Monday, June 04, 2007

Cost Of GP Visits

Even he couldn't stop NHS charges

Naturally, taxpayers' flabbers are well and truly ghasted at the thought of those high rolling GPs now demanding £20 for a surgery consultation out of office hours. Weren't they the ones who unilaterally withdrew our traditional free service when they walked away with the store? (eg see this blog)

But there are two points to bear in mind.

First, paying customers must command better attention than bulk purchase welfare cases (which is all the NHS offers). So you can demand a little service for your twenty quid. A time of your choice and a BUPA style free coffee for starters.

And second, this is simply one more sign of where we're heading. Setting aside all that tedious sloganeering from our politicos, in a world of infinite demand, free at the point of use healthcare has had its day*. Co-payment is a key element of any sustainable modern healthcare system.

I did a quick Google to find out what you pay to visit a GP elsewhere.

In France, it's €21 (£14), with 70% being refundable by state social security. Co-payment is a basic operating principle of French state healthcare, although most people take out private top-up insurance to cover some of the personal contribution.

Germany introduced a similar charge (£7) in 2004.

In Australia, it's A$55 (£23), with 60% refundable by Medicare.

In the Wild West US, it's pretty well what the market will bear- up to around $250 (£127). But as long as you've got insurance and/or are over 65 on Medicare, you pay a lot less- reportedly as little as $10 (£5).

So Britain is very much an outlier.

One way or another, co-payment is definitely heading our way.

None of which, of course, excuses the appalling performance of the Department of Health in giving over the store to the GPs without getting anything in return. How much better if they- and our motley politicos- would just accept the reality of future healthcare. We need to start discussing the real options in a grown-up way instead of pretending the Bevanite NHS vision remains possible.

*Footnote. In reality, the Bevanite NHS started charging for stuff virtually as soon as it stumbled out of bed in 1948. Within a couple of years Bevan (and scheming junior minister H Wislon) resigned from Attlee's government when it imposed charges for specs and false teeth. So much for today's politicos (ahem Dave Cameron, Andrew Lansley etc) claiming it will continue free at the point of use. It virtually never has been.
And for the political historians among you, here's a 1951 Vicky cartoon showing how the Labour Party was split between toffs and oiks.

Funny, that somehow reminds me of another party...

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