President Obama, intent on thrusting us headlong into financial bondage for decades to come with his health care reform initiatives, yammers on at every opportunity how this must all be done quickly lest the opportunity for real change evaporate like a Medicare trust fund. He is an impetuous fellow and likely has never heard the idiom imparted to most American children very early in life: Haste makes waste.

In Britain they have been experimenting with socialized medicine since 1948 and being more circumspect than our current President and Democrat run Congress have of late made some very interesting reforms of their own. The British National Health System (NHS) is the public health system in charge of 92% of healthcare delivery in England.  By the mid 1990's need for reform was recognized. Starting with the Community Care (Direct Payments) Act of 1996 people were eligible to receive direct payment of money from the government to apply to their health care. The money was only to be used for needed health care services and was given in proportion to the assessed needs of the individual patient. The patient is responsible for making their health care choices and there are social services available to assist them in how to manage their budget. Emergency services lie outside this budget and are available with the patient’s other benefits within the NHS. Although this would be great if this were available to everyone in the UK it is now only available to people requiring social services such as the disabled. It is intended to enhance their lives by empowering them with their own health care decisions. Ah, good intentions.

Apparently there can be a limit to the British governments’ largess in letting disabled persons have self determination. Two disabled pensioners Steven Harrison and Valerie Graham are currently in court to retain their privileges of Direct Payments rather than re-enter the NHS general agency care through Primary Care Trusts (PCT). PCT’s are local socialized medicine politburos that most UK citizens are subjected to where decisions for your care are made by guidelines developed by the National Institute for Health and Clinical Excellence (NICE). If all goes well for socialism the Health Care Institute of Comparative Effectiveness Research will be its  parallel in the USA.  

Mr. Harrison, 41, a former soldier, is a quadriplegic who requires significant care with his activities of daily living. He currently is able to choose his doctor and his health care attendants by employing them through monies he gets from Direct Payments. Likewise, Mrs. Graham, in her sixties and severely disabled since birth with a degenerative muscular disorder, wishes to retain the autonomy and dignity she derives from the program. The travesty in  all this stems from a change in the law that states that people can not receive funding from the NHS and social serves funded by Direct Payment programs. They must choose one or the other. In Mrs. Graham’s case it was determined that after her need for a tracheotomy her care needs were such that they fell within the purview of the NHS and she would need to drop her care provided by the Direct Payment program. Mrs. Graham has apprehensions that if she is denied Direct Payments and instead has to rely on the inferior NHS services that it would destroy her and her husband’s lives. Mr. Harrison similarly was assessed to have a health need which negated his eligibility. The cost of NHS agency care for the disabled is sometimes as much as 3 times that of care proved through Direct Payments. There is no evidence that both patients needs could not be met by self determining who would provide that care.  Mr. Harrison and Mrs. Graham presently have a discrimination suit being heard in the High Court.

George Baker, a disabled citizen and Direct Payments advocate, has written a book: “The Complete Insider’s Guide to British Health and Social Care : How to Secure the Perfect Care Package”. Seeing the possible duplication of his fate in the case of Mr. Harrison and Mrs. Graham, Mr. Parker  commented-“ I’ll tell you something now, it is beyond me how most of the decisions in the NHS and health and social sector are made and sometimes it even makes me think: You know what? Screw the NHS! It’s inefficient, ineffective and insanely expensive….let’s just have nationwide private health care instead…at least then the private businesses might compete with each other and give us more value for {our} money.” Nothing teaches like experience. 

When government is so fully ingrained in the life of its citizens the natural consequence of its paternalism is failure. In 2001 the future President of the United States, Barak Obama, said of the Constitution “..generally the Constitution is a charter of negative liberties. Says what the federal government can’t do to you, but doesn’t say what the federal government or state government must do on your behalf.”  I wish that our President did not find himself so compelled to intercede on our behalf. Worse yet, he is in a hurry.

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