The achilles heel of the US system appears to be insurance, and it is logical that they have to share information on risk. The Labour government has not reinstated Crown Immunity against damages. These are now amounting to over 2 billion pounds per year. The pressure if anything is intensifying for professional accountability, but the government is saying this has to be managed with a sort of inspectorate of professional competence to support a system of "clinical governance". Hospital trusts may get a lower insurance rating if they can show they have achieved certain clinical quality standards.
It is not clear cut socialism. The private finance initiative and other bits of privatisation are highly capitalistic, but the government seems to be building on the semi-socialised system of general practioners who act as brokers of secondary health care. They have turned the tide round from going as private fundholders, to more collective groups covering populations of 100,000. I would imagine the insurance costs are less than in the USA and Germany, and do not have to be calculated on the basis of individual patients, but aggregate liability of the hospitals.
The British NHS is definitely still a socialised area of the economy, and provides comparable health standards to those of countries spending much more on health per head of population such as the USA and Germany.
Chris Burford
London
At 11:48 01/03/99 -0800, you wrote:
>The "speaker" is "irishdoc," a physician. But, I thought you would all
>like to see the arrogance of managed care in action and how irrelevant
>the
>patient and the clinician become to an HMO.
>Marta Russell
>
>
>Yesterday I was hit with a "surprise" chart audit by your local friendly
>HMO.
> He also told me that within a few
>months, the
>information taken from charts by one HMO would soon be on the
>internet!!!!! (encrypted he claims). The idea is to be able to share
>info with all insurance companies.