*Nothing in this post should be taken personally :-)*
On 03/24/98 10:00:42, "Jeff Green" <[log in to unmask]> wrote:
>While I agree with your sentiments, I think you are fighting a losing
>battle.
That is just it. You "agree" with my stand, yet you don't want to join
the battle condemning it to failure even before it is joined!
>Healthcare in this country will be managed. The question is who will
>manage it. By opting out, you are in danger of leaving the field open
>to non-clinicians.
I am not so naive not to realise that health care in this country will
be managed.
Part of what I am trying to do is to force the hand of those sanctimonious
politicians into saying honestly and truthfully that that is what they
want.
'Managed' health care, as you put, will be 'managed' by HMO-like
organisations. In the USA, these are 'controlled' by the insurers.
Show me one HMO that is 'managed' by clinicians.
I believe that clinicians are good at delivering health care. I do not
believe they are, or will be, good at 'managing' the model envisaged
for health care in the UK (much influenced by the States).
I don't believe that clinicians will be good at the 'macro' management
of health care provision.
What they can be good at is the historic mantel they have inherited.
That is to stand up and be counted. Being a strong and influential
voice for their flock.
It is a matter of honesty and principle. I simply don't believe that my
fellow GPs in my area will be capable of 'managing that macro side of
things'. The effects of failure could be disastrous. But, like I said
before, power corrupts. There are a lot of doctors out there who are
drooling at the prospect of power and they will do anything to get a
piece of the action irrespective of what their conscience tells them.
That drooling for power hoodwinks, misleads and bends resolve and
robustness to realise its goals. At any price.
>By all means decide that healthcare is best managed by a multi-national
>but why let it happen by default.
That is not what I am saying. However, the multinationals will be
brought in to salvage the wreck when the clinicians finally put the
white flag up. Another classic tactic. Get the buggers to have a go at
it, it will shut them up, they'll fail miserably, then we can step in
and rescue it through "the third way" (Mr J Prescott, March 98).
>If that is a future that GPs want, if that future represents better patient
>care, then fair enough:
>but to let it happen by default because you *don't want to play* - that is
>in my view rather sad.
This is a corruption of what I am saying.
Do I say that I want to let it happen by default?
On the contrary, I am saying it is morally and ethically wrong and that
I'll stand up and fight for my principles all the way no matter what it
takes. I went to jail before for a principle. I am prepared to do it
again.
Now, may be we live in an era where fighting for a principle is
described as "rather sad", however, it is those "rather sad" people
who, in the end, make the difference.
That 'difference' is what you and millions others enjoy today.
Paint me in a corner or put my back to the wall and you are guaranteed
that that will bring out the best and worst in me, and God help you all
and Oscar Wilde!
Nothing, but nothing gets my back up more than being forced to do
something I do not want to do. This was one of the reasons I left my
home country and exiled myself to a place that doesn't have olives or
balconies. So, please don't talk to me about 'sad' :-)
>I have no doubt that it would. It's management skills are not in question,
>only its objectives and the future development of magaged healthcare in the
>UK
So, what are your objectives for the future development of managed
healthcare in the UK? What are the said objectives of HMG? Do they
correspond?
These are serious questions everybody needs to address. They deserve
thoughtful answers.
Ahmad
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Dr Ahmad Risk
http://www.cybermedic.org
Chairman British Healthcare Internet Association <http://www.bhia.org>
Director Internet Healthcare Coalition - USA <http://www.ihc.net>
Home: +44 1273 724866/748198
Work: +44(1737)240022 Fax: +44 1737 244660
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