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  • How’s That Government-run Health Care Working Out Britain?

    The Telegraph reports:

    Family told by NHS: Alzheimer’s is not a ‘health condition’

    NHS Worcestershire ruled that Judith Roe, 74, did not qualify for NHS funding because her condition was a “social” rather than “health” problem, even though she was so ill she could not make a cup of tea and regularly left the stove on.

    She was forced to sell her £200,000 home to pay her £600-a-week nursing home fees, which would have been funded if she had been categorised correctly.

    Mrs Roe’s family appealed to the Health Service Ombudsman, which ruled that Mrs Roe’s assessment had been incorrect and her treatment should have been funded by the NHS. NHS Worcestershire has now reimbursed them for six years of care.

    Her son, Richard, 40, urged other families in a similar situation to fight for the care they are entitled to.

    He said: “The way the health trust behaved was scandalous. It has been very stressful.

    “All the time we were told we were wrong while believing we were right.

    “They told me I should count myself lucky because there are people that are more ill than my mother, which was an outrageous thing to say.

    Substitute “Health Service Ombudsman” for the White House’s Independent Medicare Advisory Council and this story is exactly what life will be like for Americans under Obamacare.

    Helen Evans a registered general nurse and citizen of the United Kingdom, details how her country slipped into a government-run health care rationing system:

    The NHS was established in 1948. It is a single-payer health care system, directly administered by the British government, funded through taxation, and provided mainly by public-sector institutions. Because the NHS is a fully nationalized entity, the central government specifies the capital and current budgets of its regional health authorities and determines the expenditure on drugs by controlling the budgets given to each general practitioner. Overall, NHS health care is rationed through long waiting lists and, in some cases, omission of various treatments.

    For the British government, the practice of HTA facilitates rationing by delay. It is a tool that aims to ensure that expensive new technologies are initially provided only in hospitals that have the technical capacity to evaluate them. While the NHS Research and Development Health Technology Assessment Programme is funded by the Department of Health and, according to its criteria, researches the costs, effectiveness, and impact of health technologies, the Medicines and Healthcare Products Regulatory Agency (MHRA) ensures that drugs and devices are safe.

    In 1999, the government went a step further and set up the National Institute of Health and Clinical Excellence (NICE). At its heart is the Centre for Health Technology Evaluation that issues formal guidance on the use of new and existing medicines based on rigid and proscriptive “economic” and clinical formulas. With the NHS obliged to adhere to NICE’s pronouncements, criticism of NICE has been ceaseless, particularly from various patient organizations.

    NICE is a controversial body. It has tried repeatedly to stop breast cancer patients from receiving the powerful breakthrough drug Herceptin and patients with Alzheimer’s disease from receiving the drug Aricept. The criteria by which this agency makes its decisions have been kept largely secret from the public. As is inevitable with any nationalized health care system, life-extending medicines such as those to treat renal cancers are refused on the grounds of limited resources and the need to make decisions based not on genuine market economics but on an artificial assessment of the benefit that may be gained by the patient and society “as a whole.”

    In 2001, NICE deliberately restricted state-insured sufferers of multiple sclerosis from receiving the innovative medicine Beta Interferon. Claiming that its relatively high price jeopardized the efficacy of the NHS, patients with the more severe forms of the disease were told that they would have to go on suffering in the name of politically defined equity.

    In more recent years, patients with painful and debilitating forms of rheumatoid arthritis have been informed by NICE that in many instances they will not be allowed to receive a sequential range of medicines that have often been proved to be of significant benefit. Instead, the institute decreed that “people will be prevented from trying a second anti-TNF treatment if the first does not work for their condition.”

    Similarly, in August 2008, patients with kidney cancer continued to be denied effective treatments designed to prolong their lives, often by months or even a few years. The calculations used by NICE have been systematically disputed by clinical experts who are more concerned with patient welfare than with vote-seeking, but the institute has also come under fire for not involving doctors who are active on the front line of medicine: “With Sutent for instance, there was just one oncologist on the panel.”

    In January 2009, patients with osteoporosis also fell foul of NICE. The institute declared that only a small minority of patients with this debilitating disease would receive the medicine Protelos, and even they would receive it only as an extreme last resort. While clinicians and osteoporosis support groups have pointed out that more than 70,000 hip fractures result in 13,000 premature deaths in the U.K. each year and that these otherwise avoidable episodes needlessly cost the NHS billions of pounds, not only are patients being denied necessary treatments, but taxpayers’ money is wasted.

    Indeed, according to its annual reports and accounts, NICE is now spending more money on communicating its decisions than would be spent if it allowed patients access to many of the medicines it is so busy denying them. The money that the institute now spends on public relations campaigns “could have paid for 5,000 Alzheimer’s sufferers to get £2.50-a-day drugs for a year,” according to The Daily Mail.

    Devoid of a market and the language of price, this top-down system ironically ignores many of the societal costs associated with failure to treat severe illness, such as illness-related unemployment. Moreover, the fact that preventing access to more costly medicines may save money in the short term overlooks the costs for the future. If older medicines lead to more rapid deterioration of a condition, the effect could be a more expensive hospital or nursing home episode later.

    Posted in Obamacare [slideshow_deploy]

    6 Responses to How’s That Government-run Health Care Working Out Britain?

    1. Becky S., AR says:

      Yes, the USA needs health care reform, but remember – you can fire your health insurance company, but you can't fire Uncle Sam!

    2. Pingback: » Financial News Update - 08/20/09 NoisyRoom.net: Where liberty dwells, there is my country…

    3. Roger S., Ma. says:

      Yes, we can, Becky! Yes, we can, by not hiring "him" in the first place ! Believe it, we can !

    4. Jeannine, Louisiana says:

      The National Health- Britains think it's the best thing ever so maybe picking on the mistakes that happen isn't the best idea. The "Private Corparation Death Panels" that media of all stripes are starting to refer to do this thing all the time. The comparison is a dangerous one to invite. It makes a public option look good.

      Very few private insurers will pay for nursing home care- and then only rehab as far as I've seen. In Louisiana you have to sell or give away all property and then wait three years as a pauper to get a nursing home paid for. By Medicaid, the public and only insurance that covers such care. I hear it's the same everywhere, the assumption being you don't need a house to live somewhere else when you aren't coming home. And Medicaid is for the destitute. A half million house isn't destitute.

      Medicare is excellent government insurance. It doesn't pay for long term/ rest of life nursing home care.

      So the British system will pay for nursing home care? That's great! But why didn't the children get an attorney? All the British rules are published and a lawyer could've straightened it out in probably a week. Alzheimers is a degenerative brain disease and coded as such internationally. I'm surprised a letter from a neurologist wouldn't have done it.

      Using National Health as an example of why government option is bad will be a shot in the foot if any TV news people go there and ask the people over there.

      I'm a nurse practitioner. I promise, something needs to change. Single payer? NO! But use stories that make sense.

    5. sherry burdette says:

      The problem with managing our country based on voting in/voting out legislators is that once a bill is 'allowed' to be voted in, we are stuck with the damage even though we can/may vote out the offending legislator. Rather than 'wait' for next election to 'make a change', we need to work with all our might to keep the present Congress from destroying our Constitution with 'evil' legislation.

    6. Steve, ID says:

      I served my mission in Northern England for the LDS church for 2 years. Yes, I am a mormon. But that is not the issue at hand. I made some good friends over there and one that I trust expecially, I asked him about the single payer system England currently is under:

      Me: What are your thoughts on the NHS?

      Him: "They're ok. Very good considering it's for free (aside from our taxes), but you do compromise in quality/speed. I think people in England need the NHS as we're all too pikey to pay. That, and everyone's just used to it now. Why?"

      Me: I don't know if it's all over the news there or not, but Obama's healthcare bill is in the works, and he is planning on making America's healthcare a single-payer health care system. There has been a pretty huge outrage about it.

      the NHS is single payer, so we would be copying the UK.

      I guess the worry is that since the gov. is in charge of the whole thing, patients might be denied proper medicine/treatment for an ailment because the gov. deems their case too expensive or not in the public interest. A couple examples I read were the NHS denying alzheimer's and breast cancer patients from recieving breakthrough medicines because they were "too expensive."

      I know what americans think about it, so i thought it would be good to hear what the english thought.

      Him: I guess there are pro's and con's – but it also just depends on what people get used to. Here, we're used to it, and i'd say most people see more of the pro's than the con's.

      End

      —For what it's worth.

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