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Doctors admit: NHS treatments must be rationed
Fertility, multiple sclerosis and migraine therapies at risk
Denis Campbell, health correspondent
Sunday May 6, 2007
The Observer
British doctors will take the historic step of admitting for the first time that many health treatments will be rationed in the future because the NHS cannot cope with spiralling demand from patients.
In a major report that will embarrass the government, the British Medical Association will say fertility treatment, plastic surgery and operations for varicose veins and minor childhood ailments, such as glue ear, are among a long list of procedures in jeopardy.
James Johnson, the BMA chairman, will warn that patients face a bleak future because they will increasingly be denied treatments. He will urge the NHS to be much more explicit about what it can realistically afford to do and ask political leaders to engage in an open, honest debate about rationing.
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Whit!
ReplyDeleteI used to work with a French Canadian whose grandfather's cancer was being "treated" by that most exemplary bastion of fairness, the Canadian Socialized Healthcare System. She would travel back and forth a couple times a year checking on him and her extended family.
Her grandfather died at home while waiting for treatment. The family was told his "rating" wasn't high enough to receive treatment sooner. According to my friend, government workers are first in line and the average "Joe" is last. Your ranking is based on what the government perceives to be
your usefulness to society.
The young lady is a good engineer and chooses to remain in America; one of the primary reasons; private healthcare.
If we ever go to National Health Care, expect a rapid growth Private Health Care System that will leave the National or Public system in ruins.
ReplyDeleteUntil that system is regulated out of business, Deuce. Remember, that's how it ultimately works!
ReplyDeleteFrom the Wall Street Journal editorial page:
ReplyDelete"Illinois Tax Implosion
The political limits of "universal" health care."
... perhaps the cooler heads will prevail!
Chrysler Group to Be Sold for $7.4 Billion
ReplyDeleteDaimlerChrysler confirmed today that it will sell a controlling interest in its struggling Chrysler Group to Cerberus Capital Management of New York.
The new company would be called Chrysler Holding LLC, and would become the first of the Detroit carmakers to be privately owned.
You mean dismantled, don't you, doug?
ReplyDeleteMy nephew made the front page of the Orange County Paper!
ReplyDeleteLooked like Kenny Boy Lay leaving the ruins of New Century.
Special section in paper on subprimes is amazing.
New Century may never file the last quarters reports.
Their Auditing firm quit.
Headline says they laid off 2,000.
Caption under nephew says Senior VP removes personal belongings.
Wife did not get a mention, although she lost job too.
They only wrote $60 BILLION in loans the last year as foreclosures went up!
With 12k/month expenses, it's time to look for work!
Times are tough, all over, doug.
ReplyDeleteI'd advise your nephew to downsize those liabilities. I don't think their unemployment compensation will cover 12K per month.
I would be out of sync with most of you folks here. I think we need to rework our system. But I am not sure how to do that. Things are so expensive. If we are going to have a society, people shouldn't be one health crisis away from destitution. Those
ReplyDeleteEuropean countries that have some kind of national care, keep voting for it.
You guys might be right, I might be all wrong, but I would like to give it a look.
Hey, health care NECESSARILY must be rationed - not every person can get every treatment all the time. The question is - how do you choose to ration it?
ReplyDeleteWow, do all leftists just argue that they know its true because its inevitable, even if its not the case right now?
ReplyDeleteHow many leftist arguments take that form?
Anyways, healthcare cost is a problem, but with Wal-Mart, K-mart, Target & more opening up convenient care clinics, they are going to begin eating the lunch of the more expensive traditional practices.
You should note that Wal-Mart and Intel are working together on an electronic infrastructure that will create more value for their customers/patients. I think this is big news, although its rollout is a few years out.
Also note, CVS, Walgreens etc are already trusted household names for Rx's. They are also getting into the convenient care game.
What should worry practices:
-Why should a family pay a premium for a sports physical, immunizations etc and wait in a waiting room for an hour etc for care - especially when they could stroll right into a big box store and do all that while getting the kids summer clothes and school supplies?
That's where it will start; but eventually, once enough IT is there, you'll see more services offered as patients have more confidence in trusting whatever subsidiary of the big boxes provides them healthcare; the biggest problem for them is building trust.
The worst thing would be more government intervention right now. Big things are happening in healthcare; its very much a revolution and mirrors in part that which impacted finance/brokerage/banking etc over the past 10-15 years. Its just happening slowly because healthcare lacks huge overheads - unlike the financial firms.
Nurse practitioners, physicians assistants etc will allow cheaper care to be delivered to more people, lowering cost and increasing access. No god forsaken rationing could do that, no matter how much n00bs like ash wish for it.
Love the topic btw - alot is happening in healthcare; alot of problems are there too.
ReplyDeleteNot just scarcity; what about dealing with errors and iatrogenic diseases that kill tens of thousands and hurt hundreds of thousands in the US per year?
Another way to look at it:
ReplyDeleteHIV drugs were invented awhile ago, but only recently became cheap enough for wide distribution.
In a sense, the economic invention(s) that allow for cheaper production and wider distribution is at least as valuable as the molecular make-up. We really need to understand this aspect of drug economics.
Its a unique problem that may result in some interesting solutions, what with fabrication technologies gaining finesse and becoming cheaper. You can't just impose your vision of price on these economics and expect to still get value out of that machine.
Who can take seriously the suggestion that a bureaucrat will be more efficient than money-hungry enterprises? I guess if they are an Ivy-Leagure bureaucrat and have as big of a heart and as strong a moral fiber as Ash......
Yes, that sounds good, ppab, but I remember a case not so long ago,where a man here, tried to pillfer money from the group he worked with, to pay the medical bills for his wife, that was dying.
ReplyDeleteSo she dies, he gets caught, the only thing wrong he had ever done in his life, and out of love, goes to jail, and we all have to pay the cost of the incarceration, and all the other fees.
We can do better than this.
bobl,
ReplyDeleteI'm not sure what has your dander up nor what you find objectionable in the notion that health care is necessarily rationed. Cost is a method of rationing. Wal*mart won't provide the latest and greatest health care; brain surgery has long ways to go before it becomes a commodity.
I may have not made myself clear. I understand things are always stretched. But I don't think any family should go down the tubes, financially, because of a health crisis. We can pay into a general fund, and pay for that. If not, let's stop calling ourselves a 'society'. Let's be honest, and call ourselves a 'jungle'.
ReplyDeleteI agree with you. It is thoughts like that (society vs jungle) that lead to some form of socialized health care. The devil, though, is in the details.
ReplyDeleteAsh, you are aware that there are things in healthcare other than brain surgery?
ReplyDeleteThere is plenty of value to be had in services a n00b bureaucrat may label as less than "latest and greatest."
Bobal, personal health savings accounts paired with insurance provide more security and could be considered to fundamentally change medicine insofar as they introduce patient choice and pressure to lower prices into healthcare issues. I do not see those elements coming from a general fund; I just see more of the same. Who wants to pay into that fund if you aren't certain to get something out of it? If you own your HSA, you can invest it in mutual funds and make money off it, and tap into it when needed.
Not to be preachy, but in the Jungle and Society, preparation is indispensable. How could anyone expect to delegate your preparation to the government? When has that ever worked?
The easiest example of inequity is the young child born into a 'family' that hasn't 'prepared' yet requires medical treatment.
ReplyDeleteThe free market does many wonderful things, allows for much innovation, and inspires efficiency, but in a world of 'pay to get' health service some get screwed and the rich get the best. Leading edge health care is dang expensive. Regular run of the mill health care is pretty darn expensive as well, exorbitantly so for the poor. Many just don't get any.
2164th: If we ever go to National Health Care, expect a rapid growth Private Health Care System that will leave the National or Public system in ruins.
ReplyDeleteTell me that after you look into what happened when the bureaucrats at NASA settled on the design for the space shuttle and put all of America's eggs in that basket: to avoid competition they arranged for private space entrepreneurship to be forbidden by statute.
Can anyone cite an example where the government intervenes and fixes the problem of scarcity by creating a superior invention with the preferred morality built into its red tape?
ReplyDeleteAnother Great Leap Forward! Our hearts and NGO PR have aligned with the stars! Harmony beckons!
ReplyDeleteAnother problem with discussing this is the catch-all term "health care."
ReplyDeleteIn this term, we have to encapsulate everything medicine does - the exorbitant and the nominal.
That many different procedures, labs and medications have many different prices should be relevant to discussing the very idea of scarcity.
When a person cites a representative example of people not getting healthcare, isn't it important to talk about what they needed but could not get?
Our healthcare system needn't care for everyone - only the sick. The numerical difference between the two is also important, I think.
Why do the Europeans, and the Canadians , keep their system as it is, if it is so damned bad? They have had chance after chance to vote it out, and they voted it in, in the first place. The system must have them by the balls, to make them vote like that. Or, maybe there is something they like about it.
ReplyDeleteI don't have the answers, but a slogan like 'I want health care just as good as my Congressman gets' should have a good run.
I can only speak about my experience with the Canadian health care system and it has been good. Your family physician is your main point of contact. They refer you to the specialists. You don't have the cost of you or your child's ailment nagging at you when you consider whether to seek medical help or not an that is a big plus.
ReplyDeleteI live in a big city and I have never had a problem with wait times. I have read of problems, especially with respect to cancer. The system is by no means perfect but all that worry about leaving a job, being self employed, or any other cost decision regarding ones health is just not a major factor.
Well I agree with the slogan. When we can measure the Congressman's healthcare, that'd be a start.
ReplyDeleteI don't say that to be flippant, given that its a difficult problem, but there are attempts, through Pay-For-Performance to see what outcomes could be priced at. If nothing else, it'd show areas where the care is an outlier - whether that's good or bad. It's a start, and a more helpful one than the pork-tempting slogans ("your congressman's healthcare") and oft-cited icons (the 40% of people who do not buy insurance).
Consider this idea, as far as it may apply to giving you not only your Congressman's healthcare, but the lessons learned in treating decades of Congressman:
Clinical Decision Support Systems
If the knowledge gets good enough, you have to ask yourself, why couldn't a PA or a nurse practitioner, both of whom are cheaper than MDs, provide valuable services to patients at a lower price? The model could follow that of electronic finance, where the professional takes liability but manages a team of lesser skilled resources that can scale to provide more value to more people. As far as healthcare is concerned, I think this would provide healthcare to more people at lower prices. For healthcare to become more preventive (and the idea is that itd become less costly too), these kind of systems that watch for so many variables, would become very important. Pair that with the renaissance in molecular diagnostics that is occurring right now and you have the makings of drastic changes.
But the problem with any proposed change within healthcare is that most healthcare business seems small. There are few huge firms with huge overhead that could become standard bearers. For America rather than a patient to benefit, I think you'd need to implement across all these mom & pop doctor's offices. This is why Wal-Mart could be welcome: it would make the way for consolidation and standardization, something which is sorely lacking in medicine - and its hard for me to appreciate why the status quo should be preferred over something closer to "Evidence Based Medicine".
That the government is A payor does not seem harmful; if it was to become THE payor, I fail to see who that would benefit, other than those connected to organizations that would reap the benefits of government contracts.
I cannot believe that in this day and age, with government so plainly bumbling and corrupt, that people want to give it healthcare. How effing ridiculous!
Canada is not exceptional in being able to do any of those things, Ash.
ReplyDeleteAmericans can buy insurance - be it for themselves, their cars or their homes. If people do not want to prepare for lightning bolts, more power to them. But why should I be responsible for someone who put their money elsewhere, given that I'm worried enough about protecting myself from lightning bolts?
Oh wait, you say bureaucrats will save the both of us! They'll tell us the proper things our money should go towards! Well thank goodness! No more thinking about healthcare for me! Another Great Leap Forward!
Bureaucrats understand phenomena so well; their think tanks tell them all about it. How many white papers have you read about what you should be worried about, about where your money should go? Sheesh, I haven't the time; best that I delegate it to some two-bit warm body so I can go back pretending that I've arrived in Modernity and transcended the demands of self-sufficiency!
ReplyDeleteHell, why don't I just work for nothing and all my value can goto a bureaucrat whose at the helm of a beautiful plan for my future!? I cannot be trusted to fend for myself or my family! You cannot have a higher expectation of me than any heroic Katrina victim, so any resource I own transfers opportunity cost onto the government, that could better apply that resource elsewhere.
Ridiculous that these ideas aren't as salient as the value of not stepping in front of buses.
Have you asked what powers your lettered bureaucrat would like today?
ReplyDeleteUtopian tools are so eager to perfect Metropolis that they will impose any untested BS on the sociological abstraction called "society" - so long as it provides for their prestige.
ReplyDeleteHey, Bobal, I know people who died too! Their deaths were expensive and sad! I didn't learn a lesson about preparation, security and life and death and uncertainty etc. No, I learned that I should vote for a Democrat! More Canada please!
Christ, I'm going for a run cuz this S*** is effing infuriating.
Well, we will just have to do what we think is best for you too, ppad, and help you out, when you can't help yourself.
ReplyDeleteppad, you will say such non-sense until such time as you or one of yours has a mentally or physically handicapped child, then you will be looking for the government programs, and someone like my wife, who worked with them for years, a thankless job, you fool.
ReplyDeleteppad is an idiot
ReplyDeleteash is intelligent, and courteous
ReplyDelete