Friday, 14 August 2009

Hmm... now the yanks are taking shots at the NHS...

This is a very long and involved Blant with rather heavy political overtones, so bear with me, please.

Check this BBC News article first...

So, some yanks don't like the idea of free healthcare for all, eh? Can't say I'm surprised. It is, after all, a socialist idea - and for any yanks reading this socialist does NOT mean communist, which while having some core ideas of a similar vein, are not, and never will be, the same - socialism accepts that there is a need for a free market - communism does not, and that's just for starters before you get your shorts in a knot!

Anyhow... chances are that I wouldn't be here but for the NHS. Without an NHS emergency paramedic and Ambulance response system, my heart attack a year and a half ago would probably have killed me. It was a sobering thought for me, and having bitched and barked about failings in the NHS for years before, made me sit up and think.

Yes, there are failings in the NHS. Decades of mismanagement, "market driven thinking" (what the hell?! what bloody market - the NHS is not a fee-driven system, it's a Public Service available to all!), and so on, have added layer upon layer of administrative and managerial levels on top of on another - and side by side to one another - that no-one truly knew who did what, how they did whatever it was they did, for whom, and for how much.

Even after some token restoration and reorganisations over the years, it still is in several areas, a bit of a mess, to say the least. And now we have "NHS Trusts", merging of responsibilities, closure of local A&E (yank translation: ER) facilities to super A&Es covering larger areas, that results in longer travel time, eating into the "Golder Hour" of treatment time, and other "initiatives" designed, at the end of the day, to cut costs.

I'm all for efficiency savings, but NOT at the cost of cutting the time it takes to get a patient from incident to A&E - the so-called "Golden Hour" is exactly that, and the patient who gets to A&E inside the golden hour is more likely to survive than one who doesn't. By the same token, the quicker you see specialist help inside that golden hour, the better your percentage of making a full and complete recovery.

This is why the NHS is funded, in large part, by National Insurance. Everyone is required to pay it, that's UK law, and very right and proper this is, too - everyone benefits from it. Over the years, I've paid National Insurance, which while theoretically paying for the NHS, only pays a portion of the monies required to keep it going. But it doesn't pay for it all. For that, there are annual funding additions in the Budget - what yanks would call "appropriations", which are needed to maintain the NHS as an effective healthcare provider.

Indeed, the NHS has been used to form other national healthcare systems, such as the French system - and you lot don't bleat on about the French being communists, do you?

Of course not. What decent self-respecting Red eats snails, for God sake?

But this is all getting away from the core issue: Money.

What some folks have missed is that the USA already has a form of national heathcare system. It's called the The Health Maintenance Organization system, or HMO system. This is an insurance-premium-funded healthcare system, that originated in the need for a national system of healthcare funded in the private sector in the USA. As a result, it's turned into a multi-billion dollar industry, and has fingers in pretty much every pie from genetic research into pharmacology, medical instrumentation, and so on. It's a damned powerful lobby in the USA.

But it's got a major failing built-in. Bean-counters ultimately control what level of care you receive, when you need that healthcare. If you don't have insurance, you don't get healthcare. If your insurance has a certain limit to it's financial value, and your required healthcare would go over this value, you won't get that needed healthcare.

What the yanks need is a form of NHS - and that's where the doctrinal and financial arguments have collided over there.

For a land with political masters that quote the Bible so frequently, and which bleats on about free trade all the time, I think it's quite ironic that we're seeing a country that's trying to serve two masters: God, and Mammon. Here's a reminder to all you yanks out there: There's a lesson in the Good Book that says that you cannot serve two masters. Go ahead, look it up (It's Matthew 6:24, by the way).

Personally, I think the Yanks have lost the plot somewhat when it comes to nationwide healthcare.

Do they want to Bible-thump, or Billfold-thump? They cannot have it both ways, after all: They have to choose one or the other, not both.

So, when it comes to a national healthcare system, their choices are initially simple: Either they adopt a mandatory tax-funded NHS-style system modelled somewhat on ours, and put thousands in the insurance industry out of work (in a recession, no less), or they leave the system as-is, and condemn thousands of their own citizens to a continuing lack of decent and affordable healthcare.

Of course, they could merge the two ideas into one, but good Lord, what a mess that would be - and it's make the NHS's admin/management mess look like a storm in a teacup, but at least everyone'd get a chance at having a healthcare system that was actually worthy of a great nation...

However you look at it, frankly there is no easy solution: you pays yer money and takes yer choice.

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