On Wed, 5 Aug 1998 20:30:13 EDT, [log in to unmask] wrote:
>Can anyone think of a better or fairer way round the rationing problem? How
>were priorities set in the Portland experiment?
(do you mean 'Oregon'?)
Anyway. this is one sort of simple thought:
- The majority of our patients (and the majority of us!) are capable of
making decisions for themselve
- We exercise that ability almost on a daily basis
- We are also reasonably good at setting priorities for ourselves
- For example, we can put a price on our lives by deciding what premium
we can afford to yield what benefit from an insurance policy when we
die
- That premium setting is influenced by many other factors, but the
bottom line remains that we end up with 'fixing' a price on our life!
- We do the same every time we buy a house, a car, a yacht, a TV or go
on holiday etc.
- Why do we then seem totally paralised when it comes to health?
- Why do we always run away and seek desperately someone else to make
priorities for us?
- That 'someone else' always makes arbitary decisions no matter what
the informing process is
- Wouldn't it be better if we were free to set priorities for
ourselves?
- Oregon was a disaster because of the coupling of priorities to
spending of public money
- The UK government seems set to introduce compulsory second pensions
for everybody. Why? (I know the answer!)
- If you were to give me the œ670 spent on my health care every year
(in theory, because I have not made any calls on that for over 20
years!), I might be able to spend it according to my own priorities, in
my own time or just carry it over to the next year and the next and the
next so that I am ready when I need a new brain!
- Alternatively, I might decide to invest it in a suitable vehicle and
if I don't need it later, I might blow the return on going round the
world in an open top double decker bus (I do want to do that!)?
- A 'hip' costs about what? 5000 pounds? What would be the monthly
premium of an 'investment' policy that would yield 5000 pounds in, say,
10-20 years?
- We do that for school fees, why not health?
- If I were a private GP, how much would it cost you to take out an
annual 'season ticket' to see me?
- I reckon about 100-150 pounds! For a tenner a month, you can
'subscribe' to Risk's Medical Services Inc. If you don't see me at all
in one given year, you get half your subscription back + interest! Or
you get a 'no claims discount' for your next subscription whichever the
greater :-)
- And so on...
Ahmad
________________________________________
Dr Ahmad Risk
http://mednetics.org
home: +44 1273 748198
work: +44 1737 240022
fax: +44 1737 244660
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