The UK healthcare system is used as an example by members of both sides of the government-payor medicine debate in the US. These discussions prove that – like the meaning of the universe and when life begins – the definitions of justice and rationing are in the eye of the beholder(s). Some of us look at the history in the UK and the US and worry about the potential for abuse when medical access is regulated with government funds, prisons, and guns.
Kathryn Jean Lopez of the National Review Online reports (free registration required) that a 74 year-old man was sentenced to a prison term for sending pictures of the results of abortion in the mail to employees at a hospital that performs abortions.
On top of the 28 days prison time, the man in question was informed that he would be denied all but emergency, life-saving care at the (government, tax funded) hospital in question. Despite that under the National Health Service trust this hospital is his only choice, his scheduled eye exam appointment was cancelled and he has been dropped from the (government, tax funded) waiting list for evaluation (the waiting list before the waiting list) for hip replacement surgery.
I can’t think of any intimate, personal matters that are managed well by committee, much less by the process of government and law making. Medical care is very intimate and personal, and my experience with the Social Security and Medicaid disability process, TriCare, Workman’s Compensation, Medicaid and Medicare do not lead me to believe that the Federal government is qualified to hire me as a family doctor or to manage hospitals or other health care “providers.”
Because of changes to the Social Security Act and various “Omnibus” budget bills over the last 20 years (including the newspeak-named “Health Insurance Portability and Privacy Act), the Federal government and anyone who can claim to be functioning in the name of the (Federal) Secretary of Health has a right to copy anything in your doctor’s office, to open every door and drawer, and even to write their own subpoenas. Any physician or “provider” who refuses or interferes with such an action risks “exclusion” (losing the ability to bill any government medical insurance and possibly all insurances that receive payment from those government insurances.)
What may be worse, the risk of Medicare audit hangs over the head of all those who see patients who qualify for Medicare funding. The person or entity audited pays for the audit, and there have been rumors that “deals” are offered: pay $10,000 or so, and the audit will go away. In light of the fact that compliance with rules is probably impossible, can cost even small practices hundreds of thousands of dollars and carry the risk of charges of Medicare fraud and abuse with its threat of triple fines and prison time, that $10,000 can begin to look like a bargain.
In the US, we have difficulty refusing anyone virtually any medical care – far too often on the tax payers’ bill. I do wish that there could be more personal responsibility and an expectation that some payment, in some form will be paid.
However, in Mr. Atkinson’s case, he has paid in the form of taxes through the years. His healthcare should not be restricted, however he has offended in the past.
For more information, see the website of the Association of American Physicians and Surgeons. You can start with this article or this review from the American College of Physicians, which represents Internal Medicine docs)