Spiers Offers Consumer-Driven Plan for Britain

Published July 1, 2003

On June 19, the U.K.-based Institute for Economic Affairs hosted a “book launch” dinner for Patients, Power and Responsibility: The First Principles of Consumer-driven Reform, by Professor John Spiers of the University of Glamorgan. Published by Radcliffe Medical Press in association with the IEA, the book describes Britain’s need for a more consumer-directed health care system.

The Labour Party, says Spiers, “seeks to spend its way to security. This can improve capacity, but without direct incentives and competition we will never attain European levels of quality care.”

Individual responsibility drives both good health care and good personal health, Spiers notes. He sets forth the broad outlines of a more consumer-directed health care package. Among them:

  • To achieve both patient empowerment and individual self-responsibility (for own care; for the consequences of our behaviour; for choice) every patient should be given control over a personal fund of cash for medical expenses, in voucher form.
  • Every adult would become a Patient Fund Holder. The government would mandate a “core” package of health care–Patient Guaranteed Care, or “Pretty Good Care”–for which the funds would pay.
  • The core package would be legally enforceable. Under the current system, patients have no legal leverage to ensure timely and appropriate access to care.
  • The government’s principal role in the system would be to ensure incentives, choice, and competition work. Without these, no progress is likely.
  • To ensure the system has political legitimacy and change is politically persuasive, a new approach must achieve equality of access, higher quality and greater capacity of service, improved professional pay and morale, and enhanced funding by allowing individuals to pay more for better coverage.

Melissa Davis is communications director for the Institute for Economic Affairs. Her email address is [email protected].

Internet Info

Patients, Power and Responsibility: The First Principles of Consumer-driven Reform can be ordered from Radcliffe Medical Press at http://www.radcliffe-oxford.com. More information on the Institute for Economic Affairs is available at http://www.iea.org.uk.