US National Park: 150+
USA offers great photo opportunities. This is in part due to the integrated National Park system that has allowed easy & universal access from the days of Ansel Adams to the present.
USA offers great photo opportunities. This is in part due to the integrated National Park system that has allowed easy & universal access from the days of Ansel Adams to the present.
From the home of Capitalism it is perhaps very telling that it would legislate against any commercial exploitation of one of their country’s most important assets: natural beauty.
Over the course of more than 150 years, a once-radical idea has evolved into a cohesive national parks system, with a sometimes conflicting two part-mission: to make the parks accessible to all and to preserve them for future generations.
Is there anything else we could learn?
Yosemite, California, USA © 2007 Am Ang Zhang
Yosemite, California, USA © 2007 Am Ang Zhang
Yosemite, California, USA © 2007 Am Ang Zhang
Why has the might of McKinsey not been able to privatise some of the US
National Parks? Should there not be Time Shares in these most beautiful of
places?
Could our National Health
Service be like the US National Park?
Providing world class
medical care to all and preserving it for future generations!
It is amazing
how planners often overlook the most important aspect of why an organisation
such as Kaiser Permanente is a success. We need to now look at why Kaiser
Permanente is such a success. New York Times
NHS 65
Foundation Trusts will be expected to balance books or make a profit.
Instead of controlling unnecessary investigation and treatment Trusts would
need to treat more patients. This is not the thinking behind Kaiser Permanente
and is indeed the opposite of their philosophy. It may well be fine to make
money from rich overseas patients, but there is a limit as to the availability
of Consultant time. Ultimately NHS patients will suffer.
The current thinking of containing cost in the NHS by limits set to GP Commissioning
will end up in many patients not getting the essential treatments they need and
GPs being blamed for poor commissioning.
What perhaps the NHS should not ignore is one very important but simple
way to contain cost: salaries for doctors, not fees.
The side effect of the current drive of GP Commissioning is that it would no longer matter if Foundation Trusts are private or not. Before long most Hospital Consultants would only offer their expert services via private organisations. Why else are the Private Health Organisations hovering around!!!
What can GP Commissioners do?
Do exactly what Kaiser Permanente is doing: integrate!!!
Integrate GP and Consultant care. Pay doctors at both levels salaries,
not fees! In fact both the Mayo Clinic and the Cleveland Clinic pay their
doctors salaries as well as the VA and a number of other hospitals including
Johns Hopkins.
Yes, employ the Hospital Consultants; buy up the hospitals and buy back
pathology and other services.
Not big enough: join up with other commissioners.
But Kaiser is not without problems:
When a person is diagnosed with an expensive condition such as cancer,
some insurance companies review his/her initial health status questionnaire. In
most states’ individual insurance market, insurance companies can retroactively
cancel the entire policy if any condition was missed – even if the medical
condition is unrelated, and even if the person was not aware of the condition
at the time. Coverage can also be revoked for all members of a family, even if
only one family member failed to disclose a medical condition.
The government and Kaiser may well argue that its not-for-profit status
engenders different behaviour. But in the US
Sometimes their competitive behaviour gets them into trouble. The California
7/5/13 9:07 PM
IT COULD INDEED BE:
THE NHS: GREAT BRITAIN
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