Some choice points in this article based on Britian's actual history of public healthcare. Basically, costs go up, good theories on savings and egalitarian notions of how public health will promote equality remain theoretical and bureacracy and lobbying reign supreme.
http://online.wsj.com/article/SB1000142 ... _lifestyle
New Efficiencies in Health Care? Not Likely
If the British experience is any indication, generic drugs and expert commissions will do little to lower costs
== interestingly enough, there is a federal law that prevents anyone from talking about what drug companies charge the states or feds. Apparently its basically the same price of drugs in canada and in other countries. basically only american private consumers get the shaft on the price of drugs
Thus, I could not but smile a little wanly when President Barack Obama said this week that he hoped an increase in the use of generic drugs, together with an expert commission to examine the cost-effectiveness of medical treatments, would make a significant impact on the vast budget deficit of the United States. We in Britain have been there and we have done that, and our health-care costs doubled, perhaps not as a result, but certainly at the same time.
== big surprise... except to you liberals.
President Obama also wants to move from a fee-for-service system, which gives doctors an incentive to perform expensive and doubtfully effective procedures, to one in which doctors are rewarded for preventing diseases that are so expensive to treat. On paper, prevention always seems much cheaper than cure. Health-care economists prove it very elegantly and convincingly over and over again.
== yea, but again nother one of those things that sounds good on paper, below are the results
In the poorer areas, doctors had no incentive—at any rate, no financial incentive—to improve their practice. It was rather the reverse. The worse the facilities they offered, the higher their income.
== no equality after all and even worse since doctors got paid a flat fee, encouraging your patients not to come to the office means you can take on more patients and earn more money!
In the 1990s, it was decided to change all that. Family doctors began to be paid to undertake preventive measures. The experts hoped that this would save money because the cost of preventing diseases would be more than offset by the savings from not having to treat the diseases that they prevented. (It is now merely a historical curiosity that, when the NHS was set up, its proponents seriously argued and believed that its cost would inevitably decline with time, since it would make the population healthier and less in need of medical attention.)
== so of course they started to incenticize physicians to improve their patients' health... (who actually believes thats going to work) and then we get another gem, one of the arguments for establishing the public health systme in britian was costs would go down because the population would be healthier. that sure sounds familiar.
It is true that in Britain we have had our own peculiar reasons for the spectacular rise in the cost of our health-care system. First Margaret Thatcher (inadvertently) and then Tony Blair (deliberately) corrupted our civil service—Mrs. Thatcher by allowing the bureaucrats to pretend that they were businessmen, with perquisites to match; and Mr. Blair by expanding this class of persons enormously, creating a powerful political lobby. The British system is now capable of absorbing infinite amounts of money with minimal benefit to the health of the population, though with great benefit to the pocketbooks of those who work in it.
== sounds pretty much like our government
British health-care system, however, I have seen a hundred schemes of cost reduction, but I have never seen any reduction in costs, or at least any that lasted more than a few months. I can't remember a single health minister who did not promise more efficiency at less cost, or a single one who actually managed to achieve it.
== word. can i tell you about the state data center in Oregon? was supposed to save millions by consolidating IT and services for like 10 different departments... lets just say that was a disaster, except on paper.
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