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50% of UK Nursing Home Patients Abused By Government Health Care

Fans of government health care keep telling us that government can do the job, and they point to countries like the UK as examples where single payer, government run health care systems deliver high quality, compassionate care.

They are either grossly ignorant or they are lying through their teeth.

A recent study by a British healthcare regulator finds that half of all elderly people in Britain’s nursing homes are being denied basic health services.


Some older people were forced to wait months for a doctor or nurse to treat simple health problems. No doubt they were waiting for the Bureau of Bedsore Management to review the proper procedures before issuing a bandage-changing permit.

Over the polite grumbling of many advocacy groups, the British Parliament can be faintly heard tinkering away at some far overdue legislation. No doubt the grannies will get some relief just as soon as the House of Commons passes some new laws, the House of Lords (whoever they have there now that they have chased the actual, you know, Lords out of it) sagaciously tinkers with it, the Queen signs it, the bureaucrats get all the regulations nicely written, and the memos and administrative procedures get delivered to the proper offices.

Of course, the National Health Care service has been around since the 1940s and somehow these lingering little problems haven’t quite been cleared up yet.  It’s obviously just a question of getting the right regulations in place and any century now the system will by running like a fine tuned machine and there won’t be any problems at all.

There have been several disturbing revelations of abuse and neglect of patients and other mismanagement in the UK’s national health service. This report, suggesting massive neglect and abuse of the elderly, is, sadly, not alone.

Unfortunately the US Congress seems to have delivered some kind of misshapen system that will combine the bureaucracy and inefficiency of huge government programs with the cost structure of a private sector that is systematically distorted by perverse incentives and driven into overdrive by malpractice madness and defensive medicine.

But every cloud has a silver lining. If we ever do get single payer, government health care on this side of the Atlantic, we won’t have to worry about all those death panels critics keep warning us about.  Given the bureaucratic delays and inefficiencies in the system, patients can be confident that, abused and neglected as they will be in government-run nursing homes, they will die of old age before the death panels ever meet.

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  • Kenny

    A country that is so debased that it allows aborting unborned babies for the convenience of the mother won’t blink an eye of ‘aborting’ the eldery when they become a burden or a cost. Fact.

    Payback is coming to the Baby Boomers in a way they never imagined, right Mr. Mead?

  • Neville

    Just like the e.g. Cuban, Soviet and many other third world health care systems, the situation in the UK is radically different from the disaster described here if you have educated, articulate kids who can advocate for you (ideally someone in the super-privileged in this regard health care industry). So once again ‘government provision’ merely disguises inequality rather than abolishing it, because as always it turns out that “some people are very much more equal than others”.

    Meanwhile, upper middle class people in the UK have no incentive to concern themselves with this problem because its consequences primarily land on the ‘oiks’ and ‘anoraks’. And so the phenomenon continues decade after decade, essentially not impacted by these episodic government reports and sporadic media scandals.

    One reason this happens in the UK and might conceivably not in the US is that on entering the system of “free at the point of delivery” UK you leave behind in practice your right to sue your health care provider (the government). Watch the pea under the thimble for the place in Obamacare’s small print where it will for sure squash the corresponding right in the US.

  • teapartydoc

    The medical-industrial complex is in the final phase of imploding the economies of Western civilization. The future is not entirely bleak, however. What will come after the deregulation of medical care that will be required to unburden the economies of the West (keep in mind: this WILL happen, regardless of whether it occurs legislatively or off the books, so to speak, because there will be insufficient resources to enforce regulations) most of this kind of care will be offered in small facilities or homes staffed by unlicensed (probably illegal) immigrants who will be filling an economic need in the way they usually do–off the books.

  • BobJustBob

    They could do what the Dutch do and just snuff their old and sick. They even have mobile euthanasia vans…like those other guys who had mobile euthanasia vans.

  • WigWag

    So Professor Mead thinks that government sponsored single payer health insurance is responsible for what he says is 50 percent of British nursing home residents being “abused.” He goes on to suggest that thank goodness nursing home residents in the United States have it better because they are not saddled by a single payer system and Obama-care hasn’t been implemented yet.

    The Professor is right about one thing; American nursing home residents are quite a bit better off than many of their companions on the other side of the pond are.

    But once again, Mead is guilty of sloppy thinking. In fact, the overwhelming percentage of those American nursing home residents getting better care than their British cousins are members of a single-payer system. Almost all American nursing home residents belong to the single-payer government system called Medicare and a substantial majority also benefit from another single-payer government system called Medicaid.

    Mead’s theory about single-payer systems providing inferior care is obliterated by the very example he choses to cite.

    It’s another example of what happens when you place your fingers on the keyboard without pausing for a thought.

  • mark l.

    anybody know if you can sue the govt for poorly administered psych/geriatric care?

    my general assumption is ‘no’.

    it is one thing to give power over the infirmed and mentally ill. it is somethng uniqurely different if the care is done without consequence.

    no consequence, no authority…

    “Mead’s theory about single-payer systems providing inferior care is obliterated by…”


  • Andrew Allison

    Oh dear, I find myself agreeing with WigWag again! The choice of the word “abused” was, to say the least, indelicate. Under-served, perhaps, but abused?
    As WW points out, the elderly in the USA are primarily cared for by a single payer system; one that apparently delivers better service than that in the UK. We might perhaps more usefully explore the differences between various single-payer systems to see what works and what doesn’t.
    It’s certainly not hard to figure out that a medical insurance system which delivers less than half of the premium dollar in payments for service is not the answer.

  • mark l.

    “The choice of the word “abused” was, to say the least, indelicate. Under-served, perhaps, but abused?”

    i’m pretty certain without reading the actual study-with the caveat that it was a govt sponsored program to find something…

    abuse can be both physical and verbal.

    the problem is that the two side by side, become a difference, initially, of being a venial sin versus a mortal one. emphasize the dangers of one, and you diminish the other.

    there are two important psycholgists who are the pillars of understanding long term care.
    milgram and zimbardo…

    milgram’s study was fortified by the fact that he was wearing a labcoat when he did his study and presented the findings. Milgram discovered the same thing, while zimbardo is so kooky that no one takes him seriously. I didn’t, until I learned how close their studies really were.

    take abu grahib, which is just a practical example of what the two aforementioned psychologists were trying to demonstrate…

    find the flaws in abu grahib-
    young, inexperienced prison guards etc, who live under one of the most efficient chains of command. things probably took more than a day to go sideways, but not much more.

    govt run nursing care?
    what qualifications do you need? less than the requirements of being a police officer or a soldier.

    earlier comment alluded to an outsourcing of long term care facilities…
    just the opposite would happen. it would be a gold mine of low paying govt jobs for people unqualifed to pump gas…10 million union jobs at the least.

    would it be in a govt’s interest to admit that they are doing a poor job?

    a cold hard fact…
    if you are in a retirement/nursing home your future earnings are squat and you make a terrible witness-no lawyer wants your individual case. class action? healthcare privacy prevents such an occurance. even if one could go around and ask every patient in a facility if they were abused, half would be credible, and the other half would not. good luck sorting the two out.

    even if we knew the actual percentage of abused in a long term facility, it goes without saying that a govt run program would reduce the numbers of incidents…on paper.

    one could choose to believe that govt solved the problems of human nature, or merely covered them up.

  • Person of Choler

    wigwag is partly right, but in the USA, government as single payer for elder care only kicks in after the patients have spent all but a pittance of their assets on their own care. One could speculate that the better care delivered by the American system results from the fact that people are spending their own money for at least part of services they receive.

  • Donald Campbell

    I had the misfortune of requiring hospitalization on a sea cruise, and ended up at Bermuda’s only hospital, part of the British Health Care. The ICU was top notch state of the art, and outstanding care. The ‘wards’ were a different story. Over 1/2 of the beds are filled with long-term care geriatric patients.

    Of course, the state pays for this hospitalization, so there is no incentive to take the elderly home, and no incentive to create a private long-term care facility.

    I will not say that the patients are abused; however, clearly it is a mismatch between patient needs and nursing skills.

  • Basil Seal


    It may be more complex than you think.

    The American system is not a closed system in the way the British one is. Medicaid only steps in after a spend down of the patients assets and there is a five year look back period to boot. Furthermore, Medicaid funds are administered by the states which receive them as block grants. Thus there is considerable variation from state to state as to how the program works.

    Take a look at this chart:

    At first glance, you would think that Medicare and Medicaid are picking up most of the tab for long term care.

    But check this out:

    Most elderley are cared for in their homes by their familly. In other words, there is no single payer government system providing long term care to all or even most seniors. The majority of long term care is born by the families of the elderly through private insurances, out-of-pocket, or other non-government means.

    Your post also overlooks the fact that most long term care facilities are privately owned although they do accept payment from Medicare/aid. This means these facilities are sensitive to other pressures than just Medicare/aid reimbursement.

    Many nursing homes are run by charitable organizations like the freemasons or various religious organizations whose operations are subsidized by donations from their memberships (look for that to change once HHS forces Catholics out of the business) . That means at least part of the cost is being borne by the charity itself.

    Last, while medical care in the United States is far superior to what is available in Europe its worth keeping in mind that the best care comes from family members or is privately paid for. The more you rely on government insurances, the worse it gets:

  • 07tyhlg08otih

    I prefer the articles written by Walter Mead to this tabloid fodder written by an intern. I don’t dispute the facts but I’d rather read an article written by an adult. There is enough over-dramitisation and outrage on the tv news. What I expect from blog is level headed analysis.


  • DocinPA

    I think what WigWag and Andrew are missing is the fact that there is a whole lot of private money that also supports nursing homes. The ones that are purely dependent upon Medicaid aren’t much better than those in Britain.

  • Tom

    The america nursing homes we speak of are privately run. And if you think Medicaid checks come anywhere close to covering the costs, your are more deluded than I thought.

  • Kris

    07tyhlg08otih@12: “I prefer the articles written by Walter Mead to this tabloid fodder written by an intern.”

    Indeed, 07tyhlg08otih, how can we possibly take seriously something that looks like it was produced by a random mashing of the keyboard?

  • DakotaBoy

    As several above point out, the US sytem for long term nursing home care is not a single payor system. Medicare does not pay for such care, except for a short period of time when one is recovering from a condition covered by medicare. Medicaid only covers such care when one has met income and asset test eligibilty rules. Many companies providin long term nursing care refuse to take Medicaid patients at their facilities. These same facilities are genally considered to provide a better place to live than those that do take Medicaid patients.

  • richard40

    Good point that you dont need death panels, when burocratic and political incompetance and delay will do the job far more effectively. But I always thought that the British health care system was great, and the USA needed to emulate it. That is what I keep hearing from dems.

  • durable medical equipment

    If only all people can afford private health insurances then prolly they won’t have to wait that long for government health care benefits as they have their own sources of funds for their health care needs

  • http://none Louis Nicholson

    The Social Security program including Medicare and Medicaid taken together are twice the national defense budget. A big contributor to the 1 trillion deficit per year under President Obama. As yet there is no specific tax to help Medicaid. If no action is taken this problem will bring down the US and world economy.

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