I went back in 1999 and England's Continues the Struggle to Improve Health Care Delivery System

Machiavelli Was Right Great nations dislike making changes in their long established social systems. Health care delivery is a good example.

Machiavelli could have been thinking about that many decades ago when he wrote: ...there is nothing more difficult to arrange, more doubtful of success, and more dangerous to carry through than initiating changes.

I had difficulty appreciating those thoughts till I'd made several trips to Great Britain, during the past 15 years, with the intent of studying their effort to deliver health care through their National Health Service [NHS].

During my effort, I've become convinced that their health care system, and ours as well, is in need of change. Many students on both sides of the Atlantic would agree, but how to change it, what to eliminate, what to keep, pose difficult questions. The process is too fast for some, too slow for others just as Machiavelli warned.

Look at what's going on, there. Margaret Thatcher, the former Conservative Prime Minister, faced with the fact that one million of her people were on waiting lists for NHS hospital care, called for greater participation by the private health insurance industry.

The Labour Party, in need of a challenging issue for the coming general election, together with the news media, who sensed an issue with great appeal, created enough adverse public reaction to force the Conservatives to suspend the reform effort.

Great Britain spends about 6% of its GNP for health care, the least of any European country.

In the US, we hear it said in the political corridors, in the corporate board rooms and on Television, as well as read it in our daily papers: we need a national health service to correct the deficiencies that exist in our health care system.

To support my concern I would point out that many of our patients are going into heavily discounted, managed health care systems that promise high quality comprehensive care for less money. Some of these programs have already failed and others are sure to follow.

Revisit June 1999. 1.Many Dentist refusing to see NHS patients. 2. In-hospital Doctors threatening a strike. 3. Waiting lines for hospital care no shorter. Estimated that 500 cardiac patients die each year while waiting- some are children.] 4. Women demanding more Mammograms and more Pap Smears. 5. People unhappy because co-pay now required for medicines and eye-glasses. 6. Private health insurance policies, private Doctors and private hospitals now more common [15%], but government wants more.

See my article on saving managed care medicine because it's better than Government care.