Dispatches From the Front Lines of Socialized Medicine

We’re from the government (giggle), we’re here to help (chortle):

Lives will be put at risk unless the Government suspends the new 111 NHS advice line, doctors warned yesterday.

Patients have been left hanging on the phone for two hours or told to call back tomorrow because overstretched operators of the service were too busy to help.

The problems led to a surge in ambulance call-outs and casualty visits as the desperate dialled 999 for help instead.

In Manchester, the situation was so bad the previous provider, Mastercall, had to take over the phones just hours after the launch to sort out the mess.

A group of nurses, who were on a night out, were even drafted in to staff the phones. The service has now been shelved in the city until the end of April.

Sounds like a pervert’s fantasy come true: tipsy nurses give phone sex!

But this is a serious matter.

Deadly serious:

A new article published in the British Medical Journal analyzes how the UK’s rationing board–the National Institute on Health and Clinical Excellence (NICE)–applies ”quality adjusted life years” (QALY) to end of life care decisions. QALYs involve cost-benefit analyses with “quality of life” the determining factor. (See what I mean about arcane jargon?)

From, “NICE’s End of Life Decision Making Scheme: Impact on Population Health:”

Our analysis shows that use of NICE’s end of life criteria has resulted in substantial QALY losses. We have assumed that the cost of end of life drugs is met entirely through displacement of other services or treatments in the NHS. Although we do not know whether this has been the case, as the NHS budget is under increasing strain, it seems reasonable to assume that disinvestment will be required. To put the losses into context,the £549m that we estimated has been spent on the nine end of life treatments each year is more than the £505m it cost to provide dialysis for the 21,544 patients with kidney failure in England in 2009.

What does society want? The reallocation of resources to end of life interventions maybe acceptable if society truly values QALYs gained through an extension of life when a patient has a terminal illness more highly than those gained at any other time of life. In this case it would be valid to apply weights to QALYs for end of life treatments, and the QALY loss would represent societal preferences.

Talk about eye-glazing! Talk about a bore fest! And therein lies the danger: Talk about losing the humanity of the decisions being discussed!

It’s all about “society” until it’s your ass on the line. Then it’s about individuality. Do you think the Obama family—including the old lady’s old lady—will ever have to worry about what “society” wants? Line up the blue pills and the red pills, geezers, you’re next!

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