The National Health Service of Great Britain costs the taxpayers about $200 billion per year. And by the way, that is more than double what it cost ten years ago … but that is beside the point. The NHS is getting to the point where it must choose between buying expensive drugs for terminally ill patients or providing more care to more people.

Is that really a choice that you want anyone to make about your healthcare? Even worse, why should the government be the one making that choice for you?   Because you’ve virtually begged for it. Americans now think that their health care is someone else’s responsibility: either their employer or the government. We’re asking for it and begging for but the truth is that we’re not going to be pleased with it at all. Politicians will love it though.  Just think of the power! How powerful you must feel when you tell an elderly American that they can’t have a specific drug or medical procedure because someone younger needs it more.  Sorry people, but that’s the truth.

In Great Britain, 800 out of every 3,000 cancer patients lose their chance at getting life-saving drugs because it would cost too much for the NHS budget. And that number is only going to get bigger and bigger. In fact, the UK is now considering making a permanent ruling that certain medications that are “too expensive” should be excluded from government-funded treatment. So even if there are better treatments out there, you can’t have them because the government doesn’t want to pay for it.

Of course though, Americans have been taught all their lives that government is the answer for everything.  That government is supposed to make all our problems go away and that we don’t need to take any responsibility for ourselves or our children.  I just can’t believe how many pathetic people live in this country that are willing to sacrafice their childs future just so government can support their lazy fat ass.

The NHS has frequently been the target of criticism over the years. Examples of such criticism include:

Access controls

Treatments determined by NICE to be ineffective (e.g. homeopathy) or relatively cost-ineffective (i.e. drugs that have only minor effect at great cost) are simply not offered by the NHS though may be available privately. These controls have been labelled “rationing” though others argue that these are a sensible cost-control mechanism to fund only cost-effective^, evidence-based medicine although this argument is controversial as many drugs with proven efficacy (e.g. anticholinesterase for Alzheimer’s Disease^, are not fully funded.

In the NHS, GP referrals are needed to access specialist care and one of the original roles of general practitioner was to act as ‘the gatekeeper’. This role as gatekeeper has become more prominent in the 1990s with the introduction of the ‘internal market’ with GPs managing funds to buy clinical services. In 2000s, the role of gatekeeper has been increasingly moved to primary care trusts (PCTs) that issue guidelines to limit referrals to secondary care. ‘Referral management centres’ are also another recent innovation to divert referrals from GPs to cheaper nursing or therapy-led alternatives.

It has been argued that a nominal charge for an appointment with a GP could be introduced to prevent patients consulting their GP for frivolous reasons. To date, this has never been introduced to avoid the danger of patients avoiding consultations (for financial reasons) for conditions which might be potentially serious.

Politicisation

Over time, increased demand leads to continual political pressures to increase spending and widen the range of treatments available.

Supporters of the NHS would point out that the NHS has wide public support and the English population has as good a health outcome as many other similar countries, and often at much lower cost. Political pressure could work both ways, but the Blair government was elected in 1997 largely on a promise to invest more taxpayers money in health to bring spending closer to the European average. Most people would prefer to see gradual improvements within the current framework and be able to hold politicians to account for the service. This is the position of all the major political parties, none of which has an agenda to replace or make a wholesale reform to the system. The Conservative Party says its policies are aimed at “Protecting and improving our health service by putting patients back at the heart of the NHS, and trusting the professionals to ensure that they are able to use their skills to make the fullest possible contribution to patient care.”

“Paying twice”

Taxpayers who choose to pay for private healthcare must nonetheless still contribute to the NHS via taxation, and in effect “pay twice”, although the vast majority of emergency medical treatment is carried out by the NHS. This is not an effect specific to the NHS, and occurs whenever a choice between a publicly-funded and privately-funded service exists.

Some patients with complex illnesses pay for some medical services privately, while turning to the NHS for the rest of their care. In one recent case a cancer patient was told that if she paid privately for a drug that was not covered by the NHS she would have to pay for the rest of her care. NHS officials argue that allowing the practice would give wealthy patients an unfair advantage and undermine the philosophy of the system.

Waiting lists and the 18 week target

Rationing is a part of all health care systems because resources are necessarily finite. In purely private systems, health care is rationed via the price mechanism, with those being able to or wanting to pay for care getting it immediately and those not able waiting indefinitely (until they can afford it, which may be never). In the NHS, which aims to give a broad coverage of care to all without charging, health care is rationed on the grounds of clinical need, meaning that emergency cases (e.g. heart attacks) get instant access where those with less urgent needs (e.g. cataract surgery) are given lower priority and so wait longer.

Although there are obvious arguments in favour of prioritising by clinical need rather than ability to pay, it can mean that waiting lists vary widely between regions. Patients waiting can choose to have a procedure done outside their local NHS district in order to be seen more quickly, and if the waiting time is long can often get private treatment at public expense, either in the UK or abroad. A major programme is underway in the NHS to reduce all wait times to 18 weeks by December 2008. This new target starts at the point the time the patient’s own doctor writes to the hospital specialist and ends when treatment begins. It therefore includes the time to make the first appointment, and the time for all diagnostic tests to be completed, evaluated, and discussed with the patient, which were not in the previous target. It has been widely criticised by doctors, healthcare professionals, and think-tanks as diverting resources from more serious conditions to achieve politically-motivated goals, and doubts persist over its achievability.

The term bed-blockers is often used to refer to patients still receiving care, even though their acute ailment has been treated and they are fit for discharge. This strains hospital resources, through both increased costs and longer waiting times for other patients. In the UK, bed-blockers are frequently geriatric patients awaiting a placement in a nursing or residential facility.

“Superbugs”

Fatal outbreaks of antibiotic-resistant bacteria (”superbugs”), such as Methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile, in NHS hospitals has led to criticism of standards of hygiene across the NHS.

Both C. difficile and MRSA are, however, not exclusive to the NHS, existing in British private hospitals and throughout other western healthcare systems; for instance, cases doubled in the USA’s private healthcare system between 1999 and 2005, and the UK’s death rate is half that of the USA’s. The introduction of Private Finance Initiative cleaning contractors into the NHS and the associated “cutting corners on cleaning” have been blamed for the problem, as has increased drug resistance due to inappropriate prescribing of antibiotics and patients failing to complete courses of antibiotics.

Another viewpoint is that the spread of communicable diseases in hospitals is facilitated by the overcrowding in NHS hospitals with high bed occupancy rates (as the NHS has a low bed:population ratio produced by hospital bed closures and the increasing emphasis on increasing bed ‘turnaround time’).

Computerisation

The NHS has been criticised over the implementation of its National Programme for IT which is designed to provide the infrastructure for electronic prescribing, booking appointments and elective surgery, and a national care records service. The programme has run into delays and overspends, with the initial budget of £2.3 billion over three years officially revised to £12.4bn over 10 years and some sources putting it as high as £20bn. Critics including the House of Commons Public Accounts Committee and the National Audit Office claim the project is falling behind schedule. In addition, 93% of doctors within the NHS are not confident their patients’ data will be secure, some GP practices have begun to advise all their patients to opt-out of the scheme, and privacy campaigners have claimed the national care records system breaches patients’ privacy rights.

The Government and NHS national leadership have consistently argued that major capital investment in IT is necessary to transform services. Fragmented information systems, as in the US, prevent health services providing consistent data and can damage patient care where doctors may not have an overview of patients records held by another NHS body.

Dentistry

There has been a decreasing availability of NHS dentistry following the new government contract and a trend towards dentists accepting private patients only, with 10% of dentists having rejected the contract offered.

Coverage

The lack of availability of some treatments due to their perceived poor cost-effectiveness sometimes leads to what some call a “postcode lottery”.

NHS supporters would argue that the NHS has a duty to ensure that taxpayers money is used wisely and such denials are effective controls. People can always choose to go private, if they can afford it, if the treatment is legally available in the UK or elsewhere.

Deficits

Some hospitals and trusts were running a financial deficit and getting into debt.

Scandals

Several high-profile scandals have occurred within the NHS over the years such as the Alder Hey organs scandal, Harold Shipman and the Bristol Royal Infirmary inquiry.

Supporters would argue that there is nothing endemic about such issues which might equally have occurred in other types of health care establishments. They might also point out that the detection of such issues leads to better controls being established throughout the NHS for the benefit of all.

An October 14, 2008 article in The Daily Telegraph stated, “An NHS trust has spent more than £12,000 on private treatment for hospital staff because its own waiting times are too long.”

With all the fever surrounding Election ‘08, Clark wants to throw his hat in the ring with a presidential bid for 2012! His platform probably won’t get him elected, but still wants to lay it out for your perusal.  He’s got my vote!

• Spend only what you make — In a Howard administration, your president would pass a balance budget amendment to the Constitution. We’d become a pay-as-we-go country — instead of doing the opposite as we have for years.

• A flat income tax policy — The flat tax would be somewhere around 18%. There would be a high standard deduction so that those with lower incomes don’t get pinched. A flat income tax would also eliminate the corruption in Washington and let you know what tax burden you have.

• No more employer-provided retirement plans — Goodbye to the 401(k), 403(b) and any other form of employer-provided retirement. Your president would require that every dime on a dollar your earn goes into a personal retirement account with ultra-low management costs and simple investment choices.

• Just say no to socialized medicine — In a Howard administration, there would be just 12 health plans offered: 3 HMOs, 3 PPOs, 3 HSAs and 3 of the traditional 80/20 splits.

Every insurer would have to sell identical plans. That way you could switch to another insurer’s HMO plan No. 2 if your insurer’s HMO plan No. 2 is too costly. You would pay your premium based on age, and there would be no redlining based on your past medical history. You wouldn’t be required to have health insurance, but you wouldn’t be allowed to buy it when you’re sick; instead, you’d have to wait 18 months.

A word about Medicare: Seniors would buy healthcare from private insurers in one of the 12 plans, but the government would subsidize catastrophic care at ages 55 and older.

Is it possible to simultaneously achieve the first 2 platform points? Of course not. By 2020, the costs of Social Security, Medicare and Medicaid will exceed what is today the entire federal budget, according to Forbes. So we would either have to raise taxes to an unconscionable level or tell people the truth that we can not afford to be Santa Claus to everybody.

In a Howard administration, we would all need to do a hard reset about the issue of personal responsibility vs. what we expect from government. Santa’s sack is getting less and less full, so you’ve got to be your own Santa. Clark will be running on the Ebenezer Scrooge platform for 2012!

Visit Clark Howard’s website.

Visit American Solutions.

A 21st Century Individual-Centered Intelligent Health System Now! The Center for Health Transformation is a high?impact collaboration of private and public sector leaders dedicated to creating a 21st Century Intelligent Health System that saves lives and saves money for all Americans. The Center is based on the following premise: Small changes or reactionary fixes to separate pieces of the current system have not and will not work. We need a system?wide transformation. Unlike other alliances, the Center unites stakeholders across the spectrum (providers, employers, vendors, trade associations, disease groups, think tanks and government leaders at both the state and federal level) to drive transformation according to a shared vision and key principles. Our nine key strategies are:

Accelerate the Adoption of Interoperable Electronic Health Records

Create secure, interoperable electronic health records with expert systems to maximize accuracy, minimize errors, reduce inefficiencies and improve care.

Create a System and Culture of Rapid Adoption of Solutions

Create a system and culture of rapid adoption of solutions that result in better outcomes at lower cost for Medicaid, Medicare, and the private sector.

Support Information?rich Health Savings Accounts

Accelerate the adoption of information?rich health savings accounts to both incentivize and empower the individual.

Develop a New System of Health Justice and Patient Safety

Create a new system of health justice and patient safety, focusing on a much fairer, less expensive and more timely system of health justice. The current system of civil health litigation is too expensive and fails to provide justice for patients and their families.

Create a Buyers’ Market for Pharmaceuticals

Create a buyers’ market for pharmaceuticals by building a transparent system for individuals, doctors, and pharmacists of price and efficacy information about prescription drugs and medically appropriate over?the?counter drugs. The system would have an open formulary with an “after?pay” rather than a co?pay (a “Travelocity” for drug purchasing).

Establish a System for Capturing the Cost and Benefits of Better Solutions

Establish an intellectually credible, accurate system for capturing the cost and benefits of better solutions, better technologies and better outcomes in order to create a technically correct model of return on investment for solutions resulting in better outcomes at lower cost.

Create a Real?time Continuous Research Database

Develop a real?time continuous research database that advances the discovery, development, and delivery of research (turning cancer into a chronic disease by 2015 and eliminating preventable complications from diabetes by 2015).

Create a Virtual Public Health Network

Knit together these electronic systems into a virtual public health network for health protection against natural outbreaks and a bioshield against deliberate biological attack.

Turn Health & Healthcare from a Problem into an Opportunity

By implementing the first eight strategies, turn health and healthcare from a problem into an opportunity, making it the leading creator of high?value jobs and foreign exchange earning in American society (including as a first step the creation of an undersecretary of commerce for health)

Oh dear, private clinics are offering better medical care than government provided care in Canada and now there is a movement to stop these private companies from helping people who need medical care.

Since the first private MRI clinics opened their doors in Canada 10 years ago, there has been a national explosion of private health facilities with little policing by the federal or provincial governments, a report says. Read the full story.

And Americans want a government controlled healthcare system?!

Starting today, Medicare will slash hospital payments for medical mistakes resulting in patient harm and higher costs to the sprawling federal health plan for the elderly and disabled. Examples of such mistakes include transfusing patients with the wrong blood type and leaving a sponge in a patient during surgery.

So government is going to give you the middle finger if the doctor “F’s” up!  If we let these fools run our health care system, we might be better off committing suicide when we get sick!

Read the full Washington Post story.

Here’s the quote from the article. Read this and then let’s discuss.

An eye-opening survey reveals widespread belief that divine intervention can revive dying patients. And, researchers said, doctors “need to be prepared to deal with families who are waiting for a miracle.”

More than half of randomly surveyed adults — 57 percent — said God’s intervention could save a family member even if physicians declared treatment would be futile. And nearly three-quarters said patients have a right to demand such treatment.

When asked to imagine their own relatives being gravely ill or injured, nearly 20 percent of doctors and other medical workers said God could reverse a hopeless outcome.

The first thing I’d like to know is what is the demographic of the people they surveyed. For all we know they could have surveyed 100 religious extremist freaks who also believe they don’t need to work because, “God will provide.” Sure, it says its a random survey but I want more details.

I know that when someone you care about is sick or dying people are going to pray that they survive. Regardless of how religious a person is, praying always seems to be an instinctive reaction to a situation like that. But as soon as you start saying that God has more power than the doctors I start to say, “Whoa, wait a minute here people.”

What scares me here is not the people who keep praying long after the doctor says that there is nothing more they can do. What scares me are the people who ignore doctors because they believe that God will take care of them.

Guess what people? If there is a God out there, he created doctors for a reason.

(Full News Story)

The Texas Medical Center spent nearly $1.6 million last year on lobbyists who helped to deliver an estimated $3 billion in federal funds — a return of about $1,900 for each dollar spent on influencing members of Congress and the Bush administration.

With about one-third of their budgets dependent on federal largesse, at least eight of the 46 hospitals and research institutions within the sprawling complex hired dozens of Washington lobbyists.

This is what our government has turned into. You give me money and I’ll get you what you need. You know, I’ll scratch your nuts if you scratch mine! Our government has become so corrupted by lobbyist groups its sick. We’re talking, environmentalists, oil companies, health care companies, labor unions and etc. This is the reason why we need term limits. We just can’t have these two idiot parties destroy this country for their own personal interests.

Read the full story.

Click here for more information on term limits.

I completely support the idea of euthanasia. I feel that if someone has gone through every possible medical treatment and their condition has not improved or will not improve, they should have the option to end their life in dignity. Just think about this for a second. People that are suffering from Cancer, AIDS, or any terminal illness are costing their families major heartache by watching them slowly suffer and on top of that the large amount of medical bills that are pouring in. It is a very emotionally traumatic event in a persons and their families lives. I also feel that you should be able to designate a Power of Attorney in a “Designation of Health Care Surrogate” so that if you become incapable of making the decision, the person who you left responsible can make the decision for you.

As of 2008, some forms of euthanasia are legal in Belgium, Luxemburg, The Netherlands, Switzerland, the U.S. state Oregon, and Thailand. Oregon is the only U.S. state that allows some form of euthanasia. In 2005 the Bush Administration tried to challenge this Act, but lost to the Supreme Court. Good! You need to keep your filthy religious hands out of a persons choice “W”!

The Oregon Death with Dignity Act allows a capable adult Oregon resident who has been diagnosed by a physician with a terminal illness that will kill them within six months may request in writing, from his or her physician, a prescription for a lethal dose of medication for the purpose of ending the patient’s life. The request must be confirmed by two witnesses, one of whom cannot be related to the patient, be entitled to any portion of the patient’s estate, be the patient’s physician, or be employed by a health care facility caring for the patient. After the request is made, another physician must examine the patient’s medical records and confirm the diagnosis. The patient must be determined to not suffer from a mental condition impairing judgment. If the request is authorized, the patient must wait at least fifteen days and make a second oral request before the prescription may be written. The patient has a right to rescind the request at any time.

The law protects doctors from liability for providing a lethal prescription for a terminally ill, competent adult in compliance with the statute restrictions. Participation by physicians is voluntary. The law also specifies a patient’s decision to end his or her life shall not “have an effect upon a life, health, or accident insurance or annuity policy.”

The law in the Netherlands allows the medical review board to suspend prosecution of doctors who performed euthanasia when each of the following conditions is fulfilled:

* the patient’s suffering is unbearable with no prospect of improvement
* the patient’s request for euthanasia must be voluntary and persist over time (the request cannot be granted when under the influence of others, psychological illness or drugs)
* the patient must be fully aware of his/her condition, prospects and options
* there must be consultation with at least one other independent doctor who needs to confirm the conditions mentioned above
* the death must be carried out in a medically appropriate fashion by the doctor or patient, in which case the doctor must be present
* the patient is at least 12 years old (patients between 12 and 16 years of age require the consent of their parents)

Click here for more information on the Oregon euthanasia law.
Click here for more information on the Netherlands euthanasia law.

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A Health Savings Account is a tax-advantaged medical savings account available to taxpayers in the United States who are enrolled in a High Deductible Health Plan. The funds contributed to the account are not subject to federal income tax at the time of deposit. Unlike a Flexible spending account, funds roll over and accumulate year over year if not spent. HSAs are owned by the individual, which differentiates them from the company-owned Health Reimbursement Arrangement that is an alternate tax-deductible source of funds paired with HDHPs. Funds may be used to pay for qualified medical expenses at any time without federal tax liability. Withdrawals for non-medical expenses are treated very similarly to those in an IRA account in that they may provide tax advantages if taken after retirement age, and they incur penalties if taken earlier. These accounts are a component of consumer driven health care.

They also save money for most employers, while giving workers healthcare protection. By making you a part of the medical services decision process, HSAs are designed to help you manage medical expenses and reduce the continuing raising of health care expenses. Equally as important, the money you save remains part of your retirement account, even if you leave your present employer. In short, if you don’t use all the money in your HSA for medical expenses, it can accumulate as tax-free savings for your retirement. One final benefit, HSAs can pay for many more procedures than were ever allowed before by government sponsored programs.

For more information on HSA.  Click here.

Click here for information and to find HSA’s.

Sixty Per Cent of Physicians Surveyed Oppose Switching to a National Health Care Plan. Read the full story.