Doctor, doctor

Interesting that on the same day that the Republican-heavy House of Representatives repealed the healthcare reform bill, Britain’s Tory government announced plans to change a basic foundation of England’s National Health Service (NHS). Both efforts are supposed to save money for the respective governments.

It’s not entirely clear to me what, exactly, is changing in the NHS—something about putting the process of “commissioning” specialist care in the hands of General Practitioners (what we’d call Primary Care Physicians), instead of having these decisions made by commissions. I’m also not sure how effective the proposed changes are going to be, since—while the reform is meant to streamline the process and of course cut down on personnel costs—it turns out that the majority of the middle managers you’d have supposed would be eliminated are simply going to work in other areas of the system. And, BTW, this change applies only to England; I dunno what’s going on in Wales, Scotland or Ulster.

Messing with the NHS has been the political third rail in the UK that breaking Medicare is over here. No Congressmoron wants to face the prospect of the AARP storming his/her offices; and the NHS has been a basic tenet of British social contract since 1945. It was the most visible representation of HM Government’s acknowledgement that everyone in the country had sacrificed for the victory against the Axis, and that everyone was entitled to broad, basic services.

My sense, after living there several years, was that it was probably a brave new world and a fabulous system in the 1950s, but that it hadn’t progressed much in technology or approach since then, even at the turn of the century. Friends of mine there even now wait for specialist services for weeks and have to take whatever appointment the specialists graciously deign to offer them, or wait further weeks. That’s the price you pay for “free” healthcare. It’s like a nationwide HMO.

Of course, here we’re faced with the problems of expensive care, accessible only to those with money or good insurance, with insurance rates racing medical costs for the stratosphere.

I don’t know which is worse: open access to antiquated healthcare or cutting edge care available only to the moneyed.

But at least the Brits can now seek medical treatment across the EU. Not an accident, I think, that the rules for this were clarified on the day PM David Cameron announced the NHS reform.