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[afro-nets] Privatisation will wreck UK's NHS (6)

Privatisation will wreck UK's NHS (6)

I agree with Mogha Smith on privatisation of health services,
and profiteering. I am also much in favour of the greater trans-
parency that Peter Burgess advocates for, but this is unrelated
to whether a service is public or privatised.

While Richard Feachem put forward good arguments about the effi-
ciency of the Kaiser Permanente health care in the British Medi-
cal Journal (Getting more for their dollar: a comparison of the
NHS with California's Kaiser Permanente. Commentary: Funding is
not the only factor. Commentary: Same price, better care. Com-
mentary: Competition made them do it; BMJ, Jan 2002; 324: 135 -
143) Not all of us living in the USA can access Kaiser Perma-
nente health care.

My experience of US employment related health insurance is that
it is expensive -- in insurance premiums and co-payments -- and
in opportunity costs to the client. I have to run around getting
repeat referrals from a paediatrician for specialist care for my
son that uses my time, my transport costs, and a co-payment to
the paediatrician, every 3 months. In the USA drugs are phenome-
nally expensive which is a great burden for those with chronic
conditions. I find it much cheaper to obtain my asthma medica-
tion on a private prescription in the UK (full cost from a phar-
macy) than to purchase it through my health insurance in the
USA. That is the co-payments in the USA are more than the full
cost in the UK. Plus I can obtain a year's supply in the UK but
only 1 month at a time in the USA on health insurance -- which
again has opportunity costs to me obtaining repeat prescriptions
and returning to the pharmacy to collect.

A further inefficiency with employment related health insurance
is that employers annually review their insurance provision and
very often change to another insurance provider. Changes in em-
ployment also lead to changes in insurance. In 6 years, my fam-
ily and I have had 5 different insurance companies -- and Kaiser
Permanente for only 6 months! The greatest issue with employment
related health insurance is that it does not cover the poorest
in employment -- the Safeway Supermarket chain in the USA
stopped paying for health insurance for its new staff recently
and many other non-unionised employers do not provide health in-
surance. Obviously, it doesn't reach the older segments of soci-
ety who no longer work, the unemployed and the chronically sick
or disabled who are unable to work.


Ruth Hope

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