Core Tenet of U.K. National Health Service Debated

May 8, 2008

Allowing patients to pay the additional costs of treatments not funded by the U.K.'s National Health Service is unfair and would undermine the foundation of the entire health system, argues the author of a Head to Head article published online May 6 in BMJ.

THURSDAY, May 8 (HealthDay News) -- Allowing patients to pay the additional costs of treatments not funded by the U.K.'s National Health Service (NHS) is unfair and would undermine the foundation of the entire health system, argues the author of a Head to Head article published online May 6 in BMJ.

Karen Bloor, of the University of York in the United Kingdom, responds to the argument by author James Gubb that the government should permit "top-up fees," allowing individuals to privately pay for the cost of treatments not provided by the NHS.

Bloor explains that the NHS is founded upon the principle that patients' access to medical treatments and services should not be affected by ability to pay. Allowing top-up fees would mean that a wealthy patient could purchase a treatment that a poorer patient with the identical condition could not afford, dramatically reducing the fairness of health care rationing.

"The fact that treatments sometimes have to be rationed is the price paid for the comprehensiveness and humanity of the NHS," explains Bloor. "The NHS should be maintained and improved to provide care for all patients, regardless of ability to pay, and should not be undermined by an understandable but misplaced desire to provide patients with all the treatments that they want."

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