I got sent a link to this earlier today by my girlfriend. She asked my opinion on it, and I thought it would make an interesting blog post - something I haven't really done enough of recently. I read the main article, and the comments, and will comment on both.
Unfortunately, everything in this life costs money. Other than in a perfectly communist system, this is always going to be the case. This includes healthcare. We all have a limited amount of money in our bank accounts. This means that we can't afford everything we want. I have to prioritise the things that I want for the things I can afford.
Governments have the same problem, only they have a much larger budget, and a much larger number of expenses to prioritise. The obvious arguement is that if one life can be saved by a drug that costs £3000, or 100 lives can be saved by a drug that costs £30, then given a limited amount of cash, the decision is obvious. This is a simplification, but it demonstrates the point that there is a limited amount of money available, and that it is important to do the greatest good with the limited resources available.
Someone on the forum, it was suggested that this problem could be solved by taking the money from other budgets. Now, whilst I agree that there are a lot of inefficiencies in nationalised systems, such as the NHS, I'm not sure that cutting their budget is the best way to solve these. I feel for a start that efficiency might be increased by paying significantly more to the top level managers - by paying the top wages, we might entice the best managers into these positions, and therefore counterintuitively increase efficiency.We could fund these increased wages by streamlining the management system, and eliminating the excess managers. This would mean that the same budget is paying for a better system. What it doesn't do is free up any money to transfer to any other budget, perhaps the budget for medications.
So, if we can't redistribute NHS money, where else can we get the money from?
How about the education system? I don't think anyone thinks that that is worthy of a reduced budget? Sanitation? Transport? Reducing funding to either of those is going to stretch the NHS even more as people catch diseases, ambulances break down on dodgy roads, more people crash......etc.
We all wish that treatment could be provided to all people regardless of cost, but this just isn't possible.
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This raises two points. Firstly is the terrible job that those at NICE have to do. I genuinely feel sorry for them, with one of the toughest jobs in the NHS, and constantly facing criticism whatever they do.
ReplyDeleteYou could view NICE as handling the biggest MAJAX ever - limited resources for 60million sick people - and they're got to "do the most for the most". And that underlies one of the key points of the NHS, which is that everyone should get the same standard of free healthcare at the point of entry. Although we all know in practice it doesn't work like that, the idea behind NICE is to try and make it so. The principle isn't that everyone gets the particular latest and greatest drug that they want, but they get the best under a given cost:benefit analysis. Want the other drug, despite the fact that the best evidence we have says that it isn't worth it? Well, you're free to pay for more healthcare insurance...
Secondly is the "drain" on NHS budget vs other aspects of government. We have a problem in our society of things that would normally by picked up by another state-run service (from social services through to the police) being dumped on the NHS more and more. This is leading to yet more pressure on the NHS budget, to the benefit of others. So perhaps we need to look at the amount of work that is being turfed, to see how the money can be redistributed?
Finally, check out spEak You're Branes for some more laughs at the expense of HYSers... :D