Experiencing The British Healthcare System First Hand

Long ago I had offices in New York and London as well as here in my company's L.A. headquarters. I was in London frequently, but I only got sick enough to see a doctor once. One of my colleagues recommended a doctor and I went to his office. He attended to my health concerns and I left. It was fast and simple and it didn't cost me anything. I don't know how the U.K. health care system works exactly, though Ken jumped into it yesterday and tried exposing some of the lies about it floating around about it. I came across those lies when I went to Adam Schiff's health care town hall in Alhambra a little over a week ago. After reading Rep Robert Wexler's book, Fire-Breathing Liberal, I had the impression Republicans brag about not having passports and how having never traveled abroad is a badge of honor. So wasn't I surprised when I noticed that half the teabaggers who had come to the meeting were claiming to have "lived" in Canada and the U.K. and how they personally experienced the disaster of socialized medicine.

Rachel Klein is an old friend of mine, a professor at UCSD, and I asked her to recount an experience she had had when she was traveling in England a few years ago. Here's what she sent me:

The debate over health care reform and the widespread vilification of the British National Health got me thinking about my own experience with the British system. Three years ago, towards the end of the very first day of a long-planned family trip to London, a moped hit me while I was walking along a cobblestone street on the west side of Regent's Park. 

A taxi took me (along with my husband and son) to the nearest hospital where we learned that I had a badly broken femur. The next day several doctors spoke with me about the up-coming surgery and, at some point, the young anesthesiologist sat by my bed and commiserated as I shared my mostly irrational pre-op worries. The nursing staff could not have been more considerate. In fact, we had several late-night chats about politics. In all, my hospital stay lasted five days and four nights, and I returned several days later for a post-op check-up. 

Because I am not a British citizen, I received a bill: The price tag was slightly under $5,000 for everything, including the surgery and medication. Coincidentally, I even had a single room. When I returned to the U.S., with three new metal rods in my leg, several orthopedists complimented the work of the British surgeon. Within six months I was back at yoga.
 
Admittedly, the food in the London hospital was unspeakably awful-- worse, perhaps, than American hospital fare. But in the ways that really counted Britain's National Health treated me exceptionally well. I don't know for sure what an American hospital would have charged for equivalent care, but an orthopedist friend speculates that the cost would have been around $20,000.

Today is the fourth day of our Blue America campaign showing appreciation to the 65 members of Congress who have stood firm on real health care reform rather than the massive rip-off the Insurance Business lobbyists have persuaded the Blue Dogs, the Republicans and corrupt Democrats in the Senate like Blanche Lincoln, Max Baucus, Ben Nelson and Mary Landrieu to try to pass instead. More than 5,400 donors have contributed almost $325,000 and donations are still rolling in as strongly as ever. Every congressmember on the list has already gotten over $2,000 and some of the ones who have spoken out the strongest, like Barney Frank (D-MA), Anthony Weiner (D-NY), Donna Edwards (D-MD), Eric Massa (D-NY), Lloyd Doggett (D-TX), Dennis Kucinich (D-OH), Barbara Lee (D-CA), Jim McDermott (D-WA), and Raul Grijalva (D-AZ), are winding up with the largest number of donations. Their position may be under attack from Republicans, Blue Dogs, lobbyists, Insurance Industry CEOs, Rush Limbaugh, Glenn Beck and the gun-toting teabaggers, as well as shills like Rahm Emanuel and Max Baucus, but the people in this country, overwhelmingly support a choice between a government-run health care insurance option and private coverage.

An interesting contrast: the special interests and their lobbyists are pouring money into the coffers into the most corrupt members of Congress-- and in the House that means Republicans and Blue Dogs, who sell their asses daily as a matter of course. Blue Dogs, especially have been raking in the dough.

Health and accident insurers, HMOs and health services increased their contributions to Blue Dogs by at least 15 percent between the first and second quarter of this year (from $106,200 to $122,650), but by 3 percent to non-Blue Dog House Democrats. Blue Dogs' stance on health care reform is more in line with that of health insurers and pharmaceutical companies -- they oppose a public health plan unless "insurance market reforms and increased competition don't lower costs on their own," according to Politico.

In the first six months of the year, Blue Dogs have also brought in more, on average, from health insurers than both Republicans and non-Blue Dog Democrats in the House.

Blue Dog Democrats have collected $4,401, on average, through their leadership PACs and candidate committees this year. That compares to $3,085 to non-Blue Dog House Democrats and $3,820 to House Republicans.

The netroots effort we're doing at Blue America for the last 4 days has netted our 65 stalwart progressives an average of over $5,000-- even more than the bribes the Blue Dogs have taken from the Insurance Industry and Medical-Industrial Complex. And they don't have to worry about ever winding up sharing jail cells with Duke Cunningham, Tom DeLay, Jack Abramoff or Bob Ney.

One example of the lies at the heart of the crusade against health care reform: the lies about Britain's National Health Service

"I'm not standing up here and saying we have the best health care system that you should copy. That's not the intentions of me getting on the radio to you. It's -- I'm making clear that what you're hearing is not just false and distasteful, it's just far from what I expected, someone in these senior political roles, to be disseminating fear against the system."

-- former British health minister Dr. Lord Ara Darzi

by Ken

As I mentioned earlier today, even I was taken aback by the scale of the out-and-out lying being done in the right-wing assault on meaningful health care reform. The famous Luntz memo not only outlined but went into a good deal of detail about pollster Frank Luntz's proposed "messaging" for the health insurance industry's counteroffensive, but I'm not aware that it went anywhere near this far.

The memo clearly did counsel opponents of meaningful reform to make use of human "stories," and specifically targeted foreign health care delivery systems that might be cited by reform proponents as superior to ours. In the case of Britain's National Health Service, that would mean citing horror stories of long waits for specialists, or people denied care -- as if such things didn't happen every hour of every day under our system, which has become more and more obsessively devoted to denying people care, because it's good for the insurance companies' bottom line, which is the true priority of U.S. health care delivery.

Now, the disingenuousness here is splendid. When it comes to health care horror stories, heart-wrenching stories of people falling through the cracks, or rather crevices, of the system, it's hard to believe anyone in the developed world can match ours. Just think, before the so-called "health care debate" began, do you recall going as long as a day without hearing yet another story of someone who suffered irreparable harm from our mess of a "system"?

Nevertheless, it is possible for the deniers to find a usable store of stories of people who have suffered under Canada's single-payer system or Britain's. Of course they're usually ripped out of context. In the case of the NHS, for example, the stories probably date back from the years when the Conservative governments of Margaret Thatcher and John Major basically starved the system, on the apparent theory that God's plan for people who can't afford proper health care is suffering and death. Still, I understood Luntz to be suggesting using actual stories, however carefully torn from context and spun. I don't believe he was advocating what the deniers are doing: just making stuff up. (Or maybe he thought it went without saying that truth wasn't a requirement, and so he didn't need to say it?)

I mention the British system because it was American right-wing lies about the NHS that set me off yesterday on a new round of thinking about the all-lies-all-the-time mindset that is now the Right's political theology as well as the centerpiece of its strategy book.

I was a bit surprised to hear recently from someone who spends a lot of time in the precincts we here at DWT call "Inside the Beltway" that a lot of the people who infest the halls of government listen to NPR when they're in their cars moving around as well as to and from the hallowed District. Of course they know better than the preposterous shibboleth that NPR is a hotbed of liberal propaganda.

In fact, the NPR folks are so obsessed with balance that lately it has seemed to me that Morning Edition has been scrupulously "balancing" the health care debate with a seemingly uninterrupted series of arguments from the deniers "countering" arguments that sure haven't been made while I was listening. Partly, of course, it's hard for anybody to be lobbying "for" the health care reform plan when there isn't one. There are only the bills in various stages of markup before the five committees that have jurisdiction, plus a whole lot of noise from us out here in the peanut gallery.

(Of course that doesn't stop the liars and loonies of the Right from attacking "the Obama plan," or "Obamacare," when even now we don't know what the president believes in, or wants, or insists on by way of health care reform -- not to mention what he's prepared to go to the mat for.)

Nevertheless, for a long while on Morning Edition we seemed to be getting a daily diet of interested parties attacking one aspect or another of "the plan." It could be my imagination, or it could be that somebody there noticed the same thing, but lately we seem to be hearing from "our" side. And yesterday the ME team did a nice job on the hatchet job that the health care deniers have been doing on the NHS.

There was a report on the obscure Tory MP who lent his voice to the movement until he was shut up by his own Conservative Party leader. And then there was an interview with Dr. Lord Ara Darzi, a prominent surgeon and health care expert. You can hear the interview on the NPR website, but here is the official transcript, with just a couple of highlights -- rebuttals of a couple of the blatant lies -- highlighted:

STEVE INSKEEP, host:
The defenders of Britain's system include Lord Ara Darzi. He is a prominent surgeon who just finished his stint as a minister in Britain's Department of Health. He admits British health care is imperfect. Still, he says, it's a fairly straightforward system.

Dr. LORD ARA DARZI (British Government Advisor, Britain's National Health Service): Every patient, or a member of public in England, are registered with a primary care physician. You go and see your general practitioner. Your general practitioner will refer you on and the cost of that referral and the payment of that hospital is made by this local insurer, which we call primary care trust. The payment is made by a single payer.

INSKEEP: Single payer, the government, end of story.

Dr. DARZI: Yeah.

INSKEEP: There had been some reforms in the National Health Service in recent years, and that makes me wonder what it is that went wrong that needed reforming.

Dr. DARZI: Well, the National Health Service has not just come through a reform. It's come through a complete transformation over the last eight years. We did have patients on waiting lists for their operations for a long period of time. We certainly did have shortages of doctors or nurses. And the expenditure in health, back in the year 2000 was 37 billion pounds, roughly $70 billion.

INSKEEP: Mm-hmm.

Dr. DARZI: The expenditure now is 110 billion pounds. That's near enough $200 billion. The NHS in itself has grown by about a third, employing new doctors, new nurses, new hospitals. So, a lot has changed and a lot of the stories that I certainly heard over the last couple of weeks, which is being debated, are the stories of the past.

INSKEEP: So, you got to the year 2000 and found that the government-run system had just not kept up with the needs of the British public. The spending was not sufficient, the number of doctors available were not sufficient, and the wait for particular kinds of treatment was just out of control. That's what was happening and that's what you tried to fix, fundamentally.

Lord DARZI: That's correct. You know, the NHS, the last decade is a different NHS from the NHS the decade before.

INSKEEP: Well, let me get to a specific example that's been cited this month here in the United States. Senator Charles Grassley, a Republican who is deeply involved in health care negotiations, raised concerns about moving the United States anywhere near what Britain has because of an example of a fellow senator of his. Let's listen:

Senator CHARLES GRASSLEY (Republican, Iowa): I've been told that the brain tumor that Senator Kennedy has, because he's 77 years old, would not be treated the way it's treated in the United States. In other words, they say, well, he doesn't have long to live, even if he'd live another four or five years. They'd say, well, we've got to spend the money on people that have more, can contribute more to the economy.

INSKEEP: Okay. Does the British system make that kind of distinction? Here's an older fellow, you've got this treatment that you could give him but it wouldn't add massively to his life expectancy, so we'll deny that. Do you do that?

Lord DARZI: Well, I'm sorry to say that's the most ludicrous thing I've heard. I've heard that written down but I've never heard it in real speech. And the answer to that is absolutely no.

INSKEEP: So, Grassley's comment is based on nothing, so far as you can say?

Lord DARZI: Absolutely -- not just false, these are lies which have been used to set fear against reform.

INSKEEP: Ted Kennedy goes to Britain, he's a British citizen, he's going to get full treatment and that treatment is going to be fully paid for. Is that what you're saying?

Lord DARZI: Absolutely, irrespective of the tumor type as well.

INSKEEP: Let me play another clip, if I might. This comes from an ad that's been running nationwide in the United States, an ad campaign produced by a conservative political action group called The Club for Growth. And they show on the screen, an image of an old man who is mourning in a hospital bed.

(Soundbite of ad)
Unidentified Man: Twenty-two thousand, seven hundred fifty dollars: in England, government health officials decided that's how much six months of life is worth. Under their socialized system, if a medical treatment costs more, you're out of luck. That's wrong for America.

INSKEEP: That's an ad from the Club for Growth. And just to be clear: is there a meter by the bed, in effect, in Britain, and if health care gets too expensive for an individual, you cut him off?

Lord DARZI: Absolutely not. Again, it's the most ludicrous thing I've heard. And I'm just giving an example: the life expectancy in the U.K. is actually longer than it is in the U.S.

INSKEEP: But if somebody gets into a particularly difficult medical situation and treatment is particularly expensive, do you ever get to a circumstance where you say, we're just not going to pay for that treatment anymore?

Lord DARZI: Absolutely not. I'm not standing up here and saying we have the best health care system that you should copy. That's not the intentions of me getting on the radio to you. It's -- I'm making clear that what you're hearing is not just false and distasteful, it's just far from what I expected, someone in these senior political roles, to be disseminating fear against the system.

INSKEEP: Lord Darzi, thanks very much.

Lord DARZI: My pleasure.

INSKEEP: Lord Ara Darzi is a former minister in Britain's Department of Health and a surgeon at St. Mary's Hospital in London.

The coalition of the medical-industrial complex and the birthers and health care deniers and assorted other teabaggers are confident that the American people are jibbering idiots who can be whipped up into a lather of terror and rage by a massive enough campaign of lies.

#

Is It Too Late To Rescue Health Insurance Reform From The Corporate Shills In Washington?

Listen to Obama being applauded when he was running for office; it can't be denied that the prolonged applause wasn't sparked by his charisma and charm but by his words: "I happen to be a supporter of single player universal health care." Perhaps he believes that his cult of personality is bigger than the ideas that propelled his popularity. If he does, he's in for quite the shock.

It was lovely when Bill Clinton rescued those two American journalists from the clutches of North Korea and when last week 4 European and 2 Kenyan hostages were released after 9 miserable months in Somalia, but the insurance companies have been holding health care hostage for decades, not months. And it was nice when President Obama seemed to promise a crowd in Montana a couple days ago that he intends to rescue the long-held hostage and succeed where Democratic presidents since FDR and Harry Truman have failed.

There was a lot to recommend Rick Perlstein's piece in today's Washington Post, In America, Crazy Is A Preexisting Condition about birthers, town hall hecklers and the return of right-wing rage. But one section that has really stood out in my mind implies a comparison between Obama and his compromised administration and an earlier Democratic president who faced mobs of hysterical white conservatives and racists screeching-- and fully believing their own screeches-- how passing Civil Rights legislation would lead to the enslavement of the white race: "Good thing our leaders weren't so cowardly in 1964, or we would never have passed a civil rights bill-- because of complaints over the provisions in it that would enslave whites... The tree of crazy is an ever-present aspect of America's flora. Only now, it's being watered by misguided he-said-she-said reporting and taking over the forest."

That and lots of suckers eating up the Fox/Hate Talk Radio disseminated Insurance Industry distortions and then running wild with them. Even the fake "Christians" have an angle.

When Obama passed over credible health care reform advocate Howard Dean and picked a suspiciously conservative Democrat, Kathleen Sebelius, to be his Health Secretary-- after his first choice, a blatant corporate shill tainted by years of K Street connections, was proven to be too corrupt for confirmation-- many people realized the game was being thrown. This morning Ms. Sebelius confirmed that they were correct in an interview on CNN's State of the Union.

Health and Human Services Secretary Kathleen Sebelius says Obama still believes there should be "choice and competition" in the health insurance market-- but that a public option is "not the essential element."

Obama has been pressing for the government to run a health insurance organization to help cover the nation's nearly 50 million uninsured. But he had not seen a not-for-profit co-op as sufficient to offer consumers choice and competition that would bring down the costs of private insurance.

With half the teabaggers claiming they've personally lived in Canada or the U.K. and can absolutely attest to the horrors of health care in those downtrodden countries, today's Independent weighed in from the UK. They recognize that the teabaggers aren't about debate but about shilling and psychosis.

Although the Americans spend more on medicine than any nation on earth, there are an estimated 50 million with no health insurance at all. Many of those who have jobs can't afford coverage, and even those with standard policies often find it doesn't cover commonplace procedures. California's unemployed-- who rely on Medicaid-- had their dental care axed last month.

...President Obama's healthcare plans had been a central plank of his first-term programme, but his reform package has taken a battering at the hands of Republican opponents in recent weeks. As the Democrats have failed to coalesce around a single, straightforward proposal, their rivals have seized on public hesitancy over "socialised medicine" and now the chance of far-reaching reform is in doubt.

Most damaging of all has been the tide of vociferous right-wing opponents whipping up scepticism at town hall meetings that were supposed to soothe doubts. In Pennsylvania this week, Senator Arlen Specter was greeted by a crowd of 1,000 at a venue designed to accommodate only 250, and of the 30 selected speakers at the event, almost all were hostile.

Healthcare compared

Health spending as a share of GDP
US 16%
UK 8.4%

Public spending on healthcare (% of total spending on healthcare)
US 45%
UK 82%

Health spending per head
US $7,290
UK $2,992

Practising physicians (per 1,000 people)
US 2.4
UK 2.5

Nurses (per 1,000 people)
US 10.6
UK 10.0

Acute care hospital beds (per 1,000 people)
US 2.7
UK 2.6

Life expectancy:
US 78
UK 80

Infant mortality (per 1,000 live births)
US 6.7
UK 4.8

Meanwhile over at the Republican Party propaganda station, Kent Conrad (DLC-ND), a notorious insurance industry whore ($828,787) further bashed the public option, using lobbyist-prepared GOP talking points. “Look, the fact of the matter is there are not the votes in the U.S. Senate for the public option, there never have been. So to continue to chase that rabbit is, I think, a wasted effort.”

Not all Democrats have given in yet, though. Democrats more concerned with ordinary working families than with the viability of the utterly useless and no-value-added insurance companies have taken a pledge to vote against any health care bill Insurance Business "allies" try shoving down Congress' throat. With sleazy ex-congressional wheeler dealers Rahm Emanuel, now White House chief of staff, and Bill Tauzin, now head of Big Pharma's lobby, working together with some of the insurance CEOs to do a Bush-like deal to enrich the insurance companies and pharmaceutical giants at the expense of the public, it will be the ultimate act of political courage for the Progressive Caucus to stand up and just say no. Jerrold Nadler (D-NY) says progressives aren't about to give in to Emanuel's threats. "We signed a pledge to reject any plan that doesn't include a robust public option, and this plan doesn't have a robust public option."

And it isn't just Nadler who's standing up against the Insurance Industry, Big Pharma and the corrupt wheeler dealers who would sacrifice the HOPE of the millions of Americans who believed in Barack Obama when he was running for president. 57 dedicated progressives signed a letter to Nancy Pelosi pledging to oppose any health care legislation that doesn't include a robust public option now being bad-mouthed by Emanuel's team inside and outside the administration. 18 members have also signed onto the FDL pledge to only support a bill that includes a public option. This afternoon Jane explained the strategy of how this could work to prevent the Insurance Industry from running away with the reform package. These are the heroes of American families who refuse to be cowed by corporate America or by the political hacks who enable corporate America (phone numbers are included so you can call and say thanks; they deserve a thanks):

First, the members who signed the letter to Speaker Pelosi:

Earl Blumenauer (D-OR)- 202-225-4811
Corrine Brown (D-FL)- 202-225-0123
Michael Capuano (D-MA)- 202-225-5111
André Carson (D-IN)- 202-225-4011
Judy Chu (D-CA)- 202-225-5467
Yvette Clarke (D-NY)- 202-225-6231
William “Lacy” Clay (D-MO)- 202-225-2406
John Conyers (D-MI)- 202-225-5126
Elijah Cummings (D-MD)- 202-225-4741
Bill Delahunt (D-MA)- 202-225-3111
Lloyd Doggett (D-TX)- 202-225- 4865
Donna Edwards (D-MD)- 202-225-8699
Keith Ellison (D-MN)- 202-225-4755
Sam Farr (D-CA)- 202-225-2861
Chaka Fattah (D-PA)- 202-225-4001
Bob Filner (D-CA)- 202-225-8045
Marcia Fudge (D-OH1)- 202-225-7032
Raúl Grijalva (D-AZ)- 202-225-2435
Luis Gutierrez (D-IL)- 202-225-8203
Phil Hare (D-IL)- 202-225-5905
Alcee Hastings (D-FL)- 202-225-1313
Maurice Hinchey (D-NY)- 202-225-6335
Mazie Hirono (D-HI)- 202-225-4906
Michael Honda (D-CA)- 202-225-2631
Jesse Jackson, Jr. (D-IL)- 202-225-3816
Eddie Bernice Johnson (D-TX)- 202-225-8885
Hank Johnson (D-GA)- 202-225-1605
Marcy Kaptur (D-OH)- 202-225-4146
Carolyn Kilpatrick (D-MI)- 202-225-2261
Dennis Kucinich (D-OH)- 202-225-5871
Barbara Lee (D-CA)- 202-225-2661
Sheila Jackson-Lee (D-TX)- 202-225-3816
Eric Massa (D-NY)- 202-225-3161
Jim McDermott (D-WA)- 202-225-3106
James McGovern (D-MA)- 202-225-6101
Gwen Moore (D-WI)- 202-225-4572
Jerrold Nadler (D-NY)- 202-225-5635
Grace Napolitano (D-CA)- 202-225-5256
John Olver (D-MA)- 202-225-5335
Bill Pascrell (D-NJ)- 202-225-5751
Donald Payne (D-NJ)- 202-225-3436
Chellie Pingree (D-ME)- 202-225-6116
Laura Richarson (D-CA)- 202-225-7924
Lucille Roybal-Allard (D-CA)- 202-225-1766
Linda Sánchez (D-CA)- 202-225-6676
José Serrano (D-NY)- 202-225-4361
Albio Sires (D-NJ)- 202-225-7919
Jackie Speier (D-CA)- 202-225-3531
Pete Stark (D-CA)- 202-225-5065
Bennie Thompson (D-MS)- 202-225-5876
John Tierney (D-MA)- 202-225-8020
Ed Towns (D-NY)- 202-225-5936
Nydia Velazquez (D-NY)- 202-225-2361
Maxine Waters (D-CA)- 202-225-2201
Diane Watson (D-CA)- 202-225-7084
Mel Watt (D-NC)- 202-225-1510
Lynn Woolsey (D-CA)- 202-225-5161

And these are the members who are credibly onboard with the FDL Pledge:

Emanuel Cleaver (D-MO)- 202-225-4535
Pete DeFazio (D-OR)- 202-225-6416
Lloyd Doggett (D-TX)- 202-225- 4865
Donna Edwards (D-MD)- 202-225-8699
Keith Ellison (D-MN)- 202-225-4755
Bob Filner (D-CA)- 202-225-8045
Barney Frank (D-MA)- 202-225-5931
Raúl Grijalva (D-AZ)- 202-225-2435
Phil Hare (D-IL)- 202-225-5905
Rush Holt (D-NJ)- 202-225-5801
Carolyn Maloney (D-NY)- 202-225-7944
Jerrold Nadler (D-NY)- 202-225-5635
Chellie Pingree (D-ME)- 202-225-6116
Maxine Waters (D-CA)- 202-225-2201
Robert Wexler (D-FL)-202-225-3001
Lynn Woolsey (D-CA)- 202-225-5161
John Yarmuth (D-KY)- 202-225-5401

Another way to say thanks might be to stop by a brand new ActBlue page: Standing Up For The Public Option and leaving a little something for the members you want to thank.


Insurance Industry Still Holding Health Care Reform Hostage

But Jim Webb (D-VA) persuaded the Myanmar dictatorship to free John Yettaw, an American being held there. Something tells me FDR and a more robust kind of Democrat would have freed health care reform by now as well. Obama's a big disappointment. "Better than Bush or McCain" isn't enough, not even close.