Europe’s Covid Hospital Lesson

Government health care has led to funding caps and too few ICU beds

WSJ editorial.

"Europeans are back under lockdown as another virus surge threatens to overwhelm their hospitals, which even before the pandemic were sick and malnourished. This is a side effect of government-run health care and a warning to the U.S.

More than half of the ICU beds in France and two-thirds in Paris are occupied by Covid patients. “At this stage, we know that whatever we do, nearly 9,000 patients will be in intensive care by mid-November, which is almost the entirety of French capacities,” President Emmanuel Macron explained last week as he ordered a second national lockdown.

Hospitals across Europe are close to their limits. The Netherlands is sending some patients to Germany, but Chancellor Angela Merkel warned last week that “if the tempo of infections stays the same, we will reach the capacity of our health-care system within weeks.”

Some U.S. hospitals are also dealing with a Covid surge, and more could be stretched if it continues through the winter. Field hospitals have been set up in Wisconsin and El Paso. But hospitals in hardest-hit regions currently have far more capacity than those in Europe. 

Covid patients occupy 27% of ICU beds in South Dakota and 38% are still available. Virus patients take up about 40% of hospital beds in El Paso—still less than in Europe’s hot spots. Other areas of Texas that were slammed harder during the summer now have spare capacity. Covid patients occupy only 4% or so of hospital beds in San Antonio, Houston and Austin.

Unlike in Europe, hospitals in U.S. hot spots continue to perform preventive screenings and elective procedures. Delaying these reduces the quality-of-life for non-Covid patients and may lead to more deaths later from untreated diseases. Europe’s problem isn’t merely that Covid hospitalizations are increasing faster than in the U.S. Hospitalizations in the U.S. have increased by a quarter over the past two weeks compared to a doubling in Germany and the United Kingdom. But European hospitals are also straining because they have too few beds.

According to an August study in the Journal of Critical Care, the U.S. has 34.7 ICU beds per 100,000 population compared to 29.2 in Germany, 15.9 in Belgium, 11.6 in France, 9.7 in Spain, 6.6 in the U.K. and 6.4 in the Netherlands. Hospitals in Europe’s national health systems operate under global budgets that keep a tight cap on hospital funding.

This results in chronic under-investment and rationed care in normal times with patients having to wait longer for treatments and screenings. Hospitals are lean because they can’t afford to maintain spare beds and staff. Paris hospital workers this month protested that government budget cuts have cut ICU beds by half in the last 10 years.

During Europe’s spring surge, treatment in many countries was rationed, as it often is, by age. Older and frailer patients were denied admission to Italian ICUs. The Sunday Times reported last week that U.K. patients over age 80, and some over 60 with underlying conditions, were left to die. Patients over the age of 80 made up 60% of the U.K.’s deaths, but only 2.5% of those in this age group who were hospitalized received intensive care.

The American left has long idealized Europe’s government-run health care because it’s less costly, but patients pay a high price."