I Once Was Blind…

A cautionary tale about centralized medicine:

Thousands of elderly people in Britain are left to go blind because of rationing of eye surgery in the National Health Service (NHS), a report revealed on Saturday (April 6).

The Times newspaper said a survey by the Royal College of Ophthalmologists (RCO) found tens of thousands of elderly people are left struggling to see because of an NHS cost-cutting drive that relies on them dying before they can qualify for cataract surgery.

The survey has found that the NHS has ignored instructions to end cataract treatment rationing in defiance of official guidance two years ago.

The RCO said its survey has found 62 percent of eye units retain policies that require people’s vision to have deteriorated below a certain point before surgery is funded.

With more than 400,000 cataract operations carried out each year, the National Institute for Health and Care Excellence (NICE) concluded that there was no justification for policies that denied patients cataract removal surgery until they could barely see.

The RCO said that refusal to fund surgery was insulting and called into question the entire system through which the NHS approves treatments.

Ms Helen Lee of the Royal National Institute of Blind People (RNIB) said: “Cataracts can have a dramatic impact on someone’s ability to lead a full and independent life, potentially stopping them from driving and increasing their chance of serious injury by falling. The NICE guidelines make it clear cataract surgery is highly cost-effective and should not be rationed. It is nonsensical for clinical commissioning groups to deny patients this crucial treatment.”

Ms Julie Wood, CEO of NHS Clinical Commissioners, which represents local funding bodies, defended the restrictions.

She told the Times: “NICE guidance is not mandatory and clinical commissioners must have the freedom to make clinically led decisions that are in the best interests of both individual patients and their wider local populations. The NHS does not have unlimited resources.”

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Having just experienced cataract surgery myself, I was curious as to how common it was and what the waiting period entailed. While one is on the operating table, there is time for conversation. So I asked the surgeon how many of these procedures he’d done. He thought for a moment and said, “probably several thousand by now. I have two days of surgery in this suite, and one at another site. I like to keep busy so a good day is between six and twelve patients. And of course, I see my patients the next day in a follow-up visit.” The whole thing, including prep and post, takes a bit more than an hour, and I was given every single phone contact the doctor has; they don’t want complications. And, yes, it is relatively painless. [Keep in mind that I’m comparing it to chronic fibromyalgia so a bit of stinging when the B puts in the multitude of eye drops for two weeks – the sting recedes – is the most tedious part.] Now, ten hours post-op, I am using both eyes to tell you about it.

In my early years of motherhood, I had some experience of “socialized” medical care while my then-husband was in the military. The docs were grumpy – they had to serve six years back then because of the draft. I liked the corpsmen, though. Very nice fellows and responsive to the needs of a young family. The docs? Not so much. When one pediatrician found out I was breastfeeding he gestured toward my infant and harumphed, “So when he grows up to be neurotic, will you blame it on his toilet training?”

Many Indian tribes report the same dissatisfaction with their government medical care, as do our veterans. One of the first things tribes do with their casino-funded bank accounts is to procure private medical care for everyone. The veterans don’t have that luxury.

Maybe Britain could start a lottery for health care. Brits love to bet. Besides, it worked for the Irish for many years.

I found a free Kindle Margaret Thatcher autobiography on Amazon. Haven’t gotten to her views on medical care but she was a true Methodist believer in local planning so I have my suspicions where this is going.

By tne way, the British method of politics seems eminently sane, as least compared to ours…and compared to what Thailand does, per H. Numan’s delightful essays.

15 thoughts on “I Once Was Blind…

  1. Pleased you’re getting decent treatment, Dymphna.

    The problems suffered by the UK’s National Health Service are legion; I’ve just had an opthalmic checkup deferred for the second time (I have incipient, heriditary glaucoma).

    What is not helpful is the policy, begun by New “Labour” (!) under Tony Blair, but continued enthusiastically by the Tories, of putting parts of the NHS out to tender by private companies. Any public bureaucracy, not being obliged to compete, is prone to inefficiences, but it only has to break even; private providers must make a profit for their shareholders. Also such providers are less subject to public scrutiny, pleading “commercial confidentiality”, and are awarded franchises for several years, making it near-impossible for a future government to renationalise such assets without paying compensation. The pharmacy at my local hospital was farmed out to Sainsburys (a supermarket chain) recently; the queues are longer, but there’s less space for people to wait, so they back up into the corridor.

    Our railways are a particularly egregious example, involving some deaths due to experienced staff being laid off, and an extra layer of ownership (companies with limited franchises won’t buy stock so they hire it), but that would take up a lot of your space and everyone’s time.

    • Thanks for your observation.

      Yes. Government contracting with private firms is a contradiction in terms, and bound to preserve the worst of both systems: forcible participation, lack of accountability, and lack of competition. The one constant is the bureaucrats always get their cut.

  2. In the early 80s, my grandmother had an operation to remove qatarct. Then these operations were just beginning to be introduced massively in the USSR.
    After the operation, she wore glasses with very thick glasses, but was incredibly happy.

    The operation was made completely free.
    And now my very elderly mother-in-law, who has worked for the state for many years, has to pay out of her pension a huge amount of money for medical services.

  3. and if you wonder why we in SoCal are always wearing sunglasses, it is because they are our only defense against cataracts that are the body’s response to the excessive sunlight. I had a girl friend in high school who was blue-eyed Scot who had to wear sunglasses outside at all times or else she would go blind. Maybe prescription sunglasses would be a good dose of preventive medicine. They are for us in this household.

    • It’s a genetic toss of the dice first.

      I have never liked sunlight…my mother called me a mole because I liked transitional light: early morning and evening and cloudy days. All my pictures outside I had my eyes squinched up or I wore sunglasses.

      She didn’t spend much time outside – Florida heat. But she got cataracts, anyway. No doubt some of my kids will, sunglasses or no.

      There are some defenses against developing or at least delaying the onset. One is a diet heavy in green, red, and yellow vegetables. And the supplements which support the eyes. Vitamin D and K2, for example.

      Of all the diseases and disorders of old age, cataracts are probably the easiest to cure. I’d rather them than this darned fibromyalgia and scoliosis. It’s such a relief to have something that can be dealt with.

      • My wife suffers from fibromyalgia, or at least the appearance of it. We do three things, first keep the muscles loose with stretching exercises, especially around the shoulders and neck, secondly keep the posture straight (why do you think soldiers are trained to stand at attention?) as it is the healthiest for the spine and spinal cord, and thirdly go to a diet that will reduce the acid content in the body and get the blood pH to 7.4 with yes, veggies that are high in flavonoid content. Yes, and lastly, avoid coffee and alcohol (sniff!) in favor of good herbal and green teas and even find yourself in Teavana (starbuck’s pun intended), they have some rather good teas.

        • There are a number of remedies offered for fibro. Dr St Amand’s protocol works well for many people. The diet is much like a diabetic diet. He has been treating families for years. (It *is* familial, passed down through the X genes so men only develop it at about a fourth the rate of women. One fellow who used to write to me had some kind of job in intel. He was on disability because he couldn’t lift his sidearm anymore. He said his mother suffered from it and a sister, also).

          Stretching leaves me in pain, sad to say. The muscles in my shoulders and upper arms go into spasms.

  4. In Quebec, they’ve had waiting lists so long in the past that people have ended up in assisted living due to curable blindness, while waiting for their surgery.

    State-supported assisted living. That is INSANE.

    It would make sense for them to pay for people to get the surgery out of province in order to avoid that problem, because the overall cost to the province would be lower!

    I understand that the situation has been improved. At any rate, when my parents needed it a few years ago, it was available within a reasonable time. Of note is that it’s not always such a simple surgery: my dad had complications in one eye, including a displaced lens and high ocular pressure for quite some time following the operation. It required quite a lot of followup.

    • So far, there have been 2 follow-ups, both the day after surgery. Ocular pressure was measured and was WNL (within normal limits). There may come some residual dry eye, but I’ve had that for several years. Primary docs would put me on antihistamines, but what I really needed was the ophthalmic version of steroids. FINALLY, it is receding, but just getting the infection down took at least six weeks prior to surgery.

      RE any surgical procedure: the more practice your surgeon has, the fewer the post-op complications. That was definitely the case in my torn rotator cuff repair — the orthopod had done thousands and taught it at a medical school in Richmond.

  5. https://www.hollows.org.nz/

    Where I live (New Zealand) we are asked to donate $25 to the Fred Hollows Foundation – the cost of restoring sight to a person who lives in the Pacific Islands – while we in New Zealand will pay $3,500 for the same operation. The Hollows Foundation trains the equivalent of the Chinese barefoot doctors to do much of the work and has done for decades with great success. There seems to me only one reason why registered nurses in western countries cannot be trained to do the same.

    • Because the competition is great here, the surgeries are not so expensive. The cost of using the surgical suite was $350; each visit is 45. No cost for follow-up visits; they are part of the procedure. Of course it will take forever for the out-of-pocket surgery costs to surface. My Medicare and supplemental insurance have to step all over that bill before we get a copy. The post-op meds are about $75 because for some reason I haven’t been able to secure Part D of Medicare. Need to look into that.

  6. The siren song of socialized medicine (or socialized anything) is that it sounds simple and free. Leftists tend to have a deficit in appreciation of unintended (or hidden) consequences, and thus make socialized medicine as cheap, plentiful, and healthy as rain from the heavens. You can see the phenomenon in AOC: passionate speeches about how everyone has a right to a job, food, health care, yada yada, and capitalism has failed the people.

    One is tempted to say that public welfare ensures that no one lacks really essential medical services. It’s probably true at the moment, but the costs are not sustainable. I’ve heard stories from emergency room technicians that indigent people call ambulances at thousands of dollars a pop to go to the emergency room for headaches. They have vouchers for shuttle transportation, but would rather call ambulances because they won’t have to wait, and they don’t see the costs one way or another. It’s simply an extreme, but common, phenomenon when governments deal with other people’s money and don’t really care enough to enforce sensible measures.

    Once the intelligence level of the general population gets below the point of appreciating or even understanding, unintended future consequences, and if we continue the one-man, one-vote practice, where my vote is countered by an illegal who can’t read or speak English, we will eventually devolve into becoming Venezuela. The lesson couldn’t be clearer, and couldn’t be more assiduously ignored by the media and politicians.

    • Ronald your vote is not only countered by an illegal, but more often by a democrat poll worker. After watching criminals in Broward County, Florida systematicly produce votes for democrats, I believe we have reached the tipping point.
      There is simply no reason for elections not to be fair. And yet, there is the farce of UN election monitors looking to see if minorities are being intimidated. They always seem to miss that “lost” bag of votes in the precinct back room, grade school, or the trunk of some democrat’s car.

  7. I have a friend from Oklahoma who, before she retired, worked for a large hospital combine in Dallas recruiting doctors. When she retired, she did the same thing for her tribe, the Chickasaw’s. They kicked out the Indian agents and are taking care of their own medical care. The tribe does more than that, however. They build infrastructure within their nation, they sponsor schools, school programs and all sorts of social services.

  8. “Delightfully sane” politics, please give me a break. Great Britain is a small country whose problems are currently overwhelming their native people.

    It’s reliably socialist, and unreliable when it comes to resisting muslim rape gangs. It has no bill of rights, and very little backbone. And the British that I admire are dying off and being replaced by tatooed know nothings.

    Being British in 20019 merely means your priorities are multiculturalism ( with England being at the bottom ), climate hysteria, and increasing squalor and poverty. We have the same thing here in every city run by democrats.

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