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A Glimpse of Our Health Care Future

The pen is mightier than the Freud.

Jul 28, 2014, Vol. 19, No. 43 • By P.J. O'ROURKE
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To what will Obamacare lead? If the administration’s health policies continue on their present trajectory, Obamacare will lead to some form of European-style single-payer national health system.

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I have a sure and certain hope that I’m wrong about that. Sure and certain because my track record with political predictions is nearly perfect: Easy walk-over by George H. W. Bush in the 1992 election. Resignation of Bill Clinton during the Monica Lewinsky scandal. Speedy Hayekian self-organization of Iraqi society after the toppling of Saddam Hussein. Chief Justice Roberts voting that the Affordable Care Act is unconstitutional.

And hope because I retain my faith in the American creed of personal liberty and individual responsibility. Though my faith has been tested in such frequent, indeed standardized, ways that I’m beginning to feel like a public school child subjected to a federally mandated common core curriculum.

But this is no way to begin a rant. I must be careful not to lose my bad temper. That would result in raising the level of political discourse, which is something the New York Times is always calling for so it must be pernicious.

I was in Great Britain not long ago. I gave a speech about various aspects of the baby boom. (The British had one too.) Naturally I mentioned the subject of demography, and how a population front-weighted with the old folks baby boomers have become plays hell with government benefits such as the National Health Service. 

There was a question and answer period after the speech. I tried to keep the level of political discourse as low as possible: “How many in the audience are on a waiting list for treatment of a burst appendix?”

But the British—polite as always—responded that they were generally pleased with, even proud of, their National Health Service. (Give them credit for not looking a gift horse in the mouth, even if it does result in terrible dentistry.)

They pointed out that life expectancy in the U.K. is 1.2 years longer than in the United States. (Well informed, these British audiences.)

I countered that their extra longevity was mostly among men and had much to do with a U.S. murder rate of 4.8 per 100,000 versus their 1.2 per 100,000. Brits lag behind Americans in almost all forms of social chaos.

The British noted that their infant mortality rate was 4.5 per 1,000 live births while the U.S. figure was 5.2.

I charged them with not trying hard enough. Preterm births (those most likely to result in infant death) are 65 percent higher in the United States than in the U.K. The preterm births often lead to desperate attempts to save the life of the unborn child.

I went on to scold them for their cancer treatment. The breast cancer survival rate in the United States (where screening begins at 40 and takes place every one to two years) is 90.5 percent. The breast cancer survival rate in the U.K. (where screening begins at 50 and takes place every three years) is 78.4 percent. The overall cancer survival rate in the United States is 71.18 percent, compared with 54.48 percent in the U.K.

The British responded that the United States aggressively treats cancer in people so old and frail that they “survive” the cancer by dying of something else first.

And so on, all in the most civil manner. After the speech I was talking to members of the audience when a couple approached and handed me a ballpoint pen. It was an ordinary plastic ballpoint, a little thicker through the barrel than usual, and labeled “Hertfordshire Partnership NHS (NHS Foundation Trust).”

“Uh, thanks,” I said.

“Notice the metal strip along the pen,” said the male half of the couple. “It has a little window shade sort of thing attached to it. Pull out the window shade later when you’ve got time. It’s a laugh.”

“It is a laugh,” said the female member of the couple. “And we’ve both been working for the NHS for years.”

Back in my hotel room I pulled the metal strip, and a 3-by-7-inch scroll emerged. Here is what, and all of what, was printed upon it:

Tips for Emotional Wellbeing

Share your feelings with family and friends

[I tried this when I got home. Much angry shouting and crying and some thrown crockery ensued.]

Eat well

[My wife certainly wasn’t going to be cooking dinner for me that night. I assume pizza delivery counts as eating well if I order the “Vegetarian Special.”]

Keep active

[I was quite active, dodging the soup tureen hurled at my head.]

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