Alternatives to outdated court systems

Written by | Saturday 1 January 2000

Angered by the red tape of the public courts, people entering into contractual agreements in the United States began searching for ways to by-pass the courts and resolve any disputes between them more quickly and more cheaply. Before long, specialist dispute-resolution services arose to service this need. About 60,000 cases a year in the US are now handled through alternative dispute resolution - ADR - including industrial, commercial, environmental, and even international disagreements.

Time for competition in police services?

Written by | Saturday 1 January 2000

What the public want the police to do is:

    * Target criminal gangs and organized crime
    * Tackle muggings and street crime
    * Deter crime by being visible on the streets
    * Prevent burglary & recover stolen property

Medical Savings Accounts

Written by | Saturday 1 January 2000

Thus instead of US employers covering their workers for every conceivable healthcare need -- a very expensive proposition -- they instead provide only catastrophic health insurance, and give their workers back some or all of the savings as a 'medical savings account' which they can use on healthcare costs as they please. Workers like it because they decide how to spend their account, instead of having the manager of a health management organization (HMO) tell them what they can and cannot like. Employers like it because it is cheaper.

The million-year wait

Written by | Saturday 1 January 2000

Waiting lists are the inevitable consequence of a politically-driven, tax-funded, centrally-run health service. Users have no customer power over the system. Since the amount which people pay (through taxation) is unrelated to the volume of services they use, they have every incentive to demand as much service they can get, however marginal or even unnecessary. And because - unlike almost all other goods and services - there is no price mechanism to inhibit the over-demand, the central authorities have to resort to the only other strategy open to them, that of rationing.

Driving down the work

Written by | Saturday 1 January 2000

2. Anecdotal evidence from health professionals backs up this view held by the Secretary of State for Health. Many health professionals believe that there is scope for a 40% downward shift in healthcare delivery from hospitals to GPs, and from GPs to nurses and pharmacists. The agenda for this workshop asked participants what types of work could be 'downshifted' in this way; what benefits or (negative) implications might result; and what should be done to bring this reallocation about.

A. Reallocating work: from secondary to intermediate / primary care

The NHS: a dysfunctional insurer

Written by | Saturday 1 January 2000

For example, through their tax and National Insurance Charges, UK citizens have to pay for NHS services whether they use them or not. They are not paying simply to guarantee fair access for anyone who needs healthcare, regardless of their ability to pay; they are paying for their own NHS treatment, even if they decide not to rely on it. Instead of rewarding people for removing their demand from an over-stretched public service, in effect we make them pay twice.