The problem with government health systems is not that they pull the plug on Grandma. It's that Grandma has a hell of a time getting plugged in in the first place. The only way to "control costs" is to restrict access to treatment, and the easiest people to deny treatment to are the oldsters. Don't worry, it's all very scientific. In Britain, they use a "Quality-Adjusted Life Year" formula to decide that you don't really need that new knee because you're gonna die in a year or two, maybe a decade-and-a-half tops. So it's in the national interest for you to go around hobbling in pain rather than divert "finite resources" away from productive members of society to a useless old geezer like you. And you'd be surprised how quickly geezerdom kicks in: A couple of years back, some Quebec facilities were attributing death from hospital-contracted infection of anyone over 55 to "old age." Well, he had a good innings. He was 57.
And then this...
America is the Afghanistan of the Western world: That's to say, it has a slightly higher infant-mortality rate than other developed nations (there are reasons for that which I'll discuss in an upcoming column). That figure depresses our overall "life expectancy at birth." But, if you can make it out of diapers, you'll live longer than you would pretty much anywhere else. By age 40, Americans' life expectancy has caught up with Britons'. By 60, it equals Germany's. At the age of 80, Americans have greater life expectancy than Swedes.
How can this be? Well, amazingly, millions of freeborn citizens exercising their own judgment as to which of the latest drugs, tests and procedures suits their own best interests has given Americans a longer, better, more fulfilling old age to the point where there are entire states designed to cater to it. (There is no Belgian or Scottish Florida.) I had an elderly British visitor this month who's had a recurring problem with her left hand. At one point it swelled up alarmingly, and so we took her to Emergency. They did a CT scan, X-rays, blood samples, the works. In two hours at a small, rural, undistinguished, no-frills hospital in northern New Hampshire, this lady got more tests than she's had in the past decade in Britain – even though she goes to see her doctor once a month. He listens sympathetically, tells her old age often involves adjusting to the loss of mobility, and then advises her to take the British version of Tylenol and rest up. Anything else would use up those valuable "resources." So, in two hours in New Hampshire, she got tested and diagnosed (with gout) and prescribed something to deal with it. It's the difference between health "care" (i.e., going to the doctor's every month to no purpose) and health treatment – and on the latter America is the best in the world.
President Barack Obama has wondered whether this is a "sustainable model." But, from your point of view, what counts is not whether the model's sustainable but whether you are. I am certainly in favor of reform. I would support a Singapore-style system of personal health accounts – and Singapore, for Mayor Bloomberg's benefit, has the third-highest life expectancy in the world. But, under any government system that interjects a bureaucracy between you and your health, the elderly and not so elderly get denied treatment. And there's nothing you can do about it because, ultimately, government health represents the nationalization of your body. You're 84, 72, 63, 58, you've had a good innings. It's easy for him to say. And even easier for his army of bureaucrats.
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