The Wrong Direction

There are many things wrong with U.S. health care, as there inevitably are with any health care system. The question is whether America wants to go down the British-Canadian-Cuban route, to name three government medical systems Michael Moore admires in his new film Sicko. Cuba, of course, is a totalitarian state, and even Hollywood celebrities, though they like to visit, wouldn't want to live there. (Incidentally, the best health treatment available on Cuba is at Gitmo.) The United Kingdom, by contrast, is a free society, but last week's incendiary Jeep Cherokee at Glasgow Airport has shone a rare light on the curious character of its government health system.

Of the eight persons arrested so far in connection with the terrorist plot, seven are doctors with the National Health Service (the eighth is the wife of one, and a lab technician at the same hospital). The bombs failed to go off because a medical syringe malfunctioned. I don't mean it malfunctioned as a syringe (even in the crumbling NHS, the syringes usually work) but as a triggering mechanism, to which it had been adapted, though evidently not too efficiently.

Does government health care inevitably lead to homicidal doctors who can't wait to leap into a flaming SUV and drive it through the check-in counter? No. But government health care does lead to a dependence on medical staff imported from other countries.

Some 40% of Britain's practicing doctors were trained overseas — and that percentage will increase, as older native doctors retire and younger immigrant doctors take their place: According to the BBC, "Over two-thirds of doctors registering to practise in the U.K. in 2003 were from overseas — the vast majority from non-European countries." Five of the eight arrested are Arab Muslims, the other three Indian Muslims. Bilal Abdulla, the Wahhabi driver of the incendiary Jeep and a doctor at the Royal Alexandra Hospital near Glasgow, is one of over 2,000 Iraqi doctors working in Britain. Many of these imported medical staff have never practiced in their own countries. As soon as they complete their training, they move to a western world hungry for doctors to prop up their understaffed health systems: Dr. Abdulla got his medical qualification in Baghdad in 2004 and was practicing in Britain by 2006. His co-plotter, Mohammed Asha, a neurosurgeon, graduated in Jordan in 2004 and came to England the same year.

When the President talks about needing immigrants to do "the jobs Americans won't do," most of us assume he means seasonal fruit pickers and the maid who turns down your hotel bed and leaves the little chocolate on it. But in the United Kingdom the jobs Britons won't do has somehow come to encompass the medical profession. Aneurin Bevan, the socialist who created the National Health Service after the Second World War, was once asked to explain how he'd talked the country's doctors into agreeing to become state employees: "I stuffed their mouths with gold," he crowed. Sixty years ago, no amount of gold can persuade Britons to spend their working lives in the country's dirty decrepit hospitals (they spend enough of their non-working lives there, waiting to be seen, waiting for beds, waiting for operations). According to a report in The British Medical Journal, white males comprise 43.5% of the population but now account for less than a quarter of students at U.K. medical schools: in other words, being a doctor is no longer an attractive middle-class career proposition. That's quite a monument to six decades of Michael Moore-style socialist health care.

So today the NHS is hungry for medical personnel from almost anywhere on the planet, so hungry that the government set up special fast-track immigration programs: Mohammed Asha, Mohammed Haneef and their comrades didn't even require a work permit to come and practice as doctors in state hospitals. You don't have to be the smartest jihadist in the cave to see that as an opportunity, any more than it required no great expertise for the 9/11 killers to figure that the quickest place to get the picture IDs with which they boarded the plane was through Virginia's "undocumented worker" network. Everyone else from the Venezuelan peasantry to the Russia mafia knows the vulnerabilities of western immigration systems, so why not the jihad?

Maybe their mistake was trying to blow up the airport instead of wreaking subtler havoc on the infidels. Did you see this week's scare-of-the-week from the Chinese health system? "About 420 bottles of fake blood protein, albumin, were found at hospitals in Hubei province but none had been used to treat patients, said Liu Jinai, an official with the inspection division of the provincial food and drug administration." Well, this being China, where public lies about public health are routine, we just have to take Liu Jinai's word that "none had been used to treat patients." But imagine what Doctor Jihad could get up to if he stopped trying to use the syringe as a detonator and just resumed using it as a syringe?

But beyond that the Glasgow jeep story symbolizes a more basic reality. The NHS is the biggest employer in Europe, and it's utterly dependent on imported staff such as Dr. Asha and Dr. Abdulla. In the west, we look on mass immigration as a testament to our generosity, to our multicultural bona fides. But it's not: A dependence on mass immigration is always a structural weakness and should be understood as such. In the socialized health systems of the Continent, aging, shrinking populations of native Europeans will spend their final years being cared for by young Muslim doctors and nurses. Indeed, in the NHS geriatric medicine is a field overwhelmingly dependent on immigrant staff.

And what of the other end of the medical business? Take Japan, a country with the same collapsed birth rates as Europe but with virtually no immigration. In my book, I note an interesting trend in Japanese health care: The shortage of newborn children has led to a shortage of obstetricians. For in a country with deathbed demographics why would any talented ambitious med. school student want to go into a field in such precipitous decline? In Japan, birthing is a dying business.

Back at the Royal Alexandra Hospital, three doctors are under arrest, and the bomb disposal squad performed a controlled explosion on a vehicle in the parking lot. Pulled from the flaming Cherokee, Dr. Kafeel Ahmed is now being treated for 90% burns in his own hospital by the very colleagues he sought to kill. But at one level he and Dr. Asha and Dr. Abdulla don't need to blow up anything at all. The fact that the National Health Service — the "envy of the world" in every British politician's absurdly parochial cliché — has to hire Wahhabist doctors with no background checks tells you everything about where the country's heading.

© 2007 Mark Steyn