Friday, August 14, 2009

The Big Healthcare debate US v UK

I have to say that I do not work for the NHS and I am not paid to be its apologist. I must also say that it is a matter of complete indifference to me which healthcare system the US govt adopts for its people. That is a purely internal domestic issue and I would not presume to offer unsolicited advice. That there is now a debate raging in the US over the future shape and nature of healthcare must be viewed (if it must be viewed from here at all) as a healthy mark of a mature democracy.

What isn't a healthy mark of a mature democracy is deliberate and cynical misrepresentation as a scare tactic to influence the outcome of the debate.

As outlined in the previous post, the National Health Service has come in for something of a drubbing in some areas of the US media because President Obama had used it as an example of an alternative system of provision and one which could be emulated in American healthcare.

The British media has been a little slow to catch up on this but the backlash has begun if today's headlines are anything to go by. It isn't that we believe the NHS to be perfect: not at all, because it isn't. The issue is how it has been so misrepresented and maligned which has caused anger and offence.

My appeal to any American readers would be:
a) Please stop doing this if you are one of those who trying to mislead others and
b) Please use your common sense and critical faculties if you are being subjected to these "facts".

There was a much quoted case from the Daily Mail (Britain's nearest equivalent to Fox News) HERE. Here it was largely viewed as a story about a wing nut (do you not have those?) whose behaviour was deemed to be bizarre. In some US circles this plays out as evidence that the NHS is "cruel, evil and Orwellian". It is a great headline and yes, there is some criticism of NHS dental provision (but please note that as a patient registered with an NHS dentist not all aspects of my dental care are free and £100 for a crown seems a very good deal to me). What would have been a more revealing headline would have been one that trumpetted "Sixty one million Britons fix their own teeth with superglue." That would justify searing criticism of the NHS!

The NHS is not perfect. No system is. I have seen many stories of US citizens who are dissatisfied with their own healthcare over the last couple of days and I am sure there are horror stories on the web. Does this mean that the US system is "evil, cruel and Orwellian"? No, of course it doesn't. It means that like the NHS it isn't perfect.

Then we have the case of Professor Stephen Hawking. The Daily Telegraph reports:

The British physisist spoke out after Republican politicians lambasted the NHS as "evil" in their effort to stop President Barack Obama's reforms of US health care which will widen availability of treatment but at a cost to higher earners who will pay higher insurance premiums.

"I wouldn't be here today if it were not for the NHS," he said. "I have received a large amount of high-quality treatment without which I would not have survived."

Prof Hawking, who has had Lou Gehrig's disease for 40 years, was in Washington to be awarded the America's highest civilian honour, the Presidential Medal of Freedom.

He received emergency treatment in April at Addenbrooke's hospital in Cambridge. An American newspaper subsequently used Prof Hawking as an example of the deficiencies of the NHS. "People such as scientist Stephen Hawking wouldn't have a chance in the UK, where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless," it claimed.

Now if that wasn't cynical manipulation I don't know what was.

There is also webtalk of an e-mail of "unknown provenance" being circulated to mainly elderly Americans, which stated that British patients do not receive heart surgery after the age of sixty. For the record my Father had major heart surgery at the age of seventy seven and has had further non-related surgery since.

Then there is the talk of rationing of drugs. Do you not believe that all societies do this, including your own? Yes, these stories make compelling headlines and are personal tragedies for the families concerned. If, however, one looks into these case studies in more detail one inevitably discovers that the drug concerned has not yet been licenced after its clinical trials or has not been proved sufficiently effective for that medical condition for it to be considered. The real story here, and one which the government needs to sort out, is that different Health Authorities in the county have slightly differnt policies for prescribing certain drugs, rather like different American HMOs and insurance companies have different financial thresholds.

Now, while we are talking of "Death Panels" could I raise the case of 17 yr old Nataline Sarkisyan in California. Is this typical of US healthcare? I don't know, but as a Brit it would be impertinent of me to attempt to draw wider conclusions about someone else's healthcare system.

Then up pops British Conservative M.E.P. (Member of the European Parliament) Daniel Hannan on Fox News where he said he would not wish Britain's NHS "on anybody". Surely that is an authoritative statement?

Does this man have a background in healthcare? Is he his party's spokesman on health? Is he his party's spokesman on anything? Was he invited on Fox for his objectivity? (Is anybody?)

He may appear credible, but what American audiences won't know is that Hannan is regarded as a loose canon and self publicist on the lunatic fringe here and that as a result of his foray into the American healthcare debate he has been publicly rebuked by his party leader for being "off message":

Senior people at Conservative HQ have moved rapidly into damage limitation mode after the tabloid press turned on people bashing the NHS.

After a strong condemnation by shadow health secretary Andrew Lansley was not deemed enough, David Cameron, leader of the Conservative Party, was forced to issue his own response:

Millions of people are grateful for the care they have received from the NHS – including my own family. One of the wonderful things about living in this country is that the moment you’re injured or fall ill – no matter who you are, where you are from, or how much money you’ve got – you know that the NHS will look after you.

That’s why we as a Party are so committed not just to the principles behind the NHS, but to doing all we can to improve the way it works in practice. So yes, we will spend more on the NHS, but we will also improve it so that it is more efficient and responsive to patients. He also wrote: "Just look at all the support which the NHS has received on Twitter over the last couple of days. It is a reminder - if one were needed - of how proud we in Britain are of the NHS."

(Liberal Conspiracy is the UK's most popular left-of-centre politics blog)

Not so credible now Mr Hannan, eh?

Is Mr. Hannan a political non-entity then? Lets just say that A List politicians go to Westminster not to Brussels.

You see the NHS is not a party political issue here. Yes the parties bicker over funding and so on but not over the principle.

The Prime Minister, Gordon Brown and his wife Sarah also weighed in: both have used their voices on the twitter campaign in support of the NHS.

The Browns have personal cause to to praise the NHS. The P.M's sight in one eye was saved when he lost the other in a teenage rugby accident. The brown's son Fraser has cystic fibrosis, while they publicly thanked NHS staff for the support they received when their first child Jennifer died in 2001.

(The Guardian)

We also have the unedifying story of the deliberate manipulation of T.V.interviews:

A free market campaign group opposed to US President Barack Obama's health care reforms misrepresented the views of NHS patients in a bid to discredit the UK system, it has been claimed.

In an interview with The Times, two women - featured by the Conservatives for Patients' Rights group (CPR) in a US TV commercial - said that contrary to the advert, they strongly supported state-funded healthcare.

It comes amid a growing backlash in the UK over the portrayal of the NHS by conservatives in America, with Gordon and Sarah Brown joining an online campaign to defend the British system from attack.

As part of an increasingly bitter debate over the merits of health care reform, the CPR aired a series of commercials featuring interviews with patients in both the UK and Canada.

In the advert focusing on the NHS, it was claimed that people were left on lengthy waiting lists and deprived of life-saving treatments. But two of those featured in the campaign have since distanced themselves from the CPR. Kate Spall and Katie Brickell both agreed to appear in a documentary on health care reform. But neither knew that the footage would be used as part of a TV advertising campaign carried on US networks.

Ms Spall, whose mother died of kidney cancer while waiting for treatment in the UK, told The Times: "It has been a bit of a nightmare. It was a real test of my naivety. I am a very trusting person and for me it has been a big lesson. I feel like I was duped."

Ms Brickell, who was diagnosed with cervical cancer after being refused a smear test because she was too young, also said her words had been "skewed out of proportion" by the CPR.

She told The Times: "My point was not that the NHS shouldn't exist or that it was a bad thing. I think that our health service is not perfect but to get better it needs more public money, not less. I didn't realise it was having such a political impact."

Point made I think.

Look guys, carry on your own internal debate but please stop misusing my country's system.

I'll say again what I said yesterday: the UK is 18th in the World Health Organisation's ranking of healthcare provision and the US is 37th. Now if you are one of those people who want to attempt to rubbish the findings of an organisation such as the WHO then you have already lost the argument.

Life expectancy (according to 2009 statistics) for women in the UK is 81 and for men 77. In the US it is 80 and 74 repectively. Deaths in the first five years of life per 1000 of the population are 6 in the UK. In the US it is 9.

Enough of the rudeness of rubishing what you don't know.

You want to have a debate about big govt. v small govt. go ahead. Just leave us out of it.

I'll leave the last word to The Daily Mirror When papers like this move away from the usual diet of soccer, tits and celebrity gossip you can tell that there are stirrings afoot amongst the British Public.