> >>In that case, why not have a system where in any one year you pay no
> >>more than £20, or another arbitrary figure, before subsidy kicks in?
> >
>> The cost of the beaurocracy involved in establishing when you've reached
>> £20..
> Mary
This is alreedy being done in Australia where the responsibility for keeping
the receipts lies with the patient if I recall correctly.
>That's what makes means-tested welfare benefits so expensive to run.
>Ahmad
However couldn't this thread be linked to the swipe card thread so that your
cumulative expenditure AND any social circumstances exemptions are recorded
electronically and are your responsibility to update or renew as
appropriate.
Other thoughts from Australia are
1. expecting patients to pay the difference between the cost of generic and
non-generic costs (when I did an exchange two years ago patients asked to be
changed to generic drugs!)
2. paying for the cost of the drug up to a threshold of about $10.00 per
script (again encouraging consumers to ask their GP for cheaper
prescriptions and satisfying those patients who object to paying a full
prescription charge for drugs costing a few pence for the NHS).
3. there was also stronger policing of the national formulary with only a
selected range of drugs qualifying for state funding and some of these
requiring very specific clinical conditions that needed approval through a
central agency - pretty tedious on occasions but apparently very effective
as a downward pressure on prescribing costs.
Other thoughts in general on the swipe card and fraud threads.
The DR/MP from South East London (? Dartford and I think his name is Stoate)
is supposed to be very interested in the prescription system reform might be
more value for any letters than your local MP (or perhaps write to both).
However I don't know how computer literate he is.
Might there not be opportunities to set up swipe card systems (or indeed
alternative prescription charging systems one day) under the primary care
group umbrella particularly in well defined localities if we are controlling
most local health expenditure? Apart form the minor technicalities of
signing prescriptions etc this may not need anything as cumbersome as
convincing an ignorant national parliament.
Regards
Adrian
GP
Teesside
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