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.


Tags: , , , , , , , , , , , , , , , ,

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.


Tags: , , , , , , , , , , , ,

As NHS Budget Deficits balloon Britain tries to Privatize Parts of the NHS to rein in Costs and improve Quality

Posted by PITHOCRATES - March 4th, 2012

Week in Review

The proponents of Obamacare admire Britain’s National Health Service (NHS).  But they settled for Obamacare.  Which stopped short of providing national health care (though it put them on the path towards a national health care by making private health insurance either unaffordable or unavailable).  Because the nation wasn’t ready yet.  Not to mention the fact that most Americans want to repeal Obamacare. 

But they still look to the far side of the Atlantic and dream of having what they have.  Paradise.  At least, what they define as paradise.  Government control of 17.6% of the US economy (based on 2009 numbers) in addition to non-health care spending they already control.  Yeah, to them, this is what paradise is.  But, surprisingly, Britain has this now.  And is trying to move away from it (see NHS changes unavoidable and urgent, says David Cameron posted 3/3/2012 on BBC News UK Politics).

Under the NHS plans, GPs and other clinicians will be given much more responsibility for spending the health service budget in England, while greater competition with the private sector will be encouraged.

Mr Cameron said it would have been easier not to address an “invisible crisis” in the National Health Service in England.

“We could have just protected the NHS from the cuts, as we have, we could have just put in the extra £12.5bn, as we have, and we could have just left it there.

Did you catch that obscene amount of additional money the NHS needs?  £12.5 billion?  Based on the current exchange rate that’s $19.8 billion!  That’s not the budget.  That’s just the budget shortfall.  And if my math is correct that’s about a 12% budget deficit on a $167.8 billion dollar budget.  Worse, the total NHS annual budget is about 3/4 of Britain’s total annual budget deficit.  Meaning the NHS consumes approximately 75% all UK borrowings.

The NHS is bleeding.  And drowning the UK in debt.  No wonder they’re trying to privatize parts of it.  This is an economic model that cannot survive.  Especially with an aging population.  Which will only consume more health services in the future.  And make these deficit numbers grow worse. 

Here’s a lesson the US would do well in learning.  Lest they condemn themselves to making the same mistake.  Oh, wait a minute, that’s exactly what Obamacare is doing.  Repeating this same, horrible mistake.  Even though it is clear that this road they’re on will lead to disaster.  But that’s fine for the Obama administration.  Because at least they will have achieved paradise.  Control of over 17.6% of the US economy.


Tags: , , , , , , , ,