One thing you can pretty much count upon President Obama to skip in Tuesday night’s SOTU: bragging about Obamacare.

That's because the public fears it, and with good reason. I thought about this when I read this headline from the U.K. Telegraph:

Take water to relatives in hospital

Well, we’ve all seen hospital attendants who don’t seem to care about patients (and many who do care, of course). But the situation in the U.K. is really horrific: Four Britons die of dehydration and malnutrition every day in U.K. hospitals. This is not a comfortable way to go:

Few deaths can be as agonising as those caused by lack of liquids and nutrients, yet few deaths are as preventable. In every hospital, water and food are plentiful. In every hospital, nurses, doctors, registrars, and cleaners rush about the wards. Is it too much to ask that they should notice that a patient has not drunk or eaten in days?

So what does this sad state of affairs an ocean away have to do with Obamacare? Many of the architects of Obamacare, and certainly many who will administer it, are, as was Dr. Donald Berwick, Obama’s erstwhile and controversial head of the Center for Medicare and Medicaid Services, fans of the British single-payer, government controlled system.

This system, with the main decisions about patients made on a cost-basis analysis by people who are in no way related to the patient and don't necessarily have the patient's best interests at heart, inevitably, I argue, produces the callous attitude displayed by U.K medical staffers walk by thirsty sick people and don't bother to give them a sip of water.  

If Obamacare is overturned, we will still face the reality that some treatments are very, very expensive. When we confront this matter we must remember that it is important that patients, their doctors, and their families address these matters.

If patients are in charge of making decisions, they will be less dehumanized. I can’t help thinking that if the state is completely in charge of our medical system we will see more of the kind of compassionate deficit that allows sick people to die of thirst when water is near at hand. 

Heaven knows, we’ve got some brusque and arrogant medical people in the U.S. But patients retain some control over their medical decisions (at least, for the time being) and that has to contribute to the sense that they are human beings who might occasionally require a glass of water.