DIY NHS

This year Britain's National Health Service (NHS), a single payer system worthy of emulation, say its American boosters, will celebrate 60 years of queues and DIY dentistry by introducing a new "patient constitution" that, according to reports, will refuse treatment to those who smoke or spend inordinate amounts of time on the couch time eating fried Mars bars and watching Eastenders. The Telegraph editorializes:

The inadequacy of our healthcare model has led us to a senseless (and heartless) contradictory position: the Department of Health states categorically that "co-payment" is unacceptable because it would result in an unequal system in which better-off patients would have advantages that poorer ones do not. But it now plans to refuse care to people whose unhealthy lifestyles are usually associated with poverty and deprivation. The extraordinary high-handedness of these proposals is symptomatic of all that is wrong with a tax-funded monopoly health system run by central government: ordinary people are encouraged to think of healthcare as a gift of the state.

The Telegraph also uncovers an internal Department of Health memo advising doctors to steer some patients towards self-treatment, thus avoiding doctor and emergency room visits and saving the NHS billions in overhead costs

Millions of people with arthritis, asthma and even heart failure will be urged to treat themselves as part of a Government plan to save billions of pounds from the NHS budget. Instead of going to hospital or consulting a doctor, patients will be encouraged to carry out "self care" as the Department of Health (DoH) tries to meet Treasury targets to curb spending.

[…]

The Prime Minister claimed the self-care agenda was about increasing patient choice and "personalised" services. But an internal Government document seen by The Daily Telegraph makes clear that the policy is a money-saving measure, a key plank of DoH plans to cut costs.

Full story. In other NHS news, Tory leader David Cameron has pledged that the conservatives will replace Labour as "the party of the NHS."

Comments

[iowan]

Finite resources combined with infinite needs results in a negative outcome.

Basic mathematics.

[Ugly American]

What do you expect from people who can't even spell "Labor" right.

[joe]

I don't understand why the Brits don't just switch from the Canadian/English "national health care" model to the far more effective French model of private care and public insurance.

[iowan]

Just as time is unidirectional, government control only flows one direction (sans revolution).

[Episiarch]

I don't understand why the Brits don't just switch from the Canadian/English "national health care" model to the far more effective French model of private care and public insurance.

Can't be like the frogs, man. The NHS is a British institution, just like the BBC, the Queen, and toad-in-the-hole. Can't get rid of it because an idiotic socialized health system has become the very essence of Britishness.

[JW]

I don't understand why the Brits don't just switch from the Canadian/English "national health care" model to the far more effective French model of private care and public insurance.

You presume that bureaucracies are rational.

[joe]

Yeah, that's probably it.

It's a dysfunctional P.o.S., but at least it's OUR dysfunctional P.o.S.

You see a lot of this same line of thinking here in the US in criticisms of "socialist, European" universal health care.

[Reinmoose]

Speaking of which, anyone else see "I eat 33000 calories a day" (or whatever the special was called) on TLC yesterday? Those Bulging Brits really like their "fried bread" and chocolate bars.

All I can say is... 33000 calories... A DAY!
*passes out*

[Episiarch]

All I can say is... 33000 calories... A DAY!

Is that really possible? Seriously. That's 16.5 times the USRDA of 2000. Was this person fatter than Louis Anderson or something? Was it an elephant pretending to be a person?

[Tyro]

a single payer system worthy of emulation, say its American boosters

First of all, isn't saying that its American boosters say the NHS is worthy of emulation a bit of circular reasoning? If they didn't say it were worthy of emulation, they wouldn't be boosters of the system. Likewise, Americans who are boosters of the Republican party think we should vote Republican.
Next, the NHS isn't a single-payer system. It's a single provider system. Those who support single-payer systems point to systems like canada, which has multiple, independent private providers.

[robc]

Episiarch

I didnt see the 33k calorie guy, I saw it on the schedule, didnt watch it. They did a bunch of shows on super-sized people in a row, Im sure the smallest was larger than Louis Anderson.

Sometime around christmas, I saw one of the TLC shows on the woman having quints. They hold her to eat 500 additional calories a day PER CHILD. She was freaking over trying to eat 2500 additional calories. I dont think she managed it either.

[Ken Shultz]

"I don't understand why the Brits don't just switch from the Canadian/English "national health care" model to the far more effective French model of private care and public insurance."

Does the French model force most people to buy insurance?

The British may have something of a visceral* reaction to forcing people to pay for things they think they're entitled to.

Think poll tax.

*I hope we have such a reaction, should the need arise, here in the States.

[brotherben]

http://www.youtube.com/watch?v=pQ742Da8T2o

33,000 calories/day

[crimethink]

A market with a single buyer and multiple sellers is as bad or worse than one with a single buyer and a single seller. At least the latter has some efficiency gains due to reduced transaction costs.

[Episiarch]

She was freaking over trying to eat 2500 additional calories.

And 33000 >>>>> 2500. Bigtime. Methinks Reinmoose is a big fat liar. Pants on fire.

[Reinmoose]

Epi -
They actually had to demolish part of this one guy's house and get him out with a forklift.

[Reinmoose]

Granted, most of the people (there were 4) didn't consume that much, but they were all in the 10s of thousands.

[Episiarch]

They actually had to demolish part of this one guy's house and get him out with a forklift.

So it was Louis Anderson then?

[Aresen]

JW

I'm a "beneficiary" of Canada's single payer system.

Whenever someone proposes allowing private caregivers to compete, the usual responses are "the doctors will all be treating the rich and the poor won't get any care" (note the implied serfdom of doctors in the sentence) and "you want American style health care." (In Canada, if you are trying to prevent discussion of something, associate it with the US.)

My response to these 'arguments'
1) Rich people already go to private clinics in the US or on 'medical tourism' trips to Cuba and Mexico.
2) "We do have American style health care, or hadn't you noticed that 99% of the medical equipment and new drugs and procedures were developed by those American for profit health care providers you lover to despise."

[Bingo]

33,000 calories is about 25 Pizza Hut P'zones, thats a lot of food!

[Reinmoose]

Seriously, I didn't believe it myself until I actually watched the program. It was amazing in a very sickening sort of way. I turned it on while I was eating a late (and rather small) dinner, and it really made me want to stop eating.

[Lost_In_Translation]

So Canadians would rather come to the US for "treatment" and Americans go to Canada for "drugs".

[robc]

And 33000 >>>>> 2500. Bigtime. Methinks Reinmoose is a big fat liar. Pants on fire.

No, that really was the name of the show. I didnt watch it because I didnt want to see how big a fat tub of goo that would make someone.

(I also look straight ahead and speed up when passing car accidents)

[Reinmoose]

And 33000 >>>>> 2500. Bigtime. Methinks Reinmoose is a big fat liar. Pants on fire.

I'll have you know that I'm pretty skinny!!
no comment on the liar part... or the pants being on fire...

[Paul]

But they have access. Who cares if the system works? That's all that matters.

[Paul]

So Canadians would rather come to the US for "treatment"

I can't say whether Canadians would "rather" come to the US for treatment, but I can tell you that they're sent here for treatment by their government, because of the lack of healthcare services in that country.

[Lurker Kurt]

I can't say whether Canadians would "rather" come to the US for treatment, but I can tell you that they're sent here for treatment by their government, because of the lack of healthcare services in that country.

I just came across another success story about Canada's health care system:

http://www.news1130.com/news/local/article.jsp?content=20080102_101452_5180

[J sub D]

If we get the smokers and the fatties out of the system, it will be much more cost effective. Any guesses for what group, using an unacceptable portion of NHS dollars, will be next?

Hey, the poor and those with inherited conditions comes to mind, don't they?

[brotherben]

J sub D,
That would get us as a species headed back to evolution being allowed to work, A damn good start IMHO.

[Ken Shultz]

"That would get us as a species headed back to evolution being allowed to work, A damn good start IMHO."

And here I am telling people we aren't social Darwinists!

[CSS]

Rich people already go to private clinics in the US or on 'medical tourism' trips to Cuba and Mexico.

Does Cuba have better clinics than the UK?

[Matthew]

CSS,

I believe Cuba has some "private" for profit clinics for tourists. Or maybe I'm thinking of that james bond movie with Halle Berry in it.

[LarryA]

If we get the smokers and the fatties out of the system, it will be much more cost effective.

Perhaps in the very short run. However, if better health means people live longer, thus participate in the system longer, thus end up in long-term care longer, the Brits are truly screwed.

It isn't the folks who die early who cost the big health-care bucks.

Any guesses for what group, using an unacceptable portion of NHS dollars, will be next?

The elderly.

[Paul]

Any guesses for what group, using an unacceptable portion of NHS dollars, will be next?

The sick.

[Mike Laursen]

A market with a single buyer and multiple sellers is as bad or worse than one with a single buyer and a single seller. At least the latter has some efficiency gains due to reduced transaction costs.

Does your analysis depend on the assumption that the buyer is motivated to reduce the price it pays? That isn't necessarily the case when government officials, spending other people's money, are making the buying decisions.

[Juan]

CSS, Matthew.

They do. It's all for medical tourism. I have a close friend that has gone there for treatment (and also has some horror stories about the care regular Cubans get).

[Jennifer]

Why is this a surprise? Just a few months ago there was a post here about NHS doctors refusing to do surgery on a broken ankle unless the patient quit smoking first. Of course that was a precedent rather than an isolated event.

[Aresen]

Juan is exactly right.

The only reasonable description of the health care system in Cuba is "depraved."

Cuba has excellently trained doctors, but they are used to earn hard currency for the Cuban regime. People from Europe, Canada and the US travel to get medical treatments in Cuba because it is cheap and/or they can avoid the wait times in their own countries. The tourists pay in Euros, Pounds, Loonies and US dollars for treatment that, while not the most advanced, is good and efficient. The regime uses the money for its own purposes.

For ordinary Cubans - other than the Party elite - health care is hard to get and even basic medications are unavailable. Medical tourists regularly report having people beg them for any left over medications they might have.

This system - which was praised in Sicko - is the worst I have ever heard of.

[Paul]

A market with a single buyer and multiple sellers is as bad or worse than one with a single buyer and a single seller. At least the latter has some efficiency gains due to reduced transaction costs.

Right, cause with a single buyer and single seller, we'll know exactly what the cost of things are.

Oh wait.

Jennifer:

It's not a surprise. Some of us postulated this is where any single payer system would eventually end up-- especially during Clinton's attempt at such a system in the nineties. The only thing I'm surprised about, is how quickly this came about. And frankly, I'm thankful it came about so quickly. I'm sorry for those living under such a system-- but it helps illustrate the inevitability without having your arguments labeled "wild speculation" or exaggeration.

[Jennifer]

Question for Joe: a few months ago you appeared to agree with the decision to not set that man's broken bone so he could walk again unless he first gave up smoking. Having seen where that precedent led, have you reconsidered your earlier stance or do you still think it's peachy for government doctors to tell taxpayer patients "No walking for you unless you give up the butts first?"

[#]

The Master Settlement Agreement on tobacco and the subsequent massive tax hikes were pitched as necessary because of the increased healthcare costs smokers impose on the states. Do you mean to tell me the states won't treat the smokers because they smoke after they've collected all that money?

[boqueronman]

As a recipient of British genes from my parents, I can't see how this NHS "denial of service" for bad eating habits can be feasible. For those who have not seen it, check out "You Are What You Eat" on BBC America. A nutritionist is matched with a grossly overweight person or family to slim them down by changing their eating habits. One of the opening parts of the show is a display of all the food that the target eats in a week laid out on a table. Invariably, its a pile of brown or beige fried food, bread, chocolates and booze, usually beer. It's truly disgusting. While the nutritionist seems usually to be successful in changing these bad eating habits to veggies and fruit, there clearly is a massive population of poor eaters in the U.K. When crunch time comes, they will not be able to enforce these regs.