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Apr 23 2014

How to Dismantle a functioning Medical System

The fascination with the dismantling of a socialised medical system is a conservative wet dream. It’s as if the very presence of the NHS is a fetid sore on the arse of the United Kingdom rather than the reality.The NHS is a shining example of what socialised medicine can do. The UK isn’t the best in the world, but it is extremely close to it. It’s a difference of inches rather than miles. It is a far cry from the USA whose massive spending is matched to a complete lack of service. In fact what we spend in the UK per person, per capita is actually pretty good value for money.Well, what’s the problem with the NHS?

The NHS’s problem is that it’s big. Big organisations have big bureaucracy. That’s life unless you want to run an organisation through the method of crumping heads and shouting loudly at people until things get done. But the bureaucracy exists solely to meet the needs of the bureaucracy. It could do with some trimming of frivolous services and cost saving by usage of more efficient methodology. There are a lot of posts that have people who don’t really do anything and these can be repurposed to expand service.

The way to fix it is to not cut the salaries of doctors and nurses who make up the edge of the NHS. That is a frankly moronic way to do things. Doctors earn a fair wage, but it’s a crazy job. It’s a huge amount of skill and education that goes into making a doctor and it’s a lot of stress and indeed responsibility. Cutting the wages will just hurt doctors and create a system of unrest.

To put it into perspective. If anyone cut your salary, forced you to pay more tax, work longer to retirement and gave you a lower pension, would you accept it? Not really. Money may not be the prime driving force in medicine, but it does help the average doctor a lot. We aren’t talking football players, we are discussing people who work to keep you healthy and who do a job based on artifice, skill and knowledge.

The NHS is being dismantled. It’s being set up to fall. Private companies take over the running of the NHS while government cuts to doctor’s salaries combined with increases to retirement age and reductions to pensions will create an incentive for doctors to jump ship to the private system. A health system without it’s doctors (and indeed Nurses. I cannot speak for them as I have no idea how the system works for them) is like a knife without a blade.

The NHS will fall and we will see the rise of an american style system where the rich get to be healthy and the poor can only get medical care at personal cost. Private companies flog the idea that your rooms are clean and that nurses will treat you like a “person” implying that the NHS is filthy and that it treats you like a cow. Most people who think that have never ever met a real nurse or been inside a hospital if they think the NHS tolerates treating patients like cows is acceptable.

The problem is there is no hostile reaction doctors and nurses can take. It’s only money right? It’s not like lives are at stake. Doctors and Nurses cannot strike without harming patients so they cannot levy the ultimate sanction of a proper crippling strike.

This doesn’t affect doctors and nurses. We will always find work in the private sector for our skills, people will always be sick for the forseeable future. It affects our patients.

10 comments

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  1. 1
    jedibear

    It’s worth noting, I think, that it’s not like what we in the US jokingly call a “healthcare system” has *less* bureacracy than NHS. It’s just more fragmented.

  2. 2
    F [i'm not here, i'm gone]

    I’m not sure where the whole myth that private entities have less bureaucracy, waste, and corruption, and more efficiency, even comes from. It’s pure bullshit.

  3. 3
    MadHatter

    If anything there may be more. I moved from the US to an EU country with a national healthcare system and there are fewer administrative people in my doctor’s offices here than ever were in the US. Often doctors back home had to hire people specifically to deal with insurance companies whose aim is not to help you get healthcare…

    Getting access here has been amazingly easy and inexpensive.

  4. 4
    sarah00

    Privatising the NHS will lead to more bureaucracy, not less, especially if they start charging patients (which is where they’re clearly trying to get to). At the moment there’s no need to track patients beyond their medical care but if you start charging you need people to send bills, process the payments, make sure people pay on time, chase people who don’t pay on time, bring in debt collectors if they still don’t pay. It’ll be a nightmare to establish and once it’s in place going back will be nigh on impossible.

  5. 5
    Giliell, professional cynic -Ilk-

    Germany has a very complicated system of socialised healthcare.
    You have all those public insurance companies (non-profits), the private ones, you have different public administrations, publicly owned hospitals, privately owned yet run within the public system ones (Catholic ursupation of healthcare is a problem here, too) and and and.
    I often wished that we had a centralised system like the NHS. Ours is historically grown (actually we boast to have invented health insurance 750 years ago with a miners’ association) and nobody is going to change that utter chaos because too many people would lose very important positions.
    But the conservative approach is the same: change conditions so that the public healthcare is going to fail the needs of the population, piece by piece. Already a lot of it is privatised, like glasses or lenses, tooth replacement and so on and private insurance companies will sell you something to deflect the costs. If you can afford the initial premiums, that is.

  6. 6
    opposablethumbs

    Keep our NHS public campaign:

    http://www.keepournhspublic.com/whatyoucando.php

  7. 7
    lorn

    The “problem” with the NHS has nothing to do with it having a bureaucracy that, as all bureaucracies are prone to do, takes on a life of its own. Anyone who is familiar with larger corporations will immediate recognize that private industry is as capable of producing a bureaucracy every bit as self serving and inefficient as any government office.

    The right’s real problem with socialism isn’t that collectivist solutions are wasteful. Waste in a collectivist system, as most government programs are, are measured in terms of dollars in versus dollars worth of services out.

    Business doesn’t work that way. Private industry isn’t worried about the efficiencies of getting products or services to customers. The business of business is maximizing profit delivered to owners, executives, and investors. Every dollar spent on patient care is a dollar out of an investor’s pocket. The customers are given the minimum amount of product or service that is consistent with their paying. If there are no alternatives, or the alternatives are no better than those they presently enjoy, they will continue to pay. This is how medical services in the US continue to both show huge profits, and deliver such poor outcomes. If the US consumer only gets forty cents on the dollar in medical treatment the consumer will put up with it as long as there are no better deals offered.

    The main objection to socialized medicine is that the investor classes can’t easily and efficiently insert themselves between doctor and patient or optimize the system to maximize the profits flowing to them. It deeply wounds the capitalist soul to think that there is any significant economic activity going on that they can’t get a piece of.

    There was a story dating back to the late 60s about secretary of defense Robert McNamara. A business tycoon was asked what he thought about him given that he was considered such a strong business leader. The tycoon snapped back that he thought that McNamara was a pretty lousy businessman because he was put in charge of a multimillion dollar organization and hadn’t shown a profit.

  8. 8
    StevoR : Free West Papua, free Tibet, let the Chagossians return!

    Sadly, it looks terribly ominous for us here in Australia with our new government led by PM “Tea Party ” Tony Abbott likely to head in a similar direction in cutting health funding and making it harder for people to access medical help.

    With this :

    http://www.abc.net.au/news/2014-04-23/peter-dutton-fuels-speculation-of-medicare-co-payment/5406482

    probably being the start of even more regressive anti-public sector healthcare measures.

  9. 9
    smrnda

    @lorn

    I think that really is the issue. The Investor Class believes that they deserve to control everything, according to their values, and balk at any area where the measure of success is not decided by money in their pockets. To them, it’s wrong and even immoral to have any standards other than ‘good for investors.’

  10. 10
    hm

    Same issue going on Canada as well. And its being led by the former head of the Doctor’s association. He also opened a private surgery clinic in Vancouver BC to prove some kind of point. I think one of the biggest complaints I hear is about wait times but I always wonder what people think is going to happen if healthcare is privatised. It’ll be similar to the situation in the US, with those who can pay getting access and those who can’t either delaying treatment or going without.

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