Healthcare To Die For in Britain? by Ralph R. Reiland -- Capitalism Magazine

Healthcare To Die For in Britain?

In "Die in Britain, survive in U.S.," the cover article of the February 2005 issue of The Spectator, a British magazine, James Bartholomew details the downside of Britain's universal healthcare system.

Among women with breast cancer, for example, there's a 46 percent chance of dying from it in Britain, versus a 25 percent chance in the United States. "Britain has one of worst survival rates in the advanced world," writes Bartholomew, "and America has the best."

If you're a man diagnosed with prostate cancer, you have a 57 percent chance of it killing you in Britain. In the United States, the chance of dying drops to 19 percent. Again, reports Bartholomew, "Britain is at the bottom of the class and America is at the top."

Explains Bartolomew: "That is why those who are rich enough often go to America, leaving behind even private British healthcare." The reason isn't that we sue more in America, and scare doctors into efficiency, or that our medical schools are better. It's more simple than that. "In America, you are more likely to be treated," writes Bartholomew, "and going back a stage further, you are more likely to get the diagnostic tests which lead to better treatment."

More specifically, three-quarters of Americans who've had a heart attack are given beta-blocker drugs, compared to fewer than a third in Britain. Similarly, American patients are more likely than British patients to have a heart condition diagnosed with an angiogram, more likely to have an artery widened with angioplasty, and more likely to get back on their feet by way of a by-pass.

On the availability of equipment, explains Bartholomew, Britain has only half as many CT scanners per million people as the United States, and half as many MRI scanners. With lithotripsy units for treating kidney stones, the United States has more than seven times the availability per million of population than Britain.

Not only is the British equipment in short supply, but much of what's there should be loaded up and carted off to the nearest scrap dump. An audit by the World Health Organization, for instance, found that over half of Britain's x-ray machines were past their recommended safe time limit, and more than half the machines in anesthesiology required replacing. "Even the majority of operating tables were over 20 years old --- double their life span," reports Bartholomew.

Taken as a whole, Britain's universal healthcare system has evolved into a ramshackle structure where tests are underperformed, equipment is undersupplied, operations are underdone, and medical personnel are overworked, underpaid and overly tied down in red tape. In other words, your chances of coming out of the American medical system alive are dramatically better than in Britain.

"Having a diagnosis test beyond an x-ray in Britain tends to be regarded as a rare, extravagant event, only done in cases of obvious, if not desperate, need," writes Bartholomew. "In Britain, 36 percent of patients have to wait more than four months for non-emergency surgery. In the U.S., five percent do. In Britain, 40 percent of cancer patients do not see a cancer specialist."

On how things worked in an individual case, Bartholomew writes of Peggy, an American radiologist, who went to Britain to meet her English boyfriend's family. While she was there, her boyfriend's father found blood in his urine and went to a local National Health Service hospital in which no CT scans or cystoscopy tests were done. The patient had asthma and laid in his hospital bed with breathing difficulties but still didn't see a specialist. He was told it would take six weeks. Short of the six weeks, he was discharged from the hospital. Back home, before his appointment with a consultant came up, he died of an asthma attack.

Bartholomew reports that Peggy was "surprised at how ‘accepting' her boyfriend's family was." What she saw was an unexpected passivity, a lethal submissiveness to systemic incompetence and tragedy, a reaction that seemed poles apart from how things happen in the United States. Explains Bartolomew: "She didn't say too much because she did not want to come across as a pushy, arrogant American but she was thinking that ‘in America we'd go nuts if we were told we would have to wait six weeks to see a specialist. Expectations are so much higher.'"

As a footnote on Canada, the average wait for a simple MRI is three months. In Manitoba, the median wait for neurosurgery is 15.2 months. For chemotherapy in Saskatchewan, patients can expect to be in line for 10 weeks. At last report, 10,000 breast cancer patients who waited an average of two months for post-operation radiation treatments have filed a class action lawsuit against Quebec's hospitals.

None of the above is meant to say that America's health care system isn't a mess. That's just a different story, with a different set of fatal flaws.

Ralph R. Reiland is the B. Kenneth Simon professor of free enterprise at Robert Morris University in Pittsburgh.

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