Obama's Rationing Man<4>

The problem with any uniform medical guidance is that what's good for the "average" patient may not be right for any given patient.

The irony in all of this is that Berwick, at times, has eloquently argued for what he called an "extremist" patient-centered approach to

health care, in which hospitals wouldn't restrict visiting hours or force patients to wear gowns. As he said in a speech to the American

Board of Internal Medicine in 2008 of the experience of a patient at a hospital: "That's what scares me: to be made helpless before my time,

to be made ignorant when I want to know, to be made to sit when I wish to stand, to be alone when I need to hold my wife's hand, to eat what

I do not wish to eat, to be named what I do not wish to be named, to be told when I wish to be asked, to be awoken when I wish to sleep."

Yet the term "patient-centered" is typically used by supporters of a free market approach to health care who argue for more individual choice

and consumer empowerment. It's hard to think of a health care system in the world that dehumanizes patients more than Berwick's beloved

British system.

In March 2009, a report found that up to 1,200 died as a result of "appalling standards of care" at just one hospital in Britain's NHS. The

Telegraph reported that "patients (were) left for hours in soiled bedclothes.¡­" In addition, "Patients described one ward as a 'war zone'

and said people were often left in Stafford's A&E (Accident and Emergency) for hours covered in blood and without pain relief, even though

they had serious injuries. Others were left without food or drink, leading some to reportedly drink from vases when thirsty."

In November, another report estimated that up to 400 patients a year died at two other hospitals, with similar conditions that included,

according to the Telegraph, "lack of basic nursing skills, curtains spattered with blood on wards, mould in vital equipment and patients

being left in A&E for up to ten hours."

7:04 PM - 11/5/2010