Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The British are unafraid to talk about rationing. That’s something to admire.

Richard Young, MD
Policy
October 23, 2018
69 Shares
Share
Tweet
Share

I am a huge fan of Britain’s National Health Service (NHS), but probably not for the reasons many people might assume. It’s not because it’s “socialist” (a horribly inaccurate description), or that it’s nationalized, or anything like that. I’m a huge fan because somehow the people of Britain have developed the courage to talk about health care using very adult language. In the U.S., we can rarely progress beyond the equivalent of screaming toddler fits.

The British economy took a larger hit from the recession of 2008-9 than much of the rest of the world. Irrational exuberance apparently crossed the Atlantic and took root in the London financial markets. The NHS has been under the reality of “austerity” ever since (read tax hikes and budget cuts). No one is happy about the situation, but they soldier on discussing their options and trying to continue to do what the U.S. can’t: deliver the best care possible living within the realities of fixed budgets.

That’s why the BMJ has articles that use the word “rationing” in them, as do some newspaper articles in the mainstream press. The NHS is rejecting requests for hip and knee replacement surgeries that are deemed to be more marginally indicated, as well as procedures deemed to be ineffective (such as trimming up frayed menisci in arthritic knees).

Just imagine what an American reporter would do with a story of a handsome elderly man, wishing to run more marathons, who complains that Medicare denied a knee surgery his orthopedic surgeon recommended. The bottom line that the surgery is actually worthless, according to good clinical trials, would never reach the screen, the reporter instead relying on testimonials from other patients who claim the procedure got them their life back.

Unfortunately, American politics and the media continue to devolve farther and farther away from adult conversations about difficult issues. I commend my British colleagues for showing us that human psychology and public discourse still allow for making difficult decisions at the national level, where public institutions have to live within their means.

Maybe one day, we could get a bunch of British physicians and their patients to perform at Shea Stadium. Maybe that would be the catalyst to awake the Americans to the innovations coming from the other side of the pond. A boy can dream!

Keep calm and ration on.

Richard Young is a family physician who blogs at American Health Scare.

Image credit: Shutterstock.com

Prev

Don't watch too much financial news

October 23, 2018 Kevin 0
…
Next

The phone calls physicians make in the middle of the night

October 23, 2018 Kevin 0
…

Tagged as: Public Health & Policy, Washington Watch

Post navigation

< Previous Post
Don't watch too much financial news
Next Post >
The phone calls physicians make in the middle of the night

More by Richard Young, MD

  • Patients in Sweden received fewer post-op opioids. Why is that?

    Richard Young, MD
  • Medicine is too complex for computers to keep up with or understand

    Richard Young, MD
  • An American physician in Sweden. Here’s what he thought about its health care.

    Richard Young, MD

Related Posts

  • The ethics of rationing care during COVID

    M. Bennet Broner, PhD
  • In a single-payer system, who will be doing the rationing?

    Edward Hoffer, MD
  • Let’s talk about guns as a health crisis

    Aldis Petriceks
  • We need to change the way we talk about climate change

    Jacob A. Fox
  • When we talk about quality, what exactly do we mean?

    John Corsino, DPT
  • Let’s talk residency: COVID edition

    Angela Awad and Catherine Tawfik

More in Policy

  • The realities of immigrant health care served hot from America’s melting pot

    Stella Cho
  • Healing the damaged nurse-physician dynamic

    Angel J. Mena, MD and Ali Morin, MSN, RN
  • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

    Mohammed Umer Waris, MD
  • Breaking down the barriers to effective bar-code medication administration

    Amy Dang Craft
  • The locums industry has a beef problem

    Aaron Morgenstein, MD
  • Canada’s health workers are sounding the alarm. We must act, now.

    Ivy Lynn Bourgeault, PhD
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • The harmful effects of shaming patients for self-education

      Maryanna Barrett, MD | Physician
    • The power of self-appreciation: Why physicians need to start acknowledging their own contributions

      Wendy Schofer, MD | Physician
    • The endless waves of chronic illness

      Michele Luckenbaugh | Conditions
    • Skydiving and surgery: How one doctor translates high-stress training to saving lives

      Alexandra Kharazi, MD | Physician
    • Telemedicine in the opioid crisis: a game-changer threatened by DEA regulations

      Julie Craig, MD | Meds
    • How this doctor found her passion in ballroom dancing [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 10 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Ankle Sprain Physical Therapy Doesn't Shift the Pain Elsewhere
  • Use of EMR Directive Tied to Reduced Opioid Prescribing After Spine Surgery
  • Make the Diagnosis: This Bump on His Nose is a Tricky Diagnosis
  • CRT Regimen Boosts Complete Response Rate in Unresectable Vulvar Cancer
  • Fla. Doc Charged With Murder; McConnell Exits Rehab Facility; BPA on Store Receipts

Meeting Coverage

  • Ankle Sprain Physical Therapy Doesn't Shift the Pain Elsewhere
  • Use of EMR Directive Tied to Reduced Opioid Prescribing After Spine Surgery
  • CRT Regimen Boosts Complete Response Rate in Unresectable Vulvar Cancer
  • CDK4/6 Inhibition Active in Recurrent Low-Grade Serous Ovarian Cancer
  • Switch to IL-23 Blocker Yields Deep Responses in Recalcitrant Plaque Psoriasis
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • The harmful effects of shaming patients for self-education

      Maryanna Barrett, MD | Physician
    • The power of self-appreciation: Why physicians need to start acknowledging their own contributions

      Wendy Schofer, MD | Physician
    • The endless waves of chronic illness

      Michele Luckenbaugh | Conditions
    • Skydiving and surgery: How one doctor translates high-stress training to saving lives

      Alexandra Kharazi, MD | Physician
    • Telemedicine in the opioid crisis: a game-changer threatened by DEA regulations

      Julie Craig, MD | Meds
    • How this doctor found her passion in ballroom dancing [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The British are unafraid to talk about rationing. That’s something to admire.
10 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...