Sunday, April 15, 2007

[medical care] increasing dilemma of the elderly

My best friend over here would not appreciate me writing of his elderly mother and her difficulties but let's say the issue is constantly on the mind. This is exacerbated by having lost two parents and a step-parent myself [the latter recently].

The elderly and the toddler are two issues which make it very difficult to be completely non-Statist. Do we run a near-totally free system like Russia's with sub-standard treatment except at the pay clinics or do we go the whole hog the other way:

The United States has many advantages to offer the newcomer, but a stable, affordable health care system is not one of them. The phrase health care crisis is perhaps too mild. Costs are skyrocketing, lawsuits proliferating. Special interest groups aggravate the problems. Racism, poverty, drug abuse and AIDS make matters worse. Significant portions of the population can no longer afford adequate health insurance. As a result, to get good health care in the United States you have to know what you're doing.

Britain is halfway. The running down and dismantling of the NHS by Labour and the previous government has caused the finger to be pointed in different directions:

The near-withdrawal of the NHS in many areas from paying for elderly people who need health and medical care was revealed by the charity Age Concern. It follows years of controversy over the reluctance of health chiefs to pay for people who need high levels of medical and nursing care but who live in care homes rather than in hospitals. [Daily Mail]

The Eastern Daily Press has highlighted four heartbreaking cases this week of pensioners going blind, being forced to pay privately for injections to slow the progress of age-related macular degeneration.[Ellee Seymour]

Free and available to all is not possible and everyone in Health provision knows that … The blood sucking greedy Doctors . God I detest them , they prattle on about problems when you can see their Ferrari parked outside a run down Surgery.[ newmania]

Specialists & Surgeons working both in the NHS and their private practices - are in conflict of interest. They prevent the NHS being able to employ another specialist or surgeon to work full-time for the NHS, whilst they are free to disappear any time to work in their private practice.

… But if the NHS wasn’t willing to pay the prices set by the BMA & RCS (a monopoly) or if we had more surgeons & specialists, prices would have to come-down. Their price-fixing would be classed illegal by the Monopolies Commission in any other field: whether the Oil industry or Microsoft or Utilities … [Quasar9]

NHS hospitals will have no option but to invest in marketing tactics, such as advertising, if they are to survive against private firms who will already have large marketing budgets and considerable expertise in selling themselves. [BMA]

I personally feel that the state's resources, such as they are, should cover all health care costs for the elderly and babies, should cover defence and should partly subsidize free choice education and start-up businesses.

This need not mean big government, quite the opposite, which in turn would reduce wastage and make government jobs more like hen's teeth.

As far as the elderly go, the coming grey majority will have an effect on policies towards them but by then it will be too late for today's elderly.


  1. Thank you for highlighting this again, clearly something needs to be done, this is such a desperate situation, how can our medical profession ignore those in this kind of need? It goes against all the ethics and morals behind medicine.

  2. This is an important issue here in Australia, with one of the fastest aging populations in the world. South Australia has a ticking time bomb of blue rinsers, who are going to suck the next two generations dry if nothing is done. Australia has the best balance between taxation and services in this area of all the countries I have lived in. You can actually get access to services at a reasonable cost and timeframe.

  3. Yes Ellee and thanks for raising it. Colin, as a commenter said on Ellee's post, Australia could well be the model to follow.

  4. When I was a little boy, the neighbouring house in the terraced row we lived in (two up, two down, outside lavatory) had the widowed grandfather living there. In the Winter he sat by the fireplace. In the Summer, he sat in his shed. I don't think it had ever been agreed that the family would take him on. He just got past being able to live alone and it happened naturally.

    He smelled a bit funny, but I liked him. He used to talk to me when I was playing in the garden. He would tell me stories, teach me the names of the passing insects, let me pretend to smoke his pipe, that kind of thing. He didn't mind a bit being the besieged settler in a prairie schooner to my Indian chief. He had all the time in the world to spend, unlike the responsible adults.

    There would be a paedophile panic now, so sick has our society become, but it was not like that at all. He was just a lonely old man, probably remembering the little boy he had been himself, somewhere back in the 19th Century.

    I learned from him, as did the children in his own family. We certainly learned not to think of old people as belonging to another species. He represented a future part of our own lives. I only wish he had been a bit more articulate.

    The welfare state has destroyed the family's natural tendency to look after its own, having cruelly promised something better - and then failed to deliver - or rather delivered to its usual crappy standard.

    People have lived their lives on the assumption that they did not have to provide for their own old age or for that of their poorer relatives. Planning regulations even make it difficult to build houses big enough to accommodate the odd babushka.

    All the taxes taken by force against promises to provide such care have been squandered by politicians with five year horizons (and a substantial guaranteed pension). Yet another reason why I can't understand how they walk in public without being lynched.

    I have an old school friend who works in a nursing home. She tells terrible stories. The inmates are only cleaned up and looked after propertly when family are due to visit. If you can't provide for yourself, only family WILL look after you in your old age - even to that limited extent. All else is lies.

  5. I have asked Tom to publish this comment as a stand alone post.

  6. Care of the elderly is a sibject I feel strongly about too, James, as you know. There should be no question about it; the state should pay for all aspects of their care. Families, I agree, should do all that they can and I have similar memories to you: my great aunt and my grandad lived with us. My parents didn't even think about it for a minute; when the old people could no longer look after themselves, they gave them a home. But it is very, very difficult to care at home for someone with late-stage Alzheimer's. They can become quite violen. Then , having to make a decision is heartbreaking. I don't think we should forget that it was a Conservative government that first turned the NHS into a business.

  7. WC, I wish that comment were true. It's time someone turned the NHS into a business which is not (by the way) a synonym for "bad thing." Things run by the State are not morally superior (history tells us quite the contrary, actually).

  8. I don't think enterprises run by the state are necessarily better or morally superior. But I do think that if you turn an institution whose end product is people into a business, you are heading for trouble. and I was teaching when this happened to schools. I am not saying that some good things did not come of it; but an awful lot of bad things happened too. Anyway I came over again to say that as I feel strongly about care for the elderly I have just posted on what happened with my mum and I have linked to you.

  9. The question is, should our government leave our elderly people to become blind by denying them medication that will save their lives in order to make the PCT's books balance?

    There can only be one answer to this in our civilised society, so why is it allowed to happen?

  10. I have a significant other who has been diagnosed with a shrinking brain possibly alzheimers. I have a young son who is re-finding his.

    The care offered to both has been noticeable by how patchy it is. Either amazing or absent - without warning of either.

    I am stuck in the middle - having to work to pay the taxes to fight wars. The only support I have received is from my friends on line, work colleagues and the occasional professional who asks if I would like counselling (and when I said yes, they couldn't find any - I later found they offered it in the next room to the surgery !!).

    I knew what I was taking on with Bruce - he is 20 years older than me, but I thought I would get a few years of my own between raising the kids and having to care for him. Think again Shani -

    but there has to be an answer - it is just a question of trying to find it.

    The elderly of today are us in 20 years - I certainly don't want to be treated like this, so I suppose it is up to us now to make the authorities go away and come back with the right answer this time.

    Anyway - what always cheers me up at this point is to think of me 97 years of age causing mayhem in any home I am placed - why break the habits of a lifetime !!

    Hugs to you all - Shani

  11. James, of course I agree that the treatment should be funded by the NHS, provided it is a proven treatment. Some drug treatments for this disease have had less than stellar results.

    But I wanted to tell you a little story which contrasts the difference between the Russian and the Canadian system handling a similar thing.
    My husband had a malignant melanoma removed from his forehead last year. It took two separate operations including skin grafts. He got treatment immediately after the biopsy result and this did not cost us a penny.

    My Russian friend in Moscow had a malignant melanoma removed from his back, just a few weeks later. I assume in a timely manner. He had some complications and spent several weeks in hospital. Apparently it cost him $8000 US dollars (I assume the equivalent, not literally). So is there a two tier system in Russia?