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Amazing Examples Of Health Care Rationing In The UK

26 July 2010 11 Comments

When you guarantee health care for everyone with a finite budget, there is only one thing that is guaranteed: RATIONING.  UK, a great example of national health care in a developed economy, is going through some brutal budget issues with regards to their health care.  A recent article details the debacle of which I’ll post some quotes below.

  • “Some of the most common operations — including hip replacements and cataract surgery — will be rationed as part of attempts to save billions of pounds, despite government promises that front-line services would be protected. “
  • “Plans to cut hundreds of thousands of pounds from budgets for the terminally ill, with dying cancer patients to be told to manage their own symptoms if their condition worsens at evenings or weekends. “

Meanwhile, the NYT is reporting that the NHS will be decentralized in a large degree, just at the time when the U.S. is becoming more centralized. What makes us think we will be better off? Rationing is inevitable in a social health care system.

11 Comments »

  • 20smoney said:

    Alex, I understand your point, but under a centralized model, do you think rationing is more common?

  • wingtipwalker said:

    I'm so torn on this issue. There is a societal problem in that death (though inevitable) is an unacceptable outcome. I read a study not long ago (and pardon me if I butcher the data a little) that something like 90% of the average American's healthcare costs come in the last 3 years of life, and that there is little or no indication that the interventions prolonged life, at least qualitatively.

    So, in the case of a person with terminal cancer, in the last three years of life they spent 90% of their lifetime total healthcare dollars on chemotherapy, surgery, medications, and other treatments for little or no life extension and little or no improvement in quality of life.

    It's hard to think about and impossible for politicians to discuss, but if 100% of pancreatic cancer patients die within 18 months of diagnosis, why would they spend tens or hundreds of thousands of dollars treating an illness that is inevitably terminal. What's more, the treatments often make the person sicker for longer than if they would just let the disease run its course (i.e. live 12 months with no treatment and 2 weeks in hospice at end of life, vs. 18 months with 9 months in a hospital and severely weakened by surgery and chemotherapy). The answer? Americans aren't quitters, we have come to believe that it is a right/duty to fight illnesses just as it is to fight homelessness, poverty, etc. when in reality all of these things are just a natural part of life.

    Note: I'm hardly above this, if my doctor ever delivered a c-word diagnosis, I would want to seek every possible treatment.

    So, in addition to a systemic problem, it is a societal one as well. Is healthcare a right or a luxury? I think there are arguments on both sides of the table, as unpalatable as they may be.

  • TraderMark said:

    "I read a study not long ago (and pardon me if I butcher the data a little) that something like 90% of the average American's healthcare costs come in the last 3 years of life, and that there is little or no indication that the interventions prolonged life, at least qualitatively. "

    Bingo. YOu nailed it. Americans spend the most amount of money trying to extend those last few years. Its a very delicate subject and we could never have that discussion in America as adults because the minute you bring it up Sarah Palin will say you are trying to kill grandparents.

    You could solve almost the entire Medicare cost issue by coming up with some set guidelines nationally and hiring a few thousand auditors to do nothing but root out the massive fraud in the system.

    These guidelines would be controversial I am sure but if you want to pay $80K every 2 months for a cancer drug that *might* extend your life 6 months, I believe it has to come out of your pocket. Since "we the people" are paying for it, its ridiculous.

  • TraderMark said:

    (cont'd)

    Healthcare has become like university costs. There is no rational free market or supply and demand. The government is subsizing it so as to let more people partake, but in return that just allows the providers to continue to jack up prices.

    We could fix it in 3-5 years but those 3-5 years would be very tough. For example, if 98% of the people could not pay out of pocket $35,000 for a 1 night stay in the hospital guess what? Hospital prices would plunge until it came to a point where people could afford. This would cause massive losses to the hospitals, at which point they'd have to cut back on what they could pay for drugs, nurses, and doctors. Eventually we'd come to a happy median and then people could afford healthcare, and the prices would go up over time in line with income. But this would again create a massive dislocation in the near term and it will never happen. So instead we'll continue to have 8-12% annual increases in prices, and the variance between what wages could support (2-3%) and what the people sucking off the system are getting (6-8%) will be provided by a government spinning more and more debt onto debt.

    To take the example to a less controversial subject, apply the same themes to university. We are trying to let more people in college via subsidization but its allowing professor (tenured) salaries to go to the stratosphere and dorms to be built that are like palaces and on and on. Instead it should be what the market bears – profs would need to take less, building could not be ripped down and rebuilt every 20 years, but the average peon would be able to afford college. What a concept.

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  • blogc2011 said:

    You could solve almost the entire Medicare cost issue by coming up with some set guidelines nationally and hiring a few thousand auditors to do nothing but root out the massive fraud in the system.
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  • koli said:

    As Berwick tells it, "It's not a question of whether we will ration health care. It is whether we will ration with our eyes open." Frightening, but realistic.
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  • Business plan said:

    “Plans to cut hundreds of thousands of pounds from budgets for the terminally ill, with dying cancer patients to be told to manage their own symptoms if their condition worsens at evenings or weekends."
    I hope if it was possible to show a more sympathy to them….

  • blogc2011 said:

    If you want to argue that ability to pay/have insurance is a fairer way to ration ok, but as the same medical resources are available in each scenario the same amount of rationing occurs.

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  • Dentist Tucson said:

    Thank you for this post.I am glad to see that even the most developed countries are rationing their healthcare system.Rationing is a very clever decision as in this way a country can save a lot of money.