19 January 2018

Limits to the NHS: which healthcare spending should be free?

I shall be sad if the British National Health Service dies from deliberate starvation of resources, and passes into history — a lofty and "once successful" product of the human spirit. (See e.g. /https://labour.org.uk/page/nhs-crisis/). 
     However, I think the death of the free-for-all-at-point-of-use health service comes partly from the failure of the medical professionals themselves; their understandable failure to limit their costs.  The Hippocratic concept does not have space for rationing. 
     The valiant committees of the institute for health and care excellence (NICE), make recommendations that limit the way public money is spent, to maximise value for money. But perhaps not quite enough to dispel the vague notion we all share that the NHS is a bottomless money-pit. Their spending cut-off point is a sensitive matter of judgement, and may drift in time. 
     For example, I would point to the case of in vitro fertilisation (IVF), which is limited to a few rounds of implantation, and to a certain age range (see:https://www.theguardian.com/society/2018/jan/19/would-be-parents-moving-house-to-get-free-ivf-on-nhs). But we are in a badly over-populated world. And babies are not an "inalienable human right", given by providence to all. We are coming to the point where, to introduce one more life is, in effect, to introduce one more death; and incrementally intensifies the tensions and rivalries we see all around. 
     I, though over seventy myself, see some grounds for limiting free healthcare of the elderly to palliative care only.  

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