The Deadly Impact of Government-Run Healthcare in the UK 10/20/12 by Dan Mitchell

[Bob]

horrible as it is, I'm wondering if this scandal with Jimmy Saville will, together with Hillsborough, "phone hacking", expenses scandal of MPs etc, finally crack open the sick pervasive secrecy and snobbish class culture crap of this country?
and thus, help us, because it plays a large part in keeping M.E. bottled up, secret and lied about.

I don't think that these individual events will change things for us, Silverblade, but I think that they are all part of a pattern of events that is leading in a direction that is favourable us.
I think it has all come about because of the information age, and I think that we are moving towards an age of transparency that will transform politics. And this process seems to be accelerating.
Like you, I've noticed this accelerated unravelling of previously stitched up corruption.
I think it's fascinating, and it seems to be accelerating, with new major stories in the media almost every month.
Like you say, there have been so many events that have unravelled recently.

I think we've already seen a difference for ME, over the past few years, because the internet has allowed us all to coordinate our efforts, and to fight those in the establishment who would like to maintain a monopoly on ME policy. I think we might have put a brake on the excesses of those in a position of power, in relation to ME. In the USA, Reeves was forced out of the CDC, which has led to slow but sure changes. In the UK, the MRC has changed its position on ME, and has dedicated funds towards biomedical research, and it seems to be following up on its promises. I think this is probably all related to patient advocacy.

I think the difference we make will now accelerate, but we've got a lot of catching up to do, in terms of research.

I'm so thankful that we have the internet, otherwise i'd have to rely on a quarterly magazine from a patient organisation for my only source of information!

 

[alex3619]

NHS though could do with vastly more openeness,
broken into far smaller " regional units" with own budget so less top heavy bureacracy,
easy way to fix the issue with docs is slash their pay BUT, make their education free (retroactivley too) provided they stay and practice in the UK for at least 10 years destroy the BMA, and set up independant monitoring system.

[my bolding]

Hi SilverbladeTE, you are stealing my thunder! Something I am hoping to address in my blogs is the notion of separation of powers. Government has different branches that cross check each other. So does any well functioning political system. It is not clear that such checks on power exist in the medical system, except superficially. This is a failure of political process. I presume it has to do with treating medicine as a privileged system, which is fine if its scientific and impartial ... but its highly political. Once its political, either there are checks and balances or corruption is almost inevitable.

The BMA does not need to be destroyed, but it does need to be completely redesigned, and it needs to have a third or less of the power it appears to have now, with equal power going to at least two separate agencies. That is how you balance political ineptness and corruption.

Bye, Alex

 

[SilverbladeTE]

Bob
yeah, a huge "sea change" is coming, whether those scuzzballs like it or not.
Far too much of an arrogant, paternalistic but grossly inept and corrupt culture

HUGE item has just exploed yesterday on Uk politics, related to this exposing of secrets...was/is there a powerful group of paedophiles at the heart of politics and power?
Brought up by MP who set off the "Phone hacking scandal" so this isn't a joke/conspiracy theory
Long suspected such for variosu reasons
http://www.bbc.co.uk/news/uk-politics-20070093
yuch
and anyone who thinks such couldn't hasn't gone on in their country...think again.

Alex
hehe
well it need destroyed because it's so corrupt, so deeply compromsied and linked to criminality (by letting mass murderers get away with it) that it is completely untenable in a civilized society
destory it to the ground
then build completey fresh and anew, you cna never "rebuild from the inside" when things are so bad. Example, see UNUM "oh we've changed!"...bullshit they did!

as time goes on, corruption, nepotism and inpetitude always subvert our systems
we cannot afford such in this day and age, hence it's tearing our systems and very world, apart at all levels.
Hence as I keep saying, only way we can ever hope to dig out the entrenchment of privellege, corruption etc, is to have "democracy by lottery", because encumbancy guarantees corruption and stupidity
they wish re-elected so they do whatever it takes ot curry favour and stay in power.
privelege and iniquitous wealth lead to class systems where they have no understanding of the realities of life or the consequences of their actions.
whether for corruption or believing "ends justify the means" and they are "the best person to lead" and eventually become corrupt anyway, it's not viable.
Re-elect *NO ONE*: make populace lead themselves, like it or not, true representative democracy.

the party system makes damn sure no one wants ot tackle the pharma corps or others, becaue they get much of their campaign contributions from them (and other corproations/power barons) AND especially in the UK, they walk out of Parliament into nice cushy jobs with corporations they dealt with
and thus when it gets to pharma and insurance corporations, and links with welfare systems in government (D.W.P.), that affects us M.E. patients.

 

[WillowJ]

Something I am hoping to address in my blogs is the notion of separation of powers. Government has different branches that cross check each other. So does any well functioning political system. It is not clear that such checks on power exist in the medical system, except superficially. This is a failure of political process. I presume it has to do with treating medicine as a privileged system, which is fine if its scientific and impartial ... but its highly political. Once its political, either there are checks and balances or corruption is almost inevitable.

very smart, Alex.

 

[WillowJ]

the comparative success of health care systems depends on what is measured and in what way things are compared. For instance, different nations define and measure infant mortality in different ways (plus, access to health care can contribute to infant mortality as infertility treatments may produce multiples, which tend to have a low birth weight, which is a risk for mortality). Also, when we measure overhead costs, what is counted as overhead might not be directly comparable from nation to nation.

There are differences in mortality, also. When we check life expectancy rates to see whether our health care models are working, is it really relevant to include traffic accidents and gun crimes, or do we really want to know, for instance, cancer survival rates? The fact is that USA has better statistics on illness mortality and morbidity than other nations generally have.

Yet even as Stockholm and Saskatoon are percolating with the ideas of Adam Smith, a growing number of prominent Americans are arguing that socialized health care still provides better results for less money. “Americans tend to believe that we have the best health care system in the world,” writes Krugman in the New York Times. “But it isn’t true. We spend far more per person on health care . . . yet rank near the bottom among industrial countries in indicators from life expectancy to infant mortality.”

One often hears variations on Krugman’s argument—that America lags behind other countries in crude health outcomes. But such outcomes reflect a mosaic of factors, such as diet, lifestyle, drug use, and cultural values. It pains me as a doctor to say this, but health care is just one factor in health. Americans live 75.3 years on average, fewer than Canadians (77.3) or the French (76.6) or the citizens of any Western European nation save Portugal. Health care influences life expectancy, of course. But a life can end because of a murder, a fall, or a car accident. Such factors aren’t academic—homicide rates in the United States are much higher than in other countries (eight times higher than in France, for instance). In The Business of Health, Robert Ohsfeldt and John Schneider factor out intentional and unintentional injuries from life-expectancy statistics and find that Americans who don’t die in car crashes or homicides outlive people in any other Western country.

And if we measure a health-care system by how well it serves its sick citizens, American medicine excels. Five-year cancer survival rates bear this out. For leukemia, the American survival rate is almost 50 percent; the European rate is just 35 percent. Esophageal carcinoma: 12 percent in the United States, 6 percent in Europe. The survival rate for prostate cancer is 81.2 percent here, yet 61.7 percent in France and down to 44.3 percent in England—a striking variation.
...
America is right to seek a model for delivering good health care at good prices, but we should be looking not to Canada, but close to home—in the other four-fifths or so of our economy. From telecommunications to retail, deregulation and market competition have driven prices down and quality and productivity up. Health care is long overdue for the same prescription.

(my bolding)
http://www.city-journal.org/html/17_3_canadian_healthcare.html

(naturally some amount of regulation is needed - the argument is that the regulation should be the minimum necessary in order to keep people safe/not bullied. In other words, yes, solve, for example, the problem of people becoming permanently uninsurable. But do this without creating a bureaucracy which decides what health care interventions are appropriate for specific types of patients; that is what I would call unnecessary regulation--we pay doctors to help us make those kinds of decisions, and we have medical boards which, in theory, regulate the expertise of the doctors. Having non-medical politicans decide these things on a one-treatment-fits-one-profile [e.g. disease & demographics] basis is, in my opinion, untenable.)

p.s. I think some of our excess health care spending goes to research. US carries out more research than any other nation. I don't have to tell this audience about the importance of research.

 

[alex3619]

Hi Willow, yes the USA government medical research is probably more than that of the next several largest spenders combined. As for private research (big pharma etc.) they are multinational so I am not so sure. Several of the large ones were European, but they have amalgamated into huge research/marketing juggernauts.

The US medical system seems to run the gamut of fantastic to pathetic, depenging on insurance (or lack) and permitted services under various care plans. If I could pick the best medical care there is a very good chance for any particularly thing I would be picking the best in the USA.

As for cost effectiveness, thats another issue, the US is also the most expensive by far.

I think evidence based medicine should be only considered advisory. There a tendency however to adopt it as evidence based management. Thats combining management practice with science and often dodgy science at that. Its a disaster unfolding in my view. The UK pioneered this, and promoted it, and its still spreading - but largely because its been adopted by many insurance companies, primarily health care insurers.

We need something like EBM, but with more science than we have now, and less management principles governing its use. What the world risks is a the creation of a superagency that dominates medicine world wide that individual governments cannot control. It would be the ultimate monopoly. If it proceeded via strictly scientific advances, that might not be such a bad thing. However politics and big money will rapidly corrupt such an organization. Its power base needs to be decentralized, transparent and its "science" subjected to rigorous debate. It needs competition. A single unified agency funded by corporate interests would have way too much power and way too little in the way of controls on its actions.

Bye, Alex