A post by Pat
The day after the Democrats muscled the health care abomination into law, the President was out in the hinterland joking that the sky had not fallen. He really thinks we’re that stupid. (Besides, global warming is going to make the sky fall.) In fact, it is a lovely day, he said. For him maybe. For health insurers, it was just a day like any other over the past year. They continue being lambasted and vilified as much as ever. The Democrats think it is their best card to play to change public opinion. For those who are taken in by this tactic, they should be informed about the NHS disinvestment planning.
What would the President say about insurance companies if we saw stories like these? What would we think?
“Insurance CEO Says Elderly Get Confused in Hospitals, Should Receive Home Care Instead”
Insurers Say Volunteers Should Replace Home Care Professionals
“Health Insurance Co’s Tell Hospitals Reduce Costs, Fire Staff, Cut Number of Beds”
“Cut Ambulance Service To Save Money Say Insurance Execs”
Or this Orwellian gem:
Health Insurers: “We need constantly to disinvest so that we can afford to offer patients the best treatment.”
Insurers can’t dictate any of that to health care providers, but the NHS in Britain can. Those ideas are actual or suggested ways for the NHS to cut back on health care. We’ve talked about NHS horror stories before and we will again. If Obama won’t stop talking about the evil insurers, then we won’t stop pointing out what happens when governments alone manage health care.
NHS ESRC Seminar Series, March 2007–The challenge of disinvestment. (power point)
“NICE should be asked to issue guidance to the NHS on disinvestment, away from established interventions that are no longer appropriate or effective, or do not provide value for money. —CMO Annual Report 2005
Hospital wards to shut in secret NHS cuts
10 per cent of NHS staff being sacked in some areas. The loss of thousands of hospital beds. A reduction in the number of ambulance call-outs. Medical professionals being replaced by less qualified assistants.
The final details of the plans are not due to be announced until the autumn, well after the country has gone to the polls for the general election.
Tammy talked about studies questioning breast cancer screening . The BMJ has many other suggestions for reducing or eliminating treatments and screening in the name of disinvestment. It won’t be a real loss, you see, these things were never really necessary in the first place.
Honestly, not being a physician, I don’t know if these suggestions objectively have merit. For all I know, insurers may have suggested similar steps. Only a government can impose them.
Articles on disinvestment published in the BMJ
…an editorial notes that methods of promoting disinvestment tend to underestimate the factors that promote resistance to the kinds of change a strategy of disinvestment is bound to cause. They look at research indicating why disinvestment is likely to meet resistance, and list five key challenges in its management: lack of resources to support policy development; lack of agreement about comparative cost effectiveness within and between disciplines; political, clinical, and social resistance to removing an existing technology or practice; disputes over evidence; and lack of research into disinvestment as a policy option and practice. They comment that “we shouldn’t be looking only to cut things but to ensure that funding is focused on healthcare interventions and technologies that optimise health outcomes, individually and collectively.” [my emphasis]
Shrinking budgets, improving care: Trade-offs are unavoidable
Beyond the cultural, political, and ideological arguments that have been extensively discussed, there are three critical broad objectives with inherent policy trade-offs that must be considered in any debate on health care policy: high quality, disciplined funding, and maximum coverage. Coverage generally refers to the percentage of a country’s population eligible for state health care services and the comprehensiveness of these services. Quality refers to the efficiency and effectiveness of the health care services provided, and funding refers to the public expenditures for health care incurred by taxpayers.
The problem is that these three objectives cannot all be achieved concurrently. Structurally intrinsic trade-offs mean that, at most, only two of the three objectives can be satisfied.
There are specific recommendations for elimination or reduction of tests and treatments which are beyond my ability to judge. Some general concepts:
Experts’ guide to saving money in health
[Cardiology] …patients tend to be elderly, and Professor Timmis says for patients who were coping well at home before admission “every day spent in hospital is a disaster as patients lose their independence and are at risk of hospital acquired infections.”
[Gastroenterology] “We need constantly to disinvest so that we can afford to offer patients the best treatment.”
[Management] There is a need to strengthen community services to maintain patients at home and to prevent admissions,”… This is particularly important for elderly and infirm people, who “once admitted, stay much longer than necessary, incurring cost to the NHS and cost to themselves in terms of confusion resulting from a strange environment.”
[General Practice] Strengthening community support will also save money. “We can’t sustain a health system where everyone who is discharged from hospital gets care at home.” He cites the successful programme in Canada where a network of community volunteers offer support to patients in the community. Dr Heneghan suggests GPs could keep a list of volunteers to provide help such as distributing meals,visiting patients after discharge from hospital, and providing transport…
[Rheumatology] Cuts could also be made by “preventing over-investigation through vetting and reviewing requests and stopping radiography for lower back pain as per NICE guidance.” […] reducing or even eliminating follow-up for non-inflammatory conditions, and stopping direct referral to rheumatology for soft tissue conditions and simple back pain would also create savings.
When the insurance companies are gone, the government can do whatever it wants to determine the quality of our health care. If you know people who have been taken in by Obama’s anti-insurance industry demagoguery, tell them about the NHS disinvestment plans. Ask them if any insurance company could get away with it. Don’t forget the mop closets. And for good measure, NHS turns injured toddler away due to computer shutdown.
In their feeble defense of themselves, the insurance companies point out the health care bill does little or nothing to address the underlying problem of health care costs.
If we’re going to get rationed care, let it be in a competitive private insurance system, not a government run nightmare.
Leave it to the Democrats to find the solution: “Hey, let’s not raise the bridge–let’s lower the river!”
Why would a government agency repeatedly suggest ‘community volunteers’ as a solution to rising costs? I don’t get it. Isn’t the government God and Obama his promised messiah, who with unlimited resources takes care of all its children from the cradle to the grave? Why would DHS and other godlings in The One’s Heavenly Kingdom need to ask for help from charitable people who serve a different God?
Oh, I see now. They are asking for charitable acts from their own faithful, not from me or anyone else who believes that government is not the entity referred to in one of our founding documents (as the self-evident grantor of the few stated unalienable rights of Life, Liberty and the Pursuit of Happiness).