Friday, 3 October 2014

Her Majesty's National Health Service - United Kingdom

    El Gringo Viejo has an old saying that might have been said before he said it for his first time, but when he did say it for his first time in a fancy bar in Monterrey, Nuevo Leon, Mexico....yes, in Spanish....the bar became quiet.   What did he say?   "There is nothing quite as expensive as free medical care provided by a government."
     Year in, and year out the Instituto Mexicano de Seguro Social (Article 123 of the Constitucion de 1917, Estados Unidos Mexicanos)  Mexico's NHS, in service since the late 1930s. has had to have a "supplemental" before the end of the fiscal cycle.  The guarantee of a broad range of "free" prescriptions for common to not-so-common medicines usually could not last until the twelfth month either, but the supply frequently lasted until after the sixth month.   In fairness, the IMSS did serve for elevating the level of public health in Mexico, pretty much eliminating the scourge of polio, childhood diseases like measles and chicken pox, and basic health education for a large majority of Mexico.    AND,  it must be pointed out that the IMSS provides a genuine minor league level of medical intervention throughout Mexico along with near cutting-edge surgical, teaching, and research operations....pretty much commonplace in middle-sized to large urban areas.
     Problem?   Only about 50 per cent of the population is covered by the service although everyone who buys anything is at least indirectly paying for the system.   The Mexican IVA (national sales tax - 16%) pays a portion into the operation of the IMSS which is supposed to be supported by contributions from the participating workers and their employers.  That amount is providing over 10 billion dollars to keep the medical, pension, and certain other services, per year.   But, with falling birth rates, and the steady rise of the private clinics and hospitals and insurance programmes, Latin America's premier paternalistic socialist institutional initiative has changed from gold to silver to copper to iron to rock to sewer mud.  Such is the way of the all such paternalistic socialist initiatives. 
     Extracted from Mexidata-Info, Benard Thompson:
                "As to the problems, here is how Carlos Marín put it in his "El asalto a la razón" column (Milenio, Mexico City) on November 4, 2010:
"Pre-bankruptcy of Social Security
"The presidential diagnosis of the financial situation of Social Security (the most noble of Mexican institutions and the leader in public health in Latin America) is ... hopeless!
"It is of little use that [IMSS] director general Daniel Karam acknowledged to Congress approval of the transfer of surpluses (disability, life, and workers compensation insurances) to the needy to 'gain time and operational capability' in attention to beneficiaries.
"As absurd as pretending that chronic diseases might be cured in the emergency rooms, fantasizing that administrative juggling might solve the most dramatic IMSS problem.
"'The use of the reserves, that is now indispensible in order to guarantee the operation of the [IMSS], is not nor can it be the way out of the circumstances faced,' Felipe Calderón warned yesterday, [and] he said that the reserves 'are not enough, now we are not saying to meet their intended purposes but not even [enough] to deal with the operation of the institute….'
"And making one shudder: it will be Congress that determines the IMSS rescue."

This is in the City of Merida, capital of the State
of Yucatan.  On the near edge of the city is this
Centro de Altas Especialidades Medicas  where
many of the "favoured"  in Cuba come to receive
treatment, surgeries, and other medical services.
As well,  Gringos and people from various other
nations in Latin America and elsewhere come to
have medical procedures at a relatively low cost
and a relatively high quality.  This area is a mix
of IMSS and various private operations.   The
largest building, as one might imagine, is the IMSS
building, while the numerous smaller ones are
specialty clinics doing nose-jobs to eye-brow lifts,
and other more serious and substantial stuff. 

     But we return to the issue of the Brits, who seem to be happy to grouse as they wait in line to file past the tomb of Lenin and gaze upon the leathery, pallid corpse.   "How can we save the corpse?  How can we do something about his make-up and his shabby, worn out clothes?   Doesn't anyone clean up his sepulchre?"
     I mean, of course, to draw that obvious comparison to the people performing the useless obeisance to something useless like Lenin's dead body, and the Brits trying to figure out how to breathe life into the NHS.  To wit:
Doctors tell Health Secretary they are 'exhausted, drowning and furious'

A succession of angry doctors tackle Jeremy Hunt at the annual conference of the Royal College of GPs in Liverpool

Health Secretary Jeremy Hunt was tackled by a succession of angry doctors Photo: Alamy

GPs are “exhausted, drowning and furious,” the Health Secretary was told by angry doctors today.
Speaking at the annual conference of the Royal College of GPs in Liverpool, Jeremy Hunt told doctors that he understood that they felt overworked, with too few of them to meet patient demand.
But he was tackled by a succession of angry doctors, who said Government policies and comments criticising GPs were placing unfair pressure on them.
As a result, expectations had become unrealistic, one later said, with patients turning to GPs because of verucas, colds, stomach upsets – and even asking them to put the bins out.
Dr Stephanie de Giorgio, a GP from Deal in Kent, accused Mr Hunt of “continually denigrating” GPs and encouraging inappropriate demand from patients, leaving doctors overloaded.
She told Mr Hunt: “We are exhausted, drowning, and quite frankly furious with you, what are you going to do about it?”
After the public session, she said she felt that Mr Hunt’s attitude towards GPs, and criticism of some failings was fuelling increasing demand, and anger from patients.
“Patients are walking into the room looking for a fight,” she said. “Because of Jeremy Hunt’s anti-GP rhetoric, they expect us not to know what to do, and to be reluctant to refer them.”
“It is getting exhausting – by the time you get to the end of a 12-hour-day, you are wrecked.”
The GP said patients were increasingly contacting doctors about the most trivial of complaints, and asking doctors to take responsibility for their lives.
“They want a note from the doctor to join their gym, to travel on Eurostar or get a referral to a homeopath,” she said. “People come for verruca treatment, which you can get over the counter, and I’ve even known of cases where GPs have been called asking for a visit to put the bins out.”
Dr de Giorgio said much of her time was spent trying to convince patients they did not need antibiotics, with consultations of up to an hour over a simple cold, and demands for home visits for stomach upsets.
The doctor, 38, a GP for six years, said she had come close to quitting her job because of the pressures of it.
“Doctors are exhausted and they are cross,” she said. “I can’t tell you the number who said to me go sock it to the Health Secretary.”
She accused Mr Hunt of “bad-mouthing” GPs, and said doctors had been particularly hurt by criticisms of their record referring got to the heart of what we do. That felt like a personal attack on GPs, who work really hard to help diagnose cancer.”
Last year Mr Hunt said there was “unacceptable” variation among GPs when it came to the number of patients referred with suspected cancer.
“All GPs want to look after patients, to give them the best care,” Dr de Giorgio added. “We want to care for those who need it most, not pander to the worried well.”
During the conference session, a string of doctors criticised Government policies and said shortages of GPs were at “crisis point”.
Earlier this week, the Prime Minister announced plans to expand seven-day access to GPs, so all patients could see a doctor at weekends by 2020.
The plans follow 1,200 pilot schemes which are underway.
Mr Hunt was heckled when the schemes were working, with cries of “they’re not” from the floor.
In response to the criticism from Dr de Giorgio, Mr Hunt said: “I do believe that we have to respond to the changes in expectations of the public and we can't totally run away from them.
“One of the reasons why we have huge pressures in A&E departments is because the public are saying that if something goes wrong on a Saturday morning they don't want to wait until Monday or Tuesday to go to see their GP to sort it out, they want to get it sorted out right away.”
He said general practice needed to respond to the “changing expectations” of the public.
Mr Hunt said he would disagree with “any suggestion that I am not fully behind GPs.”
“I have always talked about a stronger role for general practice and always campaigned for more resources to go into out of hospital care,” he said. "What you talked about in terms of burnout is something that worries me a lot."
    This is, we should hope, a quick concentrated nutri-pill that a person can take and understand the hopelessness of putting Hillary, Fidel, or me in charge of a nation's medical system.  It should arm the reasonable thinker to follow his faith in natural law, common law, and enlightened reason to believe and know that the Obama Socialised Medicine Initiative (OSMI) was designed by Lucifer so as to provide the low information and low intelligence people "free medical services".  Even by having the "1%" pay for the programme, the money would last only briefly, and it would soon be necessary to have the Soylent Transportation Services pick up 50 year old grandmothers to be taken to the Soylent Processing and Mucilage  Plant for "counselling".   (Has anyone ever noticed how Soylendra looks and feels a lot like Soylent?  Pardon the dark humour about something so dreadfully serious.).
    But the point is true.  There is no way to run a "free 'health' service".    It is simply another scheme by which one can purchase votes with money derived from the same people who are soon to be processed.
We retire briefly from the topic and express our appreciation for the OROG's kind attention.
El Gringo Viejo