This week, BBC Radio 4 asked me to do an interview on the origins and growth of the non-state healthcare market. Boning up for it, I was reminded just how significant the independent sector is. It provides 85 percent of the UK's residential care beds, for example, and 20% of all acute elective surgery – that's the stuff like hip replacements that isn't exactly life-threatening, but which you want to get done fast anyway. Indeed, the independent sector has more beds than the NHS and local-authority care homes put together! It employs almost as many people – roughly 750,000 of them – and it accounts for a quarter of UK health and social care spending. In addition to the 15,000 nursing and residential care homes that the sector provides, private agencies care for more than 200,000 people in their own homes.
Of course, the other (unanswered) question is whether this is good. If the NHS needs so much supplementation for those who can afford it, what happens to those who can't afford it? This makes for a very compelling case that a two-tier healtchare system doesn't ration healthcare resources.
huh? yes .. I said ration. With limited resources, and infinite need, we need to RATIONALLY deliver the limited resource. This is rationing, and despite the negative connotation usually assocated with it .. this is not a four-letter word.
Bottom line is well summarized in The Onion this week.