Personal Health Budgets PHBs – a transition to a two tier US style Health Service?

“Personal Health Budgets” (PHBs) are being rolled out across the UK. Have these been publicly debated? Are the media paying attention??  Are WE paying attention??

The stated advantages of Personal Health Budgets are very persuasive but is this the whole story?  Are Personal Health Budgets just Health Vouchers which in the long run will be a subsidy to the wealthy and those with expensive private insurance who can pay to top up their voucher.   Will those less well off  (the majority ) have to make do with fixed cash limited budgets that do not keep up with inflation and personal health costs?  In short are these budgets too easy for governments (current or future) to manipulate? Will this lead to a two tier health service? Is this the unstated intention of the government? Anyone know the answer?

The article below[1] by Lucy Reynolds details how she thinks PHBs will lead to profit driven health care and a two tier system based on a US style insurance system.  Those who cannot afford or cannot get insurance will suffer a third rate cash limited service as PHBs fail to keep up with inflation in health care costs.

UPDATE: Since starting this topic I have had an interesting Twitter interaction and have been made aware of just how well PHBs are working for long term care in the pilot areas. There seems to be pretty convincing evidence of the success of PHBs . But I still worry that this is down to the commitment and sincerity of those who are implementing the pilots. What happens if the budgets are no longer sufficient to cover the costs?  I will have to leave the debate open, clearly PHBs are proving to be successfully implemented by sincere and committed people lets hope no one lets them down in the future.

For a positive view, take a look at:  People Hub Personal Health Budgets Network

This is all happening NOW. The government consultation finishes 26th April: 
Open consultation: Changes to direct payments for healthcare
., March 2013

Here’s another argument in favour (Zesty is an online Health Care Market so stands to gain from Personal Health Budgets): Personal health budgets to be rolled out in the UK.  Zesty 4th Dec 2012

[1] Here’s an argument against:
Personal health CARE budgets as a transition state to profit‐driven care  Lucy Reynolds Health Services Researcher London School of Hygiene and Tropical Medicine


GPs should not block personal budgets even if treatments have no evidence, says RCGP  Pulse 9 Jan 2013

DH consults on paying families management fee to administer personal health budgets  Pulse 4 March 2013

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