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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."
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.
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.
Uhmm... where do you live?
The only native people I know who don't pay taxes live on a native reserve.
File under 'M' for 'Manic ranting'
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
Actually the NHS was actually run pretty well. At least until Thatcher got hold of it, followed by Cameron. WHO ranking puts it significantly higher and cheaper than the US
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.
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
That's pretty misleading. More people die in hospitals in the UK because they can go to the hospitals for free. In the US, they're more likely to die at home, because they can't afford to go to the hospital.
But dead is dead, and the UK's life expectancy is better than America's, while spending less per capita on health care. No amount of spin can change that.
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
This isn't entirely true. Here in Nova Scotia, we allow landed immigrants (Permanent Residents is the current phrase du jour) to use the healthcare system. They are, after all, paying into the tax system to fund the healthcare system here. Pretty much the only thing a Permanent Resident can't do is vote.
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.
well none of those horrible things you mentioned included the number one horror: paying for healthcare of poorer people from his taxes!
nvm that private insurance isn't exactly cheap either and point of that is that you're also paying for healthcare for people who have worse health.. somehow a lot of people think that the private health insurance works like private bank account where you wouldn't pay for healthcare of others...
world was created 5 seconds before this post as it is.
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."
And if the USA had the NHS it would still have a lower life expectancy.
The lower life expectancy in the US is driven by primarily by three factors: low birth weight leading to death, road traffic accidents and homicide among the young.
There's very little the health care system can do about the last two.
Even the first is somewhat difficult since it is to some extent a function of the genetics of women of African ancestry.
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.
FFS - tax payer funded healthcare isn't socialism. Besides, you only have to look at the alternative (ie the US's Health"care" system) to realise that doesn't work either
this got me somewhat interested, and i checked out https://en.wikipedia.org/wiki/Low_birth_weight
it does mention smoking, lead and other reasons, but does not mention genetics much.
Rich
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?
So then you claim as a matter of logic that it is impossible a priori for any system to be more fair than that of a totally free market, even if said system is under democratic, rather than autocratic control as you assume?
Or maybe, you meant a kinda-sorta-free market that breaks monopolies? Or some other variation? All of which, of course, exist out of some top-down impulse, democratic or otherwise.
.: Semper Absurda
Shorter version: they should pay more money for worse care. Other options, like hiking taxes on the rich or slashing military spending to create more revenue, would just be hippie nonsense.
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!
But dead is dead, and the UK's life expectancy is better than America's, while spending less per capita on health care. No amount of spin can change that.
That really depends on the disease, doesn't it? The UK has lagged behind Europe and the US on various cancer death rates for some time.
In the US, they're more likely to die at home, because they can't afford to go to the hospital.
In the UK there are people that get sent home from hospital to die. There have also been a number of scandals regarding widespread maltreatment and neglect.
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
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!
Some debates never change. Classic British comedy here.
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."
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".
Shorter version: if you can't afford to pay, go die quietly in the street like the good little serf that you are. It's your fucking fault your last name isn't Walton, or that you
If Britain is like the U.S., and their advertized war budget is half of what it actually is, the U.K. could slash their own war spending, pay for the entire UHS budget and still be one of the more heavily armed countries on the planet.
Shorter version: the usual "job creator" bullshit. Rich people don't create jobs. Demand does. Funny how working stiffs have to work hard at crappy jobs even though they pay crappy money, but we just couldn't find CEO's to do the job unless they make in one year what would take their employees hundreds of years to earn.
What happens if we taxed the richest people at Eisenhower tax rates? They'd still be the richest people in the country!
Not at all. I'm saying that a capitalistic system is the best PRIMARY driver of healthcare delivery; I'm not saying that an atomized every-man-for-himself raw free market is consequently the best.
Voluntary associations of people into collectives (ie insurance pools) is a great example of smart group behavior in a free market.
-Styopa
This article explains the difference between the Scottish NHS and other parts of the UK. This is becoming a political hot potato in the run up to the 2014 Referendum for Scottish independence from the UK because whilst the English NHS is suffering huge setbacks after much of the service was privatised, Scotland's NHS was more tightly controlled by the devolved Scottish Government and less was outsourced to private consortia.
Even though Scottish tax payers pay the same as those south of the border; they receive much better treatment, free prescription drugs and many other benefits.
It has never been free. It's single payer - which makes it accessible to all at no further charge.
The reasons for this are complicated and mathematical.
Oh please enlighten us wise one.
If you think someone isn't free to have a different definition of "freedom" you may be a tyrant.
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
So they're "serfs" for feeding on hosts? Moralized shell games don't hide the hypocritical parasitism.
Venture capital and the risk entailed creates jobs. Someone having a coherent fucking clue and a decent implementation creates jobs.
Your average grunt is an sniveling idiot, which is easily verifiable by most any poll on anything. In a mob, they can beat their collective chests and ironically bray about their superiority, but they can't plan, build, or run a business. They just run through the paces of whatever function they were trained for, usually ditching that if someone's not monitoring, which they'll bitch about either way; then, they claim they're owed the whole fucking company, which they don't even comprehend. Funny who's claiming entitlement here. Your preaching sanctomonious envy, clearly with the intent of eventual pretense of righteous force.
Removing corruption would be one thing, but you just want coercision that profits you, while hiding behind reifications. You probably don't even comprehend that though. Those convenient fictional "we"'s that exclude or forgive your bullshit and incompetence, even as they're proudly characterized by them.
"A soft answer turneth away wrath. Once wrath is looking the other way, shoot it in the head."
Can a pyramid stand on its point?
The underlying flaw in this sort of thing is that it relies on soaking a prosperous, well educated, well connected, and very intelligent minority to subsidize a subsistance culture of ignorant, personally powerless... who are mostly given anything because they are seen as useful fodder in political games played by political elites.
Under such a system you can't really tap that minority. They're smarter then you. Smarter then me. They'll out maneuver you. And even if they didn't while they have a lot of money personally as a class it isn't enough to fund the entitlement culture. So you have to hit the next best thing which is the middle class.
The problem with soaking the middle class is that it strongly disincentivizes work, increasing income, increasing productivity, innovation, business starts (especially small business), and lots of other things that lead to economic death.
The result is that in attempting to increase revenue through these sorts of policies you tend to poison the economy and encourage a siege mentality in tax payers. What is more, your tax code will get thousands of loopholes bored into it by politicians, interest groups, etc... leading to the whole thing mostly impacting people that aren't well connected or aren't very sophisticated with their taxes.
That is what you create by treating your own people like live stock to be milked rather then citizens to be respected.
This is not an argument against all taxes. It is rather an argument against redistribution of wealth through government policy. When you do that, you make politics more important then little things like productivity, competence, work ethic, or "reality".
And the system ultimately kills itself.
Why? Because a pyramid cannot stand on its head.
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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!
Solid numbers and facts like that have truly shown us all the error of our ways.
If you think someone isn't free to have a different definition of "freedom" you may be a tyrant.
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."
Facts aren't relevant to you. You can see what is happening to the french economy. They tested my theory. They jacked up taxes... their elites either left the country or dived deep into tax shelters... revenue collapsed... all of the burden lands on the middle class and the economy's growth is flat at best.
You can see this playing out throughout the socialist countries. They're not doing well. Your parasitic ideology is rotting everything it touches.
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This didn't come to light prior to the dipshits in Washington signing Ocare.
I am Bennett Haselton! I am Bennett Haselton!
A: They didn't jack up the taxes. The courts ruled against it.
B: A few greedy celebrity assholes threatened to leave.
Your idiocy is detroying your own supposed facts.
If you think someone isn't free to have a different definition of "freedom" you may be a tyrant.
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.
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.
A. That tax... sure... many others were passed through no problem. The taxes did go up. And middle class as usual will always pay the biggest price.
B. So let me get this straight. When you covet someone else's money and think you have a right to it and get upset when they try to keep you from taking THEIR money... you don't call that greed.
But when someone acts to protect their own money that they earned from your thievery... that is greed?
You remain a moron.
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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!
You're taking a statistic and misreading it.
More Americans choose to die at home. When you have an incurable illness like cancer, a higher percentage of Americans choose to die in the comfort of their own home than at a hospital. Even the British are beginning to do the same - getting away from "institutionalized death."
It's not an economic choice, or at least, not primarily one.
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?
Obamacare is the worst thing imaginable that could've happened to the US
My guess is that you don't have much of an imagination
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
This isn't hurting the rich.
Read a newspaper. Its hitting the middle class.
People that had healthcare are seeing their premiums double. The majority of the population had healthcare.
Your comment is little more then an admission of ignorance. Kindly shut your mouth and learn. Your stupidity is sadly infectious.
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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.
Wouldn't society be better served by giving a heart transplant to, say, a young parent of three than to a wealthy spinster?
Scarce goods will always be rationed, but rationing just based on however money is already distributed is not all that likely to be efficient for accomplishing various goals.
.: Semper Absurda
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.
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.
What the hell are you talking about? Learn how to compose a sentence without running on. Did they earn money from my thievery?
I'll tell you what's greedy, millionaires who think they are entitled to live in a society without contributing to it. People who would watch (well allow, heaven forbid they should actually see it) people to live in poverty because they think they "earned" their money. Did Robert Downey Junior really do enough when he made Avengers Assemble to earn $50 million? Were those few months of leisurely filming worth more than the lifetime output 50 people?No, there are gross distortions in the rewards people earn, the tax system exists to help level out this rampant stupidity.
If you think someone isn't free to have a different definition of "freedom" you may be a tyrant.
Where you dropped on the head as a child? Yes, I am forced to pay for the sidewalk that goes past your house, whether I like to or not.
I don't know which is cuter, your lack of self-awareness or your projection.
So you're an elitist who has no problem with one's standard of living being overwhelmingly dictated by who your parents are?
False. Venture capitalists chase demand, which is what creates jobs. With no demand you have no market for your product, which means you have no need to hire workers.
Thanks for making it crystal that you play for Team Elitist Shitbag.
There is no greater entitlement than an elitist who thinks his company runs on him, or that his standard of living is independent of the society in which he lives.
Elitist doesn't just mean whatever you want it to mean when you feel like it, You greedy hypocritical sanctimonious myopic bigot. You "moral" elitists are a joke. Your sophistic "social" weaseling doesn't entitle you to manufacture debts to fit your crazed designs. You don't own anyone and should expect resistance when you try enslaving people under the pretenses of your cause. Playing self-appointed priest to some reification of "Man" grants you no special rights and absolves you of absolutely nothing in pursuit of enforcing your delusions.
"A soft answer turneth away wrath. Once wrath is looking the other way, shoot it in the head."
So paying for your medical treatment is the same as a side walk?
You remain a moron.
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It's a service for you that I don't use.. Same as I don't use your high school or your library, or your ambulance service. How many times were you dropped on the head as a child, out of curiosity?
Good, good. Nothing like the poutrage from an Obamabot in denail that he's a right winger, or in your case, an elitist shitbag in denial of the fact that he's an elitist shitbag.
Go Galt on that cake, Slick.
Then pay for my food and my house and my shoes.
OR I get to call myself a slave and you my evil task master.
And when you're done with that you can make me a sandwich. If it isn't delicious then I'll call you a heartless bastard.
Long story short... you remain a comical twit.
*flicks frozen peas at Uber's shinny forehead*
Cya, chuckles.
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