NHS & Valentine: Vanguard & Roses!

As most of us are distracted by the revolutionary drive to get rid of Hunt, we should be reminded that the most powerful person for the re-shaping (Ha! Ha! Ha!) of our NHS is none other than , yes, the chief Simon Stevens. You may be able to get rid of Hunt but another front person (you've got it) would be there to continue the good work. Simon is no fool, just watch how quickly he grab some staff, much to the dismay of others in government. Well, no names here but you can find out. Simon has stayed very quiet about Junior Doctors but can you be CEO of some place like JC Penny and not have a say? Looks like he is going to succeed in a very quiet manner to farm out most of the suppliers to privateers. No. It is not true privatisation. It is a smart way to let privateers in and continue to use our Logo. Punters, sorry clients, still sorry, patients will hardly know. But then your personal health budget that may even let you go on a cruise may not actually buy real healthcare. But you are happy!

No, Hunt is just a fall guy!

Simon Stevens spent some years in the US. Is Vanguard a re-working of Kaiser Permanente?

Simon Stevens: “The traditional divide between primary care, community services and hospitals – largely unaltered since the birth of the NHS – is increasingly a barrier to the personalised and coordinated health services patients need.”

Hard on the heels of the announcement of the devolution of NHS powers in Greater Manchester comes news of the first wave of 29 “vanguard” sites for the new care models programme, heralded last October by Simon Stevens’ Five-Year Forward View for the NHS. These frontrunner sites are meant to lead the way for better integration of health and social care.

There are three types of model: MCPs (multi-specialty community providers), concerned with moving specialist care out of hospitals and into the community; PACs (primary and acute care system), with single organisations providing hospital, GP and community services; and enhanced health in care homes, with no apparent acronym as yet, but let’s call it HICH. These models are meant to offer more joined-up care, health and rehabilitation services. Some 5 million people could benefit from the first wave of transformation.

Let us admire the roses:

Looks like the future is bright for Health Insurers as they can cherry pick!

Patients could have to start to pay charges to use basic NHS services such as GPs because the health service’s finances have become so dire, the leader of Britain’s doctors has warned. 

Dr Mark Porter, the head of the British Medical Association (BMA), said that whoever takes office after the general election will inevitably be tempted to bring in charges and may not be deterred by the unpopularity of such a seismic change to the health service.

....“You say it’s politically toxic. It’s not, really, is it? Look at dentistry and look at social care. They carry with them exactly the same offer to the public by which the NHS was set up; that we will remove from you – this society, us acting collectively – the terrible fear of bankrupting yourself by having an illness, by needing healthcare.

“And yet we allow people to be bankrupted by social care and we allow people to be deterred from seeking dental care because of charges,” Porter said.

Can we think of ways round this?

There is little doubt that a system based on insurance will need smart legislation to control the insurers. If the NHS is going to make use of wealthier individuals to use Health Insurance, then the same smart laws will need to be enacted for the regulation of Insurers. We should have learnt through the banking failures that in business, there is no such thing as self regulation.

In the US: Obamacare!

The Affordable Care Act's benefits are hidden beneath the alarmist rhetoric
Nov 5, 2012   Wendell Potter, Robin Holland

Here are some things the law will do:

·         It will prohibit insurance companies from refusing to sell coverage to people simply because they have one or more pre-existing conditions.

·         It will also prohibit them from cancelling our coverage when we get sick just to avoid paying for our care.

·         It will prohibit insurers from charging women more than men for comparable coverage and will not allow them to charge older folks more than three times as much as younger folks.

·         It will require them to spend at least 80 percent of what we pay in premiums actually paying claims and improving care.

·         It will allow young adults—who comprise the largest segment of the uninsured—to stay on their parents’ policies until age 26.

·         It will reduce the number of uninsured Americans by at least 30 million if all the states agree to accept federal dollars to expand their Medicaid programs.

That said, Obamacare is not a panacea for all that ails the U.S. health care system. I view it as the end of the beginning of reform. We will have to do more as a nation to bring everyone into coverage, to control costs and to improve the way we deliver care. But Obamacare does not resemble the law that many politicians have spent millions of dollars trying to persuade us it is.  Don’t be fooled into voting against your own best interests tomorrow.

 ©2014 Am Ang Zhang

"In fact, to save money, government can buy insurance 

for 

the mental patients and the chronically ill."

It must be very obvious that all the talk about medical cover for visitors to England never mention the need for health insurance.

Could this be because insurers have managed not to cover for everything. One need to ask the question on how one ever travel to the US where cost of medical care is extremely high.

It may well be prudent for government to insist that non EU visitors to this country must have mandatory Health Insurance as part of the admission requirement. This should apply to students and tourists alike. After all nobody in their right mind would dream of going to the US without proper insurance.

We have managed to get people to insure their cars, why not their bodies.

There is of course the need to fully control Health Insurers for those that live in England if they want cover. 

Let people opt out of the NHS if it is so bad! But Insurers need to cover every thing. 

Citizens could be given a tax break and yet have the insurance policy incorporated into their NI/NHS number so that those with the tax break, the insurer will be charged for every kind of medical care they receive if they were within the NHS.

 

Summary of a popular post:

·                     Ends discrimination against people with pre-existing conditions.

·                     Limits premium spread to normal, high risk and healthy risk to say under 20% either way of normal.

·                     Limits premium discrimination based on gender and age.

·                     Prevents insurance companies from dropping coverage when people are sick and need it most.

·                     Caps out-of-pocket expenses so people don’t go broke when they get sick.

·                     Eliminates extra charges for preventive care.

·                     Contribute to an ABTA style cover in case Insurance Companies go bust and many might.

We could legislate that Insurers will have to pay for any NHS treatment for those covered by them. It will stop Insurers “gaming” NHS hospitals. This will prevent them saving on costly dialysis and Intensive Care. Legislate for full disclosure of Insured status.

Insurers cannot drop coverage or treatment after a set period and even if they do they will still be charged if the patient is transferred to an NHS Hospital.

This will eliminate problems like PIP breast implants.

It will indeed encourage those that could afford it to buy insurance and in any case most firms offer insurance for their employees including the GMC.

To prevent gaming of Insurers by individual patients (I look after their interest too), the medical fee should be paid up front by the patient and then deduction taken from premiums. Corporate clients like those with the GMC should not be gaming Insurers.

Imagine the situation where those with “individual personalised budget” being able to “buy” their own insurance!

In fact, to save money, government can buy insurance for the mental patients and the chronically ill.

This way there will be real choice and insurers will be competing with each other to provide the worst deal.

Why?

What Health Insurer will want the business? 

Perhaps they will go back to the US and we will have our own NHS back.