NHS in action: When you get in the ambulance, you may stay there for a while

Ten minutes later an ambulance arrives and the paramedics shuttle you off to hospital.

But nothing happens when you arrive at the hospital five minutes later. Five minutes pass.

Then another five.

Then another five.

Then another five.

Still nothing. Your heart muscle is deteriorating rapidly or your brain bleed is hemorrhaging; this will affect you for the remainder of your life.

Then another five minutes pass.

Then another five.

Then, perhaps, another five or 25 or more minutes evaporate.

Finally, you gain access to a bed in the emergency room and begin lifesaving treatment.

This isn’t a dystopian nightmare born of the third world, it has been the reality for a staggering 1 in 8 ambulance patients in England this winter. As the BBC reported on Thursday, “Patients are meant to be handed over to [hospital emergency room] staff within 15 minutes, but more than 75,000 have waited at least twice as long” and “17,000 patients waited over an hour.”

The BBC interviewed the daughter of one lady who suffered a stroke but spent five hours in an ambulance before seeing a doctor.

Don’t misunderstand the issue. The problem here is not the skill and commitment of British doctors and nurses, who work very hard for far less money than their U.S. counterparts. The issue is the system by which Britain organizes its delivery of healthcare.

First off, because U.K. healthcare is free at the point of consumption, far too few Britons take personal responsibility for their choices.

Second, because of Britain’s long-term failure to invest in assisted living facilities, many older patients with long-term needs cannot be moved out of hospitals. This has meant a dramatic shortage of bed space in the context of an aging population.

Third and most important, because it is government-run and largely devoid of private influences, the British health service is highly inefficient and devoid of sufficient investment. This means that patients are sometimes denied appropriate care at moments of great health consequence, but it also creates long waiting lists for delivery of surgical treatments. This is the cost-delivery morality that Sen. Bernie Sanders, I-Vt., utterly ignores as he pretends that Medicare for all would provide an American health nirvana.

Again, don’t get me wrong, the U.S. healthcare system isn’t nearly as great as many Americans pretend it is. That said, at the margin, these ambulance waiting times suggest that it is better and also more moral than the British approach.