tag:blogger.com,1999:blog-25200961.post392861152137376832..comments2024-03-26T07:19:50.901+00:00Comments on Dr Grumble: Polysystems and Rich PicturesDr Grumblehttp://www.blogger.com/profile/04417731064007601504noreply@blogger.comBlogger7125tag:blogger.com,1999:blog-25200961.post-16842061560022210592023-09-11T19:19:18.722+01:002023-09-11T19:19:18.722+01:00First time reading, much appreciate itFirst time reading, much appreciate itSchall Trichterhttps://schall-trichter.blogspot.com/noreply@blogger.comtag:blogger.com,1999:blog-25200961.post-69430741491331173152010-03-08T21:08:57.217+00:002010-03-08T21:08:57.217+00:00What I can't work out is why no ranking journa...What I can't work out is why no ranking journalist ever points out that this will be more expensive overall.<br />____________<br /><br />As you say, Dr Aust, it is utterly obvious that the way we are heading will cost much more and not less. Journalists have a duty to point out the errors of the ways of our masters but they don't. If you want to understand why they are not doing their job watch the video I posted <a href="http://drgrumble.blogspot.com/2010/03/why-we-dont-know-what-is-going-on.html" rel="nofollow">here</a> which gives some but not, I think, all of the reasons.Dr Grumblehttps://www.blogger.com/profile/04417731064007601504noreply@blogger.comtag:blogger.com,1999:blog-25200961.post-79740385838009466442010-03-08T15:04:14.023+00:002010-03-08T15:04:14.023+00:00What I can't work out is why no ranking journa...What I can't work out is why no ranking journalist ever points out that this will be <i>more expensive</i> overall. The German style system, with "cardiology clinics" or "paediatric clinics" in the community, is more expensive than the NHS model, presumably in large partly because the clinic infrastructure must be repeatedly duplicated, and I assume also because of more complicated billing/charging. And I was always given to understand that set-ups like Kaiser made money largely by managing not to treat under-insured (but "illness rich") poor people.<br /><br />It is deeply depressing that, after the banking fiasco, the political class is still slavishly devoted to the idea that markets automatically deliver the goods.Dr Austhttp://draust.wordpress.comnoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-11559330528595588142010-03-07T22:00:07.298+00:002010-03-07T22:00:07.298+00:00Quite right Grumble. Services are being moved out...Quite right Grumble. Services are being moved out as they are hard to privatise while within a hospital. The plan is to move all but the most specialised outpatient work into polyclinics as they can then be carved up through private tendering. <br /><br />Kaiser Permanente chronic disease programmes will be used to manage most conditions. You might get into hospital for a diagnostic clinic, but as you know chronic disease follow-up is actively discouraged. <br /><br />(trainer 1)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-25200961.post-37871644236988149332010-03-05T19:13:29.835+00:002010-03-05T19:13:29.835+00:00I fear you are right, Prisoner of Hope. And we wil...I fear you are right, Prisoner of Hope. And we will all be losers as a result.Dr Grumblehttps://www.blogger.com/profile/04417731064007601504noreply@blogger.comtag:blogger.com,1999:blog-25200961.post-11529904124048830562010-03-05T15:33:56.087+00:002010-03-05T15:33:56.087+00:00I too have no idea what a "poly system" ...I too have no idea what a "poly system" is or could be BUT .... I do seem to remember health policy discussions 20 years ago talking not only about a purchaser provider split but also moving to a "plurality of providers". The discussion then moved onto identify that perhaps the NHS at local level could also develop into a system based on "plurality of purchasers".<br /><br />Early attempts to achieve this included GP fundholding practices. More recent attempts to resurrect this idea of GP consortia seem to have run out of steam.<br /><br />So if the monolithic NHS of the past (where a single authority both purchased and supplied health care at local level - paid for by taxation) is to be replaced with a system consisting of BOTH a plurality of providers (competition, contestibility ... choice!)AND a plurality of purchasers (GPs, PCTS... HMO's anyone?), then we might describe such a mess as a polysystem for the purposes of the delivery of health care - albeit to a local community still paid for out of taxation.<br /><br />If this is ever achieved all that would remain of the old style NHS would be the funding from taxation as part of a truly national insurance based approach to health care. Sadly it will then only take a small change to allow top up funding and then financial compensation for taking out private health insurance as the Conservatives have argue for before. This in turn could well encourage the complacent and contented majority to argue against state funding and from a "polysystem" funded primarily from taxation we will have arrived at the "two tier system" health care that many dread!<br /><br />I suspect therefore that the term "polysystem" describes a convenient staging post before a 2 tier health care system becomes a reality and both the term and what it represents should be resisted while there is still a chance to do so.Prisoner of Hopehttps://www.blogger.com/profile/12101614242785360125noreply@blogger.comtag:blogger.com,1999:blog-25200961.post-63811776098588587752010-03-04T22:25:16.403+00:002010-03-04T22:25:16.403+00:00As has been said before....
High Quality Health C...As has been said before....<br /><br />High Quality Health Care<br />Faster Health Care<br />Cheaper Health Care<br /><br />Pick any two, but you can't have all three.Anonymousnoreply@blogger.com