Donald Berwick former acting head of CMS and author of Obamacare wrote, in a
personal letter to “Senior Government Officials and Senior Executives of the National
Health Service in England after doing a review of the NHS.”
Donald Berwick added, “redistribution of
wealth is the very essence of a compassionate healthcare system for all.”
disagreed with Dr. Berwick in an earlier blog. I said citizens responsible for
their own health, healthcare and healthcare dollars are essential ingredients
for a cost efficient healthcare system.
are the primary stakeholders. Patients must be actively responsible for their
health. They must have a moral and intellectual responsibility for their own
health as well as a financial incentive to be responsible for themselves.
must have own their healthcare dollars, have the freedom to make their own
healthcare choices and have access to care.
government must create educational vehicles to help patients make the correct
The government must provide financial
incentives for people to make those choices.
care and medical decisions made for patients by a bureaucracy has historically
failed to control costs or provide efficient and compassionate medical care.
medicine run by bureaucrats has failed in England. Medical care consumes more
than 50% of England’s GDP.
Is A Fact (TIAF)
is wonderful for people over 65 years old. Seniors could not buy healthcare
insurance from a healthcare insurance company. The healthcare industry had not
figured out how to make money from these people so they disqualified them.
Is A Fact (TIAF)
and Medicaid provide no incentives for patients to take care of their health.
it has be demonstrated that a government controlled system creates ever
increasing bureaucracies and cost inflation.
Is Fact. (TIAF)
all of the nation’s attempts to control healthcare costs in the past 50 years
have failed. (Price control of the 70’s, HMO’s, Managed Care, PPOs.)
systems had to be abandoned. Nevertheless, healthcare policy wonks continue to
give the same advice and make the same mistakes. The policy wonks’ advice is to
institute greater government controls over medical care.
Is A Fact (TIAF)
A recent report about England’s hospital
conditions in Mid Staffordshire has emphasized the defects in England’s 60 year
socialized medicine experiment.
report only covers hospital inpatient defects. It does not cover the many
defects in outpatient services.
many patients the most basic elements of care were neglected.
for help to use the bathroom were ignored and patients were left lying in
soiled sheeting and sitting on commodes for hours.
Patients felt afraid and disenfranchised.
were left unwashed, at times for up to a month.
Food and drinks were left out of the reach of patients and many were forced to
rely on family members for help with feeding.
failed to make basic observations and pain relief was provided late or in some
cases not at all.
were too often discharged before it was appropriate, only to have to be
re-admitted shortly afterwards.
The standards of hygiene were at times awful, with families forced to remove
used bandages and dressings from public areas and clean toilets themselves for
fear of spreading infections.
healthcare conditions caused the deaths of an unknown number of patients.
Robert Francis QC Inquiry Chairman who wrote
the report covered a wide range of system failures. I will only highlight the
key failures contained in the 500-page report. This report was mandated by the House of Commons.
These defect are occurring throughout the
entire NHS system. The NHS is not as glorious as the Obama administration or
Dr. Berwick’s has idealization the NHS to be.
"The trust board did not listen
sufficiently to its patients and staff or ensure the correction of deficiencies
brought to the Trust’s attention."
The NHS bureaucracy did not put patients
first. It put the various levels of bureaucracy in charge. Bureaucracies deaden
incentives and lose focus on who is the main stakeholder in the healthcare system.
trust failed to tackle an insidious negative culture involving a tolerance of
poor standards and a disengagement from managerial and leadership
failure was in part the consequence of
allowing a focus on reaching national access targets; achieving financial
balance and seeking foundation trust status to be at the cost of delivering
acceptable standards of care."
statistical reports and collection of reports are more important that
appropriate patient care.
Francis goes on to outline how the bureaucracy puts measurements first, not
of the bureaucrats want to take responsibility for what is going wrong. Finger
pointing and blame shifting is an occupation in the British healthcare system.
NHS system includes many checks and balances. These checks and balances should
have prevented serious systemic failure of this sort."