Posts Tagged ‘National Health Service’

The UK: American Healthcare Reform’s Mirror Image

Wednesday, July 25th, 2012

If you want to see a twin of our healthcare reform battle, try the other side of the Atlantic: England is undertaking the biggest reform of its government healthcare program, the National Health Service, as part of its massive 5-year austerity program. “After a year in parliament, more scrutiny than any bill in living memory, and more than 1,000 amendments in the House of Commons and the House of Lords,” as the Guardian newspaper put it, “MPs cast their final vote for the (reform) bill.” At its heart are plans which will give primary care providers more sway over the NHS’s £106 billion annual budget, and introduce more private competition. British reform moves quicker than ours — the program takes effect over the next 12 months. A major plank of the reform is the NHS Mandate, under which the government will set targets for improvement in 60 areas of care, such as patients surviving after cancer treatment, and medical errors. The goals? Reduce administration costs by one third.

And, in another instance of seeing double, we’re watching the other side working hard to repeal it and vowing to do so on Day One if they win the next election. “The government’s reforms to the NHS in England have undermined the service and opened the door to privatization,” said (opposition) shadow health secretary Andy Burnham, who championed Labour’s motion, which claims that treatments and services are being rationed in the NHS. In an opposition-led debate on the NHS on 16 July 2012, Mr. Burnham said: “We will repeal the bill; it is a defective, sub-optimal piece of legislation that is saddling the NHS with a complicated mess.” But (government) Health Minister, Simon Burns said: “Far from the meltdown that some gleefully predicted, we have seen a robust and resilient NHS delivering better care for patients. Waiting times remain low and stable, in fact below where they were at the last general election.”

So, just to recap, here we have the conservatives championing reform and austerity and the liberals pleading for repeal in opposition to a privatized system and rationing.  All of this, of course, is part of the cost-cutting program that some say caused Britain to fall back into a double-dip recession. After the 2010 general election, Prime Minister David Cameron, leader of a coalition of the Conservatives and the Liberal Democrats, initially said that the austerity program would finish by 2015. During this period, more than £80 billion would be raised by spending cuts and tax rises. However, the program was extended to 2017 last fall with further savings £30 billion hoped for.

Can Marilyn Tavenner Save Medicare?

Monday, December 5th, 2011

President Barack Obama’s choice of Marilyn Tavenner as administrator of the Centers for Medicare and Medicaid Services — to replace Dr. Donald Berwick, whose recess appointment was set to expire at the end of the year – is more likely to survive the Senate confirmation process relatively unscathed.

A Harvard-educated pediatrician, Berwick won praise and the backing of major healthcare groups for his academic work, which focused on cutting the cost of care while improving quality and patient experience.  Republicans took exception to his praise of Britain’s National Health Service as an “example” for the United States to emulate.  Others accused him of supporting “rationing” healthcare services, a claim Berwick rejects.  “Every bone in my body, as a physician, even as a person, is to get everything (patients) want and need and to help them at every step,” he said.  “I have gone to the mat to get a last-ditch bone marrow transplant for a child with leukemia…and they are telling me I’m rationing?  They haven’t met me.”

White House officials said, “Before entering government services, Tavenner spent nearly 35 years working with health care providers in significantly increasing levels of responsibility, including almost 20 years in nursing, three years as a hospital CEO, and 10 years in various senior executive-level positions for Hospital Corporation of America.”

According to Ezra Klein, “Tavenner’s healthcare experience lies much more in management than policy.  Former colleagues describe her as a patient-centered manager, a hands-on medical professional equally comfortable in the board room and the emergency room.  And in contrast to Berwick, Tavenner isn’t associated with a grand vision for health reform, or a particular policy agenda for Medicare and Medicaid.  ‘With Marilyn, you present the information, then she makes a decision, and you move on,’ said Patrick Finnerty, who served as Virginia’s Medicaid director under Tavenner.  ‘She doesn’t make promises she can’t keep.  There are differences of opinions, and she would try to work through those.  She’s straight with folks but always respectful.’”

Tavenner started her career as a nurse at Virginia hospitals owned by the Hospital Corporation of America (HCA).  Tavenner met with success, rising from chief nursing officer to CEO.  In 2004, she was again promoted to HCA’s president of outpatient services, her first national position with the firm.  She resigned two years later, when then-Virginia Governor Tim Kaine tapped her to head the state’s Health and Human Resources department.

Tavenner has already won the American Medical Association’s (AMA) backing. “We have worked extensively with her in her role as deputy administrator, and she has been fair, knowledgeable and open to dialogue,” AMA President Peter Carmel said.  “With all the changes and challenges facing the Medicare and Medicaid programs, CMS needs stable leadership, and Marilyn Tavenner has the skills and experience to provide it.”

Senator Orrin Hatch (R-UT), the ranking Republican on the Senate Finance Committee, said that the panel would thoroughly scrutinize Tavenner, but did not say he opposes her nomination.  Despite Hatch’s mild comment, Tavenner is expected to face some difficult questioning because Senate Republicans have not overtly endorsed her.  According to a Republican healthcare lobbyist, “I can’t imagine a lot of support for her,” noting that the high-profile CMS role “always gets sucked into the controversy of the day.”  Ultimately, Tavenner is likely to be confirmed for the CMS post.

Tavenner is widely seen as a pragmatic administrator who will not rock the CMS boat. “The only way to stabilize costs without cutting benefits or provider fees is to improve care to those with the highest health care costs,” she said.  Tavenner also said she opposed Republican efforts to turn Medicaid into a block grant that would limit the amount of federal funding states can receive for the program.  “That approach would simply dump the problem on states and force them to dump patients, benefits or make provider cuts or all the above,” she said.  Tavenner “brings continuity in terms of implementing the mission,” said Len Nichols, director of George Mason University’s Center for Health Policy Research and Ethics.

Medicare, Medicaid Head Rallies Insurance Companies

Thursday, September 30th, 2010

Controversial CMS chief wants insurers to work with healthcare providers to make reform work.CMS administrator Donald Berwick has asked the insurance industry to work in good faith to implement healthcare reform in a timely manner. Dr. Berwick made his plea at a Medicare conference sponsored by America’s Health Insurance Plans, the health insurance industry’s trade group.

“We need your help, our nation needs your help,” Dr. Berwick said, noting that companies, CEOs, healthcare professionals and managers all play a role in achieving the objective, yet the insurance industry “can be among the keys of our success, the central part in navigating the success of healthcare reform.  We have a job to do, we need to make care better for America.”  Berwick told the audience that he plans to work with others at CMS to build relationships and partnerships to assure that the Patient Protection and Affordable Care Act works as intended.  “If we steadily work together to make care what it can become, trust will resurface and the rest will follow,’ he said.

Dr. Berwick, who President Barack Obama named to his post in a recess appointment that bypassed the Senate confirmation process, is not well liked by Republicans because he once wrote an article that praised Britain’s National Health Service, raising concern that he will introduce healthcare rationing.  He tried to allay those fears by saying “I urge lower costs without harming a hair on any patient’s head.  It’s a clear, stark reality.  Our healthcare system, in its current form, is not up to that job.  We cannot, with our current system of care, give Americans the care that they need and want and deserve.”

The most pressing issue is improving patient safety and cutting deaths that result from unnecessary medical errors, a specialty that Dr. Berwick developed when he headed the Institute for Healthcare Improvement.  He also called for improved prevention and treatment of diseases like obesity and depression.

Britain’s National Health Service Plans Patient Cover-Up

Tuesday, February 23rd, 2010

British-based designer Ben de Lisi has created a hospital gown that assures patient modesty.  American-born and London-based fashion designer Ben de Lisi was commissioned by the United Kingdom’s National Health Service (NHS) to design a hospital gown that solves the age-old problem of patient modesty.   The Design Council plans to introduce the redesigned hospital gowns in March as an effort to enhance patient dignity. The gowns will start being used early in 2011.

“The old hospital gown was hideous, embarrassing, ill-fitting and probably ill-making too,” de Lisi said.  “You are away from home, ill and in hospital and you have to wear this horrific garment with your arse hanging out.  I wanted the new gowns to feel fabulous and aspirational.  They are made from beautiful cotton shirting which is very smooth, cool and lux.”

De Lisi says his gowns give patients modesty, while doctors and nurses can have immediate access through cleverly located “entrance points”.  “It’s infinitely dignified, yet practical.  And Velcro doesn’t enter into the equation,” de Lisi said.  The gowns, which are in de Lisi’s signature printed fabric, are complemented by pajama bottoms, nightwear and slippers.

David Kester, chief executive of the Design Council, said “The new designs are going to be very competitively priced and within the current price range for the NHS, even with the designer connection.”  Britain’s Department of Health provided £25,000 pounds to design the new hospital wear.