Cost

I am not of a habit to copy-and-paste in this blog, but once we talk about improving the standard of medical care, this article from the recent issue of Clinical Medicine (formerly the Journal of the Royal College of Physicians of London) would be an exception.

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‘Charles, I sometimes think that some people, many distinguished in their fields, might benefit from your wisdom!’ I started.

‘Coe flattery gets you nowhere! What on earth have you been reading?’

‘We are repeatedly told that unless we improve, and spend more on our public health preventative services, the NHS costs are going to be astronomical.’

‘And what if we do? You know the answer!’

‘They will be just as astronomical!’

‘And possibly more so! Although the medium-term cost of illness might be reduced, any consequent improvement in survival would inevitably increase long-term NHS and social costs. That is unless you can arrange for the majority of 90 year olds to die of a coronary during their daily jog!’ Charles added with a smile.

‘Or game of tennis! But you are not opposed to all this type of expenditure?’

‘No I am not! Sixty years ago, it was excusable that Nye Bevan did not realise that successful medicine has long-term costs, but the authorities should realise by now that total cost might be even more astronomical if we do improve preventative services. The point is that saving money or even human resources should play no part in the equation. These measures should be judged on what they are trying to do, which is to extend healthy lifespan!’

(from Clin Med 2009; 9: 95-96)

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Well, I find it often difficult to tell whether someone is joking or using a laughter to cover the grim fact, or to tell a clever crook from an idiot.