Healthcare reform: not radical enough

The Health reforms announced yesterday are not sufficiently radical. They put lots of power into the hands of General Practitioners (GPs). Instead, power should be in the hands of individuals.

The GPs will be given a certain amount of money. They will not be able to afford to give patients all the care they might want. So GPs will be rationing care. This grim aspect of the NHS will continue – run by the GPs in future instead of, as now, Primary Care Trusts. It will still, effectively, be a rationing system. It will also be a near-monopoly since only a relatively small number of consortia will be exercising choice, not patients.

It might be argued that GPs will take account of what their patients want, but that is nothing like as much power for patients as direct choice would be.

The reforms do allow for more involvement by competing private healthcare companies. But, again, they will only be offering their services to a few hundred GP consortia, not to individual patients.

And what if you do not like the services your GP offers? You can try to find another GP. But with so few consortia, the next GP might well be in the same consortium offering the same services. And what if you have a serious pre-existing condition? Another GP might not want to take you on because of the cost you would represent.

My great fear about the new system is that it will not be a great improvement and that the increase in competition will be associated with a not very good system. This could set back the cause of competition in medical care by a decade or two.

The government should have bitten the bullet and gone for a Continental social insurance system, possibly based on the Swiss the system (see previous postings).

Here is a link to the details of the bill.

Here is the FT’s summary.

  1. A double layer of choice for better healthcare
  2. Private emergency healthcare apparently growing in Australia
  3. The Reform manifesto
  4. Government to contract out NHS hospitals to the private sector
  5. What does Obama healthcare amount to?
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