Universal health care requires ideas
By M.P. Ravindra Nathan, M.D.
Published December 19, 2006
I had an opportunity to go to London this year and visit my old Royal College of Physicians, from which I obtained my postgraduate degree in medicine many years ago. This time I was there to receive the honor of Fellow of the Royal College of Physicians of London and while there, I wanted to renew my links with the college. Having spent nearly four years in England in the 1960s before coming to the United States, I have fond memories of my days there. This indeed was an opportunity to relive those experiences and reconnect with the current status of British medicine.
The Royal College of Physicians is one of the oldest and most prestigious medical foundations in the world, incorporated by Royal Charter in 1518. The ceremonies for the presentation were spectacular, complete with the traditional procession in all its pomp and glory, which we have come to associate with all the royal functions in Great Britain.
More important, I got a chance to listen to the president, professor Dame Carol Black, and other distinguished senior physicians of the RCP who discussed the many facets of British medical education and health care.
Professor Black, in her keynote address, stressed the many challenges involved in the care of acutely ill patients in Britain's National Health Services system. She especially noted the importance of "the multidisciplinary nature of clinical practice and the evolution of teamwork and shared competencies." Fortunately, the United States adopted this policy many years ago.
It is interesting to note that Britain's National Health Services has concerns and problems like the U.S. health services; maybe more. For one thing, the NHS is facing a serious financial crisis.
"It is a bottomless pit," said a senior physician who works in a London teaching hospital. "How can you afford all these modern treatments and technology free of charge?" They are looking at alternate ways of running their programs, including outsourcing the equipment and even some of their programs to American companies. And they are increasingly favoring privatization.
We in the United States have been grappling with our own set of problems: flattening revenues for doctors, escalating medical expenses, lack of insurance for nearly 40-million people, the malpractice crisis and the advent of managed care, which hasn't made a dent in the skyrocketing medical expenses. All have become emblematic of modern times. Many are clamoring for universal health care patterned after the English or Canadian model.
But are the British happy with their socialized medicine? It was interesting to read the daily newspapers there. Here are some excerpts:
"NHS is a poor system. Often difficult to get a quick ambulance in an emergency." (Apparently, two people died while waiting for an ambulance.)
"All patient calls are screened by nurses, before they are even taken to the hospital."
"Getting a doctor's appointment takes several weeks, and even after you see the doctor, it takes another few weeks to get the results of the tests."
"NHS doctors have no zeal or enthusiasm. They often go through the motions of doctoring."
However, Patricia Hewitt, the health secretary, was quick to defend the NHS. "No problem here. Everything is media-created," she commented to the press. But the public vehemently objects.
You get the picture.
Our current system in the United States may have some drawbacks, but before we adopt any other system, especially socialized medicine, a lot of thinking and research needs to be done.
Private practice models still may be the more efficient system. As Andy Stern, president of the Service Employees International Union, said in the Wall Street Journal recently, "There seems to be broad consensus that we need a universal system that provides affordable coverage, choice of doctors and insurance plans, core benefits, and shared financing among employers, employees and government."
Every country has its own set of problems, and it behooves us to come up with solutions for our own situations. And I have no doubt that during the next decade, radical changes will occur in U.S. health systems as well. It is important for all of us - physicians, nurses, administrators, politicians and the public - to work together and come up with a formula.
Dr. M.P. Ravindra Nathan, is a Brooksville cardiologist. Guest columnists write their own opinions on subjects they choose, which do not necessarily reflect the opinions of this newspaper.
[Last modified December 19, 2006, 06:58:48]
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