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British NHS May Soon No Longer Offer Free Care
An anonymous reader writes "Coinciding with challenges in the rollout of the U.S. Affordable Care Act are challenges for NHS. The Independent reports, 'A National Health Service free at the point of use will soon be "unsustainable," if the political parties do not come forward with radical plans for change before the 2015 election, top health officials have warned. Stagnant health spending combined with ever rising costs and demand mean the NHS is facing "the most challenging period in its 65-year existence," the NHS Confederation said ... In a frank assessment of the dangers faced by the health service, senior officials at the confederation say that the two years following the next general election will be pivotal in deciding whether the NHS can continue to provide free health care for all patients. "Treasury funding for the service will be at best level in real terms," they write. "Given that demand continues to rise, drugs cost more, and NHS inflation is higher than general inflation, the NHS is facing a funding gap estimated at up to £30bn by 2020."' From The Guardian: 'Our rose-tinted view of the NHS has to change.' More at the Independent, Mirror, and Telegraph."
I sense controversy in the air, a lot of it.
much of left-wing thought is a kind of playing with fire by people who don't even know that fire is hot - George Orwell
And this is the system Democrats want the United States to emulate?
Benford's Corollary to Clarke's Law: "Any technology distinguishable from magic is insufficiently advanced."
It'll be covered by your health care.
But try to die quickly anyway.
the US's lap dog emulates its master.
Cameron must have figured out that, if US corporation can make big money out of healthcare, then britfag corps can do the same...and gratefully share some profit with his party...
Delta-Mike November Bravo Tango
- People are living more, with free Health System
- Drugs are becoming more expensive with the Free Prices System
Or ask to people die early
Or change the medicines used, some new drugs are expensive and dont offer really advantages, some are also worst then the previous used.
From what I have heard, UK has been getting a flood of immigrants who want nothing more than to live on the UK's generous welfare system.
The non-productive immigrants are totally draining the system.
Always enough money for wars, but not healthcare? Strange that.
So sack 50% of the police and use that money for the NHS. If they have enough time to lobby for more laws and fake 'pleb' evidence for the Sun Newspaper, then there's too many of them.
It's the most over-policed country in Europe.
Sack 50% of them and use the money you save to save people lives via the NHS.
Maybe if those greedy drug companies didn't insist upon 100000% markup on their drugs, health service would be more sustainable.
And that's assuming no GDP growth during that time. Actual GDP percentage will probably remain constant or rise only slightly. As a resident of a country (the USA) that spends more like 17% of its GDP on health care for outcomes that are no better (and arguably worse), I still think the UK is getting a great deal. Citations:
http://www.theguardian.com/news/datablog/2012/may/02/uk-healthcare-spending-gdp
http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS
http://shr.sagepub.com/content/2/7/60.long
Stop learning! Only you can prevent esoterrorism.
The NHS is currently underfunded, just now the government in charge would love to abolish the NHS purely for ideological reasons. Since the global recession, politics in the UK has been fought over the issues of, public spending cuts, cost of living, the welfare state, immigration; the NHS has been shunned to the side and because of this has allowed funding to minimized. A (phony) promise was made by the government back in 2009 to protect NHS spending, an increase in spending was in fact claimed but the truth is polarising.
It's privatisation in the back door, under fund it, make it under perform, all of a sudden privatisation becomes an easy argument to make.
Walk in to any ER room in Canada and you will find it full of Indians. Not "Curry Indians", but "Bannock Indians".
They generally do not work and do not pay taxes. They expect the Government to take care of them from cradle to grave. So rather than get a regular GP like most people, they fill up the emergency rooms when they or their 14 offspring have a runny nose.
Canada's system is holding up surprisingly well given the burden that the red man puts on it.
It's almost like you can't continue to give away something valuable for nearly nothing.
Seriously, there are 6? 7? billion people on the planet.
Not every one of them can have a heart transplant if they need one.
Limited things get rationed.
It's been proven time and again that allowing people to ration things electively simply means the people who get to decide, get the things.
What our world has largely decided is that money will be the determining factor. It's sad, as much of what a person earns is due to luck and circumstances beyond their control. Should a baseball player earn 100x what a teacher does simply because he was gifted with some abilities by freak chance of biology?
Nevertheless, it's the fairest system we've got.
-Styopa
"Man, the government does an awesome job running this.. They should take over more things and run them too."
Get ready for healthcare to be run like the DMV.. Obamacare is the worst thing imaginable that could've happened to the US
NHS has clearly been under pressure for quite some time. Strange that it rarely comes up in discussion.
Complaints about doctors 'double in five years'
Crackdown on migrants rights to NHS and council homes
Patients facing eight-hour waits in ambulances outside A&E departments
Watchdog issues NHS with financial health warning
Why do the UK's cancer survival rates still lag behind the rest of Europe?
Thousands of NHS operations cancelled because of blunders as complaints about standard of treatment rise
The frightening truth: NHS-managers are incentivized to ignore problems
Hungry, thirsty, unwashed: NHS treatment of the elderly condemned
Dying for a drink: Over 12,000 killed by dehydration in hospitals every year
Labour must bear the blame for the shameful decline of the NHS
much of left-wing thought is a kind of playing with fire by people who don't even know that fire is hot - George Orwell
Socialism doesn't work?
Shazam!
In Canada, prescriptions are paid for by the Patient (although the 12 major health boards can purchase pharmaceuticals in bulk and pass the savings of massive purchases on to patients --economies of scale kick in hard when purchasing 500 million pills of anything). Also, teeth and eyes are not covered except for serious medical conditions (you pay for your own glasses and cavities). One other thing the NHS has offered that Canada never did is health care for landed immigrants: In Canada you must be a citizen, and depending on your age at becoming a citizen, you will have to pay to get into the plan (If you are 18 when you become a citizen, you may not pay anything, if you are 60, you may have to pay up to $50,000, because young healthy people don't need much health care, and will spend 40 years paying into the program, at 60, you might spend 5 years paying in, and will have health needs not long after. Canada can't afford to pay for health care for the worlds elderly. These are things the NHS can look at.
At present, the NHS is still one of the more efficient healthcare systems out there - way more so than the US system, for example.
Healthcare is getting more expensive, and I would imagine that in the next few decades technologies such as synthetic organs will make it even more so. What if every elderly patient wanted a new synthetic heart, lungs, kidneys at a cost of £5,000,000 each? At some point it becomes a logical impossibility to pay for everything that can be done, for everyone. Even now it's not uncommon to find individual patients who've had £2,000,000 spent on their care (small kid with leukaemia) or who needs arthritis drugs at £30,000 pa.
The basic NHS model of prividing medical care is a good one. As a doctor I always ask 'what needs to be done' for my patient. Not 'what can they afford'? I'm frrequently appalled by the unnecessary extra scans etc I see booked in the private system here, or the insurance 'gotchas' (e.g. patient breaks ankle; sent to NHS hospital. Insurance pays for operation in a private hospital but not for the ambulance transfer to it).
The problem with the NHS system isn't that it doesn't work. It's that at present it's being attacked for ideological reasons and that presently we're being forced to do too much with too little. An injection of money would help - and as we spend less than many comparable nations on healthcare it's odd to suggest that this is unaffordable. However at some point we're going to have to accept that we can't do everything for everyone at all times.
Oh, and the hospitals are a mess, too.
For the people on the bottom that physically work and produce nothing really changes. All that people really need is food and shelter and in the western world we can afford to eat a lot less. The people at the bottom already live paycheck to paycheck and they know how to do physical work and how to fix things themselves. The people that will be hurt are the infirm that our modern society supports which includes the elderly, chronically sick and cripples. Most of us will someday at some point join the infirm.
This is the scenario after a "worldwide bankruptcy" All the land with all the houses and apartments will still exist. All the farmland that produces all the food that overfeeds our country and the rest for the world will still exist. All the fertilizers, chemicals, and natural resources will still exist. At least two thirds of the people, working to produce and distribute the above, will continue doing what they already do. Many of the poorest people of today live in luxury compared to a hundred and two hundred years ago. What will change is the "rich" will be out on the street sort to speak with their bank accounts decimated. There will be a memorable backlash against lawyers, investment bankers, and politicians that support their rackets and games.
Medical patents will be vacated and health care will go back to being affordable. Doctors will be better protected legally and not need insurance like the do now but will be subject to more public records, reviews and audits. Medicine will go back to being affordable comparable to the 1960. There will be no million dollar procedures unless you have a million dollars. People will die at 85 instead of 90. Doctors pay checks will no longer be quite so big but they will no longer need to support the insurance industry and lawyers. They will become more respectable and esteemed members of society back when children wanted to grow up to be a doctor not because of the paycheck but rather to be a hero of society.
Higher education will become affordable again but no longer be government subsidized.
UK has been getting a flood of immigrants who want nothing more than to live on the UK's generous welfare system.
Sensible arguments are can be made from the right - about NHS, immigration and other stuff, but you wrote flaming nonsense.
No economic migrant anywhere in the world is a leech on the host. They are the most hardworking - generally doing the low wage work the locals are not really keen to do. They pay taxes - may be not income tax - but every other tax when they consume products and services.
Who's the famous immigrant bogeyman in UK? The Polish Plumber. Who's he? A plumber. Someone who unclogs the stupid shit you guys excrete.
This is the same all over the world. Mexicans and Central Americans in US, Bangladeshi's in India (before partition - 60 years back - Bangladesh and India was the same country, calling Bangladeshi's illegal immigrants is stretching matters, still India has 1 billion plus population - so at least in the short term the argument 'we do not need extra heads' may make sense), Sub Saharan Africans in Italy who perish in large numbers when their boats capsize and so on.
The countries taking immigrants - willingly or otherwise - have a brighter future. You need headcount. The native population is not going to procreate in the numbers needed to keep your economy growing and humming. US is a prime example. Japan is on a long term decline for precisely the same reason - they are so insular they have a great derogatory word for non Japanese - GAICHIN. Ask yourself - do you want to live in a Japanese society full of inbred Japanese who all look the same? Parsi's in India - otherwise a very sensible community - is in decline for the same reason. They are so insular if a Parsi marries a non Parsi they are kicked out.
What you - and the type like you - also forget is the cultural and social contribution of the immigrants. Diversity and mixing of gene pool is a good idea. It makes your country stronger.
The new slogan should be "make love to someone of your opposite in gene pool, not war."
Tat Tvam Asi
European countries created socialized healthcare after they had been devastated bu WWII. They had no money for it but they had the political will. Now that they produce more wealth than ever (France GDP gown 700% since 1945, while population only doubled, for instance), European countries have the money but no political will to move it to socialized healthcare instead of shareholders profits.
I've lived in three countries, the UK with a full free health service, New Zealand with a partially free health service, and the US, and I've had contact with all of those health services for myself or my family.
The NHS in the UK is the best all round. You see your doctor, you feel that they care about you, they have the backing of a good hospital system to do anything they need to do. It can be slow to get treatment, but you can always go private if you can afford to do so, but when I had problems they were fast enough.
The system in NZ is the second best. The doctors care, and there is a smaller population so it feels more intimate. However, that smaller population means less in the way of economy of scale, so treatment might not be available or you have to travel further. Pharmac negotiates drugs on a national level so that is good for the tax payer, but maybe not for the individual that requires an esoteric cancer treatment. As with the UK you can always go private if the public system is too slow, and I've had an occasion where that was the case.
I don't really know where to begin with the US system. On the positive side its nice and shiny. Individual people do care and help you out, but it doesn't feel like the system as a whole gives a shit. There is a lot of paperwork (absent from the previous examples). There is an abundance of choice and options. When you are sick (or your kid is sick) you don't want choice or options. I was shocked that the health coverage from my company was only subsidised and I still had to pay on top, and I'm utterly confused by the insurance options and savings whatnots (you put money into an account for health stuff?). It is a complex and scary system, but at least if it turns out I have the wrong coverage I can flee home to sanity.
I hope they keep the NHS free. Adding fees will ruin feel of it. I know what they'll do if they charge fees is they'll create a health card for low income people who can't afford the cost. But it is a needless barrier to treatment, if they do that why not just raise tax?
From what I have heard, UK has been getting a flood of immigrants who want nothing more than to live on the UK's generous welfare system.
The non-productive immigrants are totally draining the system.
I challenge you to find a source for that, I dare you. No, wait, I double dare you! Ironically, immigrants subsides benefits for the rest of the rest of the UK. http://niesr.ac.uk/blog/migrants-benefits-and-public-services-what-does-new-research-evidence-tell-us
Some cities and towns have severe shortages of doctors. Vancouver is one of those places with a shortage of doctors.
Jesus was a compassionate social conservative who called individuals to sin no more.
In the British NHS, bureaucrats outnumber doctors and nurses by a hefty margin.
-jcr
The only title of honor that a tyrant can grant is "Enemy of the State."
just tax the rich more. Seriously. We put a _lot_ of effort to satisfying their whims and providing them with every creature comfort in the world. The only thing we'd lose is the (false) dream that we can have it ourselves. But then again good luck getting people to give that up...
Hi! I make Firefox Plug-ins. Check 'em out @ https://addons.mozilla.org/en-US/firefox/addon/youtube-mp3-podcaster/
now if you want to see the doctor you better be able to pay the X1000 markup at the ER or go to prison / jail
The UK's NHS has, for most of its life, been neither a single-payer nor an insurance based system ... instead its costs came out of general taxation with no treatment-accounting. By that I mean there was no financial record-keeping related to individual treatments or doctor consultations ..... Family doctors (GP) receive a flat annual sum for each patient they have registered, regardless of how many or how few times the patient visits them. Likewise Hospitals were funded based on the medical needs of the area, with no financial records kept of individual's treatment episodes.
this approach resulted in admin costs of about 5% of expenditure only
Tony Blair started the rot when his Labour government introduced the "internal market", forcing every medical episode to be recorded and costed.. The excuse being that hospitals would compete for patient-referals from family doctors ... as the NHS had gone through a phase when it relocated most district's hospital services onto single sites, most areas of the country have only a single hospital competing against itself. There was no medical advantage to this change BUT it introduced the financial recording system needed for future privatisation
The result was an explosion of admin and financial staff ..... and admin costs that reached 11% of expenditure..
the current government's reforms are predicted to push admin costs over 20% of expenditure.
The other aspect that the Tories hate is that it is paid for out of general taxation not through an insurance premium ... so the rich contribute more than the poor and the unemployed and the less affluent pensioners still receive health-care. with the original funding method, most people paid far less in their taxes for healthcare than in insurance systems such as the US.
In general there are no medical co-pays as in the US ... Drugs are free BUT, unless are exempt (over 60, under 16, etc) you pay $10 for the prescription ... there are small co-pays for a few services such as dentistry and glasses .... things like hearing aids, breathing equipment etc, are provided free .... the NHS used to be the worlds biggest manufacturer of hearing-aids, false-teeth, glasses and artificial limbs ...
Wow, I knew the UK was becoming more like the US every year, but I had no idea how much. Maybe this is Margaret Thatcher reaching out from beyond the grave to dismantle the remaining state institutions?
Nobody seems to understand that healthcare (a) has to be treated like a public good (in the economic sense) to be fairly available to everyone, and (b) that requires rationing of care to keep costs reasonable. The ACA we have now does neither of these -- it was a compromise to keep the "free market" insurance companies in on the game while giving them millions more customers.
If I were king, I would just declare Medicare to be the default universal insurance plan for everyone. That's a good compromise, since it doesn't cover everything and the insurance companies could fight over that market. It does cover catastrophic things, which is the primary failing of our system now. No one thinks the insurance companies would ever deny their claims, but they should try getting very sick sometime and see how fast the friendly relationship changes. People's taxes would go up, but they would be getting a valuable benefit for it.
The other thing single-payer care could eliminate is the tying of insurance coverage to employment. I personally know a few people whose families have serious health problems and they're literally trapped at their current employer because of the insurance plan they offer.
I think the ACA will reduce cost by a little bit, but it has flaws:
- You're still dealing with for-profit insurance companies who are looking for every reason to not cover a claim -- I doubt customer service will improve.
- The uninsured population that qualifies for subsidies isn't necessarily going to know or care about their ability to get cheap or free health insurance. It's not nice to say that people are stupid, but they are...
- Same goes for the policies themselves. Even educated people are confused by the language in health insurance policies and it's only gotten more complex with high-deductible plans, MSAs, etc.
- People who have insurance through work are just going to grumble about their rates going up and get no immediate benefit. Almost everyone vilifying single-payer healthcare has steady, well paying jobs and has never had to worry about going bankrupt if they land in the hospital. Because they don't understand the target population (low income workers with crappy or no insurance from their low-level service job) they think there's no benefit.
- The current political climate in the US labels anything beneficial that the government provides as socialism and therefore evil.
I think we should ditch the whole thing and just go single-payer. Doctors would get paid fee-for-service and not have to deal with insurance companies, individuals would be able to use healthcare without worrying about the cost, and things would be better. There's no reason a country like ours with so much wealth can't provide universal healthcare. People complain about government inefficiency, but what's efficient about tons of for profit insurance companies nickel and diming their policyholders and healthcare providers in order to make a buck? I think government would be very efficient at this task (and the NHS is -- the UK has a higher life expectancy than we do and spends less.)
You mean Congress, the President and VP and their aides get the same employer subsidies the rest of the federal workers get, it's just that instead of using the couple of plans negotiated by the federal government specifically for its employees, this subset of the federal employees will be buying their insurance from the state/federal exchanges. Will they be paying less than people who don't have an employer subsidizing their insurance and don't qualify for Medicaid assistance? Sure. But it's not the special sweetheart deal that the GOP and the right-wing media makes it out to be.
Well, there is a lot of medical tourism, families of UK residents and everything, to take advantage of the system. As a foreign UK student, I was very surprised I had rights to consultations and medication for free, without me and my family ever contributing a single dime to the system. And the proper filters, and better usage of resources. I had a GP consultation for free without talking with a much cheaper proxy beforehand, like, a nurse, you know.
Part of the problem is that useful drugs and medical equipment are often expensive, and healthcare orgs feel obligated to pay for them because they work. There is no incentive for medicine and device co's to research cheaper alternatives if healthcare orgs will keep paying for expensive ones.
Somebody has to be willing to say "no", and it will be a hard sell politically to deny people. Witness the lasting sting of Palin's "death panel" accusation (true or not).
Table-ized A.I.
Something that can't go on forever, won't.
You cannot possibly tax enough to pay for offering something for free to everyone where a significant percentage of people will abuse the privilege.
Some free heath care systems work because of cultural insularity, but that will not last forever either without sacrifices...
"There is more worth loving than we have strength to love." - Brian Jay Stanley
It does not get any cheaper than the NHS. The NHS works at base cost, how can base cost + profit margin be a cheaper alternative and more sustainable?
Thanks for saying "British" rather than English. Usually it's right. On this occasion, unfortunately, not quite so much. The NHS in England and Wales, and the NHS in Scotland, are independent from each other and have been ever since their creation in the 1940s. It's only in England and Wales that this change is happening, while in Scotland the degree of private financing and costs at the point of delivery are actually being reduced.
My reaction to this was "so what?" They still are paying around half as much per person as we do in the US with substantially the same overall results.
The NHS is a product of WW2. The british hunkered down to survive a siege by the Nazi empire. They slept in converted subway tunnels, sent their children to live with strangers in rural farms, and ate spam for years.
So when it was all said and done... the NHS made sense and seemed reasonable.
In peacetime however... not so much. The reasons for this are complicated and mathematical. Its not particularly debatable though there will always be those that will point at the sun in the sky and claim it isn't there. Such is life.
I hope the 21st century offers better. We're in the age of TOR, 3d printers, and bitcoins... hopefully we can escape these overly centralized enslaving super institutions that rob us of our individuallity, privacy, and choice.
The statists are making that hard. But the math isn't on their side. At best they'll trap people into failed systems spotted with Potemkin fakeries to preseve the illusion of competence. All it will do is run the clock out until the money is gone.
These systems don't produce anything. They don't innovate. They don't grow.
They consume. The take. They rot. And the time it takes to eat through everything depends entirely on how much there is for them to eat. Give them everything and it might take them a long time to exhaust it all. But eventually... there will be nothing and it will collapse. These sorts of systems historically have gone to war to put off the eventual collapse. Which does work... it buys you a couple more generations if you can gobble the wealth of a couple other civilizations to feed it. But in the end it is never enough.
Rome had grain ships... the super tankers of the ancient world delivering "free" wheat to rome... free entertainment... and slavery.
In the end, its all about power. Those that do not value their own power deserve to be peons. I merely wish I didn't rely upon the pathetic clowns to guard what little power I do have. Ideally justice is about consequences falling upon those that cause them. These troubles were not of my making. I do not deserve them.
I've decided to stop wasting my time responding to AC trolls/sockpuppets... so if you want a response from me... login.
So are you a racist, elitist concern troll, a classist, elitist concern troll?
Publicly they've claimed to want to maintain the NHS, but every single policy has been towards further privatisation, with the ultimate goal being that people "pay their own dues". They are the closest thing you'll find in Britain to the Republicans, but they know they wouldn't get elected if they publicly admitted to this, so they lied and a lot of people have been fooled.
That said. Norway's national health service (and I've just moved back here) is not free at the point of service. Everyone pays approximately $30 per GP consultation and something like $50-100 for a specialist appointment. Unless you're a child (in which case everything is free) or get a "free card" or if it is an emergency (in which case I've never heard anyone get charged).
A free card you get either for being unemployed, on benefits, or if you simply have alread spent more than about $300 on medical bills that year. So a few hundred dollars is the most anyone will spend on health care appointments in a year.
I find this to be a reasonable compromise and it does stop a lot of people from going to their GP "frivolously" and will thus save the health service a considerable amount of money. My only concern is that patients aren't necessarily the greatest judge of what is "frivolous". Men, in particularly, can take a long time going to the GP because they're sure "it's nothing". I'd hate for genuinely ill people to not turn up to the GP because they don't want to waste $30.
because GCHQ, MI6 and all the cameras in london are not cheap!
Some of the funding gap could be plugged by not sinking money into expensive, misconceived, mismanaged IT projects that never realise any cost benefit:
http://en.wikipedia.org/wiki/NHS_Connecting_for_Health
You hear wrongly.
http://euobserver.com/social/121778
http://www.telegraph.co.uk/news/worldnews/europe/eu/10361971/Britain-admits-it-has-no-figures-on-EU-welfare-tourist-numbers.html
Unproductive immigrants are largely a myth. People who can work themselves up enough to emigrate are not usually the sort of people to shy away from work. Statistically, an immigrant is more likely to be in work than a UK native, and is likely to make greater net payments to the state (paying taxes versus using government services) than a native.
Immigration is a knee-jerk right-wing bugbear. You can argue, if you like, that they're taking our jobs. But you can't also argue that they're all work-shy scroungers. Can't both be true.
Miss. The majority of the homeless here (San Francisco, where you obviously are not) are mentally ill. Unlike our immigrants - legal or otherwise - they do not as rule have jobs. Furthermore, many of them were shipped here illegally by irresponsible jurisdictions in distant areas of the country.
You can't make an argument about the wisdom of large nations accepting immigrants on a net basis, by referring to a particular public health issue in a single city.
Recent studies indicate that 30% of chronically homeless persons are mentally ill, while 50% of homeless persons are substance abusers. there is some overlap in these two groups: http://homeless.samhsa.gov/ResourceFiles/hrc_factsheet.pdf
According to this 2010 article, the last survey that linked homelessness and illegal immigration occurred in 2005; according to the article, when people who have "fallen off" unemployment roles are considered, the U.S. is at an average 16.9% unenployment, far higher than the current figures, which consider only those receiving unemployment, would have you believe. The article claims that illegal immigration contributes to homelessness not through arriving and subsequently being homeless themselves, but by providing a cheaper "under the counter" labor force which displaces unemployed legal residents from obtaining those jobs. Here's the article: http://www.examiner.com/article/illegal-immigration-contributing-to-homeless-crisis
and nice slap down.
Damn you!
"Whenever the cause of the people is entrusted to professors, it is lost." ~ V.I. Lenin
Is absurd to expect any other result when people elects politicians that think that the State is a problem, an obstacle to society -instead of a tool to provide and protect the general welfare- that should be destroyed and then find that under their government the State's institutions start to fail. Is no wonder than after a long spell under conservative governments, Tory and New Labor, the welfare institutions are in shambles but well, the Great UK have it's army in action around half dozen countries around the world and boomers ready to strike the Soviet Union, and a great funeral for the Iron Lady, that's a better investment of taxpayer's money than wasting it in health care.
Mexico: 100% conservative's America now!
Here is how to fix the NHS.
If you smoke, you get no free care. Period... If you are overweight by a certain margin (and it is not due to some other condition) you get no free care. Period... (BTW, I fit into this category).
This will cut the budget by half. Also, if you have never had a job in your life and you have never paid any tax/national insurance, and you are over 25, and you are not physically or mentally disabled, NO BENEFITS OR FREE HEALTHCARE...
Haters will hate, flamers go right ahead, but the money has to come from somewhere, and I for one is sick of paying 30+% of my salary in TAX and National insurance, and then another 20% VAT on purchases just to keep that sinking ship afloat.
Vic
Some debates never change. Classic British comedy here.
The NHS is a fail.
In 1948, when founded, 450k beds, 280k staff.
By 2002, 125k beds, 880k staff.
By 2010, 1.3m staff.
The NHS is a bureaucractic organization. The more money you put in, the LESS health care comes out.
This is because it is State run. It cannot fail, as other businesses can; it just gets worse and worse.
*VAST* human suffering is caused by this arrangement - appallingly ironic, since everyone on the left side of the political spectrum supports free-at-point-of-use health care since it supposedly provides health care for all.
The right-wing party hate the NHS because it represents a large slice of the economic pie that their buddies in industry want to get their fork into. They don't care that it's one of the most efficient healthcare systems in the world with excellent outcomes.
The left-wing party just fucked things up by being corrupt and not having the balls to bring the contracts started by the right-wing party to an end.
The biggest crisis facing the NHS is the Public Private Partnership scheme - in which big private companies get the contract to build hospitals and other medical facilities AND a sweetheart contract to run them for 30 years, which typically runs the total cost of ownership up to around 300% of what it actually would have cost.
That was probably the killer blow - you now have hospital trusts struggling to make their buildings payments and keep their clinical services functioning at the same time, which enables the politicians to step in and say "Look, this hospital is struggling! The only thing that can save it is the Invisible Hand of the Market!" ... with no actual coherent explanation of how a private company which by definition will take their cut off the top, can provide a better service than a public institution that has had years of practice at running an operation on a shoestring budget, having had their income cut to the bone so many times that their bones are now rather thin.
The Invisible Hand of the Market of course just wants to reach up the patient's backside and pull the gold fillings out of their back teeth. They don't care about the risky, expensive, uncommon, and difficult procedures, they care about the assembly-line procedures and services that have predictable consumption rates and costs, like hip replacements, haemorrhoids, etc, which they can monetize nicely, ignoring the fact that that surplus on these procedures is what paid for the difficult stuff, like open heart surgery that saves the lives of babies with congenital defects.
The destruction of the NHS is just outright evil, because it will result in less healthcare (because doing less and charging more makes more money), at a greater cost (when the NHS struggles, the private company is brought in. When the private company struggles, it will be bailed out), for less of the people that need it (the lower social demographics require NHS services disproportionately more and are less likely to be able to stump up the co-pay), all to line the pockets of a few Conservative party donors. Doing bad unto others for your own benefit or amusement being the definition of evil.
There's not such thing as the British NHS in terms of one large health service - there are 4. Healthcare delivered free at point of use was instigated across the whole of the UK in 1946, but the NHS in Scotland and Northern Ireland has always been decentralised with responsibility being with the Scottish Office and Northern Irish government as they were at the time. The Welsh Secretary of State took responsibility for the NHS there in 1969. Nowadays, the Westminster (UK) department of health is only responsible for England. Healthcare (along with many other matters such as justice/policing) is looked after independently by the Scottish Parliament, Northern Ireland Assembly, with the Welsh Senead also governing this (though with fewer other powers than the other two legislatures, which both have their own legal jurisdictions). So whenever reports of privatisation appear, they're normally specific to England, because it's only there that the Tories can carry out their ideological assault on the welfare state so directly.
Weaseling out of things is important to learn. It's what separates us from the animals... except the weasel."
And how many of NHS clients are illegal aliens from Muslim countries. Oooops, England is now a Muslime nation tooo! ..as they allow them free swarming all over the place. Soon their policy of gun control will be openly flouted by Muslimes openly carrying Kalash'es with total impunity as they will only obey their own laws, Sharia. Heck, heard that they want to tear down Winchester Cathedral and replace it with a madrassa to train terrorists. May even want to to to Buckingham Palace and fire the Queen as an 'infidel' and replace her with a Shreik or a grand muffy.
Up to 1,200 needless deaths, patients abused, staff bullied to meet targets... yet a secret inquiry into failing hospital says no one's to blame [dailymail.co.uk]
Yeah, I'm not saying that there's no some truth in there, but I'd want to get the story from a more trustworthy source than the blatantly partisan, fact-skewing, lying-by-omission, wouldn't-trust-them-as-far-as-I-could-throw-them Daily Mail.
"Slashdot - News and Chat Sites Deviant". (Click "homepage" link above for details).
With respect to the UK (not England, England is not the UK, just as the USA is not America): "Can't afford it" is an interesting question.
Is it rather a case of "what the government chooses to spend its money on"?
I am reminded of the quality of life in Costa Rica opposed to its neighbours: Costa Rica decided to abolish its army in 1949 and spends the money on education and health instead; it has a high level of literacy and has 'health tourists' who visit from the USA. Perhaps the issue of cost is around what you decide to spend your money on.
I am not sure Iceland went bankrupt? I think it nearly did, but the problem was that the government decided not to bail out the banks. I believe the country is doing rather well these days.
The NHS works at base cost, how can base cost + profit margin be a cheaper alternative and more sustainable?
Because there is no such thing as "base cost", there is just "cost". What the NHS considers "cost" can still be more than what the alternative calls "cost + profit margin".
Simply applying price-gouging laws to the medical profession and outlawing price shifting (ie you cannot legally recoup a poor man's emergency care by adding 20% of it to my bill in ways like a $50 aspirin) would stop most of what you claim the free market cannot fix. It should be so obvious as to be cliche, but since you seem to be a leftist moron, I'll spell it out for you... Free market != laissez faire capitalism. There is a place for price gouging laws to prevent, for example, a hospital from taking an antivenom that costs $400 to make and charging over $30k to administer it.
I've never believed in the whole "free for all" care the NHS pushes, to be perfectly honest.
And before I even start, I have Crohns, very bad Crohns, and have had it for 8 years now, it is only going downhill from here.
In this exact order:
If someone has a certain amount of income, they shouldn't get free care, defer the payment. (I'm being reasonable here, at least £100k+)
ALL emergency cases should get free care, if the emergency was not provably caused by them, free, if other, defer half the payment.
Not everyone deserves treatment. Not everyone deserves free treatment.
Pensioners should get free care, they worked for this country.
Some people straight up poison and kill themselves. Counsel them, if they turn away from it, these people should not be treated again.
Likewise, suicide, save them first time. Someone wants to kill themselves after counselling? Let them. Euthanasia should be a right. But so is advice.
People on the poorest of incomes should get free care.
If the complexities of treatment wouldn't extend their life more than 2-5 years, drop everything and work on pain management.
Operations that do not do much in terms of actually solving a major problem should NOT be free AT ALL.
etc. etc.
You get the basic idea, it is a chained list, if someone is poor but also deliberately poisoned themselves, counselling first, if that fails and they try again, turn the machine off, it isn't worth it. Literally.
Harsh? Sure. Nothing else to say there.
Some scenarios.
I'm likely going to become a horrible burden on the NHS in the coming decade, most likely with cancer or bowel operations.
If I did this on purpose, say I was smoking or eating a heavily destructive diet, I wouldn't treat me.
If I had a horrible diet in general, such as being awfully obese, I wouldn't treat me.
People have every opportunity they can get and they shit all over their bodies and here people like me and millions of others suffer pretty much every day and get shafted by NHS and Department of Work and Pensions (or similar agencies around the world) constantly. Fuck. That. It isn't fair for those that weren't given any opportunity to flourish the way they should have.
If people want to kill themselves, don't fix it, let them kill themselves. Nobody should be treated for illness they brought on themselves knowingly.
Emergency, someone is smashed with a bottle at a bar, 60k income, treated, since they have an income below 100k, free to them.
If they had 110k income, half of the payment would be deferred. Accidents happen that are sometimes only partially in our control, nobody should have to suffer ALL the blame for it. Offer some basic counselling afterwards about the dangers of it. (this is sort of standard anyway if I remember correct, such as those that do extreme sports and end up with 10 broken bones or some crap)
On the other side of the coin, they were smashed by a bottle in a fight they knowingly started, defer half payment.
Someone has a leg injury that is just getting worse and worse, joint pain. It is now a hole in the ankle right through the skin, treated to stop infection, given pads to fill it, pain treatment. Fast forward a few years later, it is just getting to the point where it cannot be maintained, chop foot off, artificial foot.
That is the current system. I know because my uncle has it. He is getting to the point where the latter is coming true, it is getting so much worse.
They still refuse to cut it off. How much would have been saved by cutting it off rather than maintaining it with pain killers, pads, antibiotics, plastic protective casing for when he showers, and crutches? Not to mention him being able to work as well.
Priorities need to be shifted, calculations need to be done, likeliness of worsening needs to be assessed and decisions be made to see which is better, chopping a limb off or treating it as best as possible. Injuries can be maintained with the correct treatments, but
It has never been free. It's single payer - which makes it accessible to all at no further charge.
That's an interesting post, but did you notice that the article is talking about the NHS? Regarding advertising, in the UK, http://www.mhra.gov.uk/Howweregulate/Medicines/Advertisingofmedicines/ states that "The Regulations prohibit the issue of any advertisement to the general public which is likely to lead to the use of a prescription only medicine (POM)."
Since you're talking about the US, that's an idea you Americans could take and run with. Once you've done that, we can all start dealing with the pharmaceutical industry's marketing towards doctors.
www.clarke.ca
That's incredibly stupid.
I use the word "stupid" because conservatives have trouble with bigger concepts which require thinking. If I'd used the words "Short Sighted" or "Over Simplified" you'd get sleepy and not be able to concentrate enough to take in the ideas necessary to realize that you're being fucking stupid.
So we'll stick with "STUPID" for the time being.
Moving on. . .
Ask yourself:
How do we measure the success of a health care system?
Well, what is its job? To treat sickness and injury, and increase the overall health of the population which uses it? Sounds about right to me. Can we agree on that?
Good.
In other words, a successful health care system can be measured by a REDUCTION in customers. The fewer sick and injured customers, the more quickly they are returned to full health, the greater the success.
You see where this is going?
Good. Now be brave and stay strapped in; don't look away because you're getting that uneasy sense that you're going to made to look at a difficult truth. . .
So in a free market health care system, with the incentive being to make money, health care becomes a money-making, for-profit system. That's private enterprise. Right? We're good on that definition? Good.
So, how does a free market health care system Fail?
-By having expenses higher than profits, right? By having losing "customers" (sick and injured people) over time. You need regular and repeat business to stay afloat and grow in success.
That's how success is measured in the business market.
So in a free market system, there is obviously, a built-in incentive to make sure that there is a constant (and in fact, increasing) demand for services. That's how all business run. They seek the growth of their customer base. This means that there is actually a NEGATIVE incentive to actually make people well, to keep populations healthy.
So then the incentive in a free market health care system is, reasonably, to make sure everybody is sick as often as possible, take long periods of time to recover, (or not at all).
See the problem?
The success of a health care system as we measured it above, and the success of a business as we just revealed are at odds with one another. They don't work together.
ONLY a publicly funded system has the incentive at the management level to TRY to shrink the customer base.
The trouble in cutting back work forces when customer bases shrink is the same in both a private and publicly funded system. You have to fight with unions and the workers hate it, but it can still get done under both systems. The solution is regulation and strong government in the publicly funded system. In business it's market incentive to cut costs. Those two solutions are different, but they can both work.
The problem is with the private sector drug companies and service providers, which strive to keep people sick through the commercialization of disease, of the poisoning of the food supply and the promotion of unhealthy eating behaviors. (The whole "Fat is evil" bullshit message. If people ate more animal fats and less grains and veggies, they'd be a lot less prone to illness.)
Are you getting any of that? Did any of that sink in?
That is perhaps the more honest thing I’ve ever read from a bureaucrat. “Free at the point of use.” Yes... How often that oh-so-important qualifier is discarded.
TANSTAAFL!
I don't get why no one talks about the general bad health of people here. If we focused on that and reducing using the Emergency Room for basic medicine, costs would drop dramatically. Kind of like the energy argument. If you focused on efficiency we wouldn't be so hung up on new sources. Of course, your health it's too much bother.
No speculation on NHS funding at this point will matter. The UK has the same ability to to spend more money on NHS as does the US and issuing more reserve currency. Even if NHS doesn't issue more currency to cover the gap, they can easily reallocate spending from their tax revenues.
Comparatively the UK spends roughly HALF of what the US does and achieve far better outcomes. NHS funding base been cut and flattened so today it is massively underfunded. As a former UK expat, the British people will throw out any government that changes the social contract of the NHS. £30B is chump change for the UK economy. This article exist simply as a comparative fodder for news between US and UK. It's totally apples and oranges.
Both here in the US and there in the UK.
"Stagnant health spending combined with ever rising costs and demand mean the NHS is facing"
Increased demand = stagnant spending?
This plan in the US will be the most expensive and intrusive plan ever put into effect, it's really chilling when you read through it, how ripe it is for abuse can only lead to one conclusion, it was meant to be abused.
"If any question why we died, Tell them because our fathers lied."
This didn't come to light prior to the dipshits in Washington signing Ocare.
I am Bennett Haselton! I am Bennett Haselton!
London traffic has become unsustainable, so the government instituted usage charges for using the roads within certain confines in London. The idea is that if people have to pay something to go there, they won't go there if they don't NEED to. I'm not sure how effective if has been, because as it is in NYC, most people driving in London HAVE to, while others use public transport or don't even bother to go.
By adding a marginal cost to medical car, however, this might improve the sustainability of the NHS in two ways. One is that it'll bring in some additional revenue. The other is that it will discourage people from going if they don't have a significant concern, reducing excessive demand on the system. I've always seen this sort of thing as good way to prevent abuse. In the US, many insurange companies require "co-payments" of like $20 when going to the doctor. As long as the cost is lower for lower-income situations, then this can have only positive effects on the system. (Well, unless the system wastes the money.)
Simple. If you smoke or drink you're not covered for public healthcare. Fuck, include obese patients as well and make an onus on doctors to records advising patients to drop their weight.
The solution to this problem is simple, by my calculation a 30 billion deficit could be solved by raising taxes by 500 per a person.
Your welcome Britain.
You wasted all that for a broken rib? Wow. Too bad you have insurance. If you didn't have insurance maybe you would realize that a broken rib needs no care. No expensive irradiation from X-rays. No doctor, no nurse, no helicopter, nothing. Just ease up on it and it will heal. All the rest was just a placebo.
You made choices alright.
your new, more market-oriented, and therefore over time more competitive, better quality, and less expensive health care overlords. And wish we could have some true, market-based reforms here in the U.S. too, like, for example, eliminating systemic impediments to the expansion of supply of healthcare products, services, and professionals.
Nonaggression works!
Never read the Express, don't know their reputation. But even before scrapping current ships, you have issues.
You're about 75% of India and dropping. I know India is super-militant with lots of overseas commitments </sarcasm>, but how small were you planning on letting your navy get?
If you compare everything vs placebo, you are comparing them to each other. If xxxxx reduces blood pressure 23% vs placebo, and yyyyy reduces blood pressure 29% vs placebo, then you know yyyyy is somewhat better at reducing blood pressure than xxxxx.
If only you could make yyyyy stop causing hair growth on the palms.
Means testing requires assessing income. People are motivated to hide income, which necessitates a large and expensive apparatus to determine (fairly!) what people's income/means actually is. Cheating becomes rampant, you wind up with Greece.
But maybe rich people in the UK are just way more honest than everywhere else.
Everyone in the UK pays National Insurance.
Drill baby drill - on Mars
Are you really dumb enough, opinionated enough or myopic enough to really believe that?
Go to any high-street in the UK on a week-day afternoon and see the hordes of benefit-claiming immigrants milling about. If you can speak their language they will happily tell you how much they love this generous but completely stupid county.
First off, the NHS system is far different from the ACA in the US. So to equate the fears of one system to another is simply apples vs oranges. Second, the free bit which is straining the system is from tourists and immigrants who do not pay into the system. The ACA is about requiring insurance while the NHS is purely free health care. Nothing in the ACA is free; you are required to carry insurance. The drain in the US comes from people without insurance and people who come to our country without it; both categories without the means to pay for services. This jacks up the rate for all the other responsible people with insurance and those who pay out of pocket. The rates of health care costs are borne mostly on those with insurance. Cars being insured for damages against uninsured motorists is a law because of the high price responsible drivers pay when they are hit by uninsured motorists. Why should the ACA be thought of any differently?
The length of this forum and its individual posts identifies the primary reason for the topics demise.
He is crazy if you think about it; I am not.
Anybody who comes to the uk must have there own PHC, weather on holiday or to live, or they are not allowed in.
News Flash! NHS has had to offer PRIVATE healthcare coverage in order to recruit Doctors for PUBLIC healthcare services. What does that tell you about what the doctors think of public healthcare in the UK?
Why is the care in the US 2.5x as expensive as the "too expensive" NHS (per person per PPP normalized GDP/capita) if the free market system works so well?
Simple - US health care is run by for profit companies and those companies have to make a profit. Not only that but there is competition, not on the price that patients pay, but on the quality and number of doctors these companies can attract thus driving up medical salaries to insane levels because ultimately they know that people will pay just about anything they can possibly afford if it comes to ensuring their good health. By contrast the NHS is non-profit and being by far the largest provider of healthcare in the UK has no concerns about competition for doctors and nurses: doctors are still well off but get only a fraction of their US counterparts.
So by the time you have finished paying for all these company profits on top of the artificially inflated doctor salaries is it any wonder that it costs you 2.5 times as much as it does in the UK?
He came to New York for a surgery, balked at the initial price estimate, and negotiated it down significantly.
Good for him. However not everyone in need of medical care is conscious and even if they are they may not be able to wait long enough to go somewhere else. Being told that you might be able to get treatment cheaper at the next hospital but only have a 50% chance of living long enough to make it there probably puts a bit of a damper on your bargaining skills.
I am curious though - what happens in the US if you are unconscious and they give you live saving medical treatment without you agreeing to the price? Can you refuse to pay on the grounds that you did not consent and would have shopped around for a cheaper alternative or is there some government mandated price list they have to follow? If not then exactly how can this be considered even vaguely fair?
Our government wants to spend £50bn (assuming it's even on budget) on a new train line too which seems to have no financial case judging from impartial and non-partisan scrutiny.
Correction: it has not much of a financial case for those in the south but quite a good financial case for those living 'up north'. But don't worry if HS2 falls through I'm sure their next big project will be to build a new Hadrian's wall just south of Sheffield to us northerners out.
This stuff gets printed on and on because it lies right on an ideological divide and sells papers / generates page views / whatever.
Yes, there is a demographic shift as baby boomers retire. No, it's not a problem other than the fact that those with the savings and capital (the baby boomers) have gotten used to roughly 80% cut in capital gains and income taxes since the NHS (or, Health Canada, in my case) was created. Time to pay for it again, raise taxes. It's still endlessly more efficient than having every doctor, hospital, and insurance co. be in a perpetual conflict of interest with their patients.
In other words, yes, those who can afford will have to start paying for health care again via taxes. Aw shucks. Don't like it? Move to U.S.A and pay twice as much for quick access to bunch of crap you don't need, then go bankrupt when you really get sick. Yeah Freidman
The problem with the NHS system isn't that it doesn't work. It's that at present it's being attacked for ideological reasons
I agree but ultimately we all have a inevitable problem to face with the rising cost of health care. The US system is getting more expensive so fewer and fewer people are covered the UK, Canadian, European etc. national care systems deal with this by consuming an ever increasing fraction of governments' tax income. At some point we are going to have to deal with this and find a way to make ethical and rational decisions about limits on treatment otherwise in the US only the rich will get medical care while for those of us elsewhere the challenge will be living long enough to receive the care we need.
Neither of these 'default' options is an acceptable solution to the spiralling cost of health care. Putting more money into the system may be a fix for now but it is just postponing the inevitable...but like everyone else I don't have a good solution to suggest and can only point out that we all need to find one.
Universal free health care promotes https://en.wikipedia.org/wiki/Social_mobility
Casteism
Let's just get that out on the table. There's no such thing as a social contract in the United States and nor should their be. I would rather have an aircraft carrier battle group and the F-35 than someone else, but the preferred answer is to have that money back in my pocket. I earned it. It's mine. Like, yeah, I do have some social obligation but its only to people who are likewise productive or were productive. The permanent underclass of Federal Pets, is, in fact, just Federal Pets, and they should have about as much rights as Fido the family dog has.
This is my sig.