Monday, September 7, 2009

"1,000 villagers wait for a dentist after just one NHS practice opens"

—Daily Mail (UK) March 10, 2009

The parlous state of NHS dentistry under Labour was exposed last night after it was revealed 1,000 people in a village ended up on a waiting list for a dentist.

Nearly one in ten of the 11,500-strong population of Tadley were forced to wait after a single NHS practice opened in the Hampshire village.

Their alternatives were paying privately, travelling miles to another NHS dentist - or going without treatment.

Local councillor Nigel Quelch said: 'When I phoned, they said they had a waiting list of 1,000. It shows what a huge demand there is for Health Service dentistry.

'But we're very grateful to the dentist for opening in Tadley.'

In 1999, Tony Blair promised that within two years everyone would have access to an NHS dentist.

Eight years later he admitted failure. A new contract, introduced three years ago to increase numbers of NHS dentists, has also been judged to have made the situation worse - with 1,000 dentists fleeing the NHS.

It means the remaining NHS dentists are overwhelmed and can't take new patients - as the Tadley case shows.

LibDem health spokesman Norman Lamb said: 'We cannot continue with a postcode lottery where people like the Tadley residents can't have access to NHS dentistry.'

Hampshire primary care trust confirmed the list had hit 1,000 in December but has since been cleared.

It said the practice now has 7,000 patients and can't take more - meaning over 4,000 have no dentist in the village.


Okay, what does the above story prove?

That health care in the United Kingdom is a failure? That a RAM expedition to Rural England is needed?

This American thinks that all it means is that a very good health care system still isn't perfect and still has room for improvement. Nothing more.

In the U.S., opponents of a national health care program point to faults in Canada's vaunted system, wring their hands that people up there suffer health care rationing and wait extra weeks for things like cancer chemotherapy, resulting in an extraordinarily high cancer rate for a developed country - much, much higher than in the U.S. with its "private" health care.

I think one can find isolated incidents of bad things happening in all countries. For example, if you look hard enough, you will find the story of a poor man in Tennessee who drove 200 miles (one assumes 400 miles round trip) to have a very painful tooth pulled by an American charity called RAM. This rather than pay a local dentist in his hometown (plentiful, btw) $50 or so to do the same job. He didn't have the money for that but did have the money to buy maybe 25 gallons of gasoline to drive 400 miles. Who believes this? Worse, who believes this is the norm? I don't believe it is commonplace for a thousand people in the UK to wait for months to see a dentist, either.

My point? Let's both sides stop searching for proof of what we all know already without needing additional proof:

1. The national health care systems of the UK, France, Canada, and others is not perfect.

2. Health care in the USA is in dire need of major reform.

I have never not advocated a new and workable, responsive, comprehensive, cost-effective, uniform health care system for the United States. (Even though my heart of hearts - and our constitution - tells me this is a matter for the individual states to handle for their citizens. But with today's mobility between states, I suppose I can stretch my principles. As long as Europe's EU agrees to get its own big health care system which is uniform for all member countries. Never mind.)

Nor, even, do I dread government bureaucrats running such a program - as long as you mean civil service employees and not politicians when you say "bureaucrats".

I repeat my objection: our congress does not have the brains to write a good plan nor the personal honor not to keep their financial benefactors in business - nor even the character to put aside personal gain for the sake of their country and for their fellow Americans. Does anyone doubt the above statements?

Raise your hand if you think Congress has the brains to write such a complicated bill or the lack of ego to allow experts to write it without porkbarrel changes if it IS written by experts.

Raise your hand if you think Congress will turn a deaf ear to the health industry lobbyists who have poured so much money into their campaign war chests over the years.

Raise your hand if you think Congress will have the guts to stand up to the lawyer associations who want to keep adding untold billions to our health care system costs through their out-of-control lawsuits - especially since Congress itself is infested with lawyers.

Those who raised your hands, go check yourself in to the nearest loony bin.

This needs to be done - cries out to be done - but it needs to be done right! Just because it was on Obama's list of campaign promises doesn't mean we need to rush into this thing with the mentality that any sort of bill is better than no bill at all.

It needs to be done one piece at a time, over a few years.

If you change the whole thing all at once and later find out you were wrong, you are dead. We all are dead. But if you change one section (and find a way to pay for that section) and find out we did it wrong, we can live to try another day and learn from our mistakes.

The first things that need attention are:

1. Coverage for people who don't have access to health care right now.

2. Better (some, at least!) regulation of the health insurance companies.

3. Tort reform.

How many people are going unserved right now? I don't know. I don't think ANYBODY knows. There are so many definitions. Some say more than 60 million people are without health insurance, or enough health insurance. I hope they are wrong. 60 million people! People! Do you realize there are only 60 million people living in all of the UK? Do you? Even if we suddenly found a pot of gold, where are all those new doctors going to come from tomorrow to serve all these instant new clients? Do you really think we could just "materialize" all the doctors there are in the UK right now?

Stop. Think about this. Put a master plan into place. Don't come up with something wild just for the sake of doing it all NOW! Put that master plan into place step by step. Don't demand all or nothing. Reform the present waste. Kill all the lawyers. Start covering the most needy. It doesn't have to be baby steps, but don't sink the whole country in one fell swoop, either.

Here is something I found in a radical right (my judgment) website that is against government health care, I guess:

"Great Britain's National Health Service (NHS) was created on July 5, 1948. As with all government programs, bureaucrats underestimated initial cost projections. First-year operating costs of NHS were 52 million pounds higher than original estimates as Britons saturated the so-called free system.

Many decades of shortages, misery and suffering followed until 1989, when some market-based health care competition was reintroduced to the British citizens."

Then they go on to list example after example of how that system has failed its citizens.

Well, I know very well that the UK system has NOT failed its citizens. I don't know this from personal experience, or by reading newspapers, but I know it by British users telling me they like their current system. I also know Parliament is just about as crazy and inept as Congress. But somehow they (the British, if not Parliament at first) got it through and working, and so can we.


A. said...

The sheer size of the task is daunting, that's true. We are a smaller country and when the NHS was formed, we were smaller still. And it was a time of change, soon after the war.

Have faith, though. You can do it.

PS, is it just me, or is the size of some of that text so small as to be almost illegible?

Stephanie B said...

Relax Max, I don't think Congress is capable of getting it all good the first go round. I'd love to see torte reform included (although torte reform is more than just healthcare), but I am not a proponent for bits and pieces at a time. Why?

Because it's just so a big problem that it has to be attacked on several fronts at once. If you don't, the tiny steps will fail, even if everyone has the best will in the world (and, as has been clearly seen, that isn't the case).

So, why am I not scared by this health care reform bill? Because it has two out of three of your big players there and because I can't imagine anything worse coming out of the government.

People have said that the government screws everything up. Well, I beg to differ. We waited for the market to fix labor practices and environmental practices and people made in-roads, but it didn't really get addressed until the government (at the people's demands) did something. Now it may not be perfect, but children aren't working in factories any more and raw sewage is no longer being dumped into the water supply.

When I look at history, I see a number of places no one ever expected the governmnet to need to step in, where the "market" was supposed to take care of its own, where greed failed to provide for anyone but the fat cats. When the government (belatedly because we WANT pure capitalism to work) stepped in, they never made it all better - but it was always (maybe almost always; I can't think of examples but perhaps you can; you're older than I am I think) better than it was before.

I suspect it would have gone even better if we didn't wait until it had gone too far. I suspect that's true this time.

By the way, we already have a decent number of doctors and hospitals per capita and spend more on healthcare than anyone else. I can't see how these reforms are going to mean more money spent per capita rather than less, at least in the long run. Just my opinion.

Relax Max said...

@A. - I hope you are right about us being able to pull it off. And I tried to retype that small type; resizing it didn't work. An unknown wonder of blogspot. I hope it is better now.

@Stephanie B - As usual we will have to agree to disagree. I don't think it has to be done all at once or is prudent to do so. Yes, the need is great and pressing. All the more reason to be careful and try to do it right.

Tort reform is not even on the table, unfortunately, according to DNC chairman Howard Dean.

Anyway, this all is argument for nothing. There is going to be a very expensive health care plan passed and it is going to come up short of what we need. You know that. I know that.

I don't think you are ever going to get me to admit the government should "take over" anything. But they can play a part.

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