This morning, I had one of those moments where you suddenly feel like you’ve slipped back to some other place or time. I was reading the tragic story of Donald Douglass, a veteran who, his family is claiming, died as a result of treatment delays at VA hospitals. After a skin cancer diagnosis in 2011, it took four months for him to get the operation he needed to treat it. By the time the operation did happen, it was too late. The cancer had spread, and he died a year later, suffering facial pain and paralysis in the interim.
It’s a terrible story. If the family is right, if more timely treatment would indeed have saved Donald Douglass’s life, then the outrage they and I and almost certainly you feel is rightly placed. This is not ok.
But as I read this story, I suddenly found myself back in the UK, where I lived for many years. There, health care is almost entirely provided through the National Health Service (NHS). Apart from a very small number of private facilities, hospitals are all run by the state. Doctors and nurses and all the other people who work in hospitals and clinics and doctors offices are paid through contracts with the government, not directly by patients or through insurance companies. It’s all centralized, all provided through a government-run system, all paid for by taxpayers.
And the problem that I most often heard discussed was waiting. For many procedures, there were long waiting lists. Could you get that knee replacement that you needed? Yes, eventually, but it might be sometime next year. What about that cancer treatment? Well, yes, probably (assuming the drug you needed had been approved by the government, not only for safety and clinical effectiveness, but also for being sufficiently good value-for-money — there’s a whole other issue there), but it might be a few months. Indeed, I remember the government proudly touting (around 2004 or 2005) its new targets for cancer treatment, that no patient would go more than 18 weeks between diagnosis and treatment.
18 weeks is about the same amount of time that Donald Douglass waited, and it was too long. Indeed, anyone who has suffered the horrors of cancer, or who has seen a loved one do so, knows that 18 weeks is far too long. Cancers can grow and spread tremendously in that amount of time. And people who otherwise wouldn’t have, die.
I have to wonder if it’s simply coincidence that both the UK’s NHS, and the US’s VA have this problem with waiting lists and times. Two different countries and two different systems, but they’re both state-run, and they both suffer this same plight. The doctors want to offer good care to patients, but it’s just near impossible to get those appointments scheduled soon enough. The system gets backlogged. There are administrative failings. There are shortages of beds.
Are we going to open ourselves up to more of these failings as we move toward a more centralized system driven by Obamacare? Could the problems we’re currently seeing with the VA spread to other non-VA hospitals? Could the quick treatment to which we’ve become accustomed slip away?