As a result, the frontline stuff gets mixed together with everything else so that it becomes hard to criticise elements without being accused of being unsupportive of the whole thing.
I think there's a problem if an organization has 'national' or '[country name]' in its name and people are forced to fund it. At that point, you seem unpatriotic if you criticize it and you don't have a choice whether you fund it or not. For most people it means they have no choice but to use the NHS. And criticism of it will be met by 'WELL I SUPPOSE YOU WANT TO MOVE TO THE US SYSTEM WHERE PEOPLE GO BANKRUPT IF THEY GET ILL?!'. And then you patiently explain
Bismarck versus Beveridge, and how in the Euro Health Consumer Index (ECHI) 2009 found that
https://archive.vn/AwxDv
Anyway, the point the reports makes is that, "Looking at the results of the EHCI 2006 – 2009, it is very hard to avoid noticing that the top consists of dedicated Bismarck countries, with the small-population and therefore more easily managed Beveridge systems of the Nordic countries squeezing in. Large Beveridge systems seem to have difficulties at attaining really excellent levels of customer value."
The following list shows the rankings of Western European healthcare systems according to their 2009 score. The Bismarck countries are in bold:
( 1 ) Holland, ( 2 ) Denmark, ( 3 ) Iceland, ( 4 ) Austria, ( 5 ) Switzerland, ( 6 ) Germany, (7) France, ( 8 ) Sweden, ( 9 ) Luxembourg, ( 10 ) Norway, ( 11 ) Belgium, ( 12 ) Finland, ( 13 ) Ireland, ( 14 ) UK, ( 15 ) Italy, ( 16 ) Spain, ( 17 ) Greece, ( 18 ) Portugal.
And then they'll say 'Isn't the US system a Bismarck system?'. And the answer is no, it is not. In a Bismarck system, you have a choice of healthcare providers, but you must pick one. No one goes bust due to healthcare costs. They'll also typically say that Beveridge systems work well in Nordic countries. This is true but those countries are small and culturally homogenous, unlike the UK. At this point, they'll accuse you of racism for thinking that 'culturally homogenous' makes a difference. Of course, it most certainly does. Your family is more like a socialist system internally than a free market one but it works because you don't act against the interests of your family members because they're family. Extend that to your street and it would be a disaster. Also, they'll say the Adam Smith Institute is Thatcherite, which is true, but the ECHI is just collecting and analyzing data. The Adam Smith Institute linked to that data because it confirmed their beliefs, but that doesn't mean the study is invalid. There are good reasons for thinking the UK should adopt a Bismarck system. Give people a choice, if they don't make a choice just give them the NHS as a default.
Incidentally here's the latest ECHI report. Page 21 contains the Bismarck vs Beveridge outcome. Spoilers- Bismarck wins again.
There really needs to be another layer in the system : drop in clinics, fracture clinics, minor injuries etc. Stuff you need to be seen quickly for but don’t need emergency - too much of that ends up clogging A and E.
A lot of drop-in clinics have closed in recent years. To be honest I've got an issue with the way GPs are gatekeepers for the whole system. I've been in other countries where you just go straight to a hospital and the person at the desk directs you to the relevant department. In the UK you can wait a long time before you get to see a GP if you're in a shitty area and even longer to get the required referral to go to a hospital. The UK's system rations healthcare by what is effectively queueing. If you've got something urgently wrong with you, this is bad news, though admittedly the NHS seems to be very good for acute problems like broken limbs. They'll patch you up and send you. What's more worrying is getting diagnosed if you have cancer, let alone treated.
I've used the healthcare systems in other places too. Given a choice of where I could get sick in Europe, I'd pick somewhere like Holland. Small country, Bismarck system, number one score on the ECHI study. The Dutch are pretty easy to deal with too. If I was trying to improve a healthcare system I'd try to clone the Dutch one as much as possible.
If you're in Asia, go to Taipei and pay cash. It's like $20 to get an X-ray with no insurance and you'll get it analyzed the same day by a US-trained doctor. And you can probably join their single-payer system if you're running low on cash.
In other news, MedCram has a new video out on PCR vs antibody tests and why we need the latter to see who is immune.
COVID-19 Update 54 with critical care specialist Roger Seheult, MD of https://www.MedCram.com Production of COVID-19 antibody test kits are ramping up - ther...
www.youtube.com
