From across the pond comes this warning via the United Kingdom’s The Times:
There is a truth about modern healthcare that, in the politics of the day, is consistently ignored. Demand will always beat supply. A story could be written every day with the same basic message. There is never enough…
Back in the real world, the pressure on cost is remorseless. A recent report from the King’s Fund and the Institute for Fiscal Studies (IFS) showed how the NHS cannot provide a comprehensive service on current assumptions after 2011. To freeze the budget again would require an extra £10.6 billion over the next spending review period. Some of the shortfall could, in principle, come from increased productivity, up to 7.7 per cent per annum, according to the IFS. This is an heroic assumption in a service in which, as the Office for National Statistics recently showed, productivity fell 4.3 per cent over the decade from 1997.
This immediate cyclical pressure is bad enough. It will be a major political headache for whichever Andrew inherits it. But the structural deficit in health spending is even more serious. The IFS has concluded that, even if the NHS budget is not cut in real terms over the next spending review period, funding is likely to fall short of the population’s healthcare needs by more than £30 billion.
That is because the demands we have of the service are now out of all alignment with our willingness to pay for them. There are more pensioners than there have been in any previous era and they are living to the ripe old ages at which they contract expensively treatable diseases. The innovative genius of health scientists has made more diseases treatable, usually with new drugs that are, at least initially, very expensive. It is not surprising that citizens demand all that can be done. In a public system, every citizen is sensitive to pain and insensitive to price.
At the same time, healthcare is getting less effective at preventing conditions, such as obesity and its associated links with diabetes, that are the upshot of dietary and lifestyle choices. The National Health Service has never really been that. It is more of a national illness-fixing service. The health of the nation actually has rather little to do with the NHS and that poor correlation is getting worse, to costly effect.
These are serious problems, but the solutions are not hard to enumerate, even if they are difficult to swallow. We cannot afford all that we can do so healthcare will have to be rationed further. We can do this by price, by availability or by time. Patients can be charged for some services that are currently free; some elective and non-catastrophic services may have to be excluded from the core set of NHS interventions; or people will again have to get used to waiting a long time.
The United Kingdom’s National Heath Service is in trouble. Not enough doctors, and what care there is available is rationed. On top of it all, money is the driving factor, not patient care. Canada is in similar circumstances.
Why do our politicians persist in their belief that a nationalized health care system is possible that can provide quality health service to all? In reading the bill (and the summaries), it can’t without cost controls, and this means rationing. This means someone is going to lose out. Is that person going to be you, your significant other, your parents, your neighbor, or just some poor schmuck that you do not know?
The best question that I can ask our elected officials is: Are you willing to set aside your enrollment in the Federal Employees Health Benefits Program (FEHBP) and join the rest of the population in this grand experiment? If you are unwilling to subject your family and yourself to the same program as what you are wanting to put us into, then kill this bill and never bring it up again.
You, our elected officials, are elected to lead the American people by example. If you are unwilling to do this, then step aside and allow someone else that has the intestinal fortitude (and qualifications) to take your place.