Friday, April 20, 2012

An American Doctor Looks at Britain's NHS

What happens when an American doc compares Obamacare to the British National Health Service? It is not a pretty sight:
My time in the British National Health Service in the 1980s was a tremendous learning experience. England still has incredible clinicians who can do remarkable work with scarce resources. The truth, however, is that working at an NHS hospital is like taking a time machine back 20 years. The infrastructure, equipment, surgical tools and medications are backward by comparison to any medium-sized hospital in the United States. The irony is that many nations afflicted with Obamacare systems have moved toward private, decentralized approaches. When teaching medical students about health care economics, I point out that the cell phone revolution began when President Ronald Reagan dismantled the market monopoly of AT&T.
I told you it was scary, yet this is what the American public wants.

Or do they?
I believe that a decentralized, patient-focused approach can work. Health insurance can be less expensive if more insurance companies compete with products that people actually want, not those their employer or the government think they need.
Actually, carriers do provide products that people want.
Cost efficiencies will happen when people use at least part of their own money to pay for health care. Futile, ridiculously expensive end-of-life treatments occur when the bill can be off-loaded onto unsuspecting taxpayers. Lastly, enormous savings will follow reform of the medical malpractice circus.
Copay plans, low deductibles, unlimited doctor visits and small payments for ER visits are quite popular which continues to fuel demand for this kind of plan. High deductible HSA plans, while popular, only comprise around 20% of plans in force.

There is some truth to what Dr. Galyon says, who wants to be the one to tell your terminally ill family member if they want to continue living they will have to absorb the cost themselves?

Malpractice claims comprise a relatively small direct cost that is factored in to health care prices, but redundant testing for CYA purposes is excessive.
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