Global Healthcare Rationing Begins?

The Independent
WSWS

Cataracts, hips, knees and tonsils: NHS begins rationing operations.

Hip replacements, cataract surgery and tonsil removal are among operations now being rationed in a bid to save the NHS money.

Two-thirds of health trusts in England are rationing treatments for "non-urgent" conditions as part of the drive to reduce costs in the NHS by £20bn over the next four years. One in three primary-care trusts (PCTs) has expanded the list of procedures it will restrict funding to in the past 12 months.

Examples of the rationing now being used include:

* Hip and knee replacements only being allowed where patients are in severe pain. Overweight patients will be made to lose weight before being considered for an operation.

* Cataract operations being withheld from patients until their sight problems "substantially" affect their ability to work.

* Patients with varicose veins only being operated on if they are suffering "chronic continuous pain", ulceration or bleeding.

* Tonsillectomy (removing tonsils) only to be carried out in children if they have had seven bouts of tonsillitis in the previous year.

* Grommets to improve hearing in children only being inserted in "exceptional circumstances" and after monitoring for six months.

* Funding has also been cut in some areas for IVF treatment on the NHS.

The alarming figures emerged from a survey of 111 PCTs by the health-service magazine GP, using the Freedom of Information Act.

Doctors are known to be concerned about how the new rationing is working – and how it will affect their relationships with patients.

Birmingham is looking at reducing operations in gastroenterology, gynaecology, dermatology and orthopaedics. Parts of east London were among the first to introduce rationing, where some patients are being referred for homeopathic treatments instead of conventional treatment.

Medway had deferred treatment for non-urgent procedures this year while Dorset is "looking at reducing the levels of limited effectiveness procedures".

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Kentucky to privatize management of Medicaid program.

Kentucky Governor Steve Beshear is spearheading the privatization of Medicaid in the state, a move that will restrict services for the program's 815,000 enrollees. More than one in five residents in the state depend upon the health care program for the poor.

Private companies will begin managing care for most recipients of Medicaid by October 1. Four private for-profit companies, including Passport, Kentucky's only managed-care company, will control the Medicaid plans.

Beshear, a Democrat, described the move as a “major sea change” in the $6 billion-a-year program. According to the Lexington Herald-Leader, it is estimated that the shift will save the state and federal government $1.3 billion over three years.

The move is part of a nationwide campaign to liquidate the joint state- and federally-funded program. In Florida, lawmakers recently instituted a cap on payments to medical providers, allowing HMOs (Health Maintenance Organizations) to effectively ration care for thousands of the most vulnerable patients. The Kentucky plan will put in place a similar management system.

At least 32 other states have announced plans to cut Medicaid costs, according to July data from the National Association of Budget Officers. Most states are seeking to reduce their budgets through slashing reimbursement rates to health providers, and by privatizing case management.

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