NCPA - National Center for Policy Analysis


February 22, 2008

The British National Health Service (NHS) has found itself wrestling with a problem its founders never anticipated: how to handle patients with complex illnesses who want to pay for parts of their treatment while receiving the rest free from the health service, says the New York Times.

Patients, doctors and officials across the health care system widely acknowledge that patients regularly pay for some parts of their treatment while receiving the rest free.  According to Dr. Paul Charlson, a general practitioner in Yorkshire, the reasons often vary widely.  For example:

  • A 46-year-old woman with breast cancer who paid $250 for a second opinion when the health service refused to provide her with one.
  • An elderly man who spent thousands of dollars on a new hearing aid instead of enduring a yearlong wait on the health service.
  • A 29-year-old woman who, with her doctor's blessing, bought a three-month supply of Tarceva, a drug to treat pancreatic cancer, for more than $6,000 on the Internet because she could not get it through the NHS.

Officials say that allowing people to pay for extra drugs to supplement government care would violate the philosophy of the health service by giving richer patients an unfair advantage over poorer ones.  But others say what is really unfair is a health service riddled with inequities.  Some drugs are available in some parts of the country but not in others.  Waiting lists for treatment vary wildly from place to place.  Some regions spend $280 per capita on cancer care, for example, while others spend just $90, says Karol Sikora, a professor of cancer medicine at the Imperial College School of Medicine.

Source: Sarah Lyall, "Paying Patients Test British Health Care System," New York Times, February 21, 2008.


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