Wednesday, October 17, 2007

The illusion of universal, national health care continues.

Health care for all: a nice dream that built the Britan's National Health Service. But here is a story from the BBC that once again indicates that this goal still remains firmly a dream.

Don Wilson, from Kent, says that he’d call NHS dentists to see them about a toothache and they’d tell him that it would be weeks before have an appointment.

Wilson tried other NHS options but none were helpful. There are openings at private dentists but not with the NHS. He says: “I went for a rummage around in my tool box and found these fishing disgorgers -- the tool you use to get a hook out of the back of the fish’s mouth. they look a bit like scissors or pliers.”

He just grabbed hold of the tooth and started pulling until he heard a cracking sound. He said it was painful but so was doing nothing. He has pulled five bad teeth this way so far with one still half in.

He said if he could get an appointment with a NHS dentist he would do it. But since he hasn’t been able to he didn’t have much choice. “If you’re in agony with toothache, you haven’t got much choice.”

The NHS did, however, save some money by never having an open for Mr. Wilson. And that gives ammunition to those who want a similar system in the U.S. It's cheaper. Imagine how cheap it would be if they rationed dentists even further.

Around ten weeks ago the Aberdeen Evening Express told of the woes of NHS dental patients in their area. They said that the number of people waiting to get on the list of an NHS dentist has grown from 16,714 one year ago to 25,058 this year. The local member of the the Scottish Parliament noted: “People are not going to dentists because they can’t get to dentists.”

While the NHS tried to open more dental clinics, more and more dentists simply stop taking NHS patients. One cost saving measure for the national service is to try to shift the actual costs for dental care from the NHS to the individual dentist. One dentist complains: “The government sets what dentists can charge, and they are same whether you are in Central London or Skye, irrespective of training or other costs.” Another said: “There are lots of costs for dentists. Some of the equipment is funded, but a lot of it has to be bought by the individual practices, and the maintenance is costly as well.”

So varying costs are neglected. A private patient comes in and pays around £25 for a basic check-up and that helps cover the costs for all the items not covered by the NHS. But for the NHS patient the government pays £7 each. The patient sees the care as free since the taxes he paid have already been taken from him and visits to the dentists don’t immediately result in more costs to himself (long term they do).

This illusionary “free” cost encourages people to make appointments while the very low amount actually paid to dentists discourages actual care. The demand goes up but the supply goes down resulting in long queues of people unable to obtain dental care. One dentist noted that many of the people in on the NHS waiting lists “are quite willing to pay £40 a month on their Sky [cable television] subscription, but not pay £10 a month for dental treatment.”

This would mean that a lot of the equipment used by NHS patients is actually paid for by private patients and that not only are people subsidizing the NHS care through taxes but private patients are paying for it as well through higher dental bills. NHS patients are paying through taxes for care that many of them simply can't get from the NHS. Private patients still are taxed for the NHS care they aren't using and then they pay for their private care on top of that plus some of that is still helping subsidize the NHS patients who are getting care. No wonder nationalized health care is cheaper. It is no mean feat to have a cheaper service if you don't give out the care required and charge people for care they aren't receiving.

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