Hinchingbrooke Hospital breaks free from the NHS Bureaucracy and Improves Health Care

Posted by PITHOCRATES - October 13th, 2013

Week in Review

Britain has government-run national health care.  The National Health Service (NHS) provides free health care to all Britons.  And the medical tourists who travel to the country for free health care.  Straining the NHS budget.  At a time when Britain’s aging population is stretching their limited resources thin.  Leading to longer wait times.  Longer travel times as they close local hospitals to consolidate their resources in fewer locations.  And rationing.

Even with their longer wait times, travel times and rationing of services they are still running a deficit in the NHS.  To address these chronic cost overruns they are trying to find £20 billion ($30.54 billion) in efficiency savings over three years.  But there is a beacon of hope for the NHS.  At Hinchingbrooke Hospital (see Set doctors and nurses free to use their common sense – as Hinchingbrooke Hospital does by Charles Moore posted on The Telegraph).

Last month, I visited Hinchingbrooke Hospital, near Huntingdon, the only NHS Trust in the country operated by a private partner…

I spent half a day at Hinchingbrooke, talking to doctors, nurses, administrators and patients, and seeing several wards…

One can visit a large organisation without being aware of big problems. Indeed, one of the great difficulties of the NHS is that internal communications are so bad that people can work well in one area without being aware of utter disaster a few yards away. In the case of Hinchingbrooke, under previous management, maternity was very good while the colorectal unit was shameful. So what follows is not definitive; but I feel I learnt something.

Uniquely in the NHS, Hinchingbrooke’s executive board is dominated by clinical practitioners (doctors and nurses, to you and me). The chief executive is an obstetrician. Only three of the 14 board members have non-clinical backgrounds.

In the only trust that has a private partner doctors and nurses determine how best to treat patients.  Instead of the faceless bureaucracy in the rest of the NHS.  Or what the proponents of Obamacare hope to force onto the American people.

One of the key working methods, borrowed from Toyota, is “Stop the Line”. Anyone in the hospital can stop the line if he or she believes that there might be a “serious untoward incident” or danger to a patient…

A similar, lesser action is a “swarm”. If you are urgently worried about something, you can summon all the relevant people together immediately. Unlike “whistle-blowing”, which is inevitably retrospective and often involves grievance and disloyalty, these ways of acting are instant and preventative. You are encouraged to use them. Someone stops the line in Hinchingbrooke most days.

Nurses work differently from most parts of the NHS. They all wear uniform, even if in managerial roles, and they are encouraged to take part in management without abandoning clinical work…

But what struck me about Hinchingbrooke was not that it was brilliantly original – simply that it was free to act according to common sense. Involve staff in decisions. Make sure that doctors and nurses can run things. Learn from commercial examples of how to improve services. Let the right hand know what the left is doing. Encourage innovation. Don’t “benchmark to the middle”, but to the top. And little things: get A&E nurses to wear identifiable name-badges; get rid of hospital car-park fines. Most of this is simple, but, in the leviathan of the NHS, it is not easy. And at present there are about 2,300 NHS hospitals in the United Kingdom, and only one Hinchingbrooke…

This is far behind the public. As you understand better if you spend a morning in Hinchingbrooke Hospital, the public want health care free at the point of use, but have no ideological prejudice about who delivers it, or how. They rightly judge by results – are they, their spouses, parents, children, well or ill? Are the staff medically competent, efficient and kind? They are not sentimental about the most shocking producer interest ever to have gained power in this country.

The one hospital where things are greatly improving is the one hospital that is moving away from bureaucratic national health care and towards private health care.  Like it once was in the United States.  While President Obama and the Democrats want to move the American health care systems towards the bureaucratic national health care of the NHS.  Where there are longer wait times.  And service rationing.  Well, everywhere in the NHS but Hinchingbrooke Hospital.

Do President Obama and the Democrats care that they will destroy the American health care system?  No.  Because it’s not about health care.  It’s about creating the “most shocking producer interest ever to have gained power in this country.”  Yes, it’s about the power.  Social Security and Medicare made the elderly dependent on government.  Giving the government power over the elderly.  If they can’t raise taxes they just threaten to cut Social Security and Medicare benefits.  National health care, though, makes everyone dependent on government.  Giving the government power over everyone.

Until the day they can no longer maintain that power.  And that day has come in Britain.  Their aging population is breaking the system.  Which is in essence a Ponzi scheme.  The masses in the workforce pay in via taxes.  And the few sick consume health care services at the top of the pyramid.  While a bloated bureaucracy makes sure to take very good care of itself.  But the aging population is shrinking the workforce paying the taxes.  And swelling the number of sick consuming the health care services.  Inverting the pyramid of the Ponzi scheme.  As it will in America thanks to Obamacare.  Because the United States has an aging population, too.

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Obamacare will Lead to Rationing and Longer Wait Times just like in the NHS

Posted by PITHOCRATES - August 17th, 2013

Week in Review

Britain has a problem with their national health care.  They have an aging population where people are living longer.  And because they are people are having more hospital stays than people were a generation earlier.  As that last decade or so of life requires a lot of medical care.  And this increase in demand for health care is happening at the same time fewer people are entering the workforce to replace the people leaving it.

So you have falling tax revenue at a time of soaring health care expenditures.  So what do you do when you have a demand that is greater than the available resources?  You ration those precious resources.  And cut costs.  By having fewer people handling a greater workload.  Which, of course, increases the waiting times to see a doctor (see GPs predict longer waiting times – survey by Nick Triggle posted 8/16/2013 on BBC News Health).

A Royal College of General Practitioners poll of 206 UK GPs found that more than 70% were forecasting longer waiting times within two years.

Eight in 10 also said they did not have enough resources to provide high-quality care, the survey showed.

A Patients Association report this year suggested that people were already having to wait longer.

Six in 10 of those polled by the royal college said patients in England were waiting longer than the recommended 48 hours…

Chairman Dr Clare Gerada said: “GPs are grappling with a double whammy of spiralling workloads and dwindling resources, and big cracks are starting to appear in the care and services that we can deliver for our patients.

In the NHS 60% of the people have to wait longer than 48 hours to see a doctor.  Unless they go to an accident and emergency department (A/E).  Where they may only have to wait 4 hours or so.  This is national health care.  And this is where Obamacare is trying to take us.  Even Harry Raid admitted this on the PBS program “Nevada Week in Review.”

So this is the future of Obamacare.  As the US has the same problems the UK has.  An aging population with people living longer into retirement.  With fewer people entering the workforce to pay for them.  So the inevitable future of Obamacare is rationing.  And longer waiting times.  Just as it is the reality in the NHS.

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More Doctors are Leaving Britain’s National Health Service for Better Jobs Elsewhere

Posted by PITHOCRATES - August 10th, 2013

Week in Review

According to BBC Radio 4 doctors in the National Health Service (NHS) are fed up with being blamed for all the woes in the NHS (see UK doctors ‘flee NHS for overseas’ says RCGP posted 8/7/2013 on BBC News health).

A constant barrage of negative headlines about the NHS is leading to a growing number of doctors fleeing Britain to practice abroad, according to the Royal College of General Practitioners.

Britain’s aging population is placing great strains on the NHS.  Health care spending is rising as people live longer into retirement while a smaller population enters the workforce to pay for them.  Leading to a doctor shortage.  Rationing of care.  And a lowering of the level of quality as fewer resources must cover more people.

According to this report everyone is blaming greedy doctors who don’t want to do their fair share of work.  This while the doctor shortage is so bad that about a third of the doctors in the NHS are immigrants.  And the British government is investing in more doctors to cope with the increasing pressures of these doctor shortages in the face of that aging population.  But there is no sympathy for doctors.  People say that they paid to educate and train them so it’s their duty to stay in the UK and look out after them.

So this is life under national health care.  Overworked doctors.  About a third of which will be immigrants.  As the treatment of doctors discourages others from entering the profession.  Creating a doctor shortage filled by immigrants.  And a general attitude among the people that because they pay for these doctors with their taxes that makes these doctors their bitch.

They also say these doctors are paid well.  Who earn around $150,000 (in U.S. dollars).  Which is a lot of money.  Yet there is a doctor shortage because more people aren’t leaping at the opportunity to earn those big bucks, too.  Why?  Because it’s too damn hard.  That’s why we pay doctors a lot of money.  It’s about the only way to encourage them to enter the profession.  To learn a very difficult field.  Put in more hours than most.  All while being blamed for all the woes in the NHS.

And they wonder why UK doctors want to leave the NHS?

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Japan’s Low Replacement Birthrate gives them an Aging Population and Soaring Debt

Posted by PITHOCRATES - July 7th, 2013

Week in Review

The United States debt as a percentage of GDP is approaching 100%.  Meaning that we owe as much as we produce in goods and services each year.  A frightening prospect.  For imagine if you earn $50,000 a year and were $50,000 in debt.  How easy do you think it would be to repay your debt?  Chances are that you will never be able to repay your debt.  But here we are.  Our government borrowing more than ever.  Without any concern of that rising debt.  They say it isn’t that bad.  Just look at Japan.  Their debt is about 200% of their GDP.  And they seem to be doing just fine (see Elderly shoplifters outstrip teenagers in Tokyo by AFP posted 7/8/2013 on France 24).

The number of elderly people caught shoplifting in Japan’s capital city has outstripped that of teenagers for the first time since records began, a report said.

A quarter of the people arrested on suspicion of the crime in Tokyo last year were at least 65 years old, figures showed, amid warnings of increasing isolation in the age group…

Around a quarter of Japan’s 128 million population is aged 65 or older, and the country has a far-below replacement birthrate of an average 1.39 children for every woman.

There are regular reports of bodies lying unfound for weeks or even months after a single, elderly person has died alone. Commentators say the phenomenon is a result of the fraying of familial ties as Japan has modernised.

When you have a replacement birth rate of 1.39 you have an aging population.  One that is growing so old that the rate of people leaving the workforce will soar while the rate of those entering the workforce will plummet.  So just as these elderly people start consuming their pensions and health care benefits the tax base that pays for them will be disappearing.  Perhaps explaining why these people are shoplifting.  As the burden to care for an aging population eventually becomes too great for a government to sustain.  So they cut back.  And leave the elderly to fend for themselves.

When people are having only 1.39 kids on average that means couples are not just having one child.  But a lot of them are having no children.  This is what birth control and abortion have given advanced nations.  The ability to wipe themselves off the map.  Either by a negative population growth rate.  Or by throwing open your borders to try and offset the population decline with new immigration.  Transforming the nation from the native population to the immigrant population.  Replacing the native culture and traditions with the immigrant culture and traditions.  Just like when the Americans moved west and replaced the culture and traditions of the Native Americans.

Two things that just don’t go together are an expanding welfare state and a declining replacement birthrate.  As you have a shrinking tax base paying for that expanding welfare state.  If you want an expansive welfare state you have to have more babies.  Plain and simple.  You have to stop using birth control.  And stop having abortions.  So you can grow the population.  To always have more people in the base of the pyramid than you do at the top.  Like any good Ponzi scheme should.  It’s either that or you have to reduce the size of the welfare state.  So you can live within your means.  That is, what your tax base can afford to pay.

Or you can keep borrowing and printing money like Japan.  And wonder when the deflation and recession of the Lost Decade of the Nineties will ever end.

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The Europeans are moving away from Green Energy as President Obama moves toward Green Energy

Posted by PITHOCRATES - June 30th, 2013

Week in Review

Europe had gone all in on the green energy bandwagon.  To save the world from catastrophic climate change brought about by manmade global warming.  But they paid a price.  They have increased the cost of electric power.  Which increased the cost of manufacturing.  Making them less competitive on the world markets.  Resulting in anemic economic growth.  And a sovereign debt crisis as tax revenues fell.

Their journey into green energy has been an unmitigated disaster.  They are now reversing course.  And climate change be damned.  If there ever was a problem to begin with.  For let’s face, what good did all of Europe’s green energy efforts do anyway?  The climate doomsayers are still warning us that we must act now before it’s too late.  So apparently whatever the Europeans did had no impact on the climate.  Only their economies (see Europe exits climate money pit as Obama jumps in by RON ARNOLD posted 6/27/2013 on the Washington Examiner).

Myron Ebell, director of the Center for Energy and Environment at the Competitive Enterprise Institute, told me, “The centerpiece of President Obama’s climate plan is a declaration of all-out war on coal. The only affordable way to reduce emissions from existing coal-fired power plants – which now provide 40 percent of the nation’s electricity – is to close them down…”

Ebell added that “Obama is pursuing his anti-energy agenda undemocratically through executive actions that bypass the people’s elected representatives in Congress.”

Autocrat Obama is also doing it without learning from the European Union’s green energy experience: skyrocketing energy prices, a ruinous slide into fuel poverty, solar panel financial meltdown, wind power bankruptcies and the specter of EU disintegration. As a result, the EU suffered an outbreak of realism.

In May, Europe’s heads of state and government at the EU Summit promoted shale gas and reduced energy prices. They would rather promote competition than stop global warming.

Obama just returned from Northern Ireland at the G8 meeting where he evidently didn’t ask why the United Kingdom removed climate change from the agenda.

European carbon markets had collapsed with the price of carbon hitting record lows, wrecking the European Union’s trading scheme for industrial CO2 emissions.

British Gas owner Centrica was buying up shale gas drilling rights in Lancashire for fracking operations. Green investors faced bankruptcy as Spain cut subsidies even further.

Large German companies such as Siemens and Bosch abandoned the solar industry, which had lost them billions, while investments in failed solar companies, including Q-Cells and SolarWorld, destroyed 21 billion euros of capital.

In response, German Chancellor Angela Merkel told a June energy conference in Berlin to expect reduced government spending on energy like wind and solar power to keep Germany economically competitive. Europe’s clean energy economy had become a black hole eating euros.

The United Kingdom is struggling to maintain their National Health Service (NHS) under the pressures of an aging population.  Fewer people are entering the workforce to pay taxes to fund the NHS.  While more people are leaving the workforce and consuming more and more NHS resources as they live longer into retirement than ever before.  A clarion call for anyone considering moving in the direction of a national health care system that also has an aging population.  Yet that is exactly what president Obama did during his first two years in office while the nation was suffering in the worst recession since the Great Depression.  Instead of cutting taxes to put people back to work he put into place massive tax hikes coming our way to fund Obamacare.  Learning nothing from the British.

Now he has an entire continent showing how wrong it is to pursue green energy.  And what does he do?  Ignores the Europeans completely and plunges headlong into the same foolish mistake they made.  Instead of cutting taxes to help put Americans back to work in the worst recovery since that following the Great Depression he plans on raising taxes on energy producers.  To fund green energy.  While increasing regulatory costs on good, dependable coal-fired power plants.  Which will increase the cost of electric power.  As well as the cost of doing business.  Not to mention the higher electric bills coming our way because of his desire to follow the Europeans down the dead-end road of Green Energy.

It’s as if the president is doing everything within his power to destroy the American economy.  Or he is completely clueless on how economies work.  He went to Occidental College, Columbia University and Harvard Law School.  So either these institutions are clueless on how economies work.  Or President Obama is purposely trying to destroy the American economy.  For someone or some institution is responsible for the president’s horrible economic policies.  They didn’t just happen.  There must be a method to this madness.  At least a reason for it.  Some reason for turning us into a failed European social democracy.

Of course, many believe that is the reason.  To turn us into a European social democracy.  To transform the country from the free market capitalism of the Founding Fathers into something closer to the state socialism favored by such anti-capitalists like Karl Marx.  Those on the left ridicule any such claims.  But Obamacare and this new Green Energy policy sure have more in common with socialism than capitalism.  As does the present anemic economy.

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Aging Populations and State-Provided Health Care will Stress State Systems to Collapse

Posted by PITHOCRATES - June 16th, 2013

Week in Review

When people provided their own health care and retirement nest eggs it didn’t matter if the population was aging or getting younger.  For each person planned to take care of him or herself.  But when the government took over health care and retirement nest eggs the age of the population began to matter.  For when the state provides these benefits they have to pay for them via taxes.  And if the population is aging that is a big problem.  Because more people are leaving the workforce and consuming health care and pension benefits than there are entering the workforce to pay for them.

Which means the government has to increase tax rates on those paying for these benefits.  And when people are living longer into retirement it really throws a wrench into the state’s plans.  For it is requiring a level of taxation that simply isn’t possible.  And this is exactly what the baby boom generation is doing to advanced welfare states throughout the world.  It’s causing greater governmental expenditures.  Resulting in larger budget deficits.  And financial crises (see Our aging population set to put a heavy toll on our systems, and we’re not ready by Simon Kent and Shawn Jeffords posted 6/14/2013 on the Toronto Sun).

The first baby boomers began turning 65 in 2012, and by 2036, one out of every four of our neighbours will be elderly…

“We don’t have a health care system in Canada, we have an acute care system,” [Sharon] Carstairs [former senator and was the first woman to lead an opposition party in Canada] after becoming Manitoba’s Liberal leader in the ’80stold QMI Agency.

The very sick are cared for well but we don’t do a good job of keeping others at home and out hospitals and high-cost facilities.

“We’re using acute care hospital beds to hold thousands of Canadians who should be in long-term care or home care,” she says…

Canada has a “little bit of breathing space” for preparations to cope with aging boomers, but not much, suggests University of Toronto professor emeritus David Foot, one of the country’s most respected demographers.

“We need to get this right to prepare for that boomer onslaught,” Foot says. “We can have an excellent system if we choose to.”

Zero hour is 2027.

“The first boomer born in 1947 reaches 80 in 2027,” Foot says.

That’s when the critical mass, the largest bulge of the baby boom, approaches 80 and will require the most care of their lives…

Canada needs to train gerontologists, therapists, psychiatrists, palliative care nurses and specialists, replace the workforce of aging nurses and the army of some 3 million volunteers who currently provide the bulk of in-home care to seniors, say experts…

“The sheer number of baby boomers that will be drawing on the system will magnify and put pressures on the systems that has not been felt before,” he says.

Both the United States and Canada have aging populations.  And a baby boomer bulge coming down the pike.  It will make it very difficult in Canada.  And far worse in the United States.  For they have about 9-times the population of Canada.  And will have 9-times the baby boomer bulge.  Making it a very poor time for the state to take over more pension and health care spending obligations.  Which is exactly what the Americans did by passing Obamacare into law.

The United States is already suffering record trillion dollar deficits.  By the time Obamacare pays to train gerontologists, therapists, psychiatrists, palliative care nurses, specialists, etc., and builds nursing homes to handle the baby boomer bulge the deficit will soar even higher.  Unless there really are death panels in Obamacare.  Which may be the only way not to break the fiscal back of the nation.  Well, there’s that.  Or they could let people provide their own health care and retirement nest eggs like they once did.  And then the age of the population would be irrelevant.  For it basically comes down to these two options.  Either we pay for our own health care and retirement.  Or the government will have to figure out how to cut costs.  And how do you do that when the largest cost is caring for the very old and the very sick?  In a word, death panels.  Well, two words, actually.

Welcome to the brave new world of Obamacare.

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Wait Times in NHS Emergency Rooms reach 9 Year High

Posted by PITHOCRATES - June 8th, 2013

Week in Review

National health care results in long wait times and rationing.  Especially when you have an aging population (see A&E waiting times at nine-year high by pa.press.net posted 6/3/2013 on MSN News UK).

Waiting times for accident and emergency patients have reached a nine-year high, according to figures…

John Appleby, chief economist at The King’s Fund, said: “Emergency care acts as a barometer for the NHS. The worryingly high number of patients waiting longer than four hours in the last quarter of 2012/13 is a clear warning sign that the health system is under severe strain…

“We’ve been absolutely clear that the NHS needs to transform the way health services are delivered to meet the needs of an ageing population focusing more on joined up services and prevention.

Under national health care if you go to an accident and emergency (A/E) and see a doctor in 4 hours you’re doing well.  Not all A/Es in Britain, though, can meet that 4 hour target.  Part of the problem is their aging population.  And the other is the long wait times elsewhere in the NHS.  For a 4-hour wait is like a walk in a park compared to the 18 weeks they have to treat you outside the A/E.  Where a general practitioner (GP) refers you to a specialist who refers you somewhere for treatment.  At which time the 18-week clock starts running.  So is it any wonder that people are flooding these A/Es?

Obamacare will greatly bureaucratize our health care.  Increasing our wait times, too.  Just like in the NHS.  Where they’ve been doing health care since 1948.  And they still don’t have it right.  Unless an 18-week wait time for treatment is your idea of right.  It isn’t their idea of right, though.  If it were people wouldn’t be overflowing their A/Es.  And causing the longest wait times in 9 years.  Just something to look forward too under Obamacare.  The new kid on the block when it comes to national health care.  Who won’t do it anywhere near as good as Britain.  Who has been trying to do it right since 1948.  And struggles to see people in the emergency room in under 4 hours.

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An Aging Population is pushing the NHS to the Breaking Point as it will push Obamacare to the Breaking Point

Posted by PITHOCRATES - May 25th, 2013

Week in Review

Britain’s Health Secretary said the problem with overworked accident and emergency rooms (A/Es) is that general practitioners (GPs) are not taking care of their patients.  Because a patient can’t make an appointment with their GP, or when they do it is 2-3 weeks later, they just go to the A/E instead.  Because they don’t want to wait.  Or can’t wait because of the pain.  Or because they have a sick child.  This is why accident and emergency rooms are overflowing.  Because the GPs aren’t doing their job.  Or so says the Health Secretary.  Something the GPs take issue with (see NHS A&E departments ‘left unsafe by political meddling’ by Nick Triggle posted 5/23/2013 on BBC News Health).

British Medical Association GP chairman Dr Laurence Buckman has given a speech pointing out the problems that lead to overstretched hospital A&E departments…

He said: “We’ve turned GP practices into places where it’s a daily challenge for receptionists to cope with huge call volumes and GPs to get through to all the people they need to see…”

Dr Buckman added: “He [Mr Hunt] does not want to bother with the facts when he can have a bash at those of us who on his own admission are overworked and strained beyond endurance.

The problem is not with the GPs.  Or with the National Health Service (NHS).  The problem is national health care.  Which may have worked well when people were having a lot of babies.  Making the population grow younger.  With more people entering the workforce than leaving it.  And those who left it had the decency to die soon.  But that was before the Sixties.  When they set up the NHS.  In the Sixties people stopped having so many babies.  Instead of the population growing younger it began to grow older.  And new advances in medical care have allowed retirees to live a long life in retirement.  So the rate of people consuming health care services is growing greater than the rate of those paying for it.  Which has overflowed A/Es.  And is straining GPs beyond endurance.

And so it will be under Obamacare.

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The NHS rations Emergency Services in Wales because of a Doctor Shortage

Posted by PITHOCRATES - May 25th, 2013

Week in Review

The opponents of national health care say it will lead to doctor shortages.  And the rationing of services.  Because the costs of health care will continue to rise as the population ages.  Which will require stretching limited resources to cover a growing number of seniors entering the health care system.  Just as fewer young people are entering the workforce to pay for them.

Fewer people working means less tax revenue.  While health expenditures rise due to that aging population.  The health authority will have no choice but to cut costs.  And that means paying doctors less.  Which will, of course, discourage people from becoming doctors.  Leading to a doctor shortage.  Is this just conjecture?  Not quite.  It’s an observation of what’s happening in the United Kingdom as the NHS struggles with a doctor shortage (see South Wales specialist hospital care plans to be revealed by Owain Clarke posted 5/22/2013 on BBC News Wales).

Health officials believe some services are spread too thinly and should be centralised in four or five hospitals instead.

They include accident and emergency and care for premature babies and children…

They argue that the changes are essential to ensure hospital care meets UK-wide professional standards and to deal with issues such as a shortage of doctors, an ageing population and financial pressures.

This is what we can expect under Obamacare.  And whatever Obamacare evolves into.  For the U.S. already has an aging population.  And financial pressures.  All they need is for the government to start cutting costs and they’ll have a doctor shortage, too.  And then the U.S. will begin to centralize emergency services into fewer hospitals.  Just as the British are doing.  As their doctor shortage causes them to ration their emergency services.  Just as the opponents of Obamacare say will happen in the United States.  Just as it is happening in the United Kingdom.  Because this is the inevitable destination of national health care.  Doctor shortages.  And rationing.

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The NHS is Rationing Health Care to give Everyone the Same Quality of Health Care

Posted by PITHOCRATES - May 18th, 2013

Week in Review

We have Obamacare because there was a crisis in American health care.  Or so said the proponents of national health care.  Not everyone had equal access to the same high-quality care some people had.  The opponents of Obamacare said a quasi-national health care system wouldn’t change that.  All it would do is stretch limited resources over more people.  Ultimately reducing the quality of care for everyone.  Like in the NHS.  Where they are closing emergency departments in south Wales because they don’t have the resources to staff them all at the same level (see Wales NHS: Abandon south Wales A&E shake-up, say Conservatives posted 5/14/2013 on BBC News Wales).

The NHS is due to announce a cut in number of specialist A&E departments in south Wales from seven to four or five.

Officials say the current range of services can no longer be provided safely at all hospitals.

They say the planned changes, due to be unveiled this month, will result in the most seriously ill patients seeing consultants more quickly, although they may have to travel further.

Hospitals across Wales have said they have faced “unprecedented” levels of admissions this spring, with A&E consultants warning their departments are at “meltdown” due to overcrowding and a bed shortage…

Speaking on behalf of the health boards involved in the South Wales Programme, Dr Grant Robinson, medical director of Aneurin Bevan Health Board, said: “We cannot continue to provide all these services in every location across south Wales.

“We need to concentrate these services to ensure all patients receive safe and sustainable care.

The NHS is national health care.  Where they provide free health care to all of their people.  But to do that some people will have to travel farther than others.  Because they just don’t have the resources to have the same specialties at all hospitals.  Not when their aging population is consuming so much of the NHS budget.  Just as an aging population will consume the majority of the Obamacare budget.

National health care works better when you have a population growing younger.  When there are more people entering the workforce than leaving it.  So there are always more people to pay the high costs of retiree benefits.  But thanks to birth control and abortion populations are aging everywhere.  Making the national health care model simply unsustainable.

These nations set up their entitlement states before birth control and abortion shrank future generations.  Not really a problem in a nation with a limited government.  But a big one in a social democracy.  For that falling birthrate not only undermines the sustainability of national health care.  It also undermines state pensions.  And public sector union benefits.  Which include generous health care and pension benefits.  None of this will survive as the consumers of these benefits grow at a greater rate than those paying for these benefits.  Which will lead to higher tax rates on a shrinking workforce.  Or anarchy.  As people take to the streets as the government simply can no longer give them their benefits.

This was really not a good time to nationalize health care.  A blind person could have seen this.  But the proponents of national health care pushed for it anyway.  Even while the NHS is struggling under the weight of an aging population.  Proving that Obamacare is more about power politics than health care.  Or that those who gave it to us are just not that bright.  Whichever it is there is one thing for certain.  We would want neither to be in charge of our health care.

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