1 Illustrate the trade-off between administrators and medical staff. Explain the involved in obtaining situation. How would this situation be principles an optimal economic affected by an incr ase in the nay of

EBK HEALTH ECONOMICS AND POLICY
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Chapter12: Medicare
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1
Illustrate the trade-off between
medical staff.
principles
optimal
administrators
and
Explain
involved in obtaining
situation. How would this situation be
affected by an increase in the pay of
doctors and nurses?
the
economic
an
What
encountered
problems
in
might
determining
be
this
solution in practical terms?
Transcribed Image Text:Questions 1 Illustrate the trade-off between medical staff. principles optimal administrators and Explain involved in obtaining situation. How would this situation be affected by an increase in the pay of doctors and nurses? the economic an What encountered problems in might determining be this solution in practical terms?
The National Health Service (NHS) in the UK was founded in 1948 and was the first state-run free
health service in the world. It originated at a time of national euphoria following victory in World War
II, which generated a sense of confidence and solidarity among politicians and public. In particular it
was felt that class distinctions were finally disappearing. The extensive rationing of products, both
during and after the war, played a big part. Not only did this result in queuing for goods by rich and poor
alike, but it gave the government a sense that state control of distribution was not only possible but in
many cases desirable. The basic objective was to provide all people with free medical, dental and
nursing care. It was a highly ambitious scheme that rested on various premises that have since proved
flawed. These were:
1 The demand for health care was finite; it was assumed that some given amount of expenditure would
satisfy all of the nation's health wants.
2 Health care provision could be made independent of market forces; in particular doctors were not
supposed to consider costs in deciding how to treat individual patients.
3 Access to health care could be made equal to all;
This means that there would be no preferential treatment according to type of customer, in particular
according to their location. The flaws became more obvious as time went by, and were aggravated by
the fact that the system was based on the old pre-war infrastructure in terms of facilities. This meant that
the provision was highly fragmented, with a large number of small hospitals and other medical centers.
The first flaw became apparent very quickly: in its first nine months of operation the NHS overshot its
budget by nearly 40 per cent as patients flocked to see their doctors for treatment. Initially it was
believed that this high demand was just a backlog that would soon be cleared, but events proved
otherwise. Webster, the official historian of the NHS, argues that the government must have had little
idea of the 'momentous scale of the financial commitments' which they had made. Since its foundation,
spending on the NHS has increased more than fivefold, yet it has still not kept pace with the increase in
demand. This increase in demand has occurred because of new technology, an ageing population and
rising expectations. At present it is difficult to see a limit on spending; total spending, public and private,
on healthcare in the USA is three times as much per person as in the UK. However, when it comes to
performance compared with other countries the UK does not fare that badly. In spite of far larger
spending in the USA, some of the basic measures of a country's health, such as life expectancy and
infant mortality, are broadly similar in the two countries. The United States performs better in certain
specific areas, for example in survival rates in intensive-care units and after cancer diagnosis, but even
these statistics are questionable. It may merely be that cancer is diagnosed at an earlier stage of the
disease in the USA rather than that people live longer with the disease. Performance can also be
measured subjectively by examining surveys of public satisfaction with the country's health serv
1996 OECD study of public opinion across the European Union found that the more of its income that a
country spends per person on health, the more content they are about the health service. This showed
that, although the British are less satisfied with their health service than citizens of other countries are
with theirs, after allowing for the amount of spending per head the British are actually more satisfied
than the norm. Italy, for example, spends more per head, yet the public satisfaction rating is far lower.
There are a number of issues that currently face the NHS. The most basic one concerns the location of
A
Transcribed Image Text:The National Health Service (NHS) in the UK was founded in 1948 and was the first state-run free health service in the world. It originated at a time of national euphoria following victory in World War II, which generated a sense of confidence and solidarity among politicians and public. In particular it was felt that class distinctions were finally disappearing. The extensive rationing of products, both during and after the war, played a big part. Not only did this result in queuing for goods by rich and poor alike, but it gave the government a sense that state control of distribution was not only possible but in many cases desirable. The basic objective was to provide all people with free medical, dental and nursing care. It was a highly ambitious scheme that rested on various premises that have since proved flawed. These were: 1 The demand for health care was finite; it was assumed that some given amount of expenditure would satisfy all of the nation's health wants. 2 Health care provision could be made independent of market forces; in particular doctors were not supposed to consider costs in deciding how to treat individual patients. 3 Access to health care could be made equal to all; This means that there would be no preferential treatment according to type of customer, in particular according to their location. The flaws became more obvious as time went by, and were aggravated by the fact that the system was based on the old pre-war infrastructure in terms of facilities. This meant that the provision was highly fragmented, with a large number of small hospitals and other medical centers. The first flaw became apparent very quickly: in its first nine months of operation the NHS overshot its budget by nearly 40 per cent as patients flocked to see their doctors for treatment. Initially it was believed that this high demand was just a backlog that would soon be cleared, but events proved otherwise. Webster, the official historian of the NHS, argues that the government must have had little idea of the 'momentous scale of the financial commitments' which they had made. Since its foundation, spending on the NHS has increased more than fivefold, yet it has still not kept pace with the increase in demand. This increase in demand has occurred because of new technology, an ageing population and rising expectations. At present it is difficult to see a limit on spending; total spending, public and private, on healthcare in the USA is three times as much per person as in the UK. However, when it comes to performance compared with other countries the UK does not fare that badly. In spite of far larger spending in the USA, some of the basic measures of a country's health, such as life expectancy and infant mortality, are broadly similar in the two countries. The United States performs better in certain specific areas, for example in survival rates in intensive-care units and after cancer diagnosis, but even these statistics are questionable. It may merely be that cancer is diagnosed at an earlier stage of the disease in the USA rather than that people live longer with the disease. Performance can also be measured subjectively by examining surveys of public satisfaction with the country's health serv 1996 OECD study of public opinion across the European Union found that the more of its income that a country spends per person on health, the more content they are about the health service. This showed that, although the British are less satisfied with their health service than citizens of other countries are with theirs, after allowing for the amount of spending per head the British are actually more satisfied than the norm. Italy, for example, spends more per head, yet the public satisfaction rating is far lower. There are a number of issues that currently face the NHS. The most basic one concerns the location of A
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