BY CAL THOMAS

Tribune Media Services

BELFAST, Northern Ireland — Regardless of how the Supreme Court rules on the “Patient Protection and Affordable Care Act” (this was written before the decision), the Obama administration has indicated it will move forward with those parts of the unpopular law it can impose on the country.

Guidebooks are helpful when going on vacation. The U.K.’s National Health Service (NHS) is the best guidebook for Americans concerned where a nationalized health system might take us.

For years throughout the U.K. there have been horror stories about declining health-care services. Last week, NHS doctors threatened a strike over a plan to raise their retirement age and pension contributions. A majority of doctors decided at the last minute not to strike after negative public reaction.

Rationing has arrived, with more than 90 percent of English health trusts restricting “non-urgent” surgeries, which include hip and knee replacements and cataract surgery. It took a freedom of information request by the media to pry this fact from the NHS.

Long waiting periods for routine surgeries are increasingly the norm here. People are amazed when an American tells them we still have fast access to our primary care physicians. In the U.K., one must often wait weeks for an appointment and then additional weeks and sometimes months for treatment, depending on the procedure.

Cost-cutting, not improving the quality of care, now seems to be the major concern of the NHS. The London Daily Telegraph last week carried a story about a 71-year-old man who had been removed from treatment for pneumonia and epilepsy because he was deemed to be too old and too sick. Professor Patrick Pullicino, a senior consultant at East Kent Hospitals, told the Royal Society of Medicine of his personal intervention to save the man. He said he encountered “significant resistance” from hospital staff. When Pullicino persuaded them to resume treatment, the man recovered and was discharged.

The story contained this scary sentence: “NHS hospitals are using end-of-life care to help elderly patients die because they are difficult to look after and take up valuable beds.” First the elderly, and then who? When cost becomes primary, what’s next? Suddenly “death panels” don’t seem so far-fetched.

NHS “looks like a supertanker heading for an iceberg,” said Mike Farrar, chief executive of the confederation that represents organizations providing NHS services. Farrar told the Telegraph, “Despite huge efforts to maintain standards of patient care in the current financial year, health-care leaders are deeply concerned about the storm clouds that are gathering around the NHS.”

For many, the storm has already struck like the torrential rain that has flooded much of the U.K. in recent days.

Here’s another recent Telegraph headline: “Lives put at risk by shortage of drugs.” The story says, “Four in five NHS trusts in England and Wales say patients are suffering ‘unacceptable’ delays for drugs to treat life-threatening conditions including cancer, Parkinson’s disease, schizophrenia and organ failure.” Drug companies are getting better prices elsewhere in Europe and so are “rationing” them here.

In the U.K., the question is not whether everyone can access “free” health care; it is the type of health care they will be able to access, and will it be high quality, or something less? If government health care isn’t working well here, why have faith it will work better in the much larger U.S.?

The United States doesn’t need the NHS as a guidebook. We have our own. It’s called Medicare and Medicaid. They are going broke and cannot be sustained without more borrowed money or sharply reduced services. When human life is regarded as disposable -- as with unborn babies -- and cost control replaces treatment as the main objective, then anything that enables government to reduce costs is possible. It then is only a matter of conditioning the public to accept lower-quality care and rationing.

Instead of keeping Obamacare, which heads in the direction of Britain’s socialized medicine and the resulting problems of reduced care and accessibility, the U.S. should enact market-based reforms in the current system (proposed by Republicans) that would expand availability and affordability while not harming the quality of great care we now have in this country.

Send comments to: Cal Thomas at tmseditors@tribune.com,Tribune Media Services, Inc.