UK Parties, Politics, and Healthcare
Great Britain has an upcoming election. Just like the United States, we have a big healthcare debate. And as usual, debates get more intense around election time.
We spend approximately 8.9% of our GDP on healthcare, and this provides a universal service with pretty good outcomes. (This compares with just over 17% GDP in the States, with perhaps 30% of the population unable to access prepaid healthcare.)
In the UK, we are aware that some care won't work — for example: a joint operation (hip or knee) may be refused for a very obese person — and there is considerable risk that they may die under anaesthetic, and a strong likelihood that they are obese condition means they won't actually benefit from the joint replacement.
But the political parties still have something to argue about:
The Conservatives (leaning to the right — small government, low taxes) argue that the family GP should hold the patient budget and (out of altruism of course) 'purchase' whatever care he thinks the patient needs.
The Labour Party (leaning to the left — central policies and targets, "nanny state") has set up a system of checks and balances where professional commissioners have the money, hospitals take the money, and both sides pay lip service to GPs but certainly don't let him have any money.
The Liberal Democrats (somewhere in the middle, but nobody is quite sure where) believe that patients should have rights, more should be done in the community, and savings from moving care out of hospital can go to lower taxes (not to the people providing care).
What they don't argue about is how much money all of this will cost: they all seem to agree that there will be more patients, but the budget will remain about the same (around £110 billion = $155 billion or $3000 per man woman or child population). So what it really comes down to is who holds the cheque-book.
I'm asking "who wants to hold the cheque-book?" The busy family GP is dedicated to medicine and to his patients, and never trained to be a manager. He or she is often ill-equipped to understand the average needs of the population of a small town, and typically doesn't want to think of it in terms of ££ and pence.
But with the parties on the electioneering trail, nobody has time to stop and ask a doctor.