The Pharmaceutical Journal Vol 267 No 7167 p425-429
29 September 2001

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Letters to the Editor

Health care

Payment creates a bond

From Dr N. Brudney, MRPharmS

The excellent article (PDF* 70K) by Dr Guy Jepson (PJ, 25 August, p269), comparing health care systems, is a useful reference for everyone concerned over the rising costs of health care and in many cases the increasing delays in receiving adequate and prompt treatment.

To pharmacists it would indicate an ever-growing community need for the training and understanding of drugs inculcated in all of us who spend our lives trying to provide pharmaceutical help and support for people in need.

There is, however, one key point that I missed in Dr Jepson’s overview. In most of the countries where health care professionals are not overwhelmed by demand for their services, and consequently provision of health care is still a caring, thoughtful and understanding practice, the patient has to pay something directly to the provider. In most cases, this payment is either wholly or partially reimbursed, either by insurance plans or governments.

I strongly believe that this payment, even if it is 100 per cent refunded, is part of the treatment. It creates a bond between the provider and the patient. It establishes who is the primary income source of the provider, and relegates the role of the funding organisation to what it should be — a money provider.

This is especially important if the money provider is a government. Too often today, in countries like the United Kingdom, the money provider becomes the employer and this destroys the patient-health care provider bond.

It would have added greatly to the value of Dr Jepson’s study if he could have incorporated this aspect in his interesting review.

Norman Brudney
Poole, Dorset

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