Andrew Jack, the FT’s pharmaceuticals correspondent, talks to Armin Fidler, lead adviser, health policy and strategy at the World Bank
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Category: Delivery
Healthcare podcast: Interview with Rifat Atun the Global Fund to fight Aids, TB and Malaria
Andrew Jack, the FT’s pharmaceutical correspondent, talks to Rifat Atun, director; strategy, performance and evaluation cluster; the Global Fund to fight Aids, TB and Malaria
Healthcare and the Recovery – an FT special report
Read the FT Healthcare and the Recovery report
• Political interests and lobbying vie with economic pressures
• After a decade of growth, austerity looms in the NHS
• The financial crisis is redefining the Gates Foundation’s priorities
UK GPs – access all areas
The latest idea from Andy Burnham, UK Secretary of State for Health, is to enable people to register with whatever doctor they like, whether or not they are in that doctor’s “catchment area”.
It has recently been suggested to me that I am being too critical of New Labour and its health policies. But here we go – personally I think you should be allowed to register to see any doctor anywhere you like – it only really becomes a problem if house calls are needed to an address which is a long way away.
But I am concerned about how this will be done. I work a couple of miles from the two hospitals where my patients are mainly seen. I can easily spend an hour, as I did earlier this week, trying to chase up and sort disparate results, letters and prescriptions to ensure I am not missing any important information, before trying to plan a safe treatment course.
It can be quite easy to miss things, and this is a system I know. When patients are seen without their notes – either as a “temporary resident” or in the “Out-of-Hours” centre – everything takes longer, because you have no notes, and you have to get full details of everything, including medication, from the start.
The French healthcare deficit – an opportunity in adversity
By Ross Tieman
Recession amplifies the challenge of healthcare funding. France, which probably has the best-quality universal-coverage system in the world, has already recognised that the chronic state healthcare deficit will this year be deeper than forecast.
Fewer jobs quickly translates into reduced receipts from working contributors. In June, the Social Security Accounts Commission estimated that the state healthcare fund deficit this year would reach €9.4bn, more than twice the €4.6bn shortfall predicted last December.
Eric Woerth, the Budget minister, said the drop in total salaries paid in 2009 would result in a shortfall of €8bn across the entire social security system. In effect, he said, the economic crisis would cost social security a total of €10bn.
Healthcare reform needs bolder action
In recent days the momentum of Barack Obama’s drive to reform US healthcare - see US health reform Q and A has seemed to fade. Congressional committees have produced bills which broadly follow White House specification. Yet these proposals remain unfinished work because the crucial questions – who pays, and how? – await answers. Raising the stakes of his own personal commitment to the project, the president went on television this week to persuade the country that the reform was needed, and still on track.
Baby talk
Labour has a reputation for being painful. Personally, I like pain relief and avoiding complications, so I chose to give birth in what I thought were the safer environs of the hospital. But in hospitals, medical staff may be rather too close to hand, and this can mean a higher risk of medical intervention without, necessarily, much benefit. The issue of Caesarean sections is a particularly sore point in this area. A number of women find themselves told to have one when they would rather not, and vice versa. Some patients are now electing to avoid the antenatal ward altogether, in the hopes of an equally safe, but less invasive birth at home.
This choice is more weighted than others since, when talking about labour, there are two people to be considered – the mother and the child. In the UK we are allowed to decline medical treatment even if it leads to our death. In fact, forcing treatment on someone who has decided against it could be construed as battery or assault. Start applying this logic to childbirth, though, and everything becomes less clear.
So, is there a discernibly greater chance of things going wrong at home? A cohort study, published this year in the British Journal of Obstetrics and Gynaecology, examined the differences in perinatal (in the time just before or after birth) mortality and morbidity in more than half a million women planning either hospital or home births in the Netherlands. They concluded that “planning a home birth does not increase the risks of perinatal mortality and severe perinatal morbidity among low-risk women” provided there was an “availability of well-trained midwives and a good transportation and referral system”.
The remainder of the article can be read here. Please post comments below.
Responses to Obama’s health care town hall on June 24
President Obama yesterday took part in a White House town hall meeting televised on ABC. During the meeting, he answered questions from audience members chosen by ABC News.
From the ABC new health care forum:
President Obama struggled to explain today whether his health care reform proposals would force normal Americans to make sacrifices that wealthier, more powerful people — like the president himself — wouldn’t face. President Obama Defends Right to Choose Best Care
A lively imaginary debate from The Health Care Blog:
Will health care Reform Improve Our Health?
“When government entered the markets for workers compensation insurance, crop and flood insurance, and disaster insurance, it often completely crowded out private options. Do you expect a new government health insurance program would do the same?
I hope so because the current private options are lousy at keeping down health care costs, or satisfying their customers. Oops, Obama can’t say that, can he.”
And from the Health Business Blog:
A public plan private plans can live with?
“From where I sit, the most exciting aspect of the healthcare reform debate is the discussion around a public plan that would compete with private plans. So I was interested to read that Senate Finance Committee members Olympia Snow (R-ME) and Charles Schumer (D-NY) appear to be negotiating a compromise bipartisan agreement that would establish a public plan -but do so in a way that would be less frightening for private insurance companies.”
Medicare for all may be the best cure for the US
By Clive Crook
For the past few months, Barack Obama and his allies in Congress have been striding towards far-reaching reform of the US healthcare system without the public paying much attention. This is changing. Interested parties are studying draft legislation to see where they stand. In spite of the Democrats’ dominance in Washington, reform will not glide through unopposed.
Using a manoeuvre called reconciliation, the administration can get reform through Congress without a single Republican vote. But the Democrats themselves are divided.
Continue reading “Medicare for all may be the best cure for the US”
US needs a public healthcare debate
The drive to reform US healthcare is speeding up. Plans have emerged from Congress and Barack Obama is calling for rapid action. Last week he told Senate Democrats that the next two months would be “make or break”.
The president still says he wants bipartisan agreement, but plans are afoot to get the job done without it. So what was once regarded as impossible – comprehensive reform of US healthcare – seems likely to happen. The question now is whether the country will like it when it gets it. The administration has learnt the lessons of the Clintons’ failed reform of the 1990s, but perhaps too well. The designers of “Hillarycare” left Congress out of the process, which Congress did not care for. This time the White House has not merely engaged Congress in a joint effort, it has surrendered the entire project.
Health and science blog
This blog, part of the FT's health series, is a forum for readers interested in the science, policy, management, technology, business and delivery of healthcare.
This blog is no longer active but it remains open as an archive.
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About our regular bloggers
Margaret McCartney is a Glasgow-based GP and FT Weekend columnist. She started writing for the Life and Arts section in 2005 and moved to the magazine in
2008. She also has her own blog: www.margaretmccartney.com/blog
Clive Cookson has been a science journalist for the whole of his working life. He joined the FT in 1987. Clive, the FT's science editor, picks out the research that everyone should know about. He also discusses key policy issues, from R&D funding to science education. 
Andrew Jack is pharmaceuticals correspondent, covering the industry and public health issues. He has been a journalist with the FT for 19 years, based in London, Paris and Moscow