Archive for the ‘healthcare’ Category

Health and Debt

July 2, 2008

There are a lot of links between health and debt. And I am not here talking about url references; many people have experienced one or more of those links, and unfortunately many more will do so.

My mind turned to this when I came across an article by Janet Daley on Monday for the Daily Telegraph ( floating the appalling idea of ‘top-ups’ in our health service.

There are two meanings to this, happily confused by some to win a different argument. There is the issue of topping up one’s medicines or treatments over and above NHS treatments, and there is the very dangerous idea of turning the NHS itself 2, 3 or four tier.

Like all health services round the world the NHS struggles to offer equal treatments everywhere and all the time. These are problems of management and funding, rather than structure. As I say that is shown by the similar difficulty of all structures in use.

The cost of new treatments and of ageing populations is also experienced everywhere, so do not be taken in by the cost arguments either.

In fact, and you may check the OECD figures on this, the NHS and British healthcare in total is far less costly than in almost every other country, and only in Britain is there near achievement of treatment of need, free at the point of delivery. In value for money I do not think there is a better system.

There are specific differences you can compare if you wish, and that will depend on a political view, or a personal experience—from the considerable discussion I have been involved in and the long interest in healthcare issues.

But Ms Daley (yes, I finally got back to that!) is actually talking of the healthcare system in the US, and the experience of it for the well off and the rich. Over the past six years or so I have had considerable discussion and revelations about the US system and in he past three I have had the cyberspace equivalent of stand up rows on it too.

My net warning to all that fall into neither the category of well off nor of rich is do not laud, applaud or talk up the US system or any aspect of it. It costs, per head of population or percentage of GDP, twice as much as our system—around 16+% against our 8+%.

Yet Americans are hardly covered at all by a convoluted, complex and out of control system that involves insurance companies, Medicaid and Medicare, patch ups, voluntary and welfare sectors, Federal involvement and State involvement, and, of course, the Aggro-chemical industry (and that is not a typo, that is my opinion ;-)).

Oh, and even if you are fully covered by insurance, you still have to pay the major part of any serious healthcare or accident treatment out of your own pocket—and always some top-up to any treatment or drugs.

And where does debt come in?

There are countless cases of American families, hit by serious illness or accident of some sort, that has required a lot of treatment—and that means ‘expensive’—that have had to find so much money for that treatment that they have ended up bankrupt, and even have lost their homes.

This situation mostly applies to middle class families—poor families are lucky to get the most basic patch up! and around a third of doctor time is wasted arguing with insurance companies. Crazy, crazy system.

That to me is uncivilised. For the richest country in the world to persist with this is quite beyond my comprehension.

But even here, where our treatment needs are met, and of course there are imperfections—still better than the imperfection of no treatment at all—ill-health and accidents cause the most serious strains on budgets, and on the ability to apply energy to keeping going.

Debt then is more than likely to rear its ugly head anyway; and facing the problems of repayment can be testing, even if our creditors are understanding and supportive.

Unfortunately an awful lot fail the test of supportiveness. Can you imagine how hard it could be if we had to find large chunks of money for the treatments as well? Value our National Health Service, resist the calls of the selfish for Americanised—including ‘privatised’—healthcare.

And let’s keep our debt problems as manageable as we can!