tag:blogger.com,1999:blog-32053362.post5412114268042834453..comments2024-03-26T00:25:34.026-04:00Comments on Not Running a Hospital: Wachter explains private practice in the UKPaul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-32053362.post-21830489610506653982012-01-22T06:28:00.746-05:002012-01-22T06:28:00.746-05:00I disagree with the comment “The NHS would come to...I disagree with the comment “The NHS would come to a grinding halt if private practice went away.” This is simply not true. Private practice in the UK health service effectively deals only with elective or planned hospital care. Everything else is covered by the NHS including general practice. There is also a limited co-payment system for medicines prescribed by general practitioners. And despite what the current coalition government is trying to do to the NHS in England, it remains one of the most cost effective ways of delivering population health care.Mikenoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-80493581234657833682012-01-17T21:56:05.472-05:002012-01-17T21:56:05.472-05:00I think it’s interesting to note that, in the U.S....I think it’s interesting to note that, in the U.S., private school teachers and public school teachers are not the same people. In the UK, NHS doctors, for the most part, practice in both the public and the private system. If the docs are salaried in the public system and the number of patients they see or some other measure of “productivity” is not a meaningful factor in how their salary and bonus, if any, are determined, they have an incentive to see fewer patients rather than more in the public system so they can maximize their compensation on the private side. While the existence of the parallel private healthcare system does reduce the burden on the NHS, there is an inherent potential conflict of interest because the docs presumably earn considerably more per hour of work from treating private pay patients.<br /><br />In the U.S., I wonder how much easier it would be for Medicare patients to find a primary care doctor if balance billing were allowed, at least for primary care, and if the patient affirmatively agreed to it before services are rendered.Barry Carolnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-57271527678482733632012-01-17T16:16:22.676-05:002012-01-17T16:16:22.676-05:00It would be interesting to see a comparison of the...It would be interesting to see a comparison of the NHS and the Canadian system, where patients have to leave the country to obtain care or procedures for which they perceive too long a wait. (I'm sure such a comparison exists, but I haven't seen it).<br /><br />I believe the U.S. will inevitably move toward a 'more nationally-determined approach' as you phrase it, Paul. I just wish we could do it in a rational manner, informed by careful study of these other systems.<br /><br />nonlocalAnonymousnoreply@blogger.com