Health Care Horror
Writing about health care in the UK, Sally Pipes of the Pacific Research Institute, writing in Forbes magazine, details some horror stories from the UK. What is terrifying is how many Americans want to bring this horror to our shores:
Vacancies for doctor and nurse positions have reached all-time highs. Patients are facing interminable waits for care as a result. This August, a record number of Britons languished more than 12 hours in emergency rooms. In July, the share of cancer patients who waited more than two months to receive treatment soared.
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The NHS has struggled to fully staff its hospitals and clinics since its inception in 1948. But today, the shortages are growing worse. Nine percent of physician posts are vacant. That’s a shortfall of nearly 11,500 doctors.
The NHS is also short 42,000 nurses. In the second quarter alone, nurse vacancies increased by 17 percent. Meanwhile, in the United States, nearly all states will have a surplus of nurses by 2030.
It’s unsurprising that people don’t want to work as nurses in Great Britain; it’s a stressful job, with long hours and terrible working conditions. Some NHS nurses are taking positions at supermarkets because stacking shelves comes with better hours, benefits, and pay, according to a report in the London Economic.
Consider one nurse’s letter explaining why she quit the profession. She described horrific working conditions. Medical professionals worked 12-hour shifts with little time for necessities like bathroom breaks or food. Managers felt they couldn’t do anything to change unsafe conditions created by overcrowded hospitals. “You cannot safely practice under such conditions,” she wrote. “Mistakes will be made and people will be harmed, some fatally.”
The shortage of providers has resulted in longer wait times for patients. In May, 4.3 million people in the United Kingdom were on waiting lists for surgery, a 10-year high. Adjusting for population, that would be like having everyone in the state of Florida on waiting lists. Roughly 3,500 British patients have been on hospital waiting lists for more than a year.
More than one in five British cancer patients waits longer than two months to begin treatment after receiving a referral from a general practitioner. In Scotland, fewer than 80 percent of patients receive needed diagnostic tests — endoscopies, MRIs, CT, scans and the like — within three months.
These delays are deadly. An analysis that covered just half of England’s hospitals found that almost 30,000 patients died in the past year while waiting for treatment — an increase of 57 percent compared to 2013.
In some cases, the NHS has refused to provide treatment at all. In June, NHS England said that it would discontinue coverage of 17 procedures, including tonsillectomies and knee arthroscopies for osteoarthritis patients.
Even when patients receive treatment, the quality of care is poor. Patients in British hospitals are four times more likely to die than in U.S. hospitals, according to an analysis of outcomes from 2,000 similar surgeries conducted by researchers from University College London and Columbia University in New York. Among the more severely ill patients, the disparity was worse; the sickest Brits were seven times more likely to die.
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NHS defenders claim that the system’s poor results are the inevitable result of underfunding. Yet spending on health care in the United Kingdom has more than doubled in the past 18 years, after adjusting for inflation.
The problem is one of supply and demand. Single-payer systems offer “free” care, so patients have no incentive to moderate their demand for care. But government cannot procure enough supply to meet that demand without bankrupting taxpayers. Government officials’ only option is to ration care.
If the horror of UK health care is too scary, read Chris Jacobs’ article on President Trump’s expansion of Health Reimbursement Accounts (HRA)
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