Government Medicine Is Politicized Medicine

News coverage of the rollout of the Obamacare exchanges was dominated by technical issues that were embarrassing to the administration. As Steve wrote this morning, these are not mere glitches but reflect the hubris inherent in the idea that government can effectively run something as vast and diverse as America’s health care system.

But there is, in my view, an even more fundamental objection to government control over health care: anything run by the government inherently becomes political. The result is that the interests of politicians take precedence over everything else. For a case in point, see the United Kingdom. Over the last year or more, we have covered the unfolding scandal of Britain’s National Health Service, where appallingly bad care–not just inept, but callous–has led to many fatalities and has shaken Britons’ faith in the NHS.

Now, in a blockbuster news story, it has come out that the Labour government tried, with some success, to cover up the tragic failings of the NHS to serve its own political interests. The Telegraph has the story:

Internal emails from the Care Quality Commission show that Labour tried to stop the watchdog from informing the public about failings at Basildon University Hospital, where patients were dying needlessly on filthy wards. The dossier of emails, released under Freedom of Information, state that Andy Burnham, the then Health Secretary, was “furious” when “graphic details” of the care failings became public.

Separate emails suggest that Mike O’Brien, the former Labour minister of state for health, told the NHS watchdog that “anything you do is political” in the run up to the General Election.

Executives at the watchdog decided that “given the political environment” a report into standards of care across the country should be “largely positive”. …

In November 2009, an investigation by the Care Quality Commission found that dozens of patients died needlessly in filthy conditions at Basildon University Hospital. However, at the time the watchdog’s website rated the trust as “good”, despite the fact managers had been concerned about safety issues at the hospital for more than six months.

Jill Finney, the then director of engagement at the Care Quality Commission, said in one of the emails: “We arguably sat on a highly sensitive safety issue for six months before informing patients and the public who believe they ‘have a right to know'”.

The CQC prepared a press release to brief newspapers about care failings at the hospital, but was contacted by the Department of Health and told not to publish the information. The email states: “DH emailed the press team just after 1 pm and asked us to stop the press release.”

By that stage, however, the regulator had already briefed three newspapers about the problems at the hospital.

When a report on the “graphic detail” of the appalling standards at the hospital was broadcast, Mr Burnham was said to be “furious”. There were also indications that Labour ministers attempted to influence a press release about a report into the state of care in the NHS.

In January 2010 Mike O’Brien, the then minister of state for health, told the regulator that “at this sort of time [close to an election] everything you do is going to be political, whether you intend it to be or not.”

He said it was “important” that the press release on the state of care in the NHS was “all agreed” with the Department of Health. Managers at the watchdog decided that the report should that in view of the political sensitivity surrounding the report, it should be “largely positive”.

Martin Marshall, the director of clinical quality at the CQC, said: “We agreed at the Board meeting yesterday that we had to get the overall tone right and that the conclusion was… this should be largely positive.

“The [Department of Health] will go through this with a toothcomb and it is naive to think that they will really only do a factual check.” A separate email from an official at the watchdog suggests that the Department of Health had that power to “amend the tone” of report as it saw fit.

While the Labour Party officials involved in the scandal have come in for much-deserved criticism, the more important point was made in one of the emails written by a Labour minister: when the government is in charge, “everything you do is going to be political, whether you intend it to be or not.” It is hard to understand why anyone would want America’s health care system to be politicized.

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