In my previous entry I suggested we should take a closer look at those healthcare systems which came out best in an international survey. How do they work? Should we move in their direction?
Nick Cowen has suggested the Civitas report Quite like heaven? Options for the NHS in a consumer age for information on the Dutch system of healthcare which came out well. There is also information of the Swiss system which also come out well.
I went to the Civitas web site and found this highly relevant part of the summary:
Evidence from abroad, particularly countries such as Switzerland and the Netherlands, indicates that it is possible to deliver universal and comprehensive healthcare, equitably and to higher standards than in the NHS.
The Dutch, in particular have succeeded in setting up a system that has the potential to harness the benefits of real competition and real choice, through insurance arrangements, while maintaining health care for public benefit through tax credits and a Health Insurance Fund.
In both systems the government is neither the provider, nor main funder, of health care, but regulator. Political interference is at a premium compared to the NHS.
The ability of the patient to choose between insurers, insurance packages and hospitals ensures the system is patient-focused. Patients are a lot more cost-conscious and, if they don't like the health care they receive, they can vote with their feet and go elsewhere.
The power of exit for providers is real and acts as a powerful incentive for them to drive up standards. (ch.5)
So two of the top-ranking systems appear to include two layers of choice for the consumer: among insurers and among providers of healthcare.
[I am afraid the 'comment' facility on the website does not appear to working reliably at present. I have asked the website host if this can be fixed.]
Posted by James Bartholomew • Indexed in NHS • Reform
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Healthcare should of course be organised (or rather self-organised) along the lines of veterinary practices. They are effectively a shop you go to to get your pet fixed. It is not free (nothing should be), and vets have to pass various examinations and so forth. All perfectly rational and simple to boot. A sign at how effective healthcare is for non humans is that no one discusses it. The fact that we are still discussing healthcare implies strongly that, as per welfare generally, we are simply not facing up to hard reality and doing something meaningful about it. There is simply no plausible argument for healthcare to be centrally controlled. It is some kind of imaginary safety blanket for Linus's on the Left.
Posted by: cybn at October 14, 2009 08:03 PM