Don’t Confuse Me With Facts

Stanley
Feld M.D.,FACP,MACE

Sometimes,
in order to believe a certain ideology, some smart people take the position of
not wanting to be to be confused by facts.  

Countries
with socialized medicine have said their citizens are happy with their care.
Therefore, this is the evidence that the U.S. should have a socialized medicine
system.

Less
than 20% of a nation’s population experiences the healthcare system at a moment
in time. The 80% who are not sick are happy because they feel secure. If they
got sick they believe they would receive free medical care. The result is the
majority of the population under a socialized medical system likes the system.

This
Is A FACT (TIAF)

Dr.
Donald Berwick former acting head of CMS and author of Obamacare wrote, in a
personal letter to “Senior Government Officials and Senior Executives of the National
Health Service in England after doing a review of the NHS.”

“You are stewards of a
globally important treasure: the NHS. In its form and mission, guided by the
unwavering charter of universal care, accessible to all, and free at the point
of service, the NHS is a unique example for all to learn from and emulate.”

Dr.
Donald Berwick added, “redistribution of
wealth is the very essence of a compassionate healthcare system for all.”

I
disagreed with Dr. Berwick in an earlier blog. I said citizens responsible for
their own health, healthcare and healthcare dollars are essential ingredients
for a cost efficient healthcare system.

Patients
are the primary stakeholders. Patients must be actively responsible for their
health. They must have a moral and intellectual responsibility for their own
health as well as a financial incentive to be responsible for themselves.

They
must have own their healthcare dollars, have the freedom to make their own
healthcare choices and have access to care.

The
government must create educational vehicles to help patients make the correct
choices.

 The government must provide financial
incentives for people to make those choices.

Medical
care and medical decisions made for patients by a bureaucracy has historically
failed to control costs or provide efficient and compassionate medical care.

Socialized
medicine run by bureaucrats has failed in England. Medical care consumes more
than 50% of England’s GDP.

This
Is A Fact (TIAF)

Medicare
is wonderful for people over 65 years old. Seniors could not buy healthcare
insurance from a healthcare insurance company. The healthcare industry had not
figured out how to make money from these people so they disqualified them.

If
the government got rid of the $250 billion dollars in administrative waste and
inefficiencies each year, Medicare and Medicaid would become sustainable.

This
Is A Fact (TIAF)

Medicare
and Medicaid provide no incentives for patients to take care of their health.

Chronic
diseases are ineffectively managed. The complications of chronic diseases
consume 80% of Medicare’s healthcare dollars. If chronic diseases were managed
properly the complication rate from chronic diseases could be decreased by at
least 50%.

This
Is A Fact (TIAF)

Many
patients do not have the incentive to take care of themselves. They leave it up
to the system to take care of them.

Unfortunately,
it has be demonstrated that a government controlled system creates ever
increasing bureaucracies and cost inflation.

This
Is Fact. (TIAF)

Most
all of the nation’s attempts to control healthcare costs in the past 50 years
have failed. (Price control of the 70’s, HMO’s, Managed Care, PPOs.)

These
systems had to be abandoned. Nevertheless, healthcare policy wonks continue to
give the same advice and make the same mistakes. The policy wonks’ advice is to
institute greater government controls over medical care.  

This
Is A Fact (TIAF)

 A recent report about England’s hospital
conditions in Mid Staffordshire has emphasized the defects in England’s 60 year
socialized medicine experiment.

The
report only covers hospital inpatient defects. It does not cover the many
defects in outpatient services. 

 The report is “Report of the Mid Staffordshire NHS Foundation Trust
Public Inquiry

5
February 2013 to the Secretary of State.”

The
report stated that;

1. For
many patients the most basic elements of care were neglected.

2. Calls
for help to use the bathroom were ignored and patients were left lying in
soiled sheeting and sitting on commodes for hours.

3.
Patients felt afraid and disenfranchised.

4. Patients
were left unwashed, at times for up to a month.

5.
Food and drinks were left out of the reach of patients and many were forced to
rely on family members for help with feeding.

6. Staff
failed to make basic observations and pain relief was provided late or in some
cases not at all.

7. Patients
were too often discharged before it was appropriate, only to have to be
re-admitted shortly afterwards.

8.
The standards of hygiene were at times awful, with families forced to remove
used bandages and dressings from public areas and clean toilets themselves for
fear of spreading infections.

9. These
healthcare conditions caused the deaths of an unknown number of patients.  

Robert Francis QC Inquiry Chairman who wrote
the report covered a wide range of system failures. I will only highlight the
key failures contained in the 500-page report. This report was mandated by the House of Commons.

These defect are occurring throughout the
entire NHS system. The NHS is not as glorious as the Obama administration or
Dr. Berwick’s has idealization the NHS to be.

"The
story the report tells is first and foremost of appalling suffering of many
patients. This was primarily caused by a serious failure on the part of a
provider Trust Board. (Bureaucracy)"

 "The trust board did not listen
sufficiently to its patients and staff or ensure the correction of deficiencies
brought to the Trust’s attention."

The NHS bureaucracy did not put patients
first. It put the various levels of bureaucracy in charge. Bureaucracies deaden
incentives and lose focus on who is the main stakeholder in the healthcare system.

"The
trust failed to tackle an insidious negative culture involving a tolerance of
poor standards and a disengagement from managerial and leadership
responsibilities".

"This
failure was in part the consequence of
allowing a focus on reaching national access targets; achieving financial
balance and seeking foundation trust status to be at the cost of delivering
acceptable standards of care."

Appropriate
statistical reports and collection of reports are more important that
appropriate patient care.

Robert
Francis goes on to outline how the bureaucracy puts measurements first, not
patients.

None
of the bureaucrats want to take responsibility for what is going wrong. Finger
pointing and blame shifting is an occupation in the British healthcare system.

"The
NHS system includes many checks and balances. These checks and balances should
have prevented serious systemic failure of this sort."

"There
were and are a plethora of agencies, scrutiny groups, commissioners, regulators
and professional bodies, all of whom might have been expected by patients and
the public to detect and do something effective to remedy non-compliance with
acceptable standards of care.

For
years that did not occur."

Watch out America!

We are falling into the same trap with Obamacare.
It might sound good to some. It will not work judging by the experience of
others.

Unfortunately,
the Obamacare’s model is the British healthcare system. I do not think the
traditional media should praise it. The traditional media should publish the
facts of history.

The
traditional media should call for the repeal of Obamacare.

 

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

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