NHS lessons for Obamacare

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FT. WILLIAM, Scotland -- The power of television to shrink the world has always amazed me. Eating lunch on the road to Ft. William, a man at the next table recognizes me and introduces himself.

Keith Farrington says he spent 15 years working as an assistant director of finance for the South East Thames Regional Health Authority, part of the National Health Service. He has strong warnings for the U.S. about Obamacare.

"The main problem is that the NHS is seen as free on delivery to everybody," Farrington said. "It is not free. The clinicians have not been trained to think about finance and budgetary control as important. For example, overseas citizens can obtain an NHS number when they visit a doctor's office. This number is seen as a passport to full NHS care, including operations and aftercare because the clinicians say it is not their job to sort out who is eligible and who is not. In this way, billions of pounds are spent on noneligible folk. ... Word has got round in Nigeria, Ghana, India and Pakistan that it is possible to receive treatment on the UK taxpayer without restraint and cheaper than paying in their own countries."

Obama claims that won't happen here. "The reforms I am proposing," he said in 2009, "would not apply to those who are here illegally." Partly true. With Obamacare, noncitizens would not be covered and would not be subject to the individual mandate, but they could still walk into any ER and get treated on the taxpayer's dime.

With such open-ended spending in the UK, the predictable has occurred. The NHS faces a 30 billion pound deficit by 2020 and, according to Tim Kelsey, director for patients and information at NHS England, is set to "run out of cash."

Each time I visit the UK I read about NHS horror stories. The Scottish Daily Mail reported on three brutal killings that might have been prevented were it not for a "catalogue of failings by a (NHS-operated) mental health trust." One of the men had been refused treatment for failing to register with a local doctor.

An investigation by the UK Daily Telegraph found that some patients are forced to wait up to eight hours inside ambulances because there are not enough beds inside hospitals. Senior NHS doctors and managers say up to 20 hospitals across the country may close to avoid financial ruin. If you are sick on a weekend, fewer doctors are available. The Telegraph quotes senior officials as saying 4,000 lives a year are lost because of poor weekend care. These officials call the current trend in the NHS "unsustainable."

One health minister referred to scandals and cover-ups in patient deaths at two hospitals as part of a "rotten culture" in the NHS. In March, the Daily Mail reported "Nearly 1,200 people have starved to death in NHS hospitals" because "nurses are too busy to feed patients." At Stafford Hospital, police are investigating the deaths of 300 patients over a four-year period. They suspect neglect, even criminality, may have contributed to their deaths. In February, the Telegraph reported "More than 3,000 people may have died unnecessarily at five NHS trusts."

Why isn't this a lesson for the U.S.? Why do people believe government is more competent than the private sector, despite numerous examples to the contrary?

The Obama administration is pressing ahead with implementing America's version of the NHS, no doubt expecting different results. Though postponing the employer mandate until 2015, beginning Oct. 1, the administration plans to start sending money to states that have already set up health care exchanges. As Washington Examiner columnist Byron York has noted, the sooner people become dependent on this latest government program the more difficult it will be to overturn the law.

Keith Farrington has a "you'll be sorry" attitude toward America concerning its version of an NHS. He is shocked that we would scuttle one of the best health systems in the world -- even with its imperfections, which can be fixed -- for one in which government controls a key part, which he predicts will produce results similar to the UK.

He speaks from experience. Is anyone in America listening?

(Readers may e-mail Cal Thomas at tmseditors@tribune.com.)

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