Rising temperature: the business of healthcare hots up

What happens when you mix medicine and the markets?

What happens when you mix medicine and the markets? Sandra Krstović gives you three diagnoses.

Prescribing the right treatment

The Health and Social Care Bill, presented to Parliament in January, has been extremely controversial. The reforms it proposes would mean totally restructuring the NHS to provide a more market-based approach to healthcare. Supporters of the reforms say they would give patients and medical practitioners more flexibility and ready the NHS for the future, but unions and others opposing them argue that implementing them would mean less spending on healthcare and a lowering of standards for the sake of making profits for private medical firms.

The Government sees the reforms as part of their "Big Society" campaign to pass on public services to private suppliers with the aim of enhancing choice and competition, as they are also advocating in their "Free Schools" scheme. However, although Cameron has stated that he hopes the forthcoming changes will cut NHS bureaucracy, he has been firm in his assertions that a privatisation of the NHS is not taking place. The Government claims that the reforms are simply modifying the NHS from a centrally-managed behemoth into a more flexible structure where the private sector can play an increased role. Doing so may mean cost savings; economist DeAnne Julius estimates savings in the region of 10 to 30 per cent may be made, while Health Secretary Andrew Lansley, thinks that the reforms will save the taxpayer over £10bn in the next 10 years.

However, Lansley is having serious problems convincing GPs that these market-based reforms are desirable. According to a recent survey conducted by the Royal College of General Practitioners, a GP representative body, over 70 per cent of GPs do not think that key changes proposed by the Government would improve the standard of healthcare in the UK.

(Im)patients

The NHS reforms will provide members of the public (or at least those who can afford to consider it) a greater range of private treatment options. And in coming years, they may be able to choose not only between different providers, but also between different geographies.

As the cost of healthcare has soared, especially in the US, medical tourism has flourished in emerging markets. To take advantage of lower prices, patients from the UK are more than willing to pack their bags and fly away for surgery. Not only are there financial savings to be made, but treatment can often be done much sooner than at home, where patients may face long waiting lists. It is estimated that a bypass surgery in India costs a third of the price of the same procedure in the UK.

And in vitro fertilisation and cosmetic surgery can be listed alongside beaches and temples as popular reasons for visiting South-East Asia and South America. Many have concluded that health care can no longer be regarded as a local service - Deloitte predicts the number of US citizens travelling abroad for medical services will reach 1.6 million in 2012.

Organic matter

The growing economic value placed on healthcare services has given rise to some shocking illegal business activities. In Kosovo, a horrific organ trade scandal has recently come to light which is currently grabbing headlines across Eastern Europe. The country's new Prime Minister, Hashim Thaçi, is facing charges of masterminding organised kidnappings of Serbians in the late 90s who were then murdered for their organs in the now-infamous "Yellow House." Thaci was first accused of these crimes in 2008 by former UN Chief Prosecutor Carla del Ponte in her book The Hunt, in which she presented substantial evidence of trafficking to back up her claims. However, her allegations were silenced by the wave of national euphoria which followed Kosovo's declaration of independence that year. But Dick Marty, a former Swiss prosecutor and politician, published a new report last December, which put forward further evidence against Thaçi. However, an inadequate witness protection system in Kosovo means that taking further action is likely to be difficult.

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