An article in The Guardian says that two-thirds of hospitals in the UK give substandard medical care. Furthermore 75% of hospitals have levels of safety that “are not good enough.” These hospitals are said to be understaffed and underfunded. These problems are expected to worsen as the government phases in cuts to the National Health Service.
If this scenario reminds you of something in the US it’s likely the VA. Here too, the bureaucrats in charge of the VA cry that they need more money to make the system work properly even though the number of veterans is steadily declining while the VA’s budget has risen 60% since the turn of the century. Government bureaucracies never have enough money to operate efficiently because efficient government is a contradiction in terms.
Every medical system in the developed world is breaking or soon will break the bank. While devising a medical system that will not kill the economy is not really that difficult, implementing such a system has so far proved impossible in the developed world. Once a benefit has been promised by the government to its people it can never be rescinded.
A program that’s “free,” ie paid by some unspecified other under the aegis of the government, suffers relentless inflation, bureaucrats multiply, and the price of things unrelated to the real service that’s supposed to be provided dramatically escalates while the putative service languishes on the periphery of of the organization that ostensibly serves it.
Medicine is the canary in the coal mine of the world’s liberal democracies. Actually, it’s the blue whale in the Grand Canyon, but the avian metaphor suffices. Human beings having tried and failed with every conceivable form of government are now about to prove that democracy is as unworkable as all the others. Churchill’s famous quip that democracy was the worst form of government known to man except for all the others seems dated. Democracy appears to be be just as useless as all the others. In short, the world may be ungovernable.
The road to hell that’s paved with good intentions was probably funded by a government grant. Certain American politicians who seem giddy when the look at the welfare programs of the Scandinavian countries seeming to be looking with eyes wide shut. Consider this article from a Swedish news site. Swedes buy insurance to skip long health queues. The article is one long kvetch about long waiting times and patient dissatisfaction with the prevailing medical system in the welfare system so admired by those who don’t have to use it. When your medical care is unfavorably compared to that of Albania (ALBANIA!) there must be a serious problem. Why can Albania operate its healthcare services with practically zero waiting times, and Sweden cannot?” … the Health Consumer Powerhouse (HCP) organization in Brussels asked. This quotation from the Swedish site linked above.
When we look at the mess that is they way American medicine is organized, we should not delude ourselves that others beyond our borders, such as they are, have solved the problem of how to deliver medical care via the government. Similarly, we should not believe that either of the two parties that take turns mismanaging the government have different alternatives for medical care. Essentially, they both have the same plan. The fabulous plan is that the federal government will put in place the means to provide all Americans with high quality, low cost, and readily available medical care. One party wants to keep Obamacare intact, while the other want to replace Obamacare with Obamacare. When a politician says he wants to replace Obamacare he’s always asked what will you replace it with? At this point the argument is lost. If it had never been passed it would not need replacement. The supposition is that once a federal program is enacted it must be eternal. How did the republic survive for 225 years without Obamacare? But the answer that a politician might give – I won’t replace it with anything is deemed suicidal.
No politician is willing to say, “You know, we just don’t do this sort of thing very well. So everyone would be better off if the government go out of the medical care business and let everyone get by as best he can. Which, of course, is equally true of many other things the government also screws up. A candidate who made such a statement wouldn’t even get his mother’s vote. What the public wants is the candidate who has the best plan to give away the most at no cost to the voter. If other voters have to pay, that’s OK.
This sort of political posturing is nothing new. it’s been going on for millenia. Quintus Cicero advised his famous brother Marcus in his A Short Handbook on Electioneering, “That people would rather you lie to them than have you deny them your help.” The authenticity of this handbook has been questioned, but the practice it recommends has been gospel for as long as there have been elections.
The argument that supports all this wasteful meddling by governments is that life is unfair and those at the bottom suffer and deserve help. The are ways to help people that don’t involve the government. I can choose to give my money to help those in need, which is very different from having the government take my money at the behest of others and then spend it on still others, typically with great waste. It is an act of charity to give money, goods and/or services to those who are less well off than you. Taking wealth from others at the point of a gun or a law is not charity, neither is it an act of justice. You can enter the proper modifier on your own. Regardless of what you call it, the taking of wealth in the guise of fairness and helping always seems to lead to the opposite of the stated purposes used to justify the confiscation in the first place. But support of nonsensical programs often buys enough votes to ensure politicians lifelong tenure.
While I’ve argued that humanity has yet to learn how to govern itself without economic ruin and the war that always seems to trail in its wake, I’ll finish where I started – medicine. The government has made it into an ouroboros. It’s too expensive to afford because the government has made it that way. This expense of course requires more government spending which makes it yet more costly. Eventually it (either medicine or the government) will swallow everything leaving only the cockroach in possession of our hospitals and clinics. Unless, in the prescient words of PJ O’Rourke, we first vote ourselves rich.