An outsider's view on the reforms
As an outsider I can’t really imagine the impact that the reforms are having. I never witnessed on my own skin a truly private healthcare system. For some reason there seems to be prevalence or a trend in the recent years to encourage privatisation of the health care system. As a senior high school student in the Czech Republic, I witnessed the recent strike of the medical staff demanding higher pay checks. A lot of them left their jobs for better paid positions in Germany and other EU countries in order to show the public how important their position are, they called this the ‘doctor’s exodus’.
The point is that privatisation is attractive because it does generate a certain profit which makes the hospitals fiscally self sufficient. In the UK some 20-30 hospitals are being threatened with closure due a lack of funds, and some £20bn are to be made in cuts over the next four years by the NHS. Hospitals are to be made more profitable in order to survive. Change seems necessary but should the government really be implementing new reforms when there are massive cuts to be made? By privatising the government leaves this burden of saving cuts to the GP commissioned committees.
To make matters worse the reforms seem to me like a mangled and incoherent system of regulations that have been altered a multiple of times to please everyone but ended in creating only more chaos than good. Instead of burying it and starting all over from a fresh start, they were refaced and then passed. The replacement for the Primary Care Trusts seems to be a very diverse committee ranging from physician and nurse representation to patient representation. If all these voices are given the floor to speak it must create a racket equal to that of a pre-school playground. Of course every voice should be represented but is it necessary to have a citizen’s panel examining how new choices and competition are working? These Commission groups appear to be perpetuating themselves in bureaucracy and affecting their environment with it as well. Furthermore with the cap on private income being lifted the influx of private patients into NHS hospitals has increases the waiting lists greatly. Suddenly doctors are supposed to be managers as well and take the blame for potential future issues.
The emphasis is on to make hospitals more competitive between each other and to fight for patients. In a way the concentration has shifted from the physical well being of the patient to his material well being. The question then is; should hospitals generate a profit? To create an institution where one of the goals is to generate a profit through providing healthcare is a logical fallacy in itself, if the institution is meant to increase the general physical health of the populace.
How can it be in the interest of such an institution to create a healthier generation that would seek less assistance of said institution? The main objective of the hospital should not be to function on the basis of demand, but lower the demand to as low as possible. A brighter future means less necessary visits, fewer procedures and less treatment altogether. To make a hospital to be able to fund itself is all fine and very good, but only if it is done in such a manner that doesn’t affect the patient’s chances of recovery and criteria for treatment.
In the US doctors don’t look at the costs of each treatment. They sign the patient up for all the tests that should be conducted and even those that shouldn’t, just to be safe. This may sound nice but in practice this means when a person is subjected to serious trauma such as that of a car accident, he or she gets visited by insurance agents every so often so the insurance agency can judge whether it is necessary to keep the patient in the hospital. Then again there are physicians who went through med school for all the wrong reasons, and put their patients to unnecessary tests and treatments in order to increase the size of the bill sent to the insurance agents. In the end the so precious patient whose well being should be the main issue is lost, confused and aggravated.
The Libertarian sentiment which dominates the reforms is, in my opinion, a grave mistake. There are certain public sectors, such as healthcare, which should never suffer an invasion from the private sector. To have a private healthcare as an alternative is fine but to eliminate any alternative and establish it as the only way to receive help is quite wrong. The private sector tends to blow prices out of proportion and thus the United States spends on healthcare more than a substantial amount above the median of the OECD countries while the use of healthcare service is often well below the median.
The reforms could appear to be beneficial but only if the government keeps a strong grip on the private companies which it will try to maintain, but there will always be some chinks in the armour. By limiting the government involvement in the public’s affairs on account of strengthening the individual’s rights has appeared to be somewhat beneficial, but if it is too benevolent it may result in extreme results where the individual’s rights are enhanced to the detriment of the society.