17 thoughts on “The envy of the world? A closer look at the Commonwealth Fund healthcare study”

  1. Posted 26/06/2014 at 19:16 | Permalink

    Here’s the best way to evaluate the NHS:

    Let people opt out of the system in return for a tax rebate equivalent to their contribution.

    If the system is as good as its defenders claim, then only a few eccentrics would take this option.

    After all, if the NHS really is the envy of the world, why is there any need to force people to contribute?

  2. Posted 27/06/2014 at 08:39 | Permalink

    Watch this space. I’m in the process of writing a paper on that idea.

  3. Posted 28/06/2014 at 16:40 | Permalink

    and a more primitive version was published here: http://www.adamsmith.org/sites/default/files/images/stories/booth-health.pdf

  4. Posted 08/07/2014 at 16:20 | Permalink

    The Commonwealth Fund report relies on highly subjective views and has no method of cross-country control. Because there is no split between funding and provision of medical service in the UK and there is no competition, then consumers and providers get their information from the same source. If the NHS isn’t going to provide a certain service/treatment then patients may not even be told that such a service could be supplied and even staff may not be aware of other (better) ways of providing it. In other systems, providers have an incentive to tell you about what they could so for you, and how they could do it better, if only the funding organisation will pay up. The latter may produce ‘creative dissatisfaction’, whereas the NHS may produce ‘blissful ignorance’.

  5. Posted 20/08/2014 at 09:22 | Permalink

    …or maybe it is just that NHS is the best healthcare system in the world!

  6. Posted 21/08/2014 at 17:02 | Permalink

    @DAO – more comprehensive and in-depth international comparisons, such as those of the OECD and ECHI rate the NHS very poorly, so it is highly unlikely that the NHS is anywhere near the best in the world. Only the CF report says otherwise and it has huge flaws (and the CEO of the NHS is on its board!)

  7. Posted 23/08/2014 at 12:50 | Permalink

    Yes I agree, all the studies are flawed. People who want to profit from privatisation of the NHS will always concentrate on the negative ones.

  8. Posted 24/08/2014 at 17:18 | Permalink

    Yes, I agree all studies have their flaws. People who stand to profit from privatization of the NHS will tend to focus on the negative ones, but this study clearly shows that there is another story.

  9. Posted 26/08/2014 at 10:25 | Permalink

    @DAO – the OECD analysis is government-funded. There is no privatisation’ agenda. There is no comprehensive analysis anywhere in which the NHS does anything other than poorly compared to other countries.

  10. Posted 30/08/2014 at 10:48 | Permalink

    There is no comprehensive analysis full stop…and the government is not interested in privatisation??

  11. Posted 01/09/2014 at 09:40 | Permalink

    @DAO – The OECD analysis – if you bother to look at it (which you haven’t) – is extremely comprehensive. It is easily the most rigorous international comparison. The OECD is funded by government – not just our government but the governments of all OECD members. It has no privatisation or other agenda. It comes out in favour of no particular model of delivery of medical care (in fact it says that no one model is inherently superior). What it does say it that the UK has one of the least efficient medical systems and that the quality of what it provides is well below average, even though the cost is average. You should try looking at its methodology and findings as your comments are not informed by having actually considered any data.

  12. Posted 01/09/2014 at 23:12 | Permalink

    I’ve seen the OECD report. It doesn’t say that UK system is inefficient or that UK quality is low or that UK cost is average. If you are impressed by lots of data thats fair enough, but overall it is not a very useful report (please see my previous comment).

  13. Posted 02/09/2014 at 09:12 | Permalink

    @Anonymous. The OECD report says PRECISELY that the quality and and quantity of medical services in the UK is below average and that the cost is average. It uses those exact words in its summary of the UK.
    See the whole thing here and read the country summary for the UK. http://www.oecd.org/eco/healthcaresystemsefficiencyandpolicysettings.htm

  14. Posted 27/04/2015 at 16:01 | Permalink

    Yes, at the point of need, NHS is free. But in the chain before the final point of need, there is increasing privatisation. Just look up the profits of Agencies that provide Nurses on short term contracts.

  15. Posted 27/04/2015 at 16:16 | Permalink

    Yes, multi-national research and analysis suffer from methodological issues regarding equivalence. Mainly due to cultural issues. So although this maybe flawed, any student of research methodology will tell you all studies have limitations, including the OECD. But given this constraint we can still take its findings towards some evidence of truth. If NHS has least spend per capita, how many more billions can we invest and still remain the least. Plenty!!

    Secondly, if borrowing at 0% interest rate is not so bad, why not invest in the NHS. Yes, debt does increase, but unlike households, the state borrows from itself. So we are still paying back World War 1 debt – and how many childrens’ children (generations) is that?

  16. Posted 23/11/2015 at 13:25 | Permalink

    Your blog entry also neglects to mention that the same study found the USA’s insurance-based healthcare system was rated the most expensive, the worst overall, the worst in more categories than any other country’s healthcare system, and rated in the bottom half of half of the categories it wasn’t rated worst in. Surely so thorough a blasting of the insurance-based healthcare system shouldn’t be discounted simply because it runs counter to your organisation’s worldview?

  17. Posted 23/11/2015 at 13:46 | Permalink

    @Brian Wakeling – But many insurance-based systems in many countries are consistently ranked very highly. This suggest that it is not the fact that the US system is insurance-based that is the problem. Indeed, a highly (and artificially) restricted supply of medical-school places, strict licensure and the way that only employer-funded medical insurance is tax-deductible are major issues in the US which inflate costs. In other words, factors that the government controls and the AMA influences.

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