Friday, January 29, 2010

Why 'Free' Health Care Costs So Much

With the debate about Health Care being quietly shoved onto the back burner over here in America, it's ironic that the failure of so-called 'free' health care in Britain has never been more apparent.

The latest? An article in the venerable Hampshire Chronicle linking the outrageous waiting lists for doctor's appointments with the thousands of 'no shows' at the doctor's office.
MORE patients are failing to turn up for hospital appointments in Winchester, costing the NHS hundreds of thousands of pounds. New figures show that in 2008-09 an estimated 22,000 appointments were missed. Full story here.

As much as I've come to question the privately-funded health care system in America, this is one example of how the right-wing critics of 'socialized medicine' actually make a legitimate point about how 'free' health care is excessively expensive and wasteful.

Case in point? How thousands of people are making doctor's appointments, but never showing up for them. That's why it's so difficult for legitimate patients to get an appointment in a realistic time frame. I remember going to the doctor back in England and having to make an appointment a week, or even two weeks, in advance. In America, they can generally see you the same day.

The difference is, of course, that in America you have to pay for your doctor's appointment. Generally, it costs you about $20 'out of pocket' and your insurance company pick up the rest.

However - and here's the good bit - if you make an appointment and fail to show up, your insurance company still gets billed for it. You booked an hour of the doctor's time and he charges you for it whether you're there or not. However, if you're a 'no show' the insurance company turns its nose up at being expected to cover the cost of your missed appointment and charges you the full whack.

Anywhere from $50 to $250 dollars, payable within 30 days.

As you can imagine, it's an incredibly effective incentive not to miss a doctor's appointment - or, if you do, at least cancel 24 hours in advance.

This is the problem in Britain. Because the doctor's appointments are 'free' there's no value attached to them, so people blithely skip showing up. Then those same idiots complain that there's such a long waiting list.

If you made every NHS patient pay a tenner for a doctor's appointment, I can guarantee that people would think more seriously about whether they really need to see a GP or not. And if you charged them £100 if they missed an appointment they'd made, I bet you'd find attendance improving dramatically.

So instantly; a new revenue stream for the cash-strapped NHS, dramatically shorter waiting lists and probably fewer patients to see overall (only the ones with something actually wrong with them would pay the £10 to go and see a doctor.)

Gordon Brown? David Cameron? If either of you want to adopt this proposal, feel free. If the American health care system has taught me anything, it's that you get what you pay for. In the case of the NHS, that's unfortunately nothing.

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