The wonders of socialized medicine

[Tony]

http://politics.guardian.co.uk/publicservices/story/0,11032,969353,00.html ..full article

Smokers and overweight people will be asked to sign contracts with their doctors to agree a programme to quit smoking and lose weight under radical plans being drawn up by the government.

In an attempt to remind people of their own responsibilities the health secretary, Alan Millburn, is examining plans for patients and doctors to agree a formal programme of treatment.

Labour sources insisted last night that the plan, outlined in a Labour party policy document as part of preparations for the next general election manifesto, did not mean patients would be denied treatment if they refused to sign.

[reprise]

Bwahahahahaha.

Sounds like the "mutual obligation" agreements which have been introduced to our social security system.

The big irony in Australia, of course, is that most weight loss and anti-smoking aids aren't available on the pharmaceutical benefits scheme, so you actually need a reasonable amount of disposable income to purchase them.

I can't wait for them to extend these agreements to safe sex practises, contraception, and alcohol consumption. :D

[BillyTK]

*sighs*

Well, at least he's reading the Guardian so there's hope yet. From the same article:

But government sources made clear last night that it had no intention of forcing people to do anything and treatment would never be denied to people. A Department of Health source said: "This is about reminding people that resources are finite. If they misuse them they are being denied to someone else."

[Tony]

Originally posted by BillyTK


Well, at least he's reading the Guardian so there's hope yet. From the same article:



What is this supposed to mean?

The fact that the government has to advise people on how to be healthy because resources are finite is telling of how pathetic socialized medicine is. I am aware that people are not forced to abide by the rules yet, IMO it is only a matter of time before they are.

[Jon_in_london]

Thats fine as long as they extend this to people who drink, ride motocycles, drive cars, use tanning salons/sunbathe etc etc....

[BillyTK]

Originally posted by Tony


What is this supposed to mean?

The fact that the government has to advise people on how to be healthy because resources are finite is telling of how pathetic socialized medicine is. I am aware that people are not forced to abide by the rules yet, IMO it is only a matter of time before they are.

Actually, I take it back because on reflection that the new plan is not going to be enforced is a stupid defense; people are responsible for their own actions and should be prepared to take the consequences.

But really, the whole treatment plan idea is nothing new, and has little legal standing. It outlines treatment and basically formalises an understanding between practitioner and patient that if the patient doesn't follow the practitioner's instructions their condition is not going to improve. Patients cannot be coerced to sign such a plan anyway; they cannot be denied treatment if they refuse or if they don't stick to the plan.

The obvious point is that there's always some form of rationing wrt health care; whether it's the UK system where need is prioritised over ability to pay, or the US system in which rationing takes the form of ability to pay. :shrugs: you pay your money (or taxes or medical insurance) and takes your choice I guess.

[reprise]

I just wonder how many "finite resources" are going to be consumed by patients going back to visit doctors to measure how much progress they're making on their treatment plan...

[BillyTK]

Originally posted by reprise
I just wonder how many "finite resources" are going to be consumed by patients going back to visit doctors to measure how much progress they're making on their treatment plan...

Very little. The cost of a doctor's consultation is minimal compared to drug costs.

[a_unique_person]

Ever taken out a life insurance policy? One of the first questions they ask is 'Smoker or Non-Smoker?'.

[iain]

This will be the wonder where all European countries spend a lot lower proportion of GDP on healthcare than the US and yet most have better health and longer average lifespans.

I can't figure out what the US is doing wrong on healthcare, but it is doing it impressively wrong.

[a_unique_person]

Originally posted by iain
This will be the wonder where all European countries spend a lot lower proportion of GDP on healthcare than the US and yet most have better health and longer average lifespans.

I can't figure out what the US is doing wrong on healthcare, but it is doing it impressively wrong.

People are making a lot more money out of it, and that is a good thing(tm).

[reprise]

Originally posted by BillyTK
Very little. The cost of a doctor's consultation is minimal compared to drug costs.

A doctor's consultation is part of the process of obtaining high cost (and quite a lot of low cost) drugs here, so I'm unclear about what you meant by this statement.

I can foresee a new form of over-servicing taking place once people are on weight loss or non-smoking management plans - "just pop back in two weeks time and we'll see how you're getting along" - when there is no medical reason for the patient to revisit the doctor.

We already have problems with people here visiting the doctor for the sole purpose of obtaining a prescription for medication which is available OTC because that medication is cheaper to the patient if it's obtained on prescription. It is not, however, cheaper to our healthcare system as the $23 for the doctor's consultation has to be factored in.

One option which has been looked at to address this situation is the issuing of a card which would allow health care card holders to purchase the medication OTC at the discounted rate, thus saving the healthcare system the additional $23.

[BillyTK]

Originally posted by reprise
A doctor's consultation is part of the process of obtaining high cost (and quite a lot of low cost) drugs here, so I'm unclear about what you meant by this statement.

Sorry! I meant that the doctor's consultation fee in isolation is minimal compared to drug costs, particularly the cost of drugs (and other medical professionals) which are required to treat the effects of smoking and obesity (which of course is conditional on the effectiveness of the treatment plan system, which at the moment seems unlikely).

I can foresee a new form of over-servicing taking place once people are on weight loss or non-smoking management plans - "just pop back in two weeks time and we'll see how you're getting along" - when there is no medical reason for the patient to revisit the doctor.

Hmmm--I doubt if these people actually would see the doctor. We've already got a surveillance clinics system in place which people with chronic conditions--asthma, diabetes, heart conditions, even smoking and obesity--attend on a regular basis, depending on the severity of their condition. These are run by a practice nurse with a specialism in the specific area, and means that the condition can be monitored but without using up a doctor's time.

We already have problems with people here visiting the doctor for the sole purpose of obtaining a prescription for medication which is available OTC because that medication is cheaper to the patient if it's obtained on prescription. It is not, however, cheaper to our healthcare system as the $23 for the doctor's consultation has to be factored in.

One option which has been looked at to address this situation is the issuing of a card which would allow health care card holders to purchase the medication OTC at the discounted rate, thus saving the healthcare system the additional $23.

I'm not sure if I understand your system, but over here prescriptions drugs cost the patient approx. £7 per item (about 17 Australian dollars?)--although there are certain age- and means-tested exemptions--so it's unlikely that someone would bother a doctor for a prescription simply to save OTC charges. OTOH, I can imagine someone having certain items prescribed for them to save on OTC charges on the basis that these are used regularly--for instance, hayfever treatments--but after the initial consultation, subsequent prescriptions wouldn't need a consultation.

[reprise]

Hmmm--I doubt if these people actually would see the doctor. We've already got a surveillance clinics system in place which people with chronic conditions--asthma, diabetes, heart conditions, even smoking and obesity--attend on a regular basis, depending on the severity of their condition. These are run by a practice nurse with a specialism in the specific area, and means that the condition can be monitored but without using up a doctor's time.

This is a system we desperately need here. We do have qualified nurse practitioners, but we don't make enough use of their skills and we certainly don't pay them enough money for the extra responsibility they carry.

[Jude]

On a related note: http://www.observer.co.uk/politics/story/0,6903,953391,00.html

This part of the article struck me as most disturbing:

Two of the largest trusts, both of which hope to be granted foundation hospital status by Milburn, went so far as to cancel dozens of operations, freeing beds during the crucial week into which A&E patients could be admitted quickly.

Apparently meeting some waiting period quota is more important than my kidney transplant.

This will be the wonder where all European countries spend a lot lower proportion of GDP on healthcare than the US and yet most have better health and longer average lifespans.


This has little to do with US health services and a lot to do with the American lifestyle. We're a very wealthy nation and like to spend this wealth on gobs of greasy, fatty, saturated (but absolutely delicious) junk food. You could fill a book with the number of diet-related diseases Americans die from.