includes grommets, or if you can't play with her because your back hurts, your wisdom teeth ache or your knee is giving out, well then too bad so sad. Welcome to "universal health coverage."

Are you really so much more afraid of your doctor than your M.P.?

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More:

A leaked copy of the [British] Government's pay and workforce strategy ... suggests that by 2011 there will be a shortage of 14,000 nurses and 1,200 GPs, while there will be a surplus of 16,200 physiotherapists, healthcare scientists and technicians.
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Overall there will be enough doctors, but they will be trained in the wrong ways for the jobs available.
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In a free market, doctors would move to where the work was, or the excess supply of consultants would drive down salaries, enabling more to be employed. But the NHS is dominated by centrally negotiated contracts that allow little such flexibility.

Even in a free market, skilled professionals can't turn on a dime. A criminal defense lawyer can't turn into an estate lawyer overnight, nor a cardiologist into a gynecologist nor a pediatric nurse into an ICU nurse. Central planning, with wage and price controls, political favoritism, diversity quotas and other anti-market agendas, only make matters worse — much much worse.

(Both items via John Ray.)

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Meanwhile:

Smokers who refuse to give up the habit should be denied some types of surgery, a respiratory expert says.

Matthew Peters said denying smokers joint replacement surgery, breast reconstructions and some other types of elective surgery was justified because the operations were more risky and costly when performed on smokers.

"In healthcare systems with finite resources, preferring non-smokers over smokers for a limited number of procedures will deliver greater clinical benefit to individuals and the community," Associate Professor Peters said in the latest issue of the British Medical Journal.

Did I say "socialized medicine"? Sorry, make that "communist medicine." (A rebuttal from — surprise — an American here.)

(Via Wired.)

To review: "Health care," like any scarce good, must be rationed. If it is not rationed by the free market (or even a semi-free market), then it will be rationed by the government. But it will be rationed.

The latest data point:

Women in labour could face lengthy journeys by ambulance to distant specialist units under plans which would strip dozens of local hospitals of consultant-led maternity services.

Department of Health proposals unveiled yesterday seek a smaller number of consultant units to deal with the most complicated births and the sickest babies.
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It would be left to local, midwife-led units to handle the majority of births, while more women would be encouraged to have their babies at home.

I'm not sure how someone can argue with a straight face that a supposed "right to health care" does not include a "right to a maternity ward" — or a "right to an obstetrician" for that matter. So much for the idea that subjective terms like "necessary," "essential" or "cost-effective" can be unshackled from "petty" economics — and petty politics. (Incidentally, this proposal is coming from the Labour Party government and is being opposed by the Conservatives — go figure.)

So what's next — refusing to provide epidurals, which are arguably "unnecessary" to the childbirth process (let alone the midwifery process)? What's a little labor pain when the national health care budget is at stake?

One other small detail, regarding the NHS' proposal to increase reliance on the (medieval) concept of midwifery:

The Royal College of Midwives said there was a shortage of 10,000 midwives and the service was facing cuts, job freezes, shortages and financial crises.

Replace highly trained physicians with lesser trained (at best) semi-professionals — who don't even exist!

Thus ever with socialized medicine.

(Via John Ray.)

Yesterday I noted that Britain's socialized medicine scheme, the NHS, somehow believes that "universal health care" does not include maternity wards and that women in labor are may soon be told to just stay home and call a midwife.

Well, if "universal health care" doesn't include a fully-trained obstetrician, then why should it include a fully-trained nurse either?

Standards of care are under threat from underqualified nurses and health workers, experts said today.

Nurses in other countries have to be qualified to degree-level but just 4% of UK nurses have a degree, they said.
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Writing in the Journal of the Royal Society of Medicine, professor Linda Shields, from the University of Hull, and professor Roger Watson, from the University of Sheffield, said US studies showed death rates were lower in hospitals where nurses had bachelor or higher degrees.
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The professors also argued that nurses were being replaced by less qualified staff.

Health care socialists like to lie about how the U.S. supposedly has, e.g., worse infant mortality rates than countries with "universal health care." But at least we have real nurses here, and real nurses save lives. Go figure.

Of course, no system, whether fully private, semi-private of fully socialist, is going to be able to give everyone all the unlimited "nursing" that they might want. Nursing services are a scarce good and must therefore be rationed, like all goods and services -- including all "health care services" -- must be rationed.

Opponents of socialized medicine are willing to concede this metaphysical truth and proceed accordingly. Health care socialists are not. And the distinction can be lethal.

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Guess what other aspect of "universal health care" in Britain is turning out not to be so universal:

Patients needing NHS dental treatment before the end of the financial year may not be able to get it, the Department of Health has said.

Some dentists have already exhausted their budgets for 2006-07 and will have no money to treat NHS patients until the end of March.

The Department of Health blamed the dentists, saying that some had been "speeding through their work" rather than spending more time with patients. Such dentists, it suggested, needed help. "The local NHS is working with these dentists to help improve the service they provide," it said.

Read that last paragraph again: Dentists "speeding through their work" (i.e., trying to be efficient and to provide as much service to as many patients as possible) are "the problem." Dentists are to be "persuaded" to work less -- in the name of "universal" health care. Remind me again how "the people" are more important than "the budget" when government runs health care? Meanwhile, other parts of the NHS budget have also been exhausted until the end of March.

More:

This is the second problem to hit NHS dentistry in as many weeks. The Government overestimated the money that would be paid to dentists by patients, who pay a proportion of treatment costs. Dentists are seeing more patients who are exempt from charges than was expected, so income is down.

So even a "Utopian" single-payer universal health care system has to worry about income, "the bottom line" and basic economics? And how else are they going to achieve that but by rationing the services they provide (i.e., running their service like a business -- a "cold, heartless" business)?

(Via John Ray.)