It is important not to mis-characterise either the American healthcare system or the strange attempt to marry market principles and political realities that characterises successive generations of Conservative healthcare reforms as actually being a free market.
In free markets the pressure on quality comes from the consumer, who is assumed to have a desire to buy quality products as well as cheap ones. This is why all three of Waitrose, Tesco and Lidl have market niches. However, this pressure only materialises when the consumer has the ability to make informed choices between different suppliers. This doesn't happen in the US healthcare system because almost everybody's health insurance is provided by an employer, so the consumer who is spending the money (corporate purchasing departments) and the consumer who evaluates the service (workforce) aren't the same person; and it's highly unlikely to happen in the UK since the lack of spare capacity in the NHS means that most people will take treatment wherever it first becomes available.
What a lot of people miss is that an awful lot of NHS treatment isn't acute: sure, if you fell off your bike and need your broken arm treating, you want to get it sorted soonest/nearest. If you discover a disturbing lump, sure, you want to get a biopsy (and other treatment, should it unfortunately be necessary) done as soon as possible.
But a huge proportion (I would guess between 15% and 30% is chronic). Heck, 10%, predicted to rise to 25% is diabetes alone. Add in mental health, obesity, and so on ... maybe 30% is far too conservative. For people like me, I don't mind waiting 2 months, heck, even 2 years, to see a team which can actually extend my life (thinking 45 years rather than 35 years is a different sum to here next year or not!) and/or improve its quality - two years of 3 out of 10 life, followed by 45 years of 7 out of 10 life beats 47 years of 4 out of 10 life for many people.
Personally, I would push, as best of a bad job, for personal healthcare budgets.
Personally, I would push, as best of a bad job, for personal healthcare budgets.
In theory I agree, though if you could manage to implement such a reform in the face of the accusations of privatising the NHS which would doubtless be flung from all corners, well...would you kindly run for Parliament so I can vote for you? I doubt you'll find predicting which constituency I'll be living in at the next election very difficult compared to that challenge.
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(no subject)
In free markets the pressure on quality comes from the consumer, who is assumed to have a desire to buy quality products as well as cheap ones. This is why all three of Waitrose, Tesco and Lidl have market niches. However, this pressure only materialises when the consumer has the ability to make informed choices between different suppliers. This doesn't happen in the US healthcare system because almost everybody's health insurance is provided by an employer, so the consumer who is spending the money (corporate purchasing departments) and the consumer who evaluates the service (workforce) aren't the same person; and it's highly unlikely to happen in the UK since the lack of spare capacity in the NHS means that most people will take treatment wherever it first becomes available.
(no subject)
But a huge proportion (I would guess between 15% and 30% is chronic). Heck, 10%, predicted to rise to 25% is diabetes alone. Add in mental health, obesity, and so on ... maybe 30% is far too conservative. For people like me, I don't mind waiting 2 months, heck, even 2 years, to see a team which can actually extend my life (thinking 45 years rather than 35 years is a different sum to here next year or not!) and/or improve its quality - two years of 3 out of 10 life, followed by 45 years of 7 out of 10 life beats 47 years of 4 out of 10 life for many people.
Personally, I would push, as best of a bad job, for personal healthcare budgets.
(no subject)
In theory I agree, though if you could manage to implement such a reform in the face of the accusations of privatising the NHS which would doubtless be flung from all corners, well...would you kindly run for Parliament so I can vote for you? I doubt you'll find predicting which constituency I'll be living in at the next election very difficult compared to that challenge.
(no subject)
It would be far better to make sensible reforms.
Hence my inability to predict where you will be living... I guess Exceter.