President Obama’s refusal to sign a bill defunding or delaying his health care law and Republicans’ insistence that such measures be a part of any bill to continue funding government are what precipitated the ongoing government shutdown. Both sides are staking out firm positions because they are operating on the same assumption – that once Obamacare starts to roll out subsidies on Jan. 1., it will be impossible to undo, no matter how much of a disaster it is. Based on the experience across the pond, this may be exactly right.
As the Washington Examiner's Philip Klein detailed in an Oct. 3 special report from London, Britain's 65-year-old National Health Service is extraordinarily resistant to change. Throughout the decades, governments have tried to put their own stamp on the NHS, but both liberals and conservatives have balked at fundamentally changing it. This was even true of the “Iron Lady,” Prime Minister Margaret Thatcher. In fact, it was her Chancellor of the Exchequer, Nigel Lawson, who famously said, "The NHS is the closest thing the English have to a religion.”
The NHS doesn’t maintain its exalted status in Britain based on superior performance. As Klein reported, “Britain typically ranks poorly among developed nations when it comes to cancer outcomes. The U.S. is well ahead of the U.K. in the five-year survival rates for 22 out of 23 different types of cancers, according to data from the American Cancer Society.”
Klein also detailed the recent scandal at Stafford Hospital in Britain, where as many as 1,200 unnecessary deaths were blamed in a government report on the appalling state of care. Nurses put trays of food out of the reach of immobile patients and left people to relieve themselves in their own beds instead of helping them go to the bathroom. In some cases, patients even drank out of dirty flower vases in the hallways because they couldn’t get water anywhere else. Under the Liverpool Care Pathway – first developed in the late 1990s – thousands of families were uninformed when their loved ones were removed from life support, and in extreme cases relatives were scolded by nurses for trying to give water to their dying loved ones.
Yet, because the NHS is free at the point of care and available to all, there’s significant resistance within Britain to serious reforms. To be sure, there are important differences between the NHS (a system in which government runs the hospitals and pays doctors) and Obamacare (a system of compulsory, highly regulated and subsidized insurance). But the NHS certainly provides a lesson in the resilience of government health programs.
Starting on Jan. 1 Obamacare will add millions of beneficiaries to Medicaid and hand out subsidies for individuals to purchase insurance. Even if the changes Obamacare is making cause severe problems for the nation’s health care system, it will become exceedingly difficult as a political matter for Republicans to strip away benefits from those already receiving them, no matter how shabby the benefits are. That is why Republicans are fighting so hard to prevent the nation from embarking on a program about which little is known except its inevitably high cost.