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End of Life Care
The Joys of Britain’s Single-Payer Health Care

Something is rotten in the NHS: Julie Mellor, the UK’s Parliamentary and Health Service Ombudsman, has released a report finding that “hundreds of thousands” die in miserable circumstances because the NHS’s end-of-life care can be “appalling.” The report, which draws on the complaints of family members, describes a system in which palliative care is neglected, medication administered incorrectly, and the dying go unserved because of state mandated limits on working hours. Here’s Mellor:

“Our investigations have found that patients have spent their last days in unnecessary pain, people have wrongly been denied their wish to die at home and that poor communication between staff and families has meant that people were unable to say goodbye to their loved ones,” she said. “We are publishing this insight so the NHS can consider the lessons to help prevent similar cases from happening again.”

It’s not the first time we’ve heard accounts like this coming out of the UK. The Stafford scandal in 2013 saw reports of horrifying conditions in one hospital in Staffordshire, which may not have been an isolated incident. By one estimation, patients in the UK are 45 percent more likely to die than those in the U.S.

Mellor’s assessment doesn’t prove that single payer is the worst of all possible systems, nor does mean the U.S. doesn’t have its own very real health care failings. And this report doesn’t touch on the issue of cost, which is one of the main metrics on which single payer advocates like to favorably compare other systems to the U.S.

What it does mean, however, is that merely switching the U.S. over to a UK-style health care system isn’t a panacea. Deep systematic health care problems are just as much of a challenge in single-payer systems as they are here.

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  • nervous122

    If single payer was a panacea for cost control, then someone needs to explain Canada, which saw a 50% increase in spending over the past decade. Or France, and their recent struggles with cost. The OECD sees most Euro models struggle with increasing costs as their populations age.

    • Andrew Allison

      blogs.wsj.com/economics/2013/07/23/u-s-health-spending-one-of-these-things-is-not-like-the-others/

  • qet

    All state-provided/paid for care is more expensive than private care. To proponents of single payer or universal insurance, the issue is solely one of fiat justitia, and all of the numbers crunching by policy wonks is just a gigantic smokescreen to distract attention from that moral motivation.

    • Andrew Allison

      As a matter of fact, all the state provided healthcare systems deliver better outcomes for about half the cost of the US private system. There is copious data supporting this assertion.

      • Mark Hamilton

        “By one estimation, patients in the UK are 45 percent more likely to die than those in the U.S.”

        Wonder if that has something to do with “better outcomes for about half the cost.” I hear the Veterans Administration is working wonders for US vets too. There is copious data on that.

        • Andrew Allison

          Actually, 100 percent of people die everywhere and, as I wrote, there is copious data (as opposed to opinions and estimates) available to support my assertion.

          • Mark Hamilton

            I’m sure. All those stories about the NHS killing patients through neglect, DVA backlogs causing deaths, etc., are all just anecdotal.

            The “facts” are in. Copious data supports state run health care giving better “outcomes” at half the “cost.”

            Indeed, it’s the exception to every other government endeavor in terms of quality, efficiency and cost-savings!

            But wait…there’s more. Act now and you can have 3 buckets of Oxyclean for only $19.99. That’s right, folks! 3 buckets for the price of one. Pick up the phone and call NOW!

  • Andrew Allison

    The commentary on the cost of the NHS overlooks the fact that it provides healthcare for every man, woman and child in the UK. The NHS also delivers better outcomes by every measure from satisfaction through infant mortality and longevity than the much more costly US healthcare system. The simple fact is that no country has the resources to provide the level of healthcare available to those in the US who can afford it to its entire population. As I have commented previously, we have a choice to make: superb healthcare for those whose insurance will pay for it, or decent hearcare for all with the option to pay for better care for those who can afford it. As get commentedents, the issue is simply fiat justica (justice for all).

    • Boritz

      What we’re seeing is some kind of coverage for some, not all with care iffy for many at the low end, and superb healthcare for the political class.

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