Despite Addendums the NHS Reform Bill still faces Opposition from Health Unions and GPs

Posted by PITHOCRATES - March 18th, 2012

Week in Review

The Royal College of GPs oppose the National Health Service (NHS) reform bill.  The bill that is trying to improve the quality of health care while reducing costs.  By introducing market forces.  And reducing the bureaucratic weight of the NHS.  Which these doctors are opposed to (see BBC News: GPs offer to help with NHS change posted 3/13/2012 on BBC News Health).

The Royal College of GPs has indicated it is willing to work again with the government on implementing changes to the NHS in England, it has emerged.

The body had been omitted from talks since declaring its opposition to the Health and Social Care Bill last month.

Chief among their concerns is the government’s determination to introduce greater competition into NHS provision.

The bill aims to allow more private companies and voluntary organisations to compete with NHS providers, something critics fear could damage the health service and undermine the drive towards integration of care.

Under the plans, family doctors are expected to play a key role in managing the NHS budget…

Dr Gerada told the BBC on Tuesday: “We still want this flawed bill, this complicated, complex bill to be withdrawn.

“But we’re not politicians, we’re doctors, and it’s the 33,000 family doctors across England that are going to have to make the health service work for their patients.

“The letter to the prime minister was one of many that we’ve written to him over the last 18 months saying ‘let’s stop polarising this debate, lets see if there’s some common ground for the sake of our patients, for the sake of the NHS’…”

Other bodies opposed to the bill include the three major health unions, the British Medical Association and the Royal Colleges of Nurses and Midwives…

But Health Minister Simon Burns said: “Patients want doctors to make decisions about their care, not managers, and that is what our reforms will deliver.”

The changes would improve services for patients while saving billions in administrative costs, to be reinvested in healthcare, he said.

Yeah, right.  They’re not politicians.  It’s just coincidental that these doctors align themselves with the three major health unions.  And the union position is nothing but politics.  Because unions protect their dues-paying members.  Patients don’t pay union dues.  So the unions don’t represent their interests.  No, they represent the interests of those treating the patients.  And chief among their concerns is how is this competition that will lower costs affect the pay, benefits and pensions of their members?  Could this be what these doctors are worried about?  Their pay, benefits and pensions?  Or is that just another coincidence?

The NHS is a bureaucratic behemoth.  Where bureaucrats make health care decisions for patients hundreds of miles away.  The NHS reform is trying to put that decision-making into the hands of the doctors who actually treat their patients.  To improve the quality of care.  And lower the cost.  By making health care more about doctors treating patients.  Than maintaining a bureaucratic behemoth that provides a comfortable life for the bureaucrats running it.  While chalking up massive annual deficits.  And creating the bulk of Britain’s national deficit.  Which can’t continue.  They have to reform the NHS.  Before it drowns under its massive costs.  And takes the country with it.

We should follow what’s happening in the NHS closely.  For it’s coming our way.  Unless they repeal Obamacare.  And if they don’t things will be worse in America.  Because America is bigger than the UK.  And the US budget for health care will dwarf that of the UK.  And if the UK can’t do it after doing it for some 60 years it’s the height of arrogance for those in the U.S. to think they can do it better.  Sadly, for what government bureaucrats lack in talent and ability they do make up for in arrogance.  Which means the collapse of the American health care system will be far greater than the problems they’re trying to fix in the ailing NHS.  Because they will ignore all empirical and historical evidence that national health care doesn’t work.  For they will just say that’s because no one as smart as they are has tried it yet.


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FT101: “Unlike government a business tries to fix bad policy before it bankrupts them.” -Old Pithy

Posted by PITHOCRATES - January 20th, 2012

Fundamental Truth

If Businesses give their Employees Overly Generous Pay and Benefits they will not be able to Stay in Business

A lot of people say businesses are greedy.  That they are always trying to go on the cheap when it comes to their employees.  The fatal flaw of capitalism some even say.  That need to make a profit.  And because of the profit-incentive businesses try to use as few employees as possible.  While paying them as little in pay and benefits as possible.  Which they, of course, do.  Because that’s the only way they can stay in business when their customers are doing the same.  When we go to the store looking for the maximum value at the lowest price.

You see, a business has to earn enough sales revenue to cover all their costs.  And their sales prices include these costs.  If these costs are too high people won’t buy from them.  So this is the reason why they pay their employees as little in pay and benefits as possible.  Because of us.  And our greed.  To keep as much of our money as possible when shopping.

So businesses can’t be overly generous to their employees.  For if they are they are then faced with two choices.  Raise prices to pay for this generosity.  Thus dissuading consumers from buying from them.  Which reduces their sales revenue.  Or they can choose not to raise their prices.  Which will increase their costs greater than their sales revenue.  Either way it’s bad for business.  For if they give their employees overly generous pay and benefits they will lose money.  And not be able to stay in business.

Businesses must make these Difficult Choices if they wish to Survive in the Real World

In free market capitalism businesses have real constraints.  They can’t be overly generous.  Because they won’t be able to earn enough revenue to cover their costs.  But neither can they be too miserly with their employees.  Because they have to be generous enough to entice them to work for them.  It’s this balancing act between generosity and being too cheap that causes a business problems.  Because in good economic times employees like to demand more.  And if they don’t get it where they currently work they will leave and work for someone else.  So employers are generous.  Sometimes too generous.  Which they usually learn when the good times end and they can no longer cover their costs at the new levels of revenue during those bad economic times.

A business cannot raise revenue by simply saying ‘raise revenue’.  For it is not up to them.  It’s up to the consumer.  And during bad economic times they’re just not buying like they once were.  Which leaves a business only one choice.  They must cut costs.  Either by cutting back on pay and benefits.  Or by really cutting back on pay and benefits.  By laying off employees.  It’s either that or they will bankrupt themselves out of business.

All businesses must make these difficult choices.  If they wish to survive.  Because they live in the real world.  Capitalism.  Where there are winners and losers.  And where businesses fail because they don’t make the difficult choices when they have to.  We’ve all seen a favorite store go out of business.  It may not always be because of the cost of their employees.  But it is always because they’re not earning enough revenue to cover their costs.

Difficult Choices are Rarely Politically Expedient and don’t bring in Many Votes

Health care costs and pensions have been the biggest costs businesses have struggled with.  That’s why defined benefit pension plans are a thing of the past.  Unless you’re in a union.  Or in government.  And employees are contributing more to the cost of their health care benefits.  Why?  Because of our aging population.  People are having fewer babies and are living longer.  And consuming more health care and pension benefits in their retirement than the actuaries ever dreamed possible when they created the health care benefit and defined benefit pension plans.

It’s no different in the public sector.  In fact, it’s worse.  Government grew.  And taxes grew to pay for that growing government.  It became more expensive to have babies.  So people had fewer.  Made possible by birth control and abortion.  Now there are fewer and fewer young people entering the work force to pay the taxes to pay for the ever growing number of seniors in their retirement.  Again, something the actuaries never calculated.  And there’s no way to fix it.  It’s a failed model.  But government won’t give up on this bad policy.  Unlike businesses have.  Because government doesn’t operate in the real world.  Like those businesses.

Government can do things businesses can’t.  They can tax.  They can run deficits.  Paid by massive borrowings.  And they can print money.  So they don’t have to make the difficult choices.  And chose not to.  Because those difficult choices are rarely politically expedient.  And don’t bring in many votes.


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