THE TELEGRAPH: The future health care in both countries must involve a mix of state and private provision, says Janet Daley.
This week, the Coalition will offer an example of how coping with an economic crisis may serve a reforming purpose. Having to cut back the power and the expenditure of the state will provide a rationale for dismantling the monolithic, bureaucratic monster that the NHS has become. In his health White Paper, Andrew Lansley will apparently propose sweeping away the command-and-control structure in which clinical decisions are taken and hospital procedures commissioned by Primary Care Trust administrators, rather than by general practitioners who actually come face-to-face with people in need of medical help.
Fine. But if GPs are to inherit all the authority in this system, then it should be possible for patients to choose – and change – their family doctors easily and without recrimination. For, alas, Mr Lansley has decided to pass on the powers that he is confiscating from the abolished PCT mandarins exclusively to doctors rather than to patients. This is a real missed opportunity, but never mind: he is at least facing the right way, devolving decision-making down to levels where it can be done with more responsiveness and sensitivity to individual needs, rather than with the impersonal, blanket uniformity of a target-driven central authority.
The US government, meanwhile, is galloping doggedly in the opposite direction, bizarrely determined to occupy precisely the ideological ground which Britain is abandoning. Barack Obama has, indeed, appointed a man as head of the American public health care programmes who professes a passion (no other word will do) for some of the most discredited features of our NHS. Dr Donald Berwick is to head the Centers for Medicare and Medicaid Services, which effectively means that he will be in charge of Obamacare – the new universal health care system on which the President has staked his political credibility.
The appointment has created an extraordinary kerfuffle, partly because it was made under highly contentious circumstances – as a “recess” appointment which allowed it to bypass Congressional approval – but primarily on account of Dr Berwick’s widely disseminated statements extolling the virtues of the most disliked aspects of state-funded medical care as we know it.
Dr Berwick professes a love (which he describes in ecstatic terms that will have a tragicomic ring to most British ears) of just those evils of a national health system with which we are exasperated: the calculated rationing of treatment, and the ruthless enforcement of uniform cost limits, which often puts the most advanced medication and procedures out of reach of patients whose lives might have been extended or transformed by them. Dr Berwick thinks that our own dear National Institute for Clinical Excellence (Nice) – which is scarcely ever out of the headlines for denying some poor suffering victim a remedy that is available in other countries – is simply wonderful. Continue reading and comment >>> Janet Daley | Saturday, July 10, 2010
Americans will come to rue the day they ever elected B. Hussein Obama into office. He is nothing other than the iPresident. That ‘i’ stands for the Internet, through which he got elected; but it also stands for incompetence, inexperience, insincerity, incapability, irrationality, immaturity, oh and, of course, Islam! – © Mark
