Hvordan vil et offentlig helsevesen utvikle seg over tid?

Her er sitater fra en som sier det som det er:

“…you--particularly you young healthy people--you're going to have to pay more [in taxes]. And … if you're very old, we're not going to give you all that technology and all those drugs for the last couple of years of your life to keep you maybe going for another couple of months. It's too expensive, so we're going to let you die. Also, I'm going to use the bargaining leverage of the federal government in terms of Medicare, Medicaid--we already have a lot of bargaining leverage--to force drug companies and insurance companies and medical suppliers to reduce their costs. But that means less innovation, and that means less new products and less new drugs on the market, which means you are probably not going to live that much longer than your parents.”

(Hele talen er linket til nedenfor, både som et filmklipp på youtube, og som tekst i en avisartikkel.)

Et offentlig helsevesen vil altså føre til støre utgifter, et dårligere tilbud, mindre innovasjon, osv. Den som sier dette er Robert Reich. Han er venstreorientert, han er tilhenger av et offentlig helsevesen, og han var medlem av Bill Clintons regjering:


Det han sier, og som er gjengitt i et utdrag over, er hva han mener en presidentkandidat bør si dersom han er ærlig.

Men la oss se hva som skjer i praksis. Vi bruker England som eksempel. (Norge er ikke et godt eksempel fordi vi har kunnet leve over evne pga de enorme oljeinntektene.) Vi siterer fra noen engelske avisoppslag:

Fra The Times: “Hazel Fenton, from East Sussex, is alive nine months after medics ruled she had only days to live, withdrew her antibiotics, and denied her artificial feeding. The former school matron had been placed on a controversial care plan intended to ease the last days of dying patients.

Doctors say Fenton is an example of patients who have been condemned to death on the Liverpool care pathway plan. They argue that while it is suitable for patients who do have only days to live, it is being used more widely in the NHS [det offentlige helsevesenet i England], denying treatment to elderly patients who are not dying.

Fenton's daughter describes the NHS system for dealing with very ill elderly patients as "a subterfuge for legalized euthanasia of the elderly."
Fra Daily Mail: "A grandfather who beat cancer was wrongly told the disease had returned and left to die at a hospice which pioneered a controversial 'death pathway.' Doctors said there was nothing more they could do for 76-year- old Jack Jones, and his family claim he was denied food, water and medication except painkillers. He died within two weeks.

But tests after his death found that his cancer had not come back and he was in fact suffering from pneumonia brought on by a chest infection."

Fra Daily Telegraph: "At around 4am on Monday, a friend of mine was woken by a call from the private care home in south-west London where her 98-year-old grandmother is resident…. 'She needs to go to hospital. Do you want that? Or would you prefer that we make her comfortable?' Befuddled by sleep, she didn't immediately grasp what was being asked of her. Her grandmother is immobilised by a calcified knee joint, which is why she is in the home. She's a little deaf and frail, but otherwise perky…. Why wouldn't she get medical treatment if she needed it? Then, the chilling implication of the phone call filtered through—she was being asked whether her grandmother should be allowed to die…. My friend is reeling…. Had she really been asked to pronounce a possible death sentence on her grandmother, a woman with no underlying ailment other than old age?"

Fra The Sun: "This crippled plumber horribly broke his arm ten months ago and is still waiting for surgery to repair it. Torron Eeles…slammed the NHS for 'unacceptable' delays—claiming they have cancelled four separate operations. His arm hangs limply by his side meaning Torron cannot work for a living and now faces the prospect of losing his home."

Fra Daily Mail "Thousands of NHS patients with previously untreatable rheumatoid arthritis could be denied a new 'smart' drug to ease their agony because it is too expensive…. The drug has been licensed throughout Europe, but the cost has led the Government's rationing body to issue a preliminary rejection of its use by NHS patients in England. The move has been condemned by patient groups, who claim severely affected patients will have to use ineffective therapies that will not stop them losing their jobs because of increasing disability."

Tidlig I september sendte en gruppe leger et brev til Daily Telegraph hvor de hevdet at de nå har "a 'national crisis' in patient care…. 'Forecasting death is an inexact science' … Patients are being diagnosed as being close to death 'without regard to the fact that the diagnosis could be wrong.'" Dr. Peter Hargreaves sier "What they are trying to do is stop people being overtreated as they are dying. It is a very laudable idea. But the concern is that it is tick box medicine that stops people thinking."

Daily Mail forteller: “Doctors left a premature baby to die because he was born two days too early, his devastated mother claimed yesterday. Sarah Capewell begged them to save her tiny son, who was born just 21 weeks and five days into her pregnancy—almost four months early. They ignored her pleas and allegedly told her they were following national guidelines that babies born before 22 weeks should not be given medical treatment. Miss Capewell, 23, said doctors refused to even see her son Jayden, who lived for almost two hours without any medical support.”

Et offentlig helsevesen vil bli dyrere og dyrere, uten at det finnes en effektiv måte å finansiere det på, og en form for rasjonering vil da nødvendigvis komme. Dette betyr at staten, via leger som reelt sett er statsansatte, vil bestemme hvem som skal leve og hvem som ikke skal få nødvendig behandling.

Slik vil det bli i alle land med et offentlig helevesen.