At Breaking Point or Already Broken? The National Health Service in the United Kingdom

Excerpt – “Crisis,” “collapse,” “catastrophe” — these are common descriptors from recent headlines about the National Health Service (NHS) in the United Kingdom. In 2022, the NHS was supposed to begin its recovery from being perceived as a Covid-and-emergencies-only service during parts of 2020 and 2021. [..] In the background of this acute [COVID] crisis, waiting lists for specialist consultation have been growing and now exceed 7 million patients (in a country of 66 million people), up from 4.4 million before the pandemic. There is substantial consensus about the causes of these crises, though different experts weight the contributory factors … Read More

Comparing Health Outcomes of Privileged US Citizens With Those of Average Residents of Other Developed Countries

“[Introduction] [..] Privileged US citizens—including thought and physician leaders—may tolerate this underperformance as applying to “others,” dismissing comparisons as mean values that do not reflect the quality of their own personal care. Privileged US citizens believe that their social connections and financial resources allow them to choose the best physicians and hospitals for their own care, thereby ensuring excellent health outcomes. One study showed that the wealthiest quintile receive 43% more health care than the poorest quintile and 23% more than middle-income US citizens. Privileged US citizens may believe that their resources ensure that they receive the world’s best health … Read More

International Reference Pricing: A Lazy, Misguided, Bi-Partisan Plan To Lower US Drug Prices

“Recent legislative proposals, including US Senate Bill S.2543, US House of Representatives Bill HR 3, and various Trump Administration proposals and plans, have advanced some form of international reference pricing (IRP) to lower drug prices. As its name suggests, IRP seeks to benchmark US drug prices to prices of similar or comparable drugs in other counties. Some proposals would have the federal government develop a reference price index based on prices paid by a select group of high-income countries, and then restrict prices to a narrow range of the index. [..] American drug pricing policy rewards large capital investments and … Read More

Getting The Price Right: How Some Countries Control Spending In A Fee-For-Service System

“In most countries with universal health insurance, physicians are paid on a fee-for-service basis, yet prices there are lower than in the US. As Miriam Laugesen and Sherry Glied explain, “Higher fees, rather than higher practice costs, volumes, or tuition expenses, are the main driver of higher US spending.” Among US policy makers, the response has been to focus on market competition, managed care, price transparency, and performance measurement. This response is grounded in the view that fee-for-service private practice and third-party payment saddle the health system with perverse financial incentives. Beginning in the 1970s, managed care emerged as a … Read More