Rationing Health Care: Patients told to wear better shoes instead of surgery
Non-profit organizations and government agencies routinely point to the United Kingdom’s national health care system as a model for care.
Before we embrace that model, patients should investigate whether the National Health Service is providing the highest quality of care. We should ask if the NHS is delivering on its promises to patients, or if bureaucracies have resorted to rationing health care.
Even in a developed country, health care rationing can become a real problem — with patients being told they can’t get the treatment that their doctor recommends.
Think health care rationing is hyperbole?
Patients in the United Kingdom are now being told to wear comfortable shoes for six months before gaining access to necessary hip replacements. According to the Daily Mail, patients are being forced to wait months and, in some cases, “must have been taking painkillers four to five times a day for two months before being considered for surgery.”
Many patients, rightfully, want to avoid painkillers. For those with a history of addiction, it’s not the right treatment. Yet, health accountants are trumping doctors’ recommendations — forcing cheaper treatments.
Hip and Knee Replacements: “Easy Target for Health Care Rationing”
Patients in need of hip and knee replacements must wait an average of 105 days before getting access to the necessary treatments. That’s a 21% increase in the average wait time since 2010. Today, more than a half-million patients are on wait lists to obtain knee and hip operations.
Steve Cannon, vice-president of the Royal College of Surgeons, told the Daily Mail that patients in need of hip and knee replacements are easy targets for accountants looking to cut costs.
“For NHS managers, hip replacements and knee replacements can generally wait because they are not life-threatening,” he says. “They are easy targets for rationing.”
Easy targets for health care rationing? Is that what we want — a health care system that punishes some patients. Although the treatment is not life threatening, it still means an incredible amount of pain and suffering for patients.
“They are very painful – they can severely inhibit people’s lifestyles,” Cannon says of the impact to patients. “The longer you wait the worse the hip becomes, day by day. The cartilage gets worn away and the bone becomes exposed. It then slowly wears away.”
Differing Care for Different Regions
When health care rationing starts, it doesn’t take long to restrict access based on other factors.
Julie Wood, the chief executive of the NHS Clinical Commissioners, told BBC Radio that care “will vary in different parts of the country.”
“Clearly the NHS doesn’t have unlimited resources,” she said. “And it has to ensure that patients get the best possible care against a backdrop of spiralling demand and increasing financial pressures.”
Is that what we want? 6 months wait for knee replacement. Quality health care determined by zip code and region.
Amid the ongoing debate about health care reform, it’s easy to get caught up in the partisan talking points. Patients must remain focused on our priorities for health care. Access. Innovation. And ensuring that the right patient gets the right treatment at the right time. Any reforms must deliver those objectives.
We must actively work to make those priorities clear to policymakers.
