Forums » Off duty » Journal club » Health reforms: what can the UK and US learn from each other?
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Health reforms: what can the UK and US learn from each other?
posted at 15/4/2011 10:30 AM BST
on bmj.com
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Posts: 78
First: 21/7/2010 Last: 16/5/2012 |
From time to time, doctors and politicians look across the Atlantic ocean to see what lessons might be learnt from comparing the UK health reforms with the US health reforms and vice versa. Here Martin Roland and Rebecca Rosen provide a superb guide for Americans who are perplexed as the “English NHS Embarks on Controversial and Risky Market-Style Reforms in Health Care.” Now I have just finished reading Jack Wennberg’s magnificent book about American medicine (Tracking Medicine, OUP 2010) in which he lays out the following principles for a reformed US system: 1. Promoting organized systems of health care delivery Roland & Rosen provide a Table 2 showing the differences between the US modes of provision and the proposed English reforms; my slightly less nuanced comparison of Lansley with Wennberg would be: 1. Destroying organized systems of health care delivery NEJM 7 Apr 2011 Vol 364 p1360 |
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Re: Health reforms: what can the UK and US learn from each other?
posted at 22/4/2011 2:38 PM BST
on bmj.com
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Posts: 70
First: 15/8/2009 Last: 10/4/2012 |
In Response to Health reforms: what can the UK and US learn from each other?: [I have yet to read Roland and Rosen's book but I do know something about US healthcare. And aas a Canadian working medicine on both sides of the border, I've seen it in comparison to our system. The principles R&R promote sound grand. But they're...unreal. Time and agan "patient choice" goes by the board when the patient has no insurance, minimal insurance, or an insurer who doesn't cover x, y, or z. Patient choice goes by the board in cases of "futility". Certainly, itis failure to insure millions of citizens--aroudn 47 million, makes its goal of "improving health care delivery" laughable. The US system is widely perceived as the least efficient, most expensive, least equitable system in the industrialized world. It's outcomes on a range of OECD indicators are not enviable. There are changes that can be made in England to diminish bureaucracy and improve care. But the US model is not the answer, I fear. look instead to Canada, or France, or Sweden, I'd say. Tom Koch Canada |
Forums » Off duty » Journal club » Health reforms: what can the UK and US learn from each other?
