Single Payer Systems Kill

NEW YORK — Before American voters embrace either Hillary Clinton’s universal-health scheme or Barack Obama’s somewhat less dirigiste single-payer proposal, they should consider the avoidable deaths that plague the mother of all state-run medical programs: Great Britain’s big-government National Health Service. Low-quality, taxpayer-funded health care killed more than 17,000 Britons in 2004, according to the TaxPayers’ Alliance in London.

TPA examined the World Health Organization’s latest-available data to contrast the NHS with the Dutch, French, German, and Spanish health systems, which are less government-dominated. Specifically, the pro-market group measured “mortality amenable to healthcare” — those deaths that a medical organization realistically should prevent. While those four countries averaged a 106.6 amenable mortality rate, Britain was almost 29 percent deadlier, with its rate of 135.3. TPA thus calculates that the NHS took the lives of 17,157 Britons who otherwise would have survived were they treated by doctors across the English Channel. This figure is more than two-and-a-half times Britain’s yearly alcohol-related deaths, and is quintuple its annual highway fatalities. Comparing 60 million Brits to 300 million Yanks, this is like a federally operated health agency eliminating 85,785 Americans in 2004.

“Anyone looking to reform the American healthcare system should learn lessons from the European experience,” says Matthew Sinclair, the TPA policy analyst who authored this study. “Britain’s NHS has produced dismally poor results. Thousands die every year, thanks to its poor performance and its failure to make good use of new resources. Other European healthcare systems deliver greater competition, decentralization, and independence from political meddling.”

No one can complain that the NHS is underfinanced. This year’s budget is $210 billion — about $1.05 trillion if adjusted to match America’s population. NHS funding climbed 221.7 percent between 1996 and 2006. Despite such largesse, “we have not increased the pace of improvement in the most important measurement of its output — its ability to save lives,” laments Professor Karol Sikora, a leader of Doctors for Reform, which hopes to inject competition and choice into British medicine.

Such goals are rare in a sector ensnared in bureaucracy. The British Department of Health supervises the NHS. In turn, the NHS includes Primary Care Trusts, NHS Trusts, and Regional Strategic Health Authorities. Drugs are controlled by the National Institute for Health and Clinical Excellence (warmly nicknamed “NICE”). The NHS Pay Review Body oversees staff compensation. Connecting for Health runs the National Programme for IT, reportedly Earth’s single, largest information technology initiative. Within this maze, it is no surprise that patient needs often yield to the wants of politicians and medicrats.

The consequences for these political considerations can be ugly.

Poor sanitation has become the NHS’ latest worry. The BBC’s Danielle Glavin worked undercover at a government hospital in Kent. “On my first day, as I emptied bins, swept, and mopped, I noticed old blood stains ingrained on the floor,” Glavin reported. In one surgical theater, “a blood-stained gown was left on a trolley for 24 hours, and used medical instruments were discarded in a sink for a day.”

This helps explain why the British government estimated that 9 percent of inpatients in 2000 suffered hospital-acquired infections. The bacterium Clostridium difficile often is associated with hospital outbreaks and extended medical stays. English and Welsh death certificates citing C. diff as a cause or contributing factor grew from about 1,000 in 1999 to 3,807 in 2005.

Diseases snuff Britons sooner than they do others in the developed world. A September 2007 Lancet Oncology article found 66.3 percent of American men alive five years after cancer diagnosis. Among male Finns, that figure was 55.9 percent, while only 44.8 percent of Englishmen survived after five years. Across the European Union, 20.1 females per 100,000 under 65 died prematurely of circulatory disease. Among British women, that number was 23.6.

Collectively, these data strongly rebuff the notion that America’s imperfect health care industry needs a booster shot of mandates and regulations. What it sorely lacks is more choice, competition, and freedom, and loads less government.

Sen. John McCain’s ideas — among them, expanded health-savings accounts; individually owned, portable health-insurance policies available across state lines; and medical-lawsuit reform — are the antidote to the “health care with a British accent” that Clinton or Obama would import, unless American voters stop them.

New York commentator Deroy Murdock is a columnist with the Scripps Howard News Service and a media fellow with the Hoover Institution on War, Revolution and Peace at Stanford University.