G. Keith Smith, M.D.

Black Flag, a company that makes roach traps, known as roach motels started an effective advertising campaign years ago:  ”Roaches check in, but they don’t check out.”  As a big fan of the free market, it had never occurred to me that a hospital would embrace the roach motel model for patients.  Welcome to Great Britain’s Staffordshire Hospital, where unlike death row where prisoners are fed, even given a last meal, patients are neglected to death, many dying of dehydration or starvation,  only to be found by family members lying dead in their own excrement.    

After reading this article, you Pharaohbamacare supporters have two philosophical options, I think:  admit that this whole idea of socialized, government-controlled medicine is a bad idea, or argue that this hospital mass-murder is acceptable collateral damage….you know…for the greater good.  It turns out that hundreds (they seriously don’t know how many, though they admit the number may be as high as 1200) of patients have died unnecessarily in this British hospital over a four year period.  These deaths are in excess of what they expected and include as causes starvation, dehydration, infection from lying in soiled sheets, to just pure neglect from a calloused staff.  

I am assuming that the number of deaths, in excess of “what they expected,” don’t include those patients who were murdered by the staff utilizing the Liverpool Care Pathway in an attempt to free up more hospital beds for more…victims.  I think it is interesting,too, that the prime minister insinuated that these neglectful murders were not confined to this one hospital.  I think it is clear from what he said in his remarks in the article that this style of “care” is widespread.  Interesting too, is that these murders occurred between 2005-2009.  That was four years ago!  I wonder who politically benefitted from the timing of this report?  I wonder how many murders might have been prevented had this report been released earlier?  

I can already hear the apologists:  ”It’s the price you must pay for everyone to have access.”  A friend of mine who lived in England for awhile told me of an old saying there:  ”The first thing you do if you get sick is buy a plane ticket.” I suppose this is one way a government can keep their health costs down….scare folks into becoming medical tourists to the greatest extent possible.  Maybe the U.K. should change the name hospital to “Hostel,” so patients will know they are about to enter a horror film not unlike a Black Flag poisonous box.

G. Keith Smith, M.D.

The National Health Service in Great Britain has made no secret about their use of the “Liverpool Care Pathway” as their favorite method to kill sick people.  They have even admitted to using this method, which consists of denying food and water to patients while simultaneously sedating them, to free up hospital beds for those waiting.  About 133,000 patients per year.  In Great Britain.  Euthanasia is standard in countries that have socialized the resources necessary to deliver health care, as having adopted the “we’re all in this together,” Marxist philosophy, puts the “good” of society ahead of individual rights.  After all, you just can’t have all of these sick folks draining the “public,” “community” resources when they could be put to “better” uses, according to the central planners.  Wow.  These folks must be really smart to know who should live and who should die.  I can’t imagine the “gunvernment” abusing this sort of power, can you?

Whether it’s rationing through death panels or shortage-causing price controls, the socialistic Unaffordable Care Act will bring murder to medicine just like all the rest of the countries that have gone down this road.  I think that we need to be thinking of a name for this.  The Brits have their Liverpool Care Pathway, Orwellian doublespeak on steroids.  I like the “Kenya-Care Pathway,” named for the home country of this law’s main proponent and the current head of state.  Any other suggestions are welcome.  I think we should name this murder before those in favor of it get a chance.  

By the way, here is a link to an article from the United Kingdom (courtesy of Brandon Dutcher at the Oklahoma Council of Public Affairs), describing how the Brits are now murdering children and babies with the Liverpool Care Pathway.  Seriously.

G. Keith Smith, M.D.

Ludwig von Mises adopted as his life motto a verse from Virgil:  Tu ne cede malis, sed contra audentior ito.  The translation is:  Do not give in to evil, but proceed ever more boldly against it.  His writings and his life reflect the extent to which he truly adopted this wisdom.  His refusal to compromise, while closing many doors to him (and nearly costing him his life, as he was forced to flee Nazi Germany), has inspired some of the greatest thinking about economics and its relationship to human behavior.  Lew Rockwell’s dream of an institute dedicated to the field popularly called “Austrian” economics, is named after Mises, no doubt signaling to all that compromise of principle would simply never be entertained.  

I’ve always liked Mises’ motto, wondering what a world would be like where more people adopted this way of thinking.  I ran into another saying this past weekend at the annual meeting of the Association of American Physicians and Surgeons (AAPS) that I wanted to share with you, no less powerful in my opinion, than Mises’ favorite quote from Virgil.

Principiis Obsta, Finem Respice.  The translation is:  Resist the beginnings, consider the ends.  Interestingly the author, Publius Ovidius Naso, known as Ovid in the English world, was, like Virgil, a poet of Latin literature.  This quote was revealed at the AAPS meeting as used by a former Nazi to describe the sequence of events in Germany that led to their fascistic insanity.  Very small steps, unnoticed by most, led to the totalitarian regime we all now know well.  

I think these two quotes have affected me because they are unfortunately applicable in our time.  Bob Dole of Kansas was asked in a debate once if there was an issue over which he was willing to lose an election.  His opponent was making the case for an absence of principle in Dole’s career.  Dole simply did not know what to say.  He, like almost anyone in politics or with power, chose victory and the maintenance or growth of their power and influence, over principle.  It seems like people will say anything these days to gain power, knowing their future actions bear no resemblance to prior pledges and promises.  

So what does any of this have to do with health care?  Universal health care was the issue that eventually brought power to the Nazis.  This is an extremely inconvenient fact for those promoting it.  Countries that have embraced this insanity have wholeheartedly embraced rationing of care to the sick and euthanasia, as an individual’s health, rather than staying an issue for that individual, became a matter for the “state.”  In Great Britain (a country Hayek warned in his Nobel prize winning “Road to Serfdom, was embracing the very economic policies of the Nazis they were fighting!) euthanasia has morphed into murder, as their Liverpool Care Pathway is used to “free up” hospital beds.  

“But that can’t happen here,” you say!  The Independent Payment Advisory Board screams otherwise.  The data mining through electronic medical record systems screams otherwise.  ”Meaningful use” and “best practices” cookbook medical approaches scream otherwise.  Accountable Care Organizations, HMO’s by another name, scream otherwise.  I think none of these small steps would have occurred had we heeded the advise from Virgil and Ovid.

G. Keith Smith, M.D.

A few years ago, I was invited to participate in a symposium on the disaster of Canadian health care by John Caldara of the Independence Institute.  This event took place in Vancouver and featured the first-hand stories of Canadian patients that were denied or neglected or worse.  You can watch Reason Magazine’s story of one of the patients here.  After listening to these heart-wrenching stories all morning, my wife and I went along to the luncheon, seated at a table with Canadians, primarily.  After making what seemed like a fairly obvious comment about the abysmal Canadian health care system, we discovered what I have since liked to call “Canadian healthcare pride.”  Our new Canadian friends were appalled that we would bash the system they had just picked apart moments before!   I’ve discovered that his nationalistic health care pride insanity is not unique to the Canadians.  On the contrary, it is widespread as I will attempt to show in this blog.  

You see, it is one thing for a Canadian to tell the story about being denied brain surgery in spite of the presence of a life threatening and growing brain tumor.  It is one thing for a Canadian to tell the story about their child denied ear tube placement only to have their life miraculously saved by an American pediatric neurosurgeon in Washington state after they developed meningitis.  

It is another thing entirely for an American to say anything derogatory to a Canadian about their system of health care.  They will almost invariably defend it.  

The Canadian health care nationalism pales in comparison to the Brits, though.  The hate mail I’ve received from the Canadians for criticizing their system pales in comparison to that I’ve gotten from the Brits.  Talk about pride.  All the while the hospital medical staff murders their sick relatives under the guise of the Liverpool Care Pathway, a harmless-sounding euphemism for their brand of euthanasia.   

I can’t leave out American Medicare beneficiaries and their nationalistic “insurance” pride.  The reaction of patients to me years ago when I was happy to provide their anesthetic free of charge, but refused to deal with “their Medicare” was enlightening.  ”What do you mean you won’t take ‘my Medicare?’”  ”Do you think I’m charity?”  The rage I witnessed made no sense to me then.  It does now.  This pride that can only be understood as a type of nationalism much like the Canadians’, explains this emotional and irrational reaction I witnessed.  

The insurance of active duty military, Tricare, is a great example of Jane Orient’s saying that “coverage doesn’t mean care.”  Tricare pays our surgery center almost exactly 1/3 of the cost of the surgeries we do.  That’s right.  Even with our efficiency, they would need to pay us 3 times what they do for us to break even.  Needless to say, no doctors are waiting in line to accept Tricare patients.  Yet in a townhall meeting, I witnessed an active duty military man go toe to toe with Senator Tom Coburn about his proposal to modify Tricare, a proposal that would increase this man’s payment slightly but would actually grant him access to care, care which is currently unavailable to him due to the price controls within this awful “insurance” product.  

Tricare pride.  Medicare pride.  Canadian care pride.  British care pride.  Victimized by their “insurance” the pride remains, nonetheless.  

Contrast that with patients that have come to our facility that are proud of the fact that they have never been insured.  They pay their bills.  They have saved for a rainy day.  They have saved enough money for an open heart surgery ($26,000 here in Oklahoma City).  They have saved enough (it doesn’t take that long when you are not paying $1800/month in insurance premiums) to pay for their hip replacement ($18,000 here in Oklahoma City).  Many of these patients would buy cancer policies or other catastrophic policies if they were available but sadly, thanks to Uncle Sam, these types of policies have been legislated out of existence.  

I guess that if you wrap filth in a country’s flag, the citizens perceive greatness no matter what is inside.  The subordination of the rights of the individual to the whims of the state is a necessary step in any socialist or fascist system of government.  I think that is the common thread in what I have described.  As an individual’s health care becomes the responsibility of the state, its evils tend to be discounted by virtue of their association with the state.  This irony shields government-run health care systems from much of the scrutiny and criticism they deserve.  Once the “healthcare provided by government” step is taken, it tends to be self-fueled, as any criticism of such a system can be painted as unpatriotic, almost treasonous. 

Samuel Johnson said that “Patriotism was the last refuge of a scoundrel.”  He meant by this that to impugn someone’s patriotism was the lowest blow one could strike, a despicable tactic by the accuser.  Let’s keep our guard up for the government healthcare boot lickers that would defend the rationing and euthanizing of the sick for the good of the many.  

G. Keith Smith, M.D. 

Here’s another example of government-run health care.  Think anyone made money on this deal?  Think the man in the white house believes that the plan that bears his name will be any different?  Maybe the idea is to treat patients such that they beg for the Liverpool Care Pathway.  Some journalists are comparing this to Auschwitz.  

G. Keith Smith, M.D.

Great Britain, just like the U.S., is going broke.  Entitlement spending will be their doom.  Their National Health Service costs 158 billion dollars a year to run.  ”But health care is free there!!”  These blokes have come up with an idea that might jolly well keep their system alive.  We bloody well can’t let the staff run out of the supplies necessary to euthanize the sick inpatients now can we?  Seriously.  The NHS admits that 1/3 of all patients that die in their hospitals are euthanized.  

So here’s their idea.  Public hospitals in England should set up profit-making branches in other countries!  Jill Lawless, writing for the Associated Press writes, “Officials said the country should capitalize on international respect for the British health care brand.”    Later, “Health Minister Anne Milton said that plan would create jobs and revenue, which would be channeled back into the health service.” 

Many of you are laughing right now.  Aren’t central planners fun?  Probably not when they deny you dialysis (remember it’s free) or murder a sick relative to free up a hospital bed.  I think they should give some thought to flying a “Jolly Roger” flag at each of these branch hospitals.  What a great logo for their “brand.”

Put yourself in the shoes of a patient walking in to one of these facilities.  However much you are charged, it will be too much, as the mission of this hospital will be to charge enough to cover the cost of your care and that of the folks back home.  Why would anyone patronize a facility with this mission?  Why wouldn’t someone else set up a hospital and charge a fair rate, charging only for your care?  How long would foreigners endure being overcharged to bail out the mother ship?

How will the NHS do a price calculation for their services?  I suggest that if they really want to make a profit they should contract with one of the “not for profit” hospital chains here in the states for a lesson in aggressive billing, or just sublet the facility out to them.  I suppose they will consider some “tax” like a VAT, added to the hospital bill but call it a TAB, for “thanks a bunch!”  

Will the British doctors operate in a for profit manner, or be salaried like back home, while the hospital acts in a “for profit” manner?  I’m thinking that if the doctors don’t care whether they are profitable, this hospital can call itself “for profit” all it wants….it will not make a dime!  On the other hand, if the doctors are offered a chance to work in a “for profit” fee for service manner in Dubai, there may not be any doctors left in England!  

What happens when a competitor hospital opens up, charging a fair rate, without the TAB?  If any talented British doctors go to Dubai, won’t they go to work for this facility not owned or operated by the NHS?  What sort of doctors would remain working in an NHS hospital when the competitor, charging probably half for better care, shows up, offering the doctors a fee for service setup?

Will they use the Liverpool Care Pathway to euthanize resource-intense patients who aren’t profitable in these new facilities?  Will they bring staff trained to simultaneously starve and sedate the sick?  Exporting these skills might actually be a good idea for the care of those remaining in England!

What does this arrangement say about the “free health care plan” back home in England?  What better evidence of failure could there be, that “for profit” hospitals need to be built all over the planet to support the bankrupt and failed system back on the home front?  Their socialism only works if allowed to piggyback onto a “for profit” system elsewhere.  What a message!

Or will the old British accent portray a higher IQ than justified, making this a brilliant marketing move, an unbeatable strategy?  Even so, what makes them think that the free market won’t create a better priced Harley Street in Dubai, as patients realize their scam? 

G. Keith Smith, M.D.

What will single payer health care look like?  There are so many places to look it’s a little confusing.  Here’s a partial list.

Canada

I pick on Canada a lot.  Why?  Lots of Canadians come to our facility for their health care.  Do I really need to say anything else?  These are people who have been told to wait for years before they can see a specialist (because there are budget “caps”).  When the money is gone, the doctor’s office is closed.  Surgeons are limited on the amount of operating room time they can have in a month.  When they have used up their time, they can do no more surgery.  Rather than have the market determine the allocation of resources, a Canadian bureaucrat creates a budget and that’s that.  Presto!  This is how the “right” to health care is born.  Doesn’t feel like a right to health care for those who come to the states for their care, though.  Probably doesn’t feel like that to the patients who die waiting in line for care, I’ll bet.  Imagine that the government guaranteed a “right” to blankets.  They then dictated how long the blanket makers could stay open manufacturing blankets.  Is it really that surprising that this approach would lead to lots of shivering blanket-less people waiting in line for their ration?  

Great Britain

I like to pick on the Brits because they harbor such nationalistic pride in regards to their health care system, even though it is based on the same faulty economic premise as their Canadian brethren.   I like to pick on the Brits because they not only euthanize their sick citizens to free up scarce hospital beds (duh…wonder how this shortage of beds came about?) they are proud of this and have even given this highway to the cemetery  a fancy name:  The Liverpool Care Pathway.  British patients that become extremely ill have a better chance of survival at home, surrounded by family and friends, as no one stands a chance once on the Pathway.  Recovery from severe illness can occur without the help of modern medicine, but recovery of the very sick isn’t likely when the hospital staff is actively murdering them.  

But there is no need to go outside of the U.S. to see the wonders of socialism in medicine.  The VA hospitals and the Indian hospitals provide examples of the wonders of efficiency brought to us in medicine from government bureaucrats.  

Our local paper’s lead article today informed us that the Department of Public Safety (office administering driver’s tests) was closing their offices for the day to participate in training their employees on how to be more efficient and friendly.  Zeke Campfield of “The Oklahoman” writes that the “operator of a local Chick-fil-A restaurant will teach examiners how to be patient and courteous.”  Wow.  That can be taught?  And in one day?  

What would happen to an employee at Chick-fil-A that was not patient with and courteous to customers?  What would a patron of Chick-fil-A do if they were not treated in a timely manner and with respect?  What would happen to Chick-fil-A if this treatment of customers were widespread?  

Campfield’s article also talks about a mother getting in to line outside of the testing center at 4:15 am, only to be turned away at the end of the day because there were simply not enough examiners to get to her son.  Three mornings in a row.  The spokesman for the Department of Public Safety muttered something about budget cuts so I’m guessing we’ll see government’s usual response, that of throwing even more money at failure.  

Try to imagine the Department of Public Safety in charge of your medical care.  Rude and inefficient staff.  No competitive fears.  Hospitals working together to institutionalize mediocrity so no one stands out as better, eliminating troublesome comparisons.  Long waiting lines.  Always blaming the lack of funding or budget caps.  

The efficiencies and quality of the private sector cannot be superimposed on government agencies for one simple reason:  without competitors, government doesn’t have to care.  Ever.  Our state government wants to introduce private sector ideas into a failed government organization.  Ironic, isn’t it, that nationally, health care bureaucrats are increasingly embracing the business plan of the Department of Public Safety (DPS), even as the DPS is looking for private sector answers?  At least the DPS hasn’t started euthanizing applicants waiting in line to free up examination spots.  

G. Keith Smith, M.D.

Here’s an interesting article.  In it is a description of a man in a British hospital dying of thirst.  Actually, he died of thirst.  Not before he called the police asking for help from his hospital bed, though. 

By passing on this description of hospital complications I in no way mean to suggest that hospitals in the U.S. can’t stand improvement.  Followers of this blog know that I am no defender of the cartel system of health care we have in this country.  That said, there are those who believe that now that we have “universal care” everything will be just great!  It is for that reason that I pass articles like this one along.

I suppose this man should have been thankful that he wasn’t actively killed by the hospital with their Liverpool Care Pathway.  Which is worse?  The indifference and neglect inflicted on this poor man or premeditated murder by the same staff with their euthanasia pathway?  Not much of a choice, is it? 

Those celebrating the court’s decision should keep their eyes open to the atrocities that will become increasingly common once this system is fully implemented.  I predict that we’ll look back and realize that some of the sick and uninsured would have avoided the hospital and recovered on their own or died in the presence and under the loving care of family members, rather than entered the hospital only to be murdered to save the state money.  Ich existiere fur das Wohl des Staates (I exist for the good of the state).

G. Keith Smith, M.D. 

Many hospitals have a chaplain or priest on their staffs, either as employees or volunteers.  I think this is a great idea.  I think it is time, however, to consider bringing veterinarians into the mix.  You see, no one knows more about, or has more experience in carrying out euthanasia than these guys.  For those Uncle Sam has decreed too expensive to treat, I think the veterinarian’s method is a more humane way to murder people than the Liverpool Care Pathway, the method admittedly used by the British National Health Service, consisting of starvation with heavy sedation. 

One third of all patients who die in British hospitals are euthanized.  Don’t believe me?  Read it here for yourself.  Don’t think this is possible here?  The UCA (unaffordable care act) gives big insurance unprecedented leeway in deciding what they’ll pay for and what they won’t.  You’ll have an insurance card, but if big insurance decides that your treatment will hurt the value of their stock….well….I think you know where you stand.  Cheap wellness kind of stuff?  You’ll be O.K.  Extensive surgery, chemotherapy and radiation for your recently diagnosed cancer?  Not so sure.

This death from neglect will start slowly and then become more commonplace as the price of health premiums and care climbs.  When One’s illness hurts Another’s pocket book, Another be more open to “putting them out of their misery.”  The UCA also applies this same compassion to newborns with birth defects.  Introducing, the Complete Lives System.  Check out this 6 minute video, then try to convince yourself that rationing care and dealing death isn’t part of this new health care plan. 

G. Keith Smith, M.D.

There are many reasons to object to government-run health care.  Some would argue that if the government runs it, it will run like everything else in the government:  poorly and corruptly.  Failure by a government program, an extremely poor performing school, for instance, simply results in more money chasing the failure.  Whatever ails the delivery of health care in the U.S. (virtually all of which has been caused by government intervention), granting the administration of this service to the folks at the department of motor vehicles or the TSA doesn’t seem like progress.

Others would say that government-run health care is a bad idea because anything that requires first the theft of an individual for the benefit of another is wrong, no matter what good is claimed to have resulted from the robbery.  The ends never justifies the means.

I think both of these positions are compelling and sufficient.  Here’s another one, though. If you are the medical ward of the state, they want you dead and they will kill you.  Think I’m too harsh?  Read this.  It turns out that 1/3 of patients who die in British hospitals are euthanized.  This is done to save money and to make beds available for more assassinations.  This British hospital path (Green Mile?) down death row is called the “Liverpool Care Pathway.”  This consists of heavy doses of morphine and other sedatives combined with denial of food and water.  Let me see…..I’m checking some of my reference texts….yep that will kill you every time.  Either component alone is sufficient to kill you.  It occurs to me that even condemned death row criminals having been granted a last meal are afforded more courtesy than these poor British patients.

So if you are one of those die-hard universal health care loonies, remember that the government, armed with the power to rob someone down the street to provide for your “free” medical care, also has (and will use) the power to kill you, if some bureaucrat believes treating your medical condition might cost too much or you are no longer useful to the state.  

This is the essence of socialism and fascism, isn’t it?  Everyone exists for the good of the state.  But once the tapeworm of government reduces us to sickness, the machine is actually better off without us, discarding us into a mass grave.  Hayek’s phenomenal book, “The Road to Serfdom” was a warning to the British that while fighting against and vilifying the fascist Germans, the British had embraced many of the ideas of their fascist society.  Looks like the British love for medical fascism has been used to achieve the same “efficiencies” of their former German foes.  

One of the most chilling parts of the article linked to above was the response by one of the government defenders of the use of this Liverpool Care Pathway.  He said that in defense of its use, if once begun a patient shows signs of improvement, it (the Liverpool protocol) is stopped.  So if you struggle while they are killing you, they let up.  No wonder the British, just like Hitler disarmed the populace before they tried this.

G. Keith Smith, M.D.