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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?
No. Where did you get that idea?
The ACA simply makes it easier to get insurance and requires people to purchase it.
There is nothing free about it.
Yes... Just fine. Those stories of long waits, or unavailable diagnostic care are just rumors, I am sure...
I am sure that some are very good. I also know that others are not. Which one do you bet our government will put out? You know... The government that gave us the TSA...
Keep some perspective. It still costs half as much per person (normalized to GDP/capita). Our medical industry increases its costs faster than inflation too, but when the free market raises prices and another 50k people lose coverage, it isn't news, it's business as usual.
Actually, if you follow international news at all, there has been a strong Conservative/Tory assault on the NHS for several years now. The assault comes in the form of privatization and the introduction of the 'free' market to the health care ecosystem. This system, if anything, is attempting to emulate the system put in place with the ACA, and the right in the UK has made it clear that they would like do what the right in America has been arguing for this whole time in terms of health care. Would the Dems have desired to emulate the original NHS, prior to its evisceration? Yes. Now? Not so much. Here's a bit of light reading on the topic, which is anything but hard to find. (Yes, they do tend to be from more leftwing sources, however, they have good information on what has been done to the NHS recently.) http://www.socialistreview.org.uk/article.php?articlenumber=11935 http://www.independent.co.uk/voices/farewell-to-the-nhs-19482013-a-dear-and-trusted-friend-finally-murdered-by-tory-ideologues-8555503.html http://www.medialens.org/index.php?option=com_content&view=article&id=676:people-will-die-the-end-of-the-nhs-part-1-the-corporate-assault-&catid=25:alerts-2012&Itemid=69
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.
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
Single-payer is what they wanted. ACA is what they could get past the Republicans.
Benford's Corollary to Clarke's Law: "Any technology distinguishable from magic is insufficiently advanced."
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.
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?
Long waits? When was the last time you went to visit your doctor in the US? I'm lucky if I can see him this week.
Same with the emergency room - unless you are bleeding all over the place chances are you'll be waiting for a couple hours.
My one scrape with socialized medicine was in Canada where they fixed a broken arm - put it in a cast. I don't remember waiting at all in the emergency room and to this day I haven't been billed.
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/
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 ...
"Like Canada where the government is laying off doctors and nurses and people are starting to get private insurance because the government isn't covering everything?"
Cite your sources for this FUD.
Signed, a Canadian who has not seen any of this.
Actually, if you follow international news at all, there has been a strong Conservative/Tory assault on the NHS for several years now.
If you follow the news you realize that Labour might have some involvement since they ran the government for so long.
Labour must bear the blame for the shameful decline of the NHS
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
- Up to 1,200 patients died unnecessarily because of appalling care
- Labour's obsession with targets and box ticking blamed for scandal
- Patients were 'routinely neglected' at hospital
- Report calls for FOURTH investigation into scandal
I'm sure there is plenty more to find.
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
Do you jerk off while spreading fud?
Iceland isn't bankrupt, they unlike everyone else, took the healthy choice of defaulting on their loans, restructured and recovered. They are actually fairing better than pretty much anyone else right now.
Why would France want to cover (illegal)immigrants (guess you left that out for your fud)? No-one else are doing so.
Greece is going bankrupt for wholly different things, it's not their public health care that are destroying them.
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.
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.
Why ever could that be?
What do you think that graph shows?
Here's what it seems to show. Between 1997 and 2008- the entire Labour term in office before the financial crash- debt dropped to 40% of GDP. This coincides with the highest increase in NHS spending in recent history. Now I'm not trying to argue a causal link- but it clearly wasn't NHS spending which caused our government debt. It spiked in 2008, which correlates with the huge government spending to nationalise and otherwise prop up financial service providers- not spending on a single other thing.
The chart goes on to show that since 2010, the debt to GDP ratio has continued to go up at a faster rate than at any time before the financial crisis. This coincides with the harshest cuts to NHS spending in recent history. So clearly cutting NHS funding hasn't made much of a difference to our government debt either.
Arguing that cutting spending on the NHS or welfare is going to make the blindest bit of difference either way is disingenuous. The only reason the Tories are cutting spending on the NHS is because they always want to cut spending on the NHS, in all circumstances. It's just their basic political modus operandi.
Yes... Just fine. Those stories of long waits, or unavailable diagnostic care are just rumors, I am sure...
Yes, they are.
Believe me,I lived for 7 years in UK and now I'm in my 6th year in USA and it is incomparable. US system is just massively inferior - and I work for a big national lab and hold the most expensive insurance option.
So yes, I'd go back to NHS any moment.
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.
The direct quote in the summary talks about doubts over
The title says
The person who transformed the first into the second has serious problems with either English or logic. "We may have to charge some patients" isn't the same as "We may have to charge all patients".
Your reference to "discontinuing free care" is ambiguous, but without qualifiers is easier to interpret along the lines of the title rather than of reality.
Ah, the chutzpa of the American winger. Call bullshit, then spout off a bunch of nonsense that's nothing but bullshit.
Bullshit. If that were the case, you'd be rattling off how this single payer country doesn't cover cancer treatments, and that one doesn't cover organ transplants. You don't because you can't.
Bullshit. They only have to get you healthy long enough to get out the door. And their bill collectors will hound you as long as they are legally allowed to and quite possibly past that as well.
Which Democrats are those? Certainly not the ones in the White House or in Congress, since they are the right wingers who first killed the possibility of single payer, then traded away the public option to the hospital lobby, and finally passed the Heritage Foundation plan/Romneycare.
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."
I woke up with a hard pain in my right side. It got worse and worse, until it was clear it wasn't cramp, but something badly wrong.
I called an ambulance. I live in a rural area, so an hour away from the nearest hospital. Ambulance was there in 10 minutes. They assessed me, took me to hospital.
After blood tests, they put me on high dose antibiotics and painkillers, and onto the ward. They suspected a gallstone. A few hours later, I had an ultrasound; no sign of a gallstone, but the gallbladder was clearly inflamed and I had an infection. They decided to see if the antibiotics would tackle the infection, so I could have elective surgery more safely in a couple of weeks to remove the gallbladder.
I got worse over night, with a worsening fever. They booked me in for emergency surgery to investigate, and I was going under anaesthetic inside an hour. Turns out, my gallbladder had turned necrotic and had started to fall apart, and needed removing in a hurry - they had to switch from keyhole to open surgery, took it out on the spot.
I then spent a week in the hospital, recovering from the 6" abdominal hole from the surgery. When I was discharged, my total bill was... £0.
I was treated with huge professionalism and care, survived what could easily have been a fatal infection with rapid treatment, and I didn't spend a second worrying about what it would cost me. Ok, the food was airline quality, but I wasn't exactly hungry anyway.
The NHS is running out of money because there's more people, living longer, wanting the latest, best drugs that cost more, while funding levels are being cut in real terms by the Tory government. That's something that will have to be dealt with, but it's certainly not a reason to kill the NHS. It's one the best things about Britain, and if we have to up our contributions a few percent to pay for it, I for one am glad to do so.
Remember kids, it's all fun and games until someone commits wholesale galactic genocide.
Competitive tenders tend to lead to buying services off ATOS and their ilk. And their professionalism and competence is in constant question. I always wondered how these outsourcing agencies still are not barred from the process.
The lowest bidder is propably not what you want.
This outsourcing nonesense has had none of the predicted benefits. Overall costs have not gone down and professionalism has not gone up. It's more of the same with a larger overhead since the outsourcing agency has a beureaucratic overhead as well as the public agency and their respective law departments. To keep the cost roughly the same the people who actually do the work get pathetic wages that in no way shape or form echo their value in the whole system.
20 minutes into the future
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).
FWIW I work for the NHS. The Labour governement indeed poured billions into the health service during their term but it was almost totally squandered on failed IT projects, an army of midde-managers, non-jobs and grossly overpaid execs.Very little of it was invested in actual patient care.
I do believe the Tories are genuinely trying to fix it, my problem with them is that they're doing their usual carpet-bombing approach instead of carefully targetting the gross inefficiencies that are blighting the NHS.
For all intensive porpoises your a bunch of rediculous loosers
Yes, they are. By and large, all of those stories ARE just rumours.
Canadians aren't exactly clamouring to emulate the US system. The Canadian woman that appeared in Republican commercials trying to smear our system had a non-threatening disorder that she felt was more serious than it actually was. She wasn't being refused care because we didn't have the capacity, she was being put on a waiting list because she could afford to wait while other people that had more threatening problems were triaged up the chain first.
We have waiting lists, yes. There are times where the system fails, yes. These are problems that every system tries to work out. But people here get care, and they get it without going bankrupt. The best case scenario in the Canadian system is that you get timely care with minimal cost. The average case is probably that you got reasonably timely care with a bit of wait, but still at minimum cost. Putting aside the worst case scenarios of death or misdiagnosis which are endemic in any system that involves humans--including the American system--you may have to wait a long time for care, but you're STILL not on the hook for any costs.
Many of the best case scenarios in the USA seem to leave middle class people with great care but crippling bills. The rich get off scott free, the poor simply don't get any care at all (or emergency room care, which is too little, too late, for too much).
I can understand not necessarily wanting the Canadian system. There are actually plenty of examples of even better systems in the world. But the fact remains that Canadian outcomes and costs are, objectively, better at lower cost. Life expectancy is higher here, infant mortality is lower.
But the current American system? A failed experiment. Try something else.