Petition the government no NHS negotiations

[Slarti]

This is a storm in a non existent tea cup. All parties know the NHS is sacred and cannot be touched, and the conservatives continue to plough more and more funds into it as they are terrified of being attacked if they don't.

More total funds, but less per patient, less per head of population, less as a % of GDP.

The same smokescreen they keep trying to pull on education.

Slarti

[Slarti]

The idea that we can give unlimited free healthcare to everyone all the time is doomed and unsustainable.

Of course we can't.

Where the NHS has a huge advantage is that amongst those who have experienced a time of real need, it's only the winners in the NHS lottery who survive to rate their care and treatment.

And that there are enough of us around who's parents and grandparents were able to tell them what it was like pre NHS and it was far from pretty.

Slarti

[Slarti]

As an example this week my foot was bothering me and so I did something I very rarely do. I went to see my NHS doctor. She said she wanted to refer me to a NHS podiatrist but told me that the waiting time would be "several months". Or I could pay for a private foot specialist and be seen the next day. Obviously I chose the latter.

You actually got to see your GP quickly. Round where we are looking at the death of the appointment system due to the shortage of GPs and I suspect we will go back to what I remember from the 60s where you all turned up and took a seat and were seen on a first come first served basis. Usual thing was to get to the surgery an hour before it opened and at least 30 minutes before the GP arrived and even then If you weren't one of the first it could be some time before you were seen.

You are also lucky that you can afford to choose to go private which many (most?) people can not.

Slarti

[StepOne]

As an example this week my foot was bothering me and so I did something I very rarely do. I went to see my NHS doctor. She said she wanted to refer me to a NHS podiatrist but told me that the waiting time would be "several months". Or I could pay for a private foot specialist and be seen the next day. Obviously I chose the latter.

You actually got to see your GP quickly. Round where we are looking at the death of the appointment system due to the shortage of GPs and I suspect we will go back to what I remember from the 60s where you all turned up and took a seat and were seen on a first come first served basis.

This is how I remember it from when I was a kid. 5 or 6 years ago, though, the GP I used at the time went back to daily open surgeries. It took a while to settle down, but the last couple of times I went, there were only 2 or 3 people waiting and I was seen within 10-15 minutes. I'm not sure why they made that change, or how successful it has been as I have now moved away, and the local GP here is very much appointment based - with the next available one being mid-July.

StepOne

[Lootman]

The idea that we can give unlimited free healthcare to everyone all the time is doomed and unsustainable.

Of course we can't. Where the NHS has a huge advantage is that amongst those who have experienced a time of real need, it's only the winners in the NHS lottery who survive to rate their care and treatment.

And that there are enough of us around who's parents and grandparents were able to tell them what it was like pre NHS and it was far from pretty.

Going back to the 1930s is not the only alternative. An insurance-based scheme could easily cover most people whilst retaining some level of accountibility and sustainability.

the local GP here is very much appointment based - with the next available one being mid-July.

Make something free and demand will always exceed supply, leading to indefinite waits and queues.

[Slarti]

So was that hip op "a waste of resources"? I expect an accountant or an insurance company actuary would say so. But for me, the fact that the NHS didn't think that way says something pretty important about what a precious organisation we have on this side of the pond.

Te accountant in me says, it probably saved money because she would have been using a lot more in the way of resources, stuck in the hospital with a broken hip.

Slarti

[Slarti]

Going back to the 1930s is not the only alternative. An insurance-based scheme could easily cover most people whilst retaining some level of accountibility and sustainability.

Like in the USA?

The fact that their system costs much more than ours and gives worse service to the general population is why I started this thread.

Slarti

[Lootman]

Going back to the 1930s is not the only alternative. An insurance-based scheme could easily cover most people whilst retaining some level of accountibility and sustainability.

Like in the USA? The fact that their system costs much more than ours and gives worse service to the general population is why I started this thread.

I have experienced healthcare in both the UK and the US. The US experience was much better.

Sure, maybe if I were dirt poor my US experience would have been inferior. But for anyone who is either willing or able to afford it, or can at least afford insurance, then you would choose the US system every time.

Does the US spend more? Sure. But it is much better so you'd expect that. Unless you have had healthcare outside of the UK then I am not sure you have a genuine appreciation of how mediocre the UK system really is.

[bungeejumper]

Te accountant in me says, it probably saved money because she would have been using a lot more in the way of resources, stuck in the hospital with a broken hip.

I've heard it said that a full hip op costs the NHS about £5,000, all included. (There are lots of variants of the op, so that's an average). A typical hospital bed costs upwards of £2,000 a week.

The NHS cost for the op is about half/one third of what you'd pay to have the op done privately in the UK. (£9,000 to £16,000.)

In the US, the average cost of a hip replacement is quoted at $39,000. https://health.costhelper.com/hip-replacement.html

Gosh. I wonder why?

BJ

[UncleEbenezer]

I have experienced healthcare in both the UK and the US. The US experience was much better.

I haven't experienced the US, and my experiences elsewhere in Europe have been too brief and simple to make much of a comparison.

But I first heard your viewpoint from an older colleague, back in the 1980s. My colleague had a dental problem, which he'd had fixed a couple of times by the NHS, only for it to come back in a couple of years each time. Then it had come back when he was working (and insured) in the US. The US dentist fixed it, and he'd been free of trouble ever since.

As for how much it costs, don't the spin-doctors have a bad habit of comparing our NHS budget with the entire healthcare spend (both public and private) in other countries when they claim we're so cheap?

[bungeejumper]

As for how much it costs, don't the spin-doctors have a bad habit of comparing our NHS budget with the entire healthcare spend (both public and private) in other countries when they claim we're so cheap?

That's what spin doctors are paid to do.

Admittedly, it isn't always easy to compare like with like expenditures across different countries, because some countries roll parts of their health costs (old age care?) into other things like social budgets or pension provisions where they aren't obviously so visible. And although you'd think that private health insurance could easily be winnowed out from the rest of the insurance pack, it isn't always so easy.

Conversely, in Germany I understand that your health insurance policy will be willing to shell out for you to spend a sunny week in a deckchair beside the sea. (Certainly used to be the case.) Then there are the tax breaks for health insurance, which also distort the picture if you compare them with countries that don't allow such perks.

What it really takes is for the general public to wise up to the distorted figures when the spin doctors produce them, and for the broadcast media to jump on the offenders. In this country, we haven't got past believing that the NHS would be £350 million a week better off if we (continued on page 94…..)

BJ

[dionaeamuscipula]

As for how much it costs, don't the spin-doctors have a bad habit of comparing our NHS budget with the entire healthcare spend (both public and private) in other countries when they claim we're so cheap?

That's what spin doctors are paid to do.

Admittedly, it isn't always easy to compare like with like expenditures across different countries, because some countries roll parts of their health costs (old age care?) into other things like social budgets or pension provisions where they aren't obviously so visible. And although you'd think that private health insurance could easily be winnowed out from the rest of the insurance pack, it isn't always so easy.

Conversely, in Germany I understand that your health insurance policy will be willing to shell out for you to spend a sunny week in a deckchair beside the sea. (Certainly used to be the case.) Then there are the tax breaks for health insurance, which also distort the picture if you compare them with countries that don't allow such perks.

What it really takes is for the general public to wise up to the distorted figures when the spin doctors produce them, and for the broadcast media to jump on the offenders. In this country, we haven't got past believing that the NHS would be £350 million a week better off if we (continued on page 94…..)

BJ

The US spends a slightly greater proportion of its GDP on publicly funded healthcare than the UK. Where the big difference arises is in the proportion of GDP spent on health insurance. In many, many cases, this is funded not by the individual but by their employer.

DM

[UncleIan]

I have experienced healthcare in both the UK and the US. The US experience was much better.

I've got an anecdote and I'm gonna use it.

[Lootman]

I have experienced healthcare in both the UK and the US. The US experience was much better.

I've got an anecdote and I'm gonna use it.

That's pretty much what everyone on this topic has done.

Experience matters.

[StepOne]

the local GP here is very much appointment based - with the next available one being mid-July.

Make something free and demand will always exceed supply, leading to indefinite waits and queues.

GP appointments are slightly different in that their marginal utility rapidly tails off unless you are actually ill, so demand is limited. My point was that the practice in Stirling was able to handle their queues in a way that gave me a better experience (I'm not sure if their system was better overall for the practice or the Health Service - the GPs tended to moan about it, but that might not be unusual!).

Cheers,
StepOne

[sunnyjoe]

the local GP here is very much appointment based - with the next available one being mid-July.

Make something free and demand will always exceed supply, leading to indefinite waits and queues.

GP appointments are slightly different in that their marginal utility rapidly tails off unless you are actually ill, so demand is limited. My point was that the practice in Stirling was able to handle their queues in a way that gave me a better experience (I'm not sure if their system was better overall for the practice or the Health Service - the GPs tended to moan about it, but that might not be unusual!).

Cheers,
StepOne

When I lived out in the sticks, my local GP had a very fine understanding of supply and demand and ran 5am surgeries to provide appointments for the farm workers

[Slarti]

Going back to the 1930s is not the only alternative. An insurance-based scheme could easily cover most people whilst retaining some level of accountibility and sustainability.

Like in the USA? The fact that their system costs much more than ours and gives worse service to the general population is why I started this thread.

I have experienced healthcare in both the UK and the US. The US experience was much better.

Sure, maybe if I were dirt poor my US experience would have been inferior. But for anyone who is either willing or able to afford it, or can at least afford insurance, then you would choose the US system every time.

You don't have to be "dirt poor" to not be able to get adequate insurance in the USA, you just have to be slightly below average income, or live in the wrong area, or have a family history of certain diseases and you can find it very difficult, if not impossible, to get insurance.

And the insurance adds another layer of cost and administration onto the healthcare system, reducing efficiency.

Slarti

[servodude]

And the insurance adds another layer of cost and administration onto the healthcare system, reducing efficiency.

Slarti

This with bells on! The insurers are not there for the benefit of the patients.

Among other projects, I am involved in the design of CPAP machines (for the treatment of Sleep Apnoea).
The majority worldwide are bought through medical insurance. At face value this means a patient only "pays" half the listed price when they receive the machine; the listed price is above the private RRP.

The real stickler though is that once they commence treatment the "compliance" data belongs to the insurer.
This should be used by their doctor to tune their treatment. In effect though their recorded use, or not, of the machine is directly used to obviate the insurer from future claims.

Not very nice
- sd

[Slarti]

And the insurance adds another layer of cost and administration onto the healthcare system, reducing efficiency.

Slarti

This with bells on! The insurers are not there for the benefit of the patients.

Among other projects, I am involved in the design of CPAP machines (for the treatment of Sleep Apnoea).
The majority worldwide are bought through medical insurance. At face value this means a patient only "pays" half the listed price when they receive the machine; the listed price is above the private RRP.

The real stickler though is that once they commence treatment the "compliance" data belongs to the insurer.
This should be used by their doctor to tune their treatment. In effect though their recorded use, or not, of the machine is directly used to obviate the insurer from future claims.

Not very nice
- sd

Prices paid vary wildly.

A chap I know on twitter is a fellow CPAP machine user, but in the USA and he is not happy with the machine provided by his insurance and so looked at buying his own. Unfortunately the cost appeared to be over $1,000! I pointed out that here we can get perfectly good ones for less than half that, if not provided by the NHS and started a thread about how American medical insurance cause prices of meds and equipment to be artificially inflated.

Slarti

[servodude]

And the insurance adds another layer of cost and administration onto the healthcare system, reducing efficiency.

Slarti

This with bells on! The insurers are not there for the benefit of the patients.

Among other projects, I am involved in the design of CPAP machines (for the treatment of Sleep Apnoea).
The majority worldwide are bought through medical insurance. At face value this means a patient only "pays" half the listed price when they receive the machine; the listed price is above the private RRP.

The real stickler though is that once they commence treatment the "compliance" data belongs to the insurer.
This should be used by their doctor to tune their treatment. In effect though their recorded use, or not, of the machine is directly used to obviate the insurer from future claims.

Not very nice
- sd

Prices paid vary wildly.

A chap I know on twitter is a fellow CPAP machine user, but in the USA and he is not happy with the machine provided by his insurance and so looked at buying his own. Unfortunately the cost appeared to be over $1,000! I pointed out that here we can get perfectly good ones for less than half that, if not provided by the NHS and started a thread about how American medical insurance cause prices of meds and equipment to be artificially inflated.

Slarti

There are some aspects of medical insurance that do make sense, but the way these machines are used is nonsense.
It goes beyond well beyond reduced efficiency, in to a business plan of exploitation and invasion of privacy.

At the risk of going too far off topic though one man's perfectly good CPAP is another's hairdryer; everyone's prescription is different and CPAPs vary greatly in capability, smarts and performance. All of them do cost more in the US if you buy them through insurance though

Have fun (& sleep well)
- sd