The NHS, life expectancy and America's health care debate.

Bureaucrats who work for the British government’s health care system are unhappy that their system of centrally planned care is being used as an example of what Americans should fear with Obamacare.

One such individual, from the Faculty of Public Health, Alan Maryon-Davis, claimed “The NHS (National Health Service does a damn fine job.” And his proof:

“We spend less on health in terms of GDP than America but if you look at health indices, especially for life expectancy, we have better figures than they do in America.”

What is interesting is how Maryon-Davis was able to include so much misinformation into one sentence. It is almost breathtaking. So let’s unpack his claim one phrase at a time.

“We spend less on health in terms of GDP than America...” This is true. But does it mean anything?

Americans spend more on cars, in terms of GDP, than do Brits. Does this mean Brits have better automobile transportation than Americans? Not at all, they have significantly less. The British government puts a lid on health care in some very simple ways: they deny it. So you can’t get the treatments in the UK that you can get in the United States.

Americans can choose to spend on these treatments, British subjects can not. If we cut the amount of health care we give out, we could cut our costs significantly. Take one example that was in the news recently, because this British woman, agreed to be interviewed by opponents to Obama’s take-over of health care.

Katie Brickell asked for a pap smear when she was 19. The NHS told her she could not have it. When she turned 20, she was told, she could ask again. She asked again, one year later. Now they told her they had changed the rules and she could only have a pap smear when she turned 25. So, once again she delayed the test. When she was 23 they told her she had cervical cancer, the very thing the test is designed to detect. She said: I gave an interview and everything I saw was truthful...” She said: “I would say to anybody in my situation now that if they had the money, they should go private.”

Luckily she was working a company that also provided private insurance. So she was immediately put on drugs that, so far, have saved her life, and appear to have put the cancer in remission. She has to take two different drugs and she acknowledges, that under NHS care “I would have had to get a lot of clearance to get that level of care. On private, that just was not an issue. If I needed a scan, it was immediate. On the NHS, it was often a two or three-week wait.”

The NHS was doing what it was designed to do: cut the costs of health care by rationing health care according to edits set by bureaucrats as their best guess as to what, is a good idea, on average. The rules are set to cut costs. In most cases a 19-year-old doesn’t need a pap smear, Katie wasn’t “most cases.” The system can’t individualize needs the way that private care can.

Thelma Nixon was told that her case of wet macular degeneration would mean she would go blind. She need injections into the eyes to prevent this. Injections, or blindness, there was no other option. The NHS told her she didn’t fit their guidelines because the cost was too great. So they decided she needed to go blind, after all NHS provides health care at a lower cost than the US and that’s a good thing.

Thelma remortgaged her home while the Royal National Institute for the Blind went to bat for her. The press caught on to the story and started campaigning for her. Since British health care is politically controlled this was causing bad publicity for the ruling party and the NHS relented—for Thelma. Those who don’t manage to create a media frenzy around themselves are not so fortunate.

But Thelma’s initial treatments were paid for by herself, from the house mortgage. And when that ran out a local businessman gave her the funds for two more treatments. Other readers of her local paper rallied to her case and provided funding. ONLY after this media frenzy was created did the NHS relent. They sent up new guidelines for assessment and will not disqualify people from care according to the new policies.

Jane Tomlinson knew that the squeeky-wheel gets the grease in the NHS system. But she didn’t want to go that route. She was an avid supporter of the NHS. She worked for the NHS as radiographer. She spent much of her time raising additional funds for the NHS. It is estimated that she raised close to $2.9 million for the NHS.

She was diagnosed with cancer. Her medical team told her that the best option for situation was treatments with Lapatinib. But that costs $11,000 for a year’s worth of care, but that’s just a fraction of the funds she raised for the NHS. Were the bureaucrats thankful? No. They told her she could not have the treatment in her region. Had she lived in other regions of the country, the bureaucrats had decided differently and she would have had the treatment. She died. The NHS Trust said: “We were deeply disappointed not to be able to offer Jane the treatment she and her consultant wanted. We support Jane and Mike’s (her husband) views that we need to debate about access to drugs that have not yet been licensed or nationally approved.” They were disappointed! Tell that to her her small son.

Remember, it is easy to cut the percentage of GDP spent on health care. Just ration it. Cut the amount of care that people are allowed to receive and you will cut the costs.

What matters, is not the percentage of GDP you spend on care, but what you get for it. We could give Americans 1950s costs on health care if we limit the care to 1950s technology. Cut out CAT scans and you can save a lot of money, and lose a lot of lives. Cut out bypass surgeries and you can lower the total amount spent on care. There is no magic in cutting health care costs. It’s easy and it is done in country after country, merely by limiting the supply of care.

We could cut the costs of education in America the same way. Just fire half the teachers and ration education. We could set up schools with waiting rooms where kids line up in the morning and the first 200 in get to go to class and the rest go home. Of course, they can try again tomorrow!

The proponent of government-run health care only whine about the costs of health care. If education is being discussed they attack America for “not spending enough.” When it comes to public transit they whine about “not spending enough.” When it comes to government programs then more. When it comes to private services then more is evil. It isn’t the cost that offends them. In the UK the same proponents of socialized care want government to spend more. Spending more is only considered evil when it is done privately.

Let’s look at the second phrase in the defense of the NHS: “if you look at health indices, especially for life expectancy, we have better figures than they do in America.”

The problem here is that life expectancy is not a measure of health. It is and it isn’t. It is a measure of life expectancy which is determined by countless other factors, of which health care, is just a small factor.

Imagine two towns, with the identical number of people, fitting precisely the same profiles. They get the exact same health care. But in one town the villages like to drive wildly, while the other town is inhabited by people afraid to drive fast then 20 mph. Which town will have a lower life expectancy?

People who smoke have a lower life expectancy than people who don’t, even if they get the identical care. A town with a higher murder rate will have a lower life expectancy than a town with few, or no murders. People who exercise and eat their vegetables will have a higher life expectancy than people who don’t. There are literally hundreds of factors which impact life expectancy which are entirely outside of the health care system.

This is widely known, but that doesn’t stop the proponents of socialized health care from using this statistic. The numbers they use are correct, but the spin they put on them isn't.

What is an objective criteria that can be used? How about survival rates for patients, suffering similar conditions, under various systems. Since the examples I used earlier, of Katie Brickell and Jane Tomlinson, involved cancer let’s explore the survival rate differences between the US and Great Britain.

The British medical journal, Lancet Oncology did just that. When it came to measuring the survival rates of cancer victims guess who came in first place: the United States, where 62.9 per cent of female patients survived. In England the rate was 52.7 per cent. For male cancer patients the news was better Americans but worse for the Brits. Sixty-six per cent of American male patients with cancer survive. In England only 44.7 per cent do.

Survival rates for cancer victims does measure health care, especially health care around the issue of cancer. Yet, the NHS apologists avoid mentioning this statistic and instead trot out life expectancy, which has little to actually do with health care. But then, what choice did Maryon-Davis have in order to make his case?

Photos: Photo #1 is of the queue outside one of the few NHS dentists in Wales taking new patients. To limit costs the NHS strictly limits the number of dentists. The results are long lines of people hoping to be allowed to see a dentist. Some pensioners have suffered so badly from tooth aches, and facing NHS restrictions on care denying them dental care, that they have resorted to pulling their own teeth. But, when they pull their teeth, instead of the NHS doing it, it lowers the percentage of health care as a part of GDP, and that's a good thing according to NHS proponents. Photo #2, Jane Tomilson and the family she left behind.

Welcome to the New Dark Ages.

It was the Fall of 1977; hard to believe so much time has passed. But I remember the event well. I was working for a newspaper at the time and was sent to Indianapolis to cover a so-called “Right to Decency Rally” that was sponsored by members of the lunatic Religious Right. Rev. Greg Dixon, a bigoted fundamentalist of the worst kind, organized the rally. Keynote speakers were Jerry Falwell and Anita Bryant.

The rally was called to push legislation that would allow the state of Indiana to arrest people for being gay and put them in prison. The bill in question specifically called for making homosexuality into a felony. And that means a serious offense against the law, even though no rights are violated.

Prior to the Rally the Falwellians rallied their troops of religious Neanderthals and had them march through the streets of Indianapolis. I marched with them, tape recorder in hand, and interviewed participants, writing notes and taking photographs. I remember one of the photos I took. It was a cherubic young girl, perhaps six-years-old at most. She was standing holding a sign calling for the execution of gay people. In fundamentalist circles they call that “family values.” I guess it is along the line of: “The family that preys together, stays together.”

That year California, and I guess much of the West, was in a drought. No surprises there. California and the West have experienced droughts for as long as history has been recorded. I mention this because of one couple I interviewed. The woman was standing there in her very long dress (anything above the knees was immodest to them). She had a Bible clutched in her hand and pressed up against her breast. Any one in public, with a Bible clutched in full view, is almost always bad news. And, in a sense, so was she. But she was far more amusing that deadly, though I have no doubt she would have happily joined in a stoning of a homosexual or, in times past, happily provided some wood to burn a witch or two.

I asked her why she was participating in this march. She explained that God hates homosexuals and God wants homosexuals punished. If man won’t punish homosexuals then God will punish man. In the deep theology of fundamentalism if you don’t hate the people they hates then their God will beat up your God and hurt you. She then went on to explain that the drought in California was the result of the state being more tolerant of homosexuals than other places in the country. Apparently the drought had nothing to do with the typical climate of the region; it is all based on the whims of her deity.

I asked her: “Are you saying that the presence of homosexuals causes droughts?”

Without hesitation she said: “Yes.”

I couldn’t resist a follow-up question. “Then, if a region is experiencing floods, would it be possible to stop the rain by busing in a lot of homosexuals?”

All right, I knew the question was absolutely ludicrous. Who in their right mind would think you could control the weather by moving gay people around the country? She paused momentarily and then said, “Yes, that would work.” To say the least, I was gobsmacked. I simply didn’t know how to respond to such explicit, utter and total stupidity. But, as I’ve said, when there is no reasonable explanation for what someone does or thinks, then there usually is an unreasonable explanation, and it is usually religious.

That was thirty years ago and society has evolved. But fundamentalist Christians don’t believe in evolution, so they stagnate.

Let us move to modern day Maine. By all standards Maine is relatively civilized place. Of course, there are still some mental antiques wandering around, stuck in some previous, dark age. One of them is Michael Heath, of an outfit called the Christian Civic League. As might be surmised Mr. Heath is a committed religionist who believes that supernatural powers are at work in the world. That would include, not just a deity, but devils and spirits—the sort of images that small children have about existence until they become more intelligent about the reality of life.

Heath is in a panic because Maine allows same-sex marriage. Add to that a spell of bad weather and you have 1977 all over again. In the jungles of the most primitive parts of the world there are people who blame every unfortunate turn of events on some scapegoat. They believe, that if you find the scapegoat, and if you kill it, or drive it out, then you will end the problems you experience. Mr. Heath is a mentally sophisticated as these savages.

In a newspaper column he laments the fact that Maine has had a rather wet summer. As he, rather badly, writes:

Our gardens droop low as if worn out and saddened. Bird and beast stay close to home, and when they do venture out, they too, seem peevish and sullen.

What is missing is the sun. God’s emblem of cheerfulness and benevolence.

Our crops are faring like our moods. The potato crop is blighted, and corn and fruit fields wither. In one historic building in Augusta, rain flood the basement…

And what is the cause of this rain:

…Maine voted in homosexual ‘marriage.’

In May, our elected officials overturned a law of nature, and in its place paid honor to evil and unnatural practices. Our leaders allowed a cloud of error to hide the light of reason, and then the rain began. How fitting that this eclipse of human reason is mirrored by the disappearance of the sun!

Heath admits” “Few people would be bold enough to suggest the cause of the endless rain and gloom, that the moral climate of Maine has caused the sun to hide its face in shame.” He is bold enough. It is raining too much in Maine because gay people were granted equal marriage rights.

Heath says that he doesn’t blame gay people per se, for the rain. “Far from it. The fault lies with a refractory governor and Legislature who imposed an immoral law on our people.” Instead he says the weather is lousy because the state gave gay people equal rights before the law. And he tells his readers, most of whom I suspect were rolling on the floor in hysterical laughter, that worse is to come: “America has seen nothing comparable to Stalin’s show trials… yet. But we are experiencing one long, interminable dark and dreary summer.”

So, even though three decades have passed, the morons that make up Christian fundamentalism have not improved one iota. Notice the conflict between these two cases. When there was too little rain in California, it was God withholding the life-giving rain to punish the sin of homosexuality—a punishment God ended shortly after when he allowed it to rain again, thus sending conflicting messages. Today, in Maine, there is too much rain. So another Village Idiot from Bibleland wanders out to blame the surplus of rain on homosexuality, or at least on the tolerance of homosexuality. Too much rain, blame the homosexuals. Too little rain, blame the homosexuals. Hell, all this time I thought we were supposed to blame global warming for all the unpleastantries of weather.

I don’t get this Christian deity at all. Am I to understand that he sends rain to punish homosexuality and he also withholds rain for the same reason? Jehovah appears a tad bit schizophrenic. He can’t make up his holy mind. Or, is does the impact homosexuals have on the weather different depending on the region in question? If gay marriage is ruining the summer in Maine thwn what happened to the summer in Iowa, which has gay marriage as well. Unfortunately for Mr. Heath the weather in Iowa as been pretty good, with it raining only 9 days out of the month, and three of those days with just trace amounts. There is enough rain to water the crops and enough sun to nourish them, all in all a pretty good balance.

Just think, for a second, how primitive the level of reasoning that is necessary for Heath to draw the conclusions that he does. One has to be practically lobotomized to think this way.

When the Catholics of the Dark Ages faced bad crops, or disease, they routinely blamed Jews and “witches” for the situation. But they were illiterate and uneducated, living in a world where the fundamentals of science had yet to be discovered. Mr. Heath has no such excuse. His ignorance is self-induced. It may well be that he is not a particularly bright man, after all the dumb of the world flock to fundamentalism pretty much the way flies flock to shit. But, neither is there a shortage of people who use religion to close down their critical thinking faculties.

To repeat: when there is no rational explanation for what people think or do, there is probably an irrational one. And when there is, the likelihood is that religion will be involved.

Photo: The grinning moron in the photo is Mr. Heath.

When everyone wants freedom.

At times you will find political figures who are willing to fight for freedom. Those, unfortunately, are rare occasions. Few individuals are willing to do this consistently. Most are, at best, sunshine libertarians —those who advocate freedom when it is safe and bright and appealing; when it has the sanction of the majority; when even the mob can applaud the virtues of liberty.

There are some trends that we can discern regarding support for freedom. And I should state that by freedom, I mean the right of the individual to control their own life, liberty and property, restricted only by the equal rights of others. This is classical liberalism, which is not the same thing that the illiberal Left promotes. And by illiberal Left I refer to such people as Nancy Pelosi, Barack Obama and Joe Biden.

On the Right we saw figures like Goldwater and Reagan, who were more liberal than not, and certainly more liberal than most on the Right. George Bush and the advocates of the Religious Right were part of the illiberal Right. Liberals want to expand freedom not restrict it. And there are people on both the Right and the Left who wish to do that.

In my view liberals on what is called the Left, and what is called the Right, are inconsistent liberals. They are advocates of freedom sometimes, and advocates of authoritarianism other times. These are liberals who fail to live up to their own principles.

Most politicians, however, lack principles. They are not advocates of great principles at all, just advocates of power, particularly power in their own hands. They are the people who see humanity as a great lump of clay and themselves as the God-chosen sculptors, with the vision and the right necessary to beat that clay into shape. And “beat” is the operative word when political power is wielded.

Most politicians, like most people, are of mixed premises. More importantly, they are people of contradictory premises. Your typical human holds political values that conflict with one another. They neatly compartmentalize these issues so as to avoid the cognitive dissonance that comes from holding conflicting values. In other words, they avoid thinking about how their own politics is a conflicting jumble of values that ultimate undermines the good values that they do hold.

Take the so-called “Tea Bag” meetings as an example. Many of these people, while shouting wildly about freedom, advocate Big Brotherism in the bedroom. They are not advocates of freedom in principle; they are advocates of their freedom, not your freedom.

That most politicians hold conflicting values of freedom is no surprise. In fact, I should not say most, I should say all. I honestly don’t know of one single prominent politician who consistently advocates freedom—not one. Some do so more than others but all apply their principles inconsistently and often, incoherently.

But there are times when most people, and most politicians, are quite libertarian, or quite liberal in the true sense of the word. When are those times? Is there a consistent pattern of activity that allows us to predict when and where someone is more likely to be libertarian? In one word: Yes.

There are two times when we know that someone will take a more libertarian position than usual. (There may be more, but there are two such occasions that I have identified and perhaps others that others would identify that I have not thought of.)

The first is what I called the gored ox issue. When an individual’s ox is the one being gored they are most likely to demand it stops. Individuals who are authors, or who like books, erotica, etc., will demand the end of censorship more than individuals who have no such interests. Farmers want the freedom to farm their land as they see best. Business owners want the right to hire the employees they think best suited for their company.

Everyone wants freedom for himself or herself. That is never the controversy. What they have problem with is freedom for others. So many authors of more erotic material may advocate hate speech regulations because they don’t write such material. Certainly the purveyors of hate typically want censorship of erotic material while demanding the absolute right to prove their own stupidity in public.

The farmer who demands the right to farm his land as he see fits may well advocate protectionist barriers to prevent the farm products of others from entering the country. The business owner who staunchly defends his own freedom of association may be quite willing to restrict your freedom of association.

Consider the misnamed book, The Conscience of a Libertarian, as an example. Author, Wayne Root, a social conservative for sure, has an entire chapter on the dangers of prohibition. Yet the chapter is not about the war on drugs, but about gambling. Mr. Root made his living convincing gamblers that they should purchase his advice—advice that many of them says is no better than average. Root’s salesmen would use high-pressure techniques to convince people to “subscribe” at high fees to Roots advice service.

A side note: I put these handicappers in the same category as many investment newsletters. When someone is making his money selling you advice on how to make money, be suspicious. If their advice were of real value then they would be getting rich, not by selling their advice, but by implementing it themselves.

The second time that we find individuals more actively promoting libertarian principles is when they are out of power. Everyone wants to deny power to his or her opponents but grab power for him or herself. Consider the perfect example of modern conservatives in the form of the Republican Party. Out of power they wail about small government.

When Big Brother Georgie was in power, over the last two terms of office, these Republicans rolled over, dropped their drawers and shouted: “Give it to me Big Boy, give it to me!” Unfortunately for us, when they got screwed, so did we. At no point did the Republicans find the guts to stand up for a single one of those “limited government” principles that they claimed to support.

The moment George Bush was consigned to the trash heap of history, and the Republicans lost control of government to the authoritarian Left, they started screaming about out-of-control government. Basically these Republicans took the government, severed the brakes completely on the downhill drive, handed the wheel to Obama and then started whining about the speed.