The Face Of Single Payer

I’ve been sitting on this story for some time, just trying to find a way to write about it without completely losing it. And I think I finally can.

In England, a woman was having a very difficult pregnancy. She ended up going into labor 21 weeks and five days after conception. The record for a suriving baby is 21 weeks and six days.

And it still is.

The fetus did not survive.

Oh, it was born alive. Its heart beat, it breathed, it moved. But under the definition of the National Health Service, it was too early. So it was denied any care whatsoever — and the miscarriage took almost two hours after delivery to recognize that it was not alive.

Fortunately for Sarah Capewell, she was under the care of Britain’s universal health coverage system. Had she been in the US, things might have turned out differently.

Under the current US system, the doctors would not have denied her medicines to delay her labor or strengthen her fetus. Had she still delivered, the doctors and nurses would have moved heaven and earth to save the little boy. (Here, he would have been a human being.)

Had her insurance company balked at picking up the tab, the hospital would have continued to provide it and worried about the bill later. And later, if the insurer couldn’t be shamed into paying, the community would have rallied to her support. There would be donation cans in every convenience store. There would be web pages where people could make donations. A bank would set up a special account for those who wanted to help her.

The news media would have gone ape over the story. The little boy would be touted as “the youngest baby ever to be born alive.” Ms. Capewell would be flooded from offers from reality shows. Diaper makers would race to make the tiny diapers he’d need so they could boast of helping.

And even if all that didn’t happen, Ms. Capewell might still be burdened with huge debts. But she’d know that she — and everyone else — had done everything they could to save him.

But luckily for her, she’s in England. And in England, we see the “single-payer” system in all its glory.

Why did the hospital refuse to care for the fetus? Because the government’s rules said it wasn’t a baby. It wasn’t a human being, and wouldn’t be for days.

In the US, when doctors run into such situations, they can choose to ignore the rules and policies and guidelines. The risks they run are pretty much limited to losing their jobs.

But in England, it’s different. The government is their boss. If they defy the rules, getting fired is the least of their concerns.

In the US, the doctor can simply go to another hospital, or go into private practice. They are still doctors. But in England, if you’re fired by the government, your career is over. There are no other employers of doctors.

Also, your employer’s rules have the full force of law behind them. You’ve not only committed a firing offense, you’ve broken the law. You can be fined or, possibly, even imprisoned.

Given that, it’s remarkably easy to look at a tiny — oh so tiny — baby and convince yourself that it’s not a real human being, but a simple miscarriage that is still moving and breathing. You can ignore it, secure in the knowledge that without assistance it will soon be as dead as the government has deemed it to be.

(Hat tip to the inestimable Wretchard, one of the best thinkers in the blogosphere today.)

More disturbing words (and a picture) below the fold.

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That is not Jayden Andrew Christopher Capewell.

He was not born on October 3, 2008.

He did not die 99 minutes later.

That is a 22-week miscarriage that was delivered with a beating heart and two breathing lungs, but that was soon corrected by the wisdom of the British National Health Service.

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