Daily Diversions (Web Log)

David's Mental Meanderings
8th February 2000

In November, I moved to the Third World.

One week last month, in one of the most technologically advanced, industrialized nations on the planet, there were three available intensive care beds. Let me put this into perspective. The United Kingdom has a population roughly one-fourth that of the United States - nearly 60 million. That's more than the population of California. And three ICU beds.

When an operation was performed at my local General Hospital, the patient came out of surgery without a bed available. He was taken on a journey of 100 miles, through two hospitals (and driven right past many others), before a bed was found for him. It was a successful operation. Due to the post-operative trauma of being carted half-way across the country, he needlessly died the next day. This was not a trip across West Texas, but west across Wales, where the distance between towns is often measured to the half-mile.

I thought socialized medicine would mean freely available medical care. When I went to register with my local GP (conveniently less than a block from my house), I mentioned that I hadn't had a physical for years and that perhaps it would be a good idea to give me a once-over. After all, I'm 35 and reaching the age when I should be wary of various cell malformations which might start to take root and grow. During my standard 7 ½-minute National Health Service appointment, I was told that physical examinations "are not part of the ethos of the NHS." In other words, they don't have time or money to probe, prod and draw a little blood.

Suddenly I understood why this country has one of the highest rates of cancer deaths in the world. Not just in the "industrialized" world - on the entire planet. The same goes for heart disease. There is just no money spent on preventative medicine.

The UK spends less on health care than any other nation in Europe. Last month the newspapers seemed to think that the UK spent more per capita than Poland, but this month they have discovered that even the Poles spend more than the British. The amazing thing about this is that in the UK there is a state monopoly on health care, yet the government spends less state money than the US, France or Germany, which have private and public-private systems.

In the last decade, the number of hospital beds in the UK has declined from 194,000 to 103,000. Britain has fewer than three doctors per 1,000 population. Let's put this in practical terms. During this current flu epidemic, France has been hit five times as hard as the UK, per capita, and there has been no crisis in the French health care system. There was no shortage of hospital beds, no lack of doctors, no rationed medicine.

And it's not like they have to build more hospital rooms. There's no such thing. Patients are kept in wards. Yep, giant rooms filled with every imaginable communicable disease. British hospitals are a very dangerous place to stay. (I once saw pictures of a US hospital in the 1940s -- or was it '30s -- that looked like the hospitals they show on television here.)

Because the waiting lists for operations can be so long (years, at times) some people have chosen to pay for their surgery privately. Though all doctors are in the employ of the government, they are allowed to moonlight. Not only that, but the patients who come see them on the side are given first priority. So it's either mortgage the house for a timely heart operation (as one person mentioned in the paper today did) or die waiting (as did another). These are not isolated incidents; every local paper carries NHS horror stories on a daily or weekly basis.

It used to be that the thought of changing the National Health Service was unthinkable to Britons. Even now, certain of my in-laws are quick to proclaim this the best health care system in the world. The great architect of the NHS, Aneurin Bevan, was recently polled the Man of the Century in Wales. But things have gotten so bad that the imminent death of his creation is rumoured on the front pages of all the newspapers on regular basis. They just don't know how they will replace it. Newspaper articles often make comments that the US health care system is the best in the world coupled with pleas of "Oh, no, please, not the US health care system!"

But let me bring this back to a personal level once again. While there are no hospital beds, there is, however, money to spend on me. The same NHS is building a nice new prosthetic leg for me. Free. No waiting lists. I feel a twinge of guilt that there are people being shipped all over the country looking for a hospital bed while resources are being spent to make me a slightly more comfortable $7000 leg. Right now, I am on the right side of socialized medicine -- one of the lucky few whose need corresponds with available care.

Of course I will probably die of a horrible completely treatable disease (and Mrs. Holford assures me that I am quite the hypochondriac), but until I do, I will be able to walk comfortably every where I go.

I walk everywhere I can, because gasoline is $5.00 per gallon. But I'll deal with that another time.