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Government Control Leads to Denial of Care

Government Control Leads to Denial of Care

By Robert Tracinski - October 19, 2009

Remember the whole controversy over "death panels"-the idea, as President Obama dismissively put it, that greater government control over medicine would cause bureaucrats to "pull the plug on grandma"?

Well, for weeks now Britain's newspapers have been filled with articles about the National Health Service pulling the plug on grandma.

The latest is the story of a woman who had to fight her doctors for weeks after they withdrew care from her 80-year-old mother. According to the London Times:

Hazel Fenton, from East Sussex, is alive nine months after medics ruled she had only days to live, withdrew her antibiotics, and denied her artificial feeding. The former school matron had been placed on a controversial care plan intended to ease the last days of dying patients.

Doctors say Fenton is an example of patients who have been condemned to death on the Liverpool care pathway plan. They argue that while it is suitable for patients who do have only days to live, it is being used more widely in the NHS, denying treatment to elderly patients who are not dying.

Fenton's daughter describes the NHS system for dealing with very ill elderly patients as "a subterfuge for legalized euthanasia of the elderly." In other words, a death panel.

This is just the latest story. For some time, British newspapers are always filled with reports about the failures of the National Health Service, but the barrage has intensified in recent months. A sampling:

From the Daily Mail, October 13: "A grandfather who beat cancer was wrongly told the disease had returned and left to die at a hospice which pioneered a controversial 'death pathway.' Doctors said there was nothing more they could do for 76-year- old Jack Jones, and his family claim he was denied food, water, and medication except painkillers. He died within two weeks. But tests after his death found that his cancer had not come back and he was in fact suffering from pneumonia brought on by a chest infection."

From the same day's Daily Telegraph: "At around 4am on Monday, a friend of mine was woken by a call from the private care home in south-west London where her 98-year-old grandmother is resident.... 'She needs to go to hospital. Do you want that? Or would you prefer that we make her comfortable?' Befuddled by sleep, she didn't immediately grasp what was being asked of her.... Then, the chilling implication of the phone call filtered through-she was being asked whether her grandmother should be allowed to die.... My friend is reeling.... Had she really been asked to pronounce a possible death sentence on her grandmother, a woman with no underlying ailment other than old age?"

Most of the recent British stories concern the Liverpool Care Pathway, an NHS-approved system in which doctors are encouraged to withdraw medical support for patients they deem too infirm to live. But in early September, a group of doctors sent a letter to the Daily Telegraph arguing that "the scheme is causing a 'national crisis' in patient care.... 'Forecasting death is an inexact science,' they say. Patients are being diagnosed as being close to death 'without regard to the fact that the diagnosis could be wrong.'" Dr. Peter Hargreaves says, "What they are trying to do is stop people being overtreated as they are dying. It is a very laudable idea. But the concern is that it is tick box medicine that stops people thinking."

For an especially infuriating example of this "tick-box medicine"-which is not just applied to the old-see a heart-breaking report in the September 10 edition of the Daily Mail:

Doctors left a premature baby to die because he was born two days too early, his devastated mother claimed yesterday. Sarah Capewell begged them to save her tiny son, who was born just 21 weeks and five days into her pregnancy-almost four months early. They ignored her pleas and allegedly told her they were following national guidelines that babies born before 22 weeks should not be given medical treatment. Miss Capewell, 23, said doctors refused to even see her son Jayden, who lived for almost two hours without any medical support.

She was shocked to discover that another child, born in the US at 21 weeks and six days into her mother's pregnancy, had survived. Amillia Taylor was born in Florida in 2006 and celebrated her second birthday last October. She is the youngest premature baby to survive.

I understand that extremely premature babies have very low survival rates and a high risk of serious medical complications. But the decision about whether or how much to treat an infant should be made by the parents in consultation with their doctors-not according to the orders of some faceless medical board. Yet that's what happens when your doctor is reduced to just another bureaucrat ticking off boxes on government paperwork.

This is how an alleged "right" to government-provided health care leads to the denial of care. As government health-care budgets inevitably spiral out of control, hospitals find themselves with insufficient resources, so a centralized health-care bureaucracy tries to control costs by making sure patients are granted or denied care according to predetermined rules drafted by a medical rationing board. Britain has one, the National Institutes for Health and Clinical Excellence, known by the Orwellian acronym NICE--and President Obama wants to create a similar board in the US to provide "guidance" about which treatments are "cost-effective" and should be allowed.

In such a system, the patient has little or no control precisely because he is not the one paying the bills, so no one has to listen to him. That's what happens when people surrender their actual right to health-care, the right to contract for it privately with doctors and insurance companies, in exchange for an illusory "right" to whatever care the government chooses to provide-or withhold.

The British press may be roiled by this story, but you won't read about any of this in American newspapers. Hence, the current health-care debate has taken on a dramatic irony worthy of a great work of fiction. Just as America is debating whether to give the government a dominant role in health care, Britain is agonizing over the horrific consequences of just such a government-controlled system. But no one in America knows about this, because our press wants to pretend it doesn't exist.

In a good thriller, the protagonists would learn the real story just in time to save themselves from disaster. Perhaps Americans will find out what is happening in Britain in time to stop ObamaCare. But in a tragedy, knowledge of the future we can expect under government control would arrive too late, after we have already signed over our lives to the state.

The story isn't written yet, so the outcome is still our choice.

Robert Tracinski is editor of The Tracinski Letter and a contributor to RealClearMarkets.

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