A $25 tip will be given for a reasonably good
answer.
I would like someone to look into the academic research into the
causal relationship between increased healthcare capacity, and
increased demand for healthcare, in European healthcare systems. The
main source I expect would be academic papers. Virtually all medical
papers are indexed by PubMed (medline on line) so I would expect most
of your time to be spent in:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
Background
I am a medical doctor/consultant working in the United Kingdom. It
has often seemed to me that healthcare demand is driven by the
healthcare available. For example, when MRI scans first came out, we
doctors would only propose them to people with conditions we thought
were likely to be very serious (cancer, serious sports injuries, etc.)
Now that MRI scanners are common and inexpensive, a lot of people
with simple headaches get them!
Healthcare in the UK is rationed by waiting lists. If you are
diagnosed with a non-urgent surgical condition (eg. a knee problem),
you have to wait up to six months for arthroscopy to diagnose and
treat the problem. In recent years the UK government has spent a
great deal more on healthcare (spending is up 30% in real terms in the
last 5 years). However, because waiting lists are now shorter, we
doctors are more likely to put people on the waiting lists for more
minor conditions as the case for rationing health care isn't as great.
Another case is: in a clinic, there are three doctors. When a new
doctor is appointed, one would logically expect that the three
doctors' workload reduces by 1/3. In reality, while there may be a
short period in which this happens, soon all four doctors are working
as hard and as long as the three doctors did.
This is because doctors "autoregulate" the amount of care people get.
The doctors may simply give patients more time, or may treat more
patients with less serious conditions.
I'm not very interested in papers based on clinical systems outside
Europe. Ideally, they should be based on the UK medical system. |