The NHS is gearing up to make the NHS more like the American Health Care System prior to Obamacare

Posted by PITHOCRATES - September 30th, 2012

Week in Review

Big change is coming to the NHS.  Their great centralized National Health Service is about to become decentralized.  In an effort to cut out of control costs.  And improve the quality of care (see NHS ‘could get worse from 2013’ by Branwen Jeffreys and Nick Triggle posted 9/27/2012 on BBC News Health).

The health service is currently busy getting ready for the government’s reforms to go live in April…

Under the reforms, GP-led bodies, called clinical commissioning groups (CCGs), will take charge of much of the NHS budget, replacing primary care trusts (PCTs) which will be scrapped…

The NHS is at the start of a savings drive – it has been told to save £20bn by 2015 through becoming more productive.

Britain’s aging population has increased the demands on the NHS.  The number of patients are rising as retirees leave the workforce and suffer the ailments of age.  While the number of new workers entering the workforce to replace them is falling.  As is the tax revenue from those working.  Hence the savings drive.  Because of that aging population.  And the reforms are a decentralization of the NHS.  Putting local doctors in charge of treatment decisions for their patients.  And in charge of the money.  Taking health care back a little to how it used to be.  When a person’s family doctor was in charge of their treatment.  Not a distant bureaucrat.  Like it currently is in the U.S. prior to the full implementation of Obamacare.  But soon will be no more.  Something for the Americans to look forward to once they fully implement Obamacare.  Perhaps sooner than the British.  As the Americans are jumping into a national health care system with all the problems the British now have.

Meanwhile, a BBC survey of 1,005 people suggested 60% believed services would have to be cut…

Some 61% agreed that they expected the NHS would have to stop providing some treatments and services in the future due to rising costs and increasing demands.

Nearly three-quarters also said they did not trust the government with the health service…

“The end of the public sector pay freeze next April may add to financial pressure and increase the strain on services.

“The difficulty will be finding ways to absorb these costs without compromising the quality of care for patients.”

But health minister Lord Howe maintained the NHS was “on track” to achieve its savings target…

Waiting times have been kept low, infections have been reduced, there are more doctors, more diagnostic tests and more planned operations,” he added.

This is, of course, what that aging population will do to a national health care system.  As more patients enter the health service than the population grows to pay for it (with an expanding tax base) you get longer wait times, more infections, fewer doctors relative to patients, fewer diagnostic tests and fewer planned operations.  Which forces the health service to find ways to make their limited resources cover more of that expanding patient base.  And key to their reforms is making health care more efficient.  By putting the people closest to their patients in charge of their patients’ treatments.  So they can get more from their NHS funds.

The U.S. has the same problem Britain has.  An aging population.  And yet the U.S. and Britain are moving in two different directions with their health care systems.  Who is right?  The one making changes based on the accepted reality of the impact of an aging population?  Britain.  Or the one making changes based on their confidence that they can do national health care better than everyone who has ever tried?  The U.S.  Despite that aging population.

Britain is moving in the right direction.  Because they have no choice but to move in that direction.  Whereas the U.S. has a choice.  Because their health care has been in the private sector up until Obamacare.  In fact that has worked so well that the British are moving in that direction.  Which makes us scratch our heads at those moving away from it.  Are they so full of themselves, are they suffering from such delusions of grandeur, that they think they can do the same thing (national health care) and expect to get different results?  Albert Einstein had a word for thinking like that.  Insanity.


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The Form-Based Efficiency of the NHS fails to Save a Baby from Chicken Pox

Posted by PITHOCRATES - May 5th, 2012

Week in Review

A baby dies despite the efficient use of forms in national health care (see Baby boy died from chicken pox after doctors sent him home THREE times – and all he needed was simple antibiotics by Paul Sims posted 5/3/2012 on the Daily Mail).

Hospital staff missed three vital opportunities to save a toddler with chicken pox and he would be alive today if they had acted, a coroner said yesterday.

Lewis Mullins was seen by doctors three times in three days after his mother became convinced his condition was deteriorating rapidly.

But on each occasion she was given painkillers to make her son more comfortable and sent home…

Rotherham coroner Nicola Munday said Lewis would have almost certainly have survived the infection had staff ‘heeded’ the warning signs, carried out routine tests and treated him…

She rushed her son to Rotherham’s NHS walk-in centre on Wednesday, March 30 last year and was told he had infected chickenpox.

But a questionnaire filled in by a nurse, which detailed Lewis’s pain, rash, high temperature, shaking episodes and breathing problems, was not passed to the GP who later saw him.

As a result the GP thought he was treating him for chickenpox and nothing more…

This is medicine on a grand scale.  National health care.  And what Obamacare will be like.  Where the focus will be on cost cutting and greater efficiencies.  Digitizing medical records.  Using forms and checklist discipline to process as many human inputs into the system as possible.  To make those limited health care resources stretch as far as possible.  Instead of old time medicine.  Where you have a family doctor.  And your family doctor knows you and your family.  Your family history.  A doctor that sees your children growing up.  A doctor that knows your child.  And his or her brothers and sisters.  Knowing them as children.  And not as checklists.  But we can’t have that with national health care.  And we won’t have that with Obamacare.  Because that will take too many doctors.  And too much time.  So our doctors will become strangers.  Strangers who peruse a checklist.  Then goes on and processes the next human input into the health care machine.

This would probably not have happened in the United States.  For even though health care there is still not nationalized most children receive a chicken pox immunization.

Miss Conlay is now calling for a national immunisation programme for chicken pox. Vaccination is routinely available in the United States and Canada, but it is not offered to children in the UK…

Of course one can only assume the reason why the UK doesn’t is for the same reason that directs every decision in the NHS.  Cost.  Currently immunization clearly isn’t cost-effective.

It’s not the people in the NHS.  It’s the NHS.  The system.  Which is asking them to do the impossible.  For with their aging population and rising budget deficits they have little choice but to cut costs and pursue greater efficiencies.  And even though there is this great example of a large national health care system struggling to deal with an aging population and rising deficits the United States is heading down this same road.  Only with more human inputs to the health care machine.  That is struggling to deal with an aging population and rising deficits as well.  Who likes to hold up the model of Medicare as a success story.  Even though they project Medicare to go bankrupt in a decade or two.  So enjoy your health care in America while you can.  For if Obamacare isn’t repealed these are the kind of stories we’ll be reading about.  Only on a grander scale.


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