Tuesday, January 13, 2009

If the English can do it, why can't we?

December's Dose of Reality describes how the United Kingdom, which truly does have socialized medicine, continues to improve their system. In the United States, we have a serious shortage of primary care physicians. Yet, primary health care is vital to the wellbeing of a nation's population, and to keeping the costs of that health care down: nip a disease in the bud, or prevent its occurence in the first place, and it's a lot less expensive for everybody concerned. So the UK is taking a sensible approach:
The new emphasis on primary care in the United Kingdom follows two paths. One tactic is to use modern technology to maintain each patient’s lifelong health record; it details each visit to a primary doctor or specialist, lab results, and any treatment and medication received. That allows both the primary doctors and the specialists to easily download the information when needed, and thereby serve the patients better. The second approach is to make more use of interdisciplinary teams for taking care of patients in ways that maximize care and best utilize medical talents.

One consequence is that nurses are taking on an increasing proportion of the work. They may be the first to see patients with minor illnesses, and they are assuming more responsibility for routine management of chronic diseases. Another is that the role of the primary doctor is being emphasized to the extent that primary care doctors are making more money. Paid by a combination of risk-adjusted capitation and a 25 percent additional amount for performance, primary care doctors in the United Kingdom now have average annual earnings of $220,000. The average annual income of a primary care doctor in the United States is far less, about $150,000.
So the question is, if the UK can not only afford to improve health care but also increase doctors' salaries while at the same time reducing overall costs, why can't we? (Hint: they have universal health care and we don't.)

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