Fool Britannia by Pat Conrad MD

Yesssirrreeee, this is the kind of story I love!  I love it because it is logical, factual, and yet poetic in serving up exactly what is deserved.

Last year the British National Health Service found out that it had spent a few billion pounds more than had been allocated, leading to new measures to curb expenditures.  “In North Yorkshire, England, hospital leaders have decided to cut back by denying hip and knee surgeries to smokers who refuse to quit, and those with Body Mass Indices above 30.”  They rightly figure that expensive surgeries are more likely to fail in the obese and smoked, and can either save money by making patients healthier, or at least by denying expensive surgeries.  For years esteemed colleagues on this site have pointed out how all reforms are doomed to failure without patient accountability, and Voila!, here it is.  It is logical that whoever pays for your health care, be it a big corporation or kindly state, will want to stretch those funds as far as possible.  And why stop with smoking and overindulgence?  Why should someone be eligible for a heart cath if they aren’t willing to take statins recommended by the payer?  Why should someone receive a endoscopy if they can’t prove total abstinence from all alcohol first?  There is a very strong argument that motorcycles should be permanently outlawed, given all the money that could be saved by getting retiree Harley packs off the road.

NHS guidelines are used to justify withholding information on new treatments from patients in order to not “distress, upset, or confuse them,” which probably saves on anxiolytic expenditures.  The NHS quite reasonably determined that expensive new therapies for senile blindness need not be covered until the hopeful recipient was down to one working eyeball.  Honestly, it’s just selfish to want TWO working eyes when your neighbor is trying to kick smokes so that he can get on the hip replacement waiting list (average wait 11 months).

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103450cookie-checkFool Britannia by Pat Conrad MD