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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Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  3 comments for “Fool Britannia by Pat Conrad MD

  1. Aaron M. Levine, MD
    August 16, 2017 at 10:16 am

    And a newspaper article in the Houston Chronicle yesterday states the majority of physicians want a single payer plan. They feel it will make it simpler, more efficient and reduce denials.

    I once caught a show from the BBC called “oh minister” I think. He was giving an award to the cleanest hospital in the British System. He wanted to interview the patients. He was told they kept the hospital clean by refusing to treat patients. Any money for patient care would require laying off staff, and the union objected to that.

  2. Perry
    August 15, 2017 at 7:06 am

    He who pays the piper calls the tune, mate.

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