NHS closes Emergency Departments to Save Costs while Angering Britons

Posted by PITHOCRATES - October 14th, 2012

Week in Review

Some of the most expensive services in health care are emergency departments.  Or A/E departments in Britain.  For accident and emergency departments.  Because you need a lot of staffing to handle everything from a heart attack to severe trauma from an accident to a difficult pregnancy.  Doctors, nurses, technicians, orderlies, pharmacists, administrative, cleaning, security, etc.  Not to mention the diagnostic equipment.  Medical devices.  Medicine.  Oxygen.  It adds up.  So it’s no surprise that the NHS is looking at A/E closures to cut costs (see 28,619 Mail on Sunday readers write to Government to stop A&E closures… and Ministers still do nothing by Nick Craven and David Rose posted 10/13/2012 on the Daily Mail).

Thousands of you sent in your protests against A&E closures – and this week we delivered two bulging mailbags full of your demands to David Cameron’s doorstep.

Nearly 30,000 Mail on Sunday readers have called for the Government to reverse the policy of downgrading and axeing local casualty departments across England and Wales.

A total of 28,619 protests were lodged – 17,170 coupons, 7,377 emails and 4,072 text messages – all prompted by fears that the policy for big, centralised A&E departments could risk lives as it leads to longer journey times to hospital…

Changes in London could result in a massive 47 per increase in the number of people served by each A&E department.

You ever waited for a long time to see a doctor in a crowded emergency waiting room?  Before Obamacare in America?  It was not uncommon on a busy night to wait for up to 3 hours if you had a non-life-threatening condition.  Now imagine being in that waiting room with 47% more people waiting with you.  Which could easily extend that wait time to 4-5 hours.  Or more.  Which is what will happen as Obamacare mutates into a national health service like they have in Britain.  Which is what the proponents of Obamacare want.  National health care.

At that time even the proponents of Obamacare won’t like Obamacare.  And they, too, will mail in enough complaints to fill two bulging mailbags.  (Based on the US having five times the population of the UK, that would probably be 10 bulging mail bags.)  Because these people will want everything for nothing.  But they won’t understand the cost of everything.  Or why the health service will have to cut costs, increase wait times and ration health care treatment.  And they will.  Because the NHS is.  And they can probably do national health care better than Obamacare ever will.

As as well as travelling longer distances after answering 999 calls, it will have to pick up seriously ill patients who turn up at the so-called ‘urgent  care centres’ which are set to replace A&Es but in reality cannot treat any life-threatening conditions.

At just one of the hospitals where A&E is due to close, Ealing, there is already an urgent care centre which transfers up to 50 patients a day to casualty.

Currently, this is a short journey down a corridor, but if casualty closes, as planned, all the patients will have to be transferred by blue-light ambulance to an A&E somewhere else, probably West Middlesex 20 minutes away, or Northwick Park, 45 minutes away.

To cut costs national health care services have really only one option.  As they cannot tell people to have 10% fewer accidents and health care emergencies.  Which leaves health care overhead.  If you close an emergency department (A/E department) you can save some money.  Close a few and you can save a lot of money.  So they do.  And make people travel further for their health care.  Up to 45 minutes by ambulance.  Perhaps an hour or more by car.  Even longer by train for those non-life-threatening emergencies.

This is the future of health care in America.  Under Obamacare.  And whatever that evolves into.  The NHS had some good years.  Before the British population began aging.  Now the British population is older.  More people are leaving the workforce while fewer are entering to replace them.  And as they leave the workforce they’re consuming more and more health care services.  Causing the cost strains in the NHS.  And the need for those cost savings.

This would be the starting point for the Americans.  They would not have the good years the NHS had.  Because right from the get-go they will be struggling with the costs of an aging population.  Which they will have to tackle right away by cutting costs, increasing wait times and the rationing of health care treatment.  Meaning that when trying to provide everything for everyone they will end up providing only for those some bureaucrat deems worthy of those limited health care resources.  They won’t be called death panels in the new health care law.  But they will be death panels.  Because someone will have to decide who gets those limited health care resources.  And who doesn’t.  Because they just won’t be able to give everything to everyone.  As the proponents of Obamacare think they will be able to.  And they will be none too happy when they learn this unpleasant little fact.

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The High Cost of National Health Care is causing the NHS to Close Hospitals in Wales

Posted by PITHOCRATES - September 29th, 2012

Week in Review

Proponents of Obamacare want a full-blown national health care system like the British NHS.  Because that’s the only way to guarantee quality health care for all Americans.  And not just those who can afford it.  The problem with the American system, they say, is the pursuit of profits.  Making money on people’s ill health.  Which is just wrong.  And immoral.  Only when they remove the profit incentive can the American health care system approach the British model.  And become a health care utopia.  Where they provide everything for everyone.  And no one ever has to worry about their health care needs (see South Wales hospital shake-up plans defended posted 9/27/2012 on BBC News Wales).

Health bosses have defended proposals to concentrate some specialist hospital services in south Wales in four or five locations.

The Conservatives and Plaid Cymru have expressed concerns that the plans could see key local health services downgraded or closed…

The current shape of NHS in south Wales is based on a model of district general hospitals developed in the 1960s.

But the health boards say that is unsuited to deal with modern pressures on the health service.

Centralising some services, such as high-level care for children and newborn babies, in fewer large hospitals would allow patients to get access to the best care around the clock, they said.

Unless, apparently, you live in south Wales.  Where that ‘everything for everyone’ turns out to be really, really expensive.  And the only way they can afford to pay for that is by making people travel further for their health care needs.  As they ration services to fewer larger hospitals.  That turns health care into an economies of scale, assembly line-like production model.  To maximize the health care services a shrinking number of doctors can provide.

Health Minister Lesley Griffiths said it was essential patients had safe, sustainable services as close to home as possible – and the status quo was not an option.

But the Conservatives said the plans would lead to the downgrading of hospitals, and blamed the Welsh government for failing to recruit enough doctors.

Andrew RT Davies, Tory leader in the assembly, told BBC Wales: “[The current system] is unsustainable because they are unable to find the clinicians to fill the rotas.

“It is my contention this is happening because the health service in Wales has been starved of cash, and the Welsh government, and Carwyn Jones as particular as first minister, has failed to fill the medical rosters by supporting the health boards in recruiting doctors into Wales.”

Starved for cash?  Has failed to fill the medical rosters?  Failed to recruit doctors to Wales?  Doesn’t sound much like a health care utopia to me.   Apparently that national health care system simply can’t afford to provide everything for everyone.  At least without making them travel awhile for their health care needs.

This is the future of Obamacare.  When you start providing everything for everyone costs rise.  And when costs rise you don’t have many options.  You can cut pay and benefits of your health care providers.  A major cost of any health care system.  But if you don’t pay doctors well it won’t encourage people to become doctors.  And let’s face it, it isn’t easy to be a doctor.  That’s why we pay doctors a lot.  To encourage them to do these hard jobs that so few of us are willing to do.

So you can only cut pay and benefits so far.  In fact the best you’ll probably be able to do is to decrease further pay increases.  So that leaves the only other alternative.  Rationing.  Closing hospitals and making people travel further for their health care needs.  Which the NHS is doing in Wales.  And Obamacare will be doing everywhere in the U.S.  Because costs are costs. Whatever the NHS goes through any other national health care system will go through.  So if they ration services Obamacare will ration services.

And, of course, Obamacare will raise taxes.  For awhile.  Until they can raise taxes no more.  Like the British can no longer do.  So the NHS is closing hospitals.  Like Obamacare will eventually do in the United States.  As Obamacare turns to the last cost saving measure.  Rationing.  Which will include those death panels.

Some health care utopia, huh?

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Obese Girls in the UK add to the Budget Problems of the already Cash-Strapped NHS

Posted by PITHOCRATES - September 2nd, 2012

Week in Review

I’m sure they hear the same arguments in the UK as they hear in the US.  That we have to increase government spending on nutritional programs for the poor.  Especially poor children.  Because no child should go to bed hungry.  Yet at the same time the Mayor of New York City wants to limit the size of pop you can buy in a theater or from a street vendor because our kids are too fat.  And the First Lady of the United States wants kids to eat vegetables instead of food that tastes good because our kids are too fat.  So some in government are arguing both sides of the same issue to generate more government control and more government revenue.

In the UK they have even another metric to measure childhood obesity by.  And it’s a really sad one (see As obesity soars, girls of 11 are being given breast reduction surgery on NHS by Daniel Martin posted 8/27/2012 on the Daily Mail).

Girls as young as 11 are having breast reduction operations on the Health Service, figures show.

More than 100 girls aged 16 and under have had the surgery in the past five years after suffering severe back pain.

Health experts say some cases could be because children now tend to be significantly heavier than a few years ago, putting more pressure on their backs…

The surgery will cost the taxpayer some £5,000 a time, and critics will argue that the cash-strapped NHS should not be paying for such procedures when those with cancer and other serious conditions are not getting the drugs they need…

Over the past five years, 21,328 women of all ages have had breast reduction operations on the NHS. In the latest year for which figures are available, 2010/11, the total was 4,212 – almost 12 every day.

Clearly in advanced countries many of our kids are not going to bed hungry.  It is a sad benefit of an advanced country.  We can make food so plentiful, inexpensive and tasty that our poor have obesity problems.  I’m not sure what the economic circumstances are with the girls in the linked article but if they live in the UK chances are their families are paying a lot of taxes to support their welfare state so the odds are good they are not from a rich family.  Besides, if they were rich they’d probably pay top-dollar to treat their daughters in a private facility.  But that’s neither here nor there.  What’s particularly interesting in this story is the economics of it.

At current exchange rates £5,000 is about $7,935 US.  So those 4,212 surgeries in 2011 cost the taxpayers $33.4 million dollars.  Sounds like a lot until you realize the NHS annual budget is approximately $166.6 billion (see Figure A.1: Department of Health CSR settlement 2007 – announced opening position).  So these surgeries are only 0.02% of the NHS budget.  Which just staggers the mind.  But this to be expected when a national health care service pays for everything for everyone.  It’s incredibly expensive.

When the US passed their own version of national health care, Obamacare, the Democrats sent misleading budgetary information to the Congressional Budget Office.  Such as including tax revenue for ten years while including benefits for only six years.  Transferred some $716 billion out of Medicare.  And other accounting shenanigans.  So when the CBO scored Obamacare it came in at $940 billion over ten years.  Which was less than $1 trillion.  The magic number.  Because it would make Obamacare less costly than the wars in Iraq and Afghanistan.  But when you look at the budget of the NHS you just know they’re playing fast and loose with their numbers.

The US has approximately 5 times the population of the UK.  So they would have approximately 5 times the patients in Obamacare than they have in the NHS.  And approximately five times the cost of the NHS.  So if you multiply the NHS annual budget by five you get a likely cost of Obamacare for one year.  $833.1 billion.  Only slightly less than the original CBO scoring of Obamacare for a ten year period.  Multiplying this out over ten years brings it up to $8.3 trillion.  Making the original CBO score light by 886,256%.  An enormous mistake.  Or misrepresentation.  Of what it will cost to give everything to everyone.

If they don’t repeal Obamacare there won’t be any money left to prevent children from going to bed hungry.  But there should be a corresponding reduction in other health care expenses.  As hungry children won’t have an obesity problem.

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