I’m keeping this issue fairly short this week since I know you are eager to get out of the office and start enjoying the Fourth of July Weekend.
I actually prefer to call it Independence Day. Too many people forget why we are celebrating the date in all of the excitement over beer and hot dogs and fireworks and sunscreen and sand in their bathing suits.
In fact, it was a day of serious purpose and great courage as the signers took on the most powerful empire in the world and signed their names as traitors to the King of England. How many of us would dare to do the same?
It is ironic, then, that the United Kingdom created its National Health Service on July 5, 1948, the day after American Independence Day. Going from Independence from the Crown in the Colonies, to maximum Dependence on the State in the Mother Country. Quite a journey.
This issue focuses on the National Health Service at age 60. This year it sounds like a lot of Brits are ready to sign a Declaration of Independence from the National Health Service. Let’s see if they are up to the task.
IN THIS ISSUE:
- Canada Ain’t So Hot, Either
- Short Takes
First Baby Changes Her Mind
Aneira Thomas made headlines on July 5, 1948 as the first child born under the Britain’s brand new National Health Service (NHS). She and the NHS both turn 60 on Saturday. An article in Wales Online says, “If she had been born just a day earlier, Aneira’s parents would have been charged a shilling and sixpence for her delivery at the Amman Valley Hospital in Ammanford.” But thanks to NHS, they didn’t have to pay a penny – at least not in fees. The article forgets to mention how much they paid in taxes for her free birth.
Her parents were so enthusiastic about free babies that they named their daughter after the founder of the NHS, Aneurin Bevan. But 60 years later, both she and the NHS are showing their age. She retired with back problems, and Ms. Thomas says of the NHS, “I feel the caring has gone out of it now. It’s all about chasing statistics, meeting that target or this target. The real point of health care – looking after people who are ill and really caring for them – has more or less gone.”
SOURCE: Wales Online
Politicians Should Get Out of Health Care
She is not alone. Writing in the London Telegraph, Janet Daley says, “Absolutely everybody now seems to be agreed that the politicians should get out of the healthcare business.” She adds, “Patients and their families, long assumed to be grateful recipients of whatever was given to them, have become sophisticated, knowledgeable consumers who will protest and demand redress when judgments made above their heads deny them what they believe to be the best possible treatments.”
But she isn’t impressed with the “reforms” proposed either by Labour or by the Tories. Labour is still fixated on “targets” imposed by the central government and the Conservatives are more interested in pleasing doctors than in pleasing patients, in her view. “When it comes to giving patients any real power, all the political parties are hopeless: they live in fear of those militant, superbly organised medical lobbies who see patient choice as a threat. But it is no use. Patient power is about to burst onto the scene by default.”
She expects the recent interest in “topping up” (that is, paying for private services in addition to NHS provided care) will result in insurers offering “top-up” policies, and says, “it will be a short step then to a system where everyone has a healthcare account” that will be “under the individual control of the patient.”
SOURCE: London Telegraph
Labour No Longer Trusted
Another article in the Telegraph reports that “Labour (is) no longer trusted on NHS reforms.” The article reports that only about 20 percent of the country “believe the Labour party will deliver a better health service over the next ten years,” while 31 percent say the Tories would do better.
It adds, “The results of the latest poll confirm a shift in the political debate over health care, away from funding and towards improved management and organisation. After years of above-inflation increases in health spending, most voters now believe the NHS has enough money. But they worry that the service has become bureaucratic and over-burdened with managers.”
SOURCE: London Telegraph
Labour Tries to Lock it Down
So, mindful of these concerns the Labour government has rolled out a new reform plan. The Health Secretary, Alan Johnson, is quoted by Polly Toynbee in The Guardian as saying it is “A momentous point in the history of the NHS, a 10-year plan that is a once-in-a-generation opportunity.” Ms. Toynbee dismisses the hype and say the plan doesn’t really do very much – which is a good thing in her view, since she likes the NHS just the way it is.
Among other things, the new “constitution” of the NHS would give everyone the right to “demand whatever the National Institute of Clinical Excellence certifies as the best cost-effective treatments for the NHS.” Now, think about that sentence for a minute. People will have the right to “demand” (apparently not “receive”) only those treatments that a committee has decided are good for the NHS (not for the patient). People in the UK apparently do not have a “right” to “demand” any other sort of treatment.
But Ms. Toynbee says “this is clever politics” because installing such a constitution would make it harder for a future Conservative government to institute meaningful change in the NHS.
SOURCE: The Guardian
Opinion Leaders Know Change is Coming
Ms. Toynbee (above) is whistling past the graveyard, trying to cement into place a system that most of the leadership in the UK (and the public) agrees is failing. London’s venerable Institute of Economic Affairs (IEA) has just published the results of “a major new survey of 100 leading British health opinion formers on the future of the NHS.” The study was conducted by Dr. Helen Evans who heads a group called Nurses For Reform, and allowed respondent to speak off the record to ensure candid responses.
The study found that, “While the NHS is itself now charged with being ‘inequitable’, ‘two tier’, ‘rationed’ and ‘costly’, a majority also believe it is too ‘monopolistic’ and want to see a much greater role for private funding arrangements – which could include personal health savings accounts.”
Interestingly, 81 percent of respondents support direct-to-consumer advertising of prescription drugs. They say that the current restriction “promotes consumer ignorance – so that they do not demand expensive drugs.”
The announcement concludes, “this book illustrates what ordinary members of the public have known for several years. The NHS is no longer a dearly loved British institution. It is a Stalinist nationalised embarrassment that should now be quietly and deftly consigned to the dustbin of history.”
SOURCE: Nurses For Reform
Our friend David Gratzer, MD, had a great op-ed in Investors Business Daily the other day. In it he describes the evolving views of Claude Castonguay, widely considered the architect of the Canadian health system.
Dr. Gratzer writes, “Years ago, Canadians touted their health care system as the best in the world; today, Canadian health care stands in ruinous shape.” He quotes Castonguay, “We thought we could resolve the system’s problems by rationing services or injecting massive amounts of new money into it, (but now) we are proposing to give a greater role to the private sector so that people can exercise freedom of choice.”
Dr. Gratzer adds, “What would drive a man like Castonguay to reconsider his long-held beliefs? Try a health care system so overburdened that hundreds of thousands in need of medical attention wait for care, any care; a system where people in towns like Norwalk, Ontario, participate in lotteries to win appointments with the local family doctor.”
He cautions Americans not to repeat the errors of Canada in their quest to improve our system.
SOURCE: Investors Business Daily
Writing in the Star Press, Michael Hicks makes the interesting observation that many of the most rabid proponents of bigger government in health care have “been strangely quiet these past few months.” He thinks it is because a full-throated debate “would seriously cripple some of their candidates this November.” He lays out the dilemmas and concludes, “Fixing health care is not going to be easy.”
SOURCE: The Star Press
You never know where you might come across a great article about Health Savings Accounts. The magazine Furniture Style holds an annual competition on ideas to help furniture store owners “boost their bottom line.” The winner this year – David Harkness of Harkness Furniture in Tacoma, Washington for setting up an HSA for his 38 employees. “The company’s gross cost for medical expenses dropped from $309.38 to $211.96 per employee.”
SOURCE: Furniture Style Magazine
The Wall Street Journal ran a substantial article on the tensions between Lancaster County’s Amish and Old Order Mennonites and the local hospitals. The religious orders shun insurance and government hand outs, and insist on paying directly for the services they consume. But the two area hospitals charge self-pay patients the maximum possible charge. Jesse Martin, a local farmer, has paid $400,000 for the care of his children and owes another $287,000. The hospitals in this story don’t look great. Lancaster General Hospital, in particular, had profits of $137 million, spent $350 million on capital improvements including a 12 level parking garage , expanded executive offices, and a new lobby with marble floors and a grand piano, and paid its CEO $1.28 million last year. But being a non-profit it pays no taxes even though it spent only $3.3 million, or 0.5 percent of its revenues, on charity care. Seems like it wouldn’t kill them to charge Mr. Martin the Medicare rate plus 25 percent.
SOURCE: Wall Street Journal
- The UK’s NHS Turns Sixty