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“The result will be that at the end of this Parliament we will once again be back into a debate that I thought we had buried – whether tax based health care free at the point of need is the right basis for health provision. That is the last debate we should be having, but it will be product of this Bill. I believe the Secretary of State when he says he supports the NHS. But by the end of this Parliament, when the structural flaws are clear, he is not going to be around to defend it.” David Miliband […]
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The principle changes in the Patient Protection and Affordable Care Act, signed into law on 23rd March 2010, mean that it is mandatory for people to buy healthcare insurance (or face fines), and encourages insurers to insure people who are deemed as high-risk, and would have previously been denied coverage. The PPACA takes a step in the right direction for US healthcare in terms of reducing the number of people who are uninsured. One of the most notable aspects of the Act is the creation of health insurance exchanges, which will provide federal assistance for those who are not covered by […]
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In order to address the issue of where the NHS reforms may lead, and qualify the argument of the status quo of implicit priority setting of care combined with the Health and Social Care Act reforms, an increased integration with market mechanisms through greater use of private sector services, and the already existing financial pressure that the NHS is under will lead to care being rationed within the NHS, it is useful to use the example of the Oregon Health Plan, where prominence was given to the priority setting of care. Whilst the demographics are different, as is the political […]
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What is rationing / priority setting? Rationing and priority setting are referred to somewhat interchangeably within the literature, with little focus on the actual terminology, and more upon the outcome of priority setting and its impact upon healthcare.  Priority setting, “a more or less systematic approach to distributing the available resources among demands”, can lead to rationing of care, defined as “a failure to offer care, or the denial of care, from which patients would benefit”. Rationing can also be defined as any form, either implicitly or explicitly, of allowing people to “go without beneficial services” due to constrained costs. […]
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Economics of healthcare in England The UK spends 9.6% of its Gross Domestic Product (GDP) on healthcare . The NHS accounts for 87% of all health expenditure in the UK, with private health insurance (which covers 12% of the population) accounting for 1% of health expenditure, and some paying out of pocket. The NHS budget of £108.9 billion is funded through 90.3% general taxation revenues; 8.4% from National Insurance contributions (which both employer and employee make); and 1.3% from patient charges such as prescriptions (88% of prescription users are exempt from the charge) and dental charges. Spending on primary care by […]
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30th April 2013 Ian Goley: One of the main questions that has come up in the literature review, when people say that they want to defend the NHS from the NHS reforms, what is the NHS? Clare Gerada: That is a very very very good question. And it’s such a good question because nobody ever asks it, and I ask it because people talk about “the NHS” and I say what do you mean. They usually say it’s a service made up of hospitals, doctors and nurses that are free at the point of use. It isn’t, the NHS is […]
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