The thing
that hath been,
it is that
which shall be; and that which is done is that which shall be done:
and there
is no new thing under the sun.
Ecclesiastes
1:9
This
summer’s entertainment has been that of the alleged ritualistic sexual activity
of some well known politician.
Why
should so much media time be wasted on such matter or was it a deliberate
distraction from something more important?
No
it was not even about the Junior doctor’s contract but more of that later as Tannhäuser
is opening at the Met in just a few days time.
Tannhäuser in the kingdom of the goddess Venus, by Henri Fantin-Latour. Photograph: akg-images
The
sexual exploits of the elite Parisians were no different to that of modern day
politicians:
Wagner's decision to place the obligatory ballet in the opening scene
also offended the influential Jockey Club, whose members were in the habit of
arriving at the interval to see their mistresses dance before going backstage for sex. By the third night, dog
whistles could be bought in the streets outside the Opéra for the express
purpose of interrupting the performance.
But what is most important is the new NHS Vanguard:
Without
new legislation or public debate a new NHS is happening or so we thought. The
Cockroach Catcher wrote on September
7 2015:
Simon Stevens spent
some years in the US.
Is Vanguard
a re-working of Kaiser Permanente?
I have always admired
Simon Stevens and his ability to quickly picked some of the best loved people
in the NHS to promote Vanguard. The like of which has not been seen in any State run change since Bevan. But Vanguard is going to mean a good deal more than we were led to believe. I suspect that the people working for him are either not aware or they were told not to divulge it. Like Steve Jobs, the smartest people keep their main aim to
themselves. He has picked the people that were very savvy with Social Media and that part of the NHS is exploding with
little reference to the
plight of Junior Doctors or the bribery
of GPs. Nothing should distract now! But is everything about Vanguard new inventions of Simon Stevens?
Remember:
The thing that hath been,
it is that which shall be; and that which is done is that which shall be done:
and there is no new thing under the sun.
Ecclesiastes 1:9
Lets see what Bloomberg say:
BRITISH EXPERIENCE
UnitedHealth followed up on June 30 with another report for lawmakers pinpointing $332 billion in savings through better use of technology and administrative simplification. If enacted, those changes would potentially benefit UnitedHealth's Ingenix data-crunching unit. Ingenix, with annual revenue of $1.6 billion, is poised to establish a national digital clearinghouse to ensure the accuracy of medical payments and provide a centralized service for checking the credentials of physicians.
Stevens, an Oxford-educated executive vice-president at UnitedHealth, once served as an adviser to former British Prime Minister Tony Blair. In that capacity, Stevens tried to fine-tune the U.K.'s nationally run health system. Today he tells lawmakers that theU.S. need not follow Britain's example. Concessions already offered by the U.S. insurance industry—such as accepting all applicants, regardless of age or medical history—make a government-run competitor unnecessary, he argues. "We don't think reform should come crashing down because of [resistance to] a public plan," Stevens says. Many congressional Democrats have come to the same conclusion.
UnitedHealth has traveled an unlikely path to becoming a Washington powerhouse. Its last chairman and chief executive, William W. McGuire, cultivated a corporate profile as an industry insurgent little concerned with goings-on in the capital. From its Minnetonka(Minn.) headquarters, the company grew swiftly by acquisition. McGuire absorbed both rival carriers and companies that analyze data and write software. Diversification turned UnitedHealth into the largest U.S. health insurer in terms of revenue. In 2008 it reported operating profit of $5.3 billion on revenue of $81.2 billion. It employs more than 75,000 people.
Stevens argues that while UnitedHealth will likely benefit financially from health reform, the company will also aid the cause of reducing costs. He cites what he says is its record of "bending the cost curve" for major employers.
During a media presentation in May in Washington, Stevens said medical costs incurred by UnitedHealth's corporate clients were rising only 4% annually, less than the industry average of 6% to 8%. But that claim seemed to conflict with statements company executives made just a month earlier during a conference call with investors. On that quarterly earnings call, UnitedHealth CEO Hemsley conceded that medical costs on commercial plans would increase 8% this year.
Asked about the discrepancy, Stevens says the lower figure he is using in Washington represents the experience of a subset of employer clients who fully deployed UnitedHealth's cost-saving techniques, including oversight of the chronically ill. "These employers stuck at it for several years," he says. "We are putting forward positive ideas based on our experience of what works."
Now 4 days later Steven
Carne in Open Democracy:
And Stevens' PACS (part of
Vanguard) are explicitly modelled on San Francisco's Kaiser Permanante’s
Accountable Care Organisation model (a latter development of the American HMO
model)- despite US concerns about restrictions on which patients can be treated
where, long wait times, and still high costs.
I asked a friend in California recently what
Kaiser were like. She smiled, “Oh they're great! ‘Til you get sick”. Their
focus on prevention and health resilience belies a reluctance to provide full
health care that might cost shareholders their profit. Only a top-up payment
plan will see you in the real hospital.
SNAP.
England has
never seen anything quite like this:
Steven Carne again:
The manipulative buzzword bingo tries to persuade us that when we take part in their endless focus groups, petitions and surveys, we are helping the ‘struggling’, ‘failing’ NHS to meet the ‘challenges of the 21st century’.
At a recent event we were given another buzz phrase. “Be the Change You Want to Be...”
We are learning as quickly as we can. But the actions and spin of NHS England and the corporate health, insurance, technology and pharma companies are bewildering and confusing to those of us trying to keep up. Just as we’d begun to get our heads around 2012’s Clinical Commissioning Groups (CCGs) and Commissioning Support Units (CSUs), new NHS boss Simon Stevens’s Five Year Plan ushered in a new layer of jargon and organisational spaghetti – Primary & Acute Care Systems (PACS) and Multidisciplinary or Multispecialty Health Teams (MHTs).
If you read it thinking it made
any sort of reasonable sense - then we need to worry.
One of the key weapons being used
against the NHS, public and campaigners is the growing misuse of socially
minded vocabulary and community development buzzwords.
You’ll all have come across them.
Engaged, participatory, resilient, empowering, co-produced, personalised,
sustainable….
You’ll find these buzzwords all
over the NHS, mixed with a dash of new age personal therapy speak borrowed from
the West Coast of America (as we’ll see shortly, there are other imports from
the West Coast, too).
……. This dishonest vocabulary aims
to fool the public into supporting a host of dubious changes. It relies on a
counterpoint image of a desperately archaic NHS, crumbling in an inevitable
apocalypse of overweight aging diabetic bed blockers who really should know
better and die in their own beds – “Care Closer to Home”.
It glosses over the fact that
public funding is being withheld (and wasted on market bureaucracy).
The thing that hath been,
it is that which shall be; and that which is done is that which shall be done:
and there is no new thing under the sun.
Ecclesiastes 1:9
