Friday, 16 January 2009

Healthcare budget changes planned

Some of this seems mildly promising:

The new Health Bill will enable patients to receive direct payments to spend on health services of their choice. Lord Darzi, who will unveil the plans, first trailed the idea last year in his report on the future of the NHS.

It is thought the payments would particularly benefit people with long-term conditions such as Parkinson's or Motor Neurone disease, or those who use mental health services.
But I don't like the sound of this:

The Bill will also place a legal duty on the NHS and its providers to take note of the NHS Constitution, which sets out the "rights and responsibilities" of patients and staff.
For better or worse, we are forced to pay for the NHS through our taxes, we are customers; we have "rights" and the NHS has "responsilities".

Or this:

Other contents include previously announced measures to protect children and young people from the harm caused by smoking ...
Source: The Metro

9 comments:

AntiCitizenOne said...

I did find it interesting. More like a form of catastrophic insurance, however the problem is still that the insurance premium is not tied to the risk, so it still tend to financially incentivise bad behaviour.

Mark Wadsworth said...

It doesn't actually incentivise bad behaviour, it just doesn't disincentivise it. But tobacco and alcohol duties do, to some extent, and in cash terms those revenues more than make up for any extra 'cost' which smokers/drinkers impose.

Plus I'm not sure what relevance this has to Parkinson's.

Dick Puddlecote said...

The "protect children and young people from the harm caused by smoking" bit is the tobacco display ban and vending machine restrictions shoe-horned into the Health Bill.

AntiCitizenOne said...

MW: At a high level the way the NHS is funded means that people who look after their health tend to pay more than people who do not.

Mark Wadsworth said...

AC1, OK, would it make any difference if tobacco and alcohol taxes were ring-fenced for NHS spending?

AntiCitizenOne said...

It might be interesting thought experiment if You bought Health care vouchers with Fags + Booze.

Mark Wadsworth said...

It's administratively easier to ring fence tobacco and alcohol duties. You can't expect some poor old wino to save up all the 'vouchers' he gets with each six pack of Newky Brown to pay for the treatment of his inevitable liver sclerosis.

AntiCitizenOne said...

I can! Insurance is about pooling people together with similar risk profiles and aligning the premium. It seems to me that ring-fencing tax makes prudent drinkers subsidise alcoholics.
It also means that those people who abuse their health by not drinking in moderation (drinking too little is unhealthy) don't get a subsidy.

Mark Wadsworth said...

ring-fencing tax makes prudent drinkers subsidise alcoholics.

No, actually. 'Prudent drinkers' pay less in alcohol duty that alcoholics, so it evens out.

It also means that those people who abuse their health by not drinking in moderation (drinking too little is unhealthy) don't get a subsidy.

Fair point. But non-drinkers presumably don't get liver sclerosis etc; you could earmark alcohol duties for drink-related illnesses and tobacco duties for lung cancer treatment and so on. It will be interesting to see what The Righteous do with the vast surpluses ...