More Budget Cuts increase Wait Times to see Doctor in the National Health Service

Posted by PITHOCRATES - February 23rd, 2014

Week in Review

The problem with national health care is that it is zero-sum when it comes to budgeting.  There is one big pie of funding that they divide throughout the system to pay for all of its parts.  But anyone who has ever paid attention to a budget debate in Washington has seen that there is never enough in the pie.  And no one is ever satisfied with their slice of the pie.  Worse, every department will spend every last cent in their appropriation lest they reduce next year’s appropriation by the amount of any unspent funds in this year’s appropriation.  No matter how wasteful that spending is.  Such as for conferences in Las Vegas.  Or extravagant office parties at home.

Britain’s National Health Service (NHS) is straining under the cost of an aging population.  More people are leaving the workforce than are entering it.  Which means fewer people are paying taxes.  Just as the number of people using the resources of the NHS is growing.  Forcing the NHS to do more with less.  Which has everyone complaining about their chunk of the NHS budget (see ‘Unprecedented’ cuts see GPs warn half of Britain will be unable to get appointments by Charlie Cooper posted 2/23/2014 on The Independent).

More than 34 million people will fail to secure an appointment with their doctor at some point this year, the GP’s professional body has claimed, blaming “unprecedented” cuts to funding for family practices.

The Royal College of General Practitioners said that the profession was “on its knees” and called for GPs to get a larger share of the NHS budget.

However, the Department of Health dismissed their findings – which would imply that more than half the UK population will miss out an appointment this year – as “complete nonsense” and accused the college of “sensationalising” the issue.

General practice has seen its share of the NHS budget – which totalled more than £109bn in England last year – significantly eroded in recent years, from 11 per cent in 2005/06 to 8.5 per cent in 2011/12…

“GPs and practice nurses want to provide high quality care for every single patient who seeks a consultation, and over the last decade we have increased the number of patients we see each year in England by 40m,” she said. “However [we] can’t keep doing more for less…”

“The GP survey showed the vast majority of patients are satisfied with their GP and rated their experience of making an appointment as good,” the spokesperson said, adding that GPs had been given an extra £50m to modernise services and stay open longer.

Whenever you want to see your doctor you need to make an appointment.  In the NHS that could take a few weeks.  Which is driving a lot of people to the A/E (accident and emergency departments).  Because they are sick now.  And don’t want to wait 2 weeks to see a doctor to get an antibiotic for their strep throat.

If you read the comments following the linked article you can get a feeling of what the British people think about the NHS.  And an idea of what Obamacare may lead to.  They love their NHS.  But are exasperated by it.  Some think the doctors are too greedy.  But there isn’t a mad rush to become a doctor to relieve the doctor shortage.  So whatever the pay is it isn’t enough to get people to join the profession.  Which ultimately increases the wait times to see a doctor.

The problem is that aging population.  People who remember a kinder and gentler NHS remember one before the baby boomers retired and overloaded the system.  Who are living longer into retirement.  Consuming more of the NHS’ limited resources than people did before the baby boomers retired.  Had Britain (and every other advanced economy) not reduced its birthrate around the Sixties they would not have this problem now.  But they did.  So they are.  As we will, too.  And every other advanced economy with an aging population will.  Making it a very bad time for national health care.  Yet President Obama and the Democrats have given us Obamacare at precisely this time.  Which is guaranteed to make health care in the United States worse.  If you don’t believe that just read the comments following the linked article.


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Obamacare may cause up to 65,000 Needless Deaths based on what’s happening in the NHS

Posted by PITHOCRATES - July 14th, 2013

Week in Review

The problem with national health care is simple economics.  Supply and demand.  Things that cost more are in lower demand.  Things that cost less are in higher demand.  And free things are over consumed.

In Britain they have the NHS.  The National Health Service.  It’s not health insurance.  Like Obamacare is.  It is health care funded by the taxpayers.  What they designed Obamacare to become.  After causing businesses to drop costly mandated health insurance for their employers.  And making it near impossible for private health insurers to remain in the insurance business.  Once they meet these objectives then the government can transform Obamacare more into something like the NHS.  Where people get ‘free’ health care.  Paid for not by private insurance policies.  But from the tax revenue of the federal government.  Where they can over consume all the free health care they can get their hands on.  Such as demanding antibiotics every time they get the sniffles.

Sounds good to some.  Primarily to those who don’t have health insurance.  Because they choose not to pay for it.  Why?  Because it is so expensive.  And it’s so expensive because health insurance is no longer insurance.  Because it covers almost everything.  Instead of just the large, unexpected, catastrophic expenses.  The things insurance used to pay for.  While we paid for checkups and routine doctor visits out of pocket.  So we paid for the little things that we could expect and budget for.  While buying insurance for the things we could not expect or budget for.  And the system worked.  It kept costs under control because we were paying for most of what we were receiving.  Creating a direct relationship between the services we received and the money we spent.  Which introduced market forces into the equation.  But ever since health insurance became an employee benefit there have been fewer and fewer market forces in the equation.  Which has lead to the explosion in health care costs.

Nationalizing health care only removes market force from the equation further.  Which will, of course, raise costs.  As there will be nothing to keep health providers efficient while maintaining high standards of quality.  For if their customers aren’t paying them they don’t have to please their customers with efficiency or high quality care.  They just have to meet the minimum state requirements.  And keep asking the government for more money.  Until the government has no money to give.

And as a large health bureaucracy develops things become more impersonal.  More machine like.  Where patients are units of input.  That have to be processed according to strict bureaucratic guidelines.  Not necessarily what’s best for the patient.  The amount of paperwork rises.  And health care providers spend more time pushing paper than interacting with units of input.  Patients.  People at the hospital must bow to the distant health care authority.  Often following rules and regulations that don’t make sense all of the time.  Frustrating them.  And making them apathetic in their jobs.

Then efficiencies fall.  And costs rise.  Health care providers are forced to do more with less.  Spreading their limited resources over more and more patients.  Unable to provide high quality to everyone they do just the minimum for everyone.  While their apathy turns to indifference to their patients’ wellbeing.  You create an environment like this eventually over time you get this (see ‘Up To 13,000 Needless Deaths’ In NHS Hospitals posted 7/14/2013 on Sky News).

Up to 13,000 people may have died needlessly in NHS hospitals since 2005, according to a report to be published in the coming days…

The report, to be released on Tuesday, will criticise care standards and management failures, fuelling concerns about a problem with the NHS’s culture where whistleblowers are afraid to speak out and regulators often fail to do their job…

Sir Bruce examined not just mortality rates, but measurements including infection levels, the number of patients suffering from preventable and potentially fatal signs of neglect, and the numbers harmed by so-called “never events” such as operations on the wrong part of the body, or surgical instruments left inside a patient.

National health care will eventually poison the greatest assets of the health care system.  Its people.  Taking a good system and making it bad over time.  And you know it’s bad when ‘surgical instruments left inside a patient’ is a metric they track.  Apparently because it happens so often that it is something that they can count.

So take a good look.  This is national health care.  The ultimate destination of Obamacare.  Which will kill some 65,000 people over 8 years (the U.S. has about five times the population of Britain so they will have five times the number of needless deaths).  That comes to about 8,125 a year.  Which isn’t that far below the national homicide rate.  Imagine that.  Raising deaths in our health care system to near the national homicide rate.  That’s what we can expect with Obamacare.  As our health care system struggles to do more with less.  Overwhelming our heath care providers.  And making them grow ever more apathetic.  Just like they have in Britain.


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