Remember How Much Your New Medicare Chief Loves the NHS?
"Dying cancer patients to be told to manage their own symptoms." Things sound pretty grim to me at the NHS, our new role model for enlightened medical care.
An investigation by The Sunday Telegraph has uncovered widespread cuts planned across the NHS, many of which have already been agreed by senior health service officials. They include:
* Restrictions on some of the most basic and common operations, including hip and knee replacements, cataract surgery and orthodontic procedures.
* Plans to cut hundreds of thousands of pounds from budgets for the terminally ill, with dying cancer patients to be told to manage their own symptoms if their condition worsens at evenings or weekends.
* The closure of nursing homes for the elderly.
* A reduction in acute hospital beds, including those for the mentally ill, with targets to discourage GPs from sending patients to hospitals and reduce the number of people using accident and emergency departments.
My own experience of the NHS--I lived in Britain for about seven years--was that it was pretty good for things like routine sniffles. I was always seen promptly, and I reckon the standard of care was perfectly adequate.
Then my brother came to visit me after spending three months backpacking in India, and on his first night at my place had a massive epileptic seizure on my floor. He'd never had one before, and of course I freaked out completely. We rushed him to the hospital, where they did a basic checkup and told us cheerfully, "Well, it's probably nothing, but of course it could be meningitis, since he's been in India, and it could always be a brain tumor." And how would we rule that out, we asked? You'd start with a CT scan, said the doctor. But alas, he couldn't authorize that. You needed to have three seizures before the NHS would pay for it.
Fortunately, my brother had health insurance. We went to a private hospital, where we were relieved of the agony of wondering whether he had a brain tumor within a few hours.
Now, before you jump to ideological conclusions, there's a twist to this story: My brother can't afford private insurance in the US anymore, because while he didn't have a brain tumor, he does have epilepsy.
That's definitely a big flaw in the system, too.
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Re: Remember How Much Your New Medicare Chief Loves the NHS?
And then there's this, from the NYTimes: "Britain Plans to Decentralize Health Care."
Jun '10
Re: Remember How Much Your New Medicare Chief Loves the NHS?
If for example, a person in the US, with no health insurance, went into a hyperosmolar coma, was rushed to the hospital, and discovered to their surprise, it happened because they have untreated diabetes, then they've just entered a new category of insurance customer. In a private system, how do you avoid making distinctions between people in medical danger and people not in medical danger? If their income is low, they've moved from an insurance client to a charity client. Nothing wrong with that. It's not their fault that they're diabetic. They've just moved to a different pool of insurance customer--a more expensive pool. I think that's the ONLY place where government should step in--cases where people can't afford to buy into the insurance pool they belong in.
May '10
Re: Remember How Much Your New Medicare Chief Loves the NHS?
Is that the red pill or the blue bill?
May '10
Re: Remember How Much Your New Medicare Chief Loves the NHS?
Shouldn't "insurance" companies be assessing the risk they incur by the cost of care the patient will probably need? Don't we need to reform health "care" to make it affordable by de-emphasizing "insurance" (like government mandates on insurance) and emphasizing health "care"?
I ask these questions and put the "care" and "insurance" in quotes because there should be a difference, but there isn't one in America. Didn't the regulation by government create the extreme health "care" costs by forcing businesses in to health "insurance" systems?
I ask because I have no idea if this is even true, but it seems wrong to make insurance companies abandon actuarial accounting. Even though we speak and think otherwise, shouldn't health insurance be _exactly_ like car insurance, homeowners insurance, renters insurance, etc... Policies provided based on risk?
Jun '10
Re: Remember How Much Your New Medicare Chief Loves the NHS?
This debate is devolving into one of anecdotes when what started the discussion was an economic question. No matter what type of healthcare is available, or not, cost cutting and facilities closures are economic questions which in turn raises the following questions in my mind: 1) Is it wise to deny private capital to flow into any economic sector, such as medicine, when there exists a demand exaggerated by improper costing (The situation in Canada)? By improper costing I mean that the service is provided at substantially below its cost of production: Think Mercedes Benz priced at below ten grand a car. 2) Is it a good idea to place service delivery decisions in the hands of politicians and bureaucrats insulated from the consequences of their decisions? 3) In a capital intensive industry such as medicine, is it wise to adjudicate such capital flows politically? 4) Is it wise to place the issue of doctor remuniration in the hands of politicians, especially those beholden to union or labour support for their political positions? 5) Is it economically wise to limit by fiat patent protection for drug producers?
Jun '10
Re: Remember How Much Your New Medicare Chief Loves the NHS?
What the above questions should show are the potential conflicts of interest that governments are in when they socialize medicine. Recently in my jurisdiction the government made it illegal to ride a bicycle without a helmet. The question was argued on public safety, but was the decision to introduce the legislation based on the cost to the government of treating head injuries that presented ot the ERs. Being Canadian, I'll never know, as the government pays for my healthcare.
What is not commonly known, I know this because a good friend is a doctor, is that GPs in this area are often too busy to see chronic patients because they consume too much of their time, when the doctor can only bill a pittance per visit that doc will eliminate as many of his difficult patients as possible. What is also not commonly know in that the number of patients per day that doctors in this area can see is limited, cross the limit and the doctor cannot bill for the visit, so doctors close offices early and thereby increase waiting lists.
May '10
Re: Remember How Much Your New Medicare Chief Loves the NHS?
No matter what we say about insurance or payment systems, we are wasting our time. All the accumulated annual profits of all healtjh insurers wouldn't keep this thing ging any longer than would confiscating 100% of the wealth of the "rich" to plug the annual deficit.
The only way to fix this is to change the fundamental business models of every single player involved- pharmas, hospitals, doctors, insurers, government. That is done by turning this into a retail model, changing the licensing/approval regimens, and letting technology loose to do what it does in every other segment of the economy.
When we are all desperate, it will happen. Till then, I expect all of the usual special interests to protect their turfs and their current failed business models.
May '10
Re: Remember How Much Your New Medicare Chief Loves the NHS?
The hubris of Washington "leaders" really is tough for me to wrap my head around. Why couldn't we trim government tinkering, with a few limited safeguards and subsidies for those cases and patients at the fringes? When did politicians decide they could abolish risk itself?
Ryan Gaines makes an important point, that health care and health insurance have become horribly tangled concepts. But so has "ownership:" see GM, Fannie, Freddie, and the CRA. And "productivity," too: see perpetually extended unemployment benefits. All thanks to the outsized egos of politicians who think they can fix everything, or at least trick 51% of their constituents into believing they did.
May '10
Re: Remember How Much Your New Medicare Chief Loves the NHS?
You know, Cas, it never occurred to me cost-cutting was a reason for making bicycle helmuts compulsory here in my state in Australia While I can see the sense of doing it for safety reasons especially with regards to children riding along busy roads, the notion that the regulation was implemented due to economic reasons never occurred to me. I don't suppose we can be too cynical when it comes to governments.
Here in Australia, we have great health care professionals and facilities but there's a lot of waiting involved in the public system before anyone can see you. Specialists are spread thinly. My oldest had a minor accident years ago and we spent A LOT of time waiting around just for 10 minutes of surgical consultation. This didn't include the 2 or 3 follow-up visits. I don't go to the hospital for minor complaints... we have our local GP for that but I've known overseas students who have and they claimed to have waited over 2 hours (at least) to be seen.
May '10
Re: Remember How Much Your New Medicare Chief Loves the NHS?
I don't really know all the complexities of the Australian health system but what I am certain is that at every election (since I've lived here) on a State and Federal level, the inevitable quibble over hospital funding never fails to rear its ugly head.
I took up health insurance for myself before I had the children so I could go private when I had babies. I've never regretted it.
May '10
Re: Remember How Much Your New Medicare Chief Loves the NHS?
Claire, Your experience with the NHS, with the exception of your brother, has been vastly different from mine. A mistreatment of a basic urinary track infection made my wife really ill for months. An emergency visit to the hospital with my 3 year old son had us waiting in a filthy reception area, complete with blood stains on the floor. I simply would not work in the UK without private health insurance.
the NHS is the worst health system by far in the 12 countries in which I have lived, including developing countries. It is a national disgrace with numerous horror stories in the press every week. How our new health czar could be fan, how any sentient human could be a fan, is beyond me.
I suppose that if your aim is wealth redistribution or population reduction, the NHS has much to commend it.