Professor Alain Enthoven is one of the world's leading health policy analysts. In this paper for ASI, he reflects gloomily on the prospects for real improvements in NHS delivery unless there are more radical reforms than the politicians are contemplating.
Medical Savings Account
Neither the NHS nor private health insurance plans run efficiently because neither adequately reflect demand of medical services. In both schemes there is no connection between usage and cost of services to the consumer, creating an over-demand for services. Attempts have been made to curb this problem by private insurers in the use of co-payments or other means of sharing service costs with consumers. This paper contends that independent Medical Savings Accounts, paid into by the employer but under the control of the consumer will sovle this problem by providing resources for care, but creating incentives for patients to use only the services they require.
Unitary Medical Regulation
The regulation of clinical practice must focus on the clinical service standards that are delivered to patients, and not on protecting professional self-interest. It must be accepted and trusted as such by the public. We envisage therefore a single regulatory authority that is independent of the healthcare professions. It should be dominated by lay representatives, and perhaps chaired by a lawyer rather than a clinician.
Read it here.
Patient Centred Medical Regulation
5 per cent of doctors are estimated to be making the wrong decisions - that amounts to 5,000 doctors with 100,000 patients. There is a need for improved regulation of the medical profession with the emphasis centred on the patient. Currently the public is untrusting of the medical profession, This briefing paper sets out guidelines for a new shape to regulation.
Read it here.
Public, Private and People
Despite a supportive government and half a century of above inflation inflation increases, the National Health Service is still under strain. In the past few weeks alone, doctors have criticised it for long waiting times, diagnostic mistakes and it's poor record of treating heart disease, cancer and other serious diseases. Everyone accepts that we need to upgrade and modernise UK healthcare. But to do that most effectively we must develop a wider involvement in the process, with real partnerships between the NHS, the private sector and the patients themselves.
Read it here.
A Successful National Health Service
In 'A Successful National Health Service', Nick Bosanquet argues that the NHS should enter into a range of partnerships and agreements and should commission services from private and voluntary providers.
Too Big to Manage
You can read the full paper here
Good Health - The Role of Health Maintenance Organizations
The United States have been plagued by rising insurance premiums. However, this has brought about a competitive response in the shape health maintenance organizations. This solution involves the doctors and hospitals in the insurance process, giving them more incentive to cure the patient as speedily as possible, less incentive to devise ever-costlier and purposeless procedures.
In this paper, Dr. Eamonn Butler looks at the case for health maintenance organizations within the UK.
Read the full paper here.