Deconstructing Socialized Medicine?


Socialized health care is great, and it’s a money saver, too. That’s why England is looking to decentralize it.
The health care budget in Great Britain has tripled in the past 13 years and the budget needs to stabilize.
According to the manifesto titled “Equity and excellence: Liberating the NHS” which was presented to the Parliament, England is planning to change the way in which health care is being delivered.
They’re planning to abolish primary care trusts, which currently make decisions about who gets what health care. They want to increase the choices available to patients. In fact, the plan sets out by stating that “Patients will be in charge of making decisions about their care.” “Shared decision-making will become the norm: no decision about me without me.” Patients will also be able to rate the quality of care provided at hospitals and clinical departments so that other patients can make an informed decision whether to go to those facilities.
Government micromanagement will also decrease. In fact, the document’s Executive Summary specifically states “The forthcoming Health Bill will give the NHS greater freedoms and help prevent political micromanagement.”
The Health System will only evaluate clinically credible and evidence-based outcome measures, not process targets. “We will remove targets with no clinical justification.” Does that mean that they won’t have to play medical Bozo Buckets in England?
Providers will also be paid based on outcomes and performance.

So far, sounds like a lot of changes heading in the direction of free market medicine.

The plan would also both increase payments to … and increase involvement of … primary care providers.
And there’s a lot of feel good discussion of how the plan will increase quality of care and efficiency of care – all while reigning in costs.

One of the experts in the Times article highlighted a problem with the plan “The real mistake [is creating a plan]motivated by the principle of efficiency savings. History shows clearly that quality will suffer as a consequence.” Goes back to that whole principle about “Fast care, free care, quality care. Pick any two.” It appears that British patients may be faced with a decision whether they want to pay more money for better quality.

But I still have to credit Great Britain for this new plan, because I think there are a lot of good ideas here.


  1. WC-
    The problem is that people still believe UHC in the US will save them from themselves and any catastrophe that comes about.

    Sadly, the general public delves no further when they hear what they want to hear.

    I applaud the UK for getting on the ball. But how blind are we, here? Yikes!!

  2. I often wonder if the sort of free-market health care system that we want can, at this point, only be achieved by first going to a more socialized-style of health care delivery.

    The UK is promoting a level of choice and transparency that, I think, is only possible because the government has exerted control for such a long time, and can enforce that transparency.

    In the US, I don’t think its practically possible to get to that level without some strong hand that changes the relationships among patient/consumers, insurance/payer companies, and the government.

    • I often wonder if the sort of free-market health care system that we want can, at this point, only be achieved by first going to a more socialized-style of health care delivery.

      And I wonder how many people will die in the process. Malpractice lawyers can make a killing (pun intended) if this happens.

    • Matt:

      I have to agree with you that we have to change the relationship between the patient and who pays the bill. I personally think we should have a free market where healthcare providers and institutions compete like Walmart and Target.

      As to the UKs transparency in their health system. I am taking care of several patients who have come over from London. Each has a medical problem that would have been treated very differently here. In fact they have come here for that very reason. It is all but impossible to get any records from their treating hospitals in the UK. Their medical issues are the result of occurrences that here in the US would have a medical malpractice carrier on the phone right away to settle.

  3. “free market medicine”, no, not even slightly, your putting your own views onto something I’m afraid you know little about. Its just the normal political tinkering that comes about after every change in government, replace one layer of bureaucracy with another, brand it with your party name. Yes the budget has gone over the top, but much of that was catchup on previous underspending. Just leaving things alone for a while would have been the best plan, but new governments can never do that. For the patient it means nothing at all.

    You see an article about health care. I see a journalist who cannot even get the first word of the article right, yes like most American’s she has interchanged Britain and England. After getting the first word wrong what is the quality of the rest of the article going to be like? (It should be England when referring to this proposed change, or the UK for the whole system nhs/hscni ).

    “It appears that British[sic!] patients may be faced with a decision whether they want to pay more money for better quality”

    No, you have totally misunderstood everything.

Leave A Reply