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16 | Healthcare
and chronic conditions and low-income families
and their children. The economic crisis is
increasing the burden on the government-based
schemes as more people become eligible due to
rising unemployment. For Medicare, the scheme
specifically for those aged 65 and over, this prob-
lem is exacerbated by the baby boom generation
now on the verge of retirement.
The need for co-ordinated care in the US is
clearly an issue too. Chronically ill patients in
government-funded schemes see an average of 13
doctors and fill an average of 50 prescriptions
each year. Other inefficiencies have been high-
lighted; for example, 20 percent of adults with a
chronic illness have medical tests that are dupli-
cated, compared to only nine percent in the UK.
These problems in the system need to be tackled
head on.
The major fault is the quantity model on
which the system works. The more patients a mandatory cover, with penalties if they’re unin- income-based tax system so healthcare is avail-
doctor sees or the more treatments that take sured. Tax credits and/or subsidies may be able to all. It’s a system that provides for many
place, the higher the doctor or hospital is ranked. offered to help low-income individuals, and gov- and that the UK couldn’t function without.
This is essentially flawed and has been a key ele- ernment schemes may be extended to cover Republicans, specifically Sarah Palin, have been
ment in the plans for reform. Quality of care can unemployed people. A new insurance market- particularly critical of the NHS. She has termed
reduce long-term costs and make the US health- place called the Exchange could allow individuals Obama’s plans as “evil” with governmental
care system reflective of the costs it incurs. and small businesses to get competitive pricing “death panels” who will decide who gets care and
on insurance, possibly with tax credits if needed. who doesn’t. The US group Conservatives for
Where does the potential for Larger employers may be legally required to pro- Patients Rights has also criticised the UK’s
improvement lie? vide or help provide insurance for all employees. National Institute of Health and Clinical
The reform aims to give affordable healthcare It’s hoped this reform will reduce the long- Excellence (NICE). NICE decides which medi-
cover to all Americans. Once passed, it will be term problem of escalating insurance costs for cines get approval for use in the UK. The US
against the law to reject someone because of a individuals, the government and businesses. It government may consider using it as a possible
pre-existing condition, their age or gender – as is will also protect people from debt and bankrupt- model for their drug approval system.
currently the practice among insurers in an effort cy due to health costs, and aims to ensure quality
to avoid high-risk customers. Also, insurers will care for all Americans. The future
no longer be able to revoke cover if someone gets Obama has plans to finalise the health reform
sick, unless their claims are fraudulent. Opposing opinions bill this year. But with a weak economy, differing
Obama has outlined plans to have an inde- Big insurers led by the likes of America’s Health perspectives, concerns on how the reform will
pendent panel of medical experts review and Insurance Plans (AHIP) and Blue Cross Blue pass and budgetary restrictions, it will take time
streamline the current system. It’s hoped that this Shield Association oppose the idea of a govern- to put in place. It will also take time to move
can be done through improved health informa- ment-run public plan in the form of the from the current system to a new fully functional
tion technology, more focus on evidence-based Exchange. They claim it will make the govern- model.
medicine practice (possibly including a medicine ment a competitor, regulator and financier, all in But I, one of many, see the value of the social-
approval body), co-ordinated care and care man- one. ist ethos the Obama administration is introduc-
agement. Other people are opposed to a “socialised ing. Health inequality, fear to access and lack of
There has also been a call to focus on preven- medicine” model. They claim it focuses on a provision of healthcare are all at the core of a
tive medicine in order to reduce claims. This will community ideology similar to communism. poor society.
include screening (at no extra cost) for breast Objectors have criticised this liberal view in com- But most importantly, in Obama’s own pre-
cancer, bowel cancer and diabetes as part of parison to other healthcare systems around the dictions, unless we tackle in a bold and unerring
health insurance plans. Discussions about posi- world, in particular the UK. However, these manner the rise in the cost of healthcare provi-
tive wellbeing and increasing taxes on products objectors have been largely dismissed for having sion, we will find that indeed the world is a poor-
such as tobacco, alcohol and sugar-sweetened archaic and non-progressive political reserva- er place.
drinks are also underway. tions.
How this new reform will work isn’t clear yet. The National Health Service (NHS) in the UK Dr Sneh Khemka
It may fall to individuals to arrange their own works by paying for healthcare through an Medical Director, Bupa International
November 2009 Investment International www.investmentinternational.com7
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