Sunday, July 25, 2010

Hurray for Britain! "Britain Plans to Decentralize Health Care"

so reports New York Times in its July 24, 2010 article:

Britain Plans to Decentralize Health Care
(Sarah Lyall, 7/24/2010 New York Times)

"LONDON — Perhaps the only consistent thing about Britain’s socialized health care system is that it is in a perpetual state of flux, its structure constantly changing as governments search for the elusive formula that will deliver the best care for the cheapest price while costs and demand escalate.

"Even as the new coalition government said it would make enormous cuts in the public sector, it initially promised to leave health care alone. But in one of its most surprising moves so far, it has done the opposite, proposing what would be the most radical reorganization of the National Health Service, as the system is called, since its inception in 1948.

"Practical details of the plan are still sketchy. But its aim is clear: to shift control of England’s $160 billion annual health budget from a centralized bureaucracy to doctors at the local level. Under the plan, $100 billion to $125 billion a year would be meted out to general practitioners, who would use the money to buy services from hospitals and other health care providers.

"The plan would also shrink the bureaucratic apparatus, in keeping with the government’s goal to effect $30 billion in “efficiency savings” in the health budget by 2014 and to reduce administrative costs by 45 percent. Tens of thousands of jobs would be lost because layers of bureaucracy would be abolished.

"In a document, or white paper, outlining the plan, the government admitted that the changes would “cause significant disruption and loss of jobs.” But it said: “The current architecture of the health system has developed piecemeal, involves duplication and is unwieldy. Liberating the N.H.S., and putting power in the hands of patients and clinicians, means we will be able to effect a radical simplification, and remove layers of management.” " [Emphasis is mine. The article continues.]

Just when the US is about to exert unprecedented government and bureaucratic control over health care, Britain is going the opposite way of cutting the government and bureaucratic control and "putting power in the hands of patients and clinicians".

Way to go, Mr. Cameron. I still don't think much of your "community organizing" idea with your "Big Society" thingy (please don't ape Obama), but I do like your health care reform idea of giving the power back to patients and practitioners. I like your Chancellor of Exchequer's idea of 25% haircut of government spending, too, although I don't think much of the tax increase part of his budget.

Even though I'm not British or living in Britain, I nonetheless feel somehow encouraged by the news like this. There's a sense that things will get better for Britain, that things may be starting to move in the right direction, that there is a spring in the steps, so to speak. In other words, there is "hope", maybe.

Alas, that sense is currently sorely lacking in the former British colony across the Atlantic.

Now, let's see what Obama's recess appointee (as the head of the Centers for Medicaid and Medicare Services) Dr. Donald Berwick, who is in love with the British health care system as it stands now, is going to do. He wanted to copy the British system. I dare him to copy the new British system that may emerge soon.


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