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Who'd be a Millennial?

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Clitheroekid
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Who'd be a Millennial?

#105236

Postby Clitheroekid » December 19th, 2017, 10:46 pm

I wasn't sure where to post this. It's a bit serious for a pub board, but I find Polite Discussions somewhat heavy going, and in any event I'm not necessarily inviting a discussion - I just thought it was a brilliant summary of where the USA is today (and much of it applies equally to the UK) and particularly the contrast between the life that we Baby Boomers have had and what the Millennials have.

I'm constantly shocked at the sheer brutality of much of the American system, from the lack of gun control to the insane criminal justice system that sends people away for life for possessing cannabis, but the article illustrates just how big a concern the lack of any state healthcare system is for so many Americans. The failure to provide any real safety net for seriously ill people is possibly the worst aspect of US civil society, and must call into question whether the USA can properly call itself a civilised country.

(Hmm, perhaps i should have been on the PD board, after all!)

Be warned, it's a very long read, but I found it quite engrossing (though I felt the suggested remedies were a bit feeble). Incidentally, I found the best way to read it was to scroll down using the mouse wheel.

http://highline.huffingtonpost.com/arti ... llennials/

Lootman
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Re: Who'd be a Millennial?

#105240

Postby Lootman » December 19th, 2017, 11:10 pm

Clitheroekid wrote: how big a concern the lack of any state healthcare system is for so many Americans. The failure to provide any real safety net for seriously ill people is possibly the worst aspect of US civil society, and must call into question whether the USA can properly call itself a civilised country.

At the same time, the US is the leading innovator of medical advances by orders of magnitude. Moreover whenever a really sick UK person needs the very best healthcare, or overpaid footballers, they go to the US. So is their system really the worst? Or maybe the best?

Ironically when the so-called "public option" of ObamaCare was mooted, it was criticised because it requires so-called "death panels" to assess who to treat and who to allow to die, much as the NHS does except of course that is downplayed here. And what were the criteria for the decisions of the death panels? Why, economic utility of course. The 20 year old engineer gets saved and the 60 year old welfare recipient is allowed to die.

Are some Americans left by the wayside? Yes. Does the UK spray too much money at those who contribute the least in the UK? Also, yes. This topic is not simple or one-dimensional.

redsturgeon
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Re: Who'd be a Millennial?

#105286

Postby redsturgeon » December 20th, 2017, 8:55 am

Moderator Message:
You are right CK it is not really the right board. I will leave a shadow here and move it to the Health and Wellbeing board since you don't really want it on PD.

redsturgeon
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Re: Who'd be a Millennial?

#105290

Postby redsturgeon » December 20th, 2017, 9:06 am

I have to admit I am finding it a struggle to work through the strange formatting but I will persevere.

One point I would make though regarding the US healthcare system...surely the one easy marker of the health of a nation is the average life expectancy...it is going down in the USA and they are currently 53rd in the world. Not really a good sign!

John

bungeejumper
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Re: Who'd be a Millennial?

#105318

Postby bungeejumper » December 20th, 2017, 10:59 am

I couldn't get into the Huffpost link at all. Instead I got a dodgy-looking page telling me that I needed to upgrade my Internet Explorer 11 to, errm, Internet Explorer 11.

Lootman, probably nobody would disagree that America has the lead in cutting-edge healthcare technology, but that's far from being the same thing as suggesting that it has the best healthcare system. The uninsured tens of millions are in another world from the rest of the population. That's just stating the obvious, of course it's the fact that it isn't obvious to American legislators that worries me.

BJ

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Re: Who'd be a Millennial?

#105319

Postby Ashfordian » December 20th, 2017, 11:01 am

redsturgeon wrote:I have to admit I am finding it a struggle to work through the strange formatting but I will persevere.

One point I would make though regarding the US healthcare system...surely the one easy marker of the health of a nation is the average life expectancy...it is going down in the USA and they are currently 53rd in the world. Not really a good sign!

John


Is that the fault of the healthcare system or the population's disregard for their own health?

Obesity is not the fault of the healthcare system

redsturgeon
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Re: Who'd be a Millennial?

#105326

Postby redsturgeon » December 20th, 2017, 11:12 am

Ashfordian wrote:
redsturgeon wrote:I have to admit I am finding it a struggle to work through the strange formatting but I will persevere.

One point I would make though regarding the US healthcare system...surely the one easy marker of the health of a nation is the average life expectancy...it is going down in the USA and they are currently 53rd in the world. Not really a good sign!

John


Is that the fault of the healthcare system or the population's disregard for their own health?

Obesity is not the fault of the healthcare system


What is the point of a health care system if it does not improve the health of a nation?

Public health and health education are major parts of any healthcare system and are the parts probably more responsible for increase in life expectancy over the last one hundred years than fancy treatments for rare diseases or state of the art brain surgery.

If you read what I said I did not attribute fault but merely pointed out an interesting and perhaps useful measurement of health outcomes.

John

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Re: Who'd be a Millennial?

#105352

Postby doug2500 » December 20th, 2017, 12:52 pm

I think most people interested in this thread might also be interested in this article:

Guns are america's blind spot, the NHS is ours:

http://www.niallferguson.com/journalism ... hs-is-ours

Lootman
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Re: Who'd be a Millennial?

#105377

Postby Lootman » December 20th, 2017, 4:03 pm

doug2500 wrote:I think most people interested in this thread might also be interested in this article:

Guns are america's blind spot, the NHS is ours:

http://www.niallferguson.com/journalism ... hs-is-ours

Yes, I've never understood this obsessive infatuation with the NHS which, based on my experiences with it, has always been mediocre.

"Blind spot" is a good way of putting it. it's like the third rail of British politics - no politician is allowed to ever criticise it or suggest an alternative, which is probably why the NHS still has almost a monopoly on healthcare delivery. Even the Thatcher privatisation juggernaut barely touched the precious NHS.

The Emperor has no clothes.

Ashfordian
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Re: Who'd be a Millennial?

#105417

Postby Ashfordian » December 20th, 2017, 6:52 pm

redsturgeon wrote:
Ashfordian wrote:
redsturgeon wrote:I have to admit I am finding it a struggle to work through the strange formatting but I will persevere.

One point I would make though regarding the US healthcare system...surely the one easy marker of the health of a nation is the average life expectancy...it is going down in the USA and they are currently 53rd in the world. Not really a good sign!

John


Is that the fault of the healthcare system or the population's disregard for their own health?

Obesity is not the fault of the healthcare system


What is the point of a health care system if it does not improve the health of a nation?

Public health and health education are major parts of any healthcare system and are the parts probably more responsible for increase in life expectancy over the last one hundred years than fancy treatments for rare diseases or state of the art brain surgery.

If you read what I said I did not attribute fault but merely pointed out an interesting and perhaps useful measurement of health outcomes.

John


In the example of the US (and the UK) the education of the population is more than enough for them to know the problems they are creating for themselves. It does not require the healthcare system to be responsible for public health education. This is where your marker fails when the population don't take responsibility for their own actions. I agree in the past this was a worthy marker but today an irresponsible population makes it a largely pointless measurement

redsturgeon
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Re: Who'd be a Millennial?

#105419

Postby redsturgeon » December 20th, 2017, 7:00 pm

Ashfordian wrote: I agree in the past this was a worthy marker but today an irresponsible population makes it a largely pointless measurement


How would you measure the success of a healthcare system, if not by measuring the health of the people covered?

Shiny machines?

Cutting edge drugs?

Money spent?

Posh buildings?

John

Ashfordian
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Re: Who'd be a Millennial?

#105420

Postby Ashfordian » December 20th, 2017, 7:13 pm

redsturgeon wrote:
Ashfordian wrote: I agree in the past this was a worthy marker but today an irresponsible population makes it a largely pointless measurement


How would you measure the success of a healthcare system, if not by measuring the health of the people covered?

Shiny machines?

Cutting edge drugs?

Money spent?

Posh buildings?

John


None of the above if the population refuse to take responsibility for their own actions.

It's your view that means the NHS is under so much pressure as you are making it a healthcare problem! The NHS could save nearly 10% of its budget if the population took responsibility for its actions. That is the yearly cost of type II diabetes on the NHS which is mostly self inflicted.

redsturgeon
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Re: Who'd be a Millennial?

#105422

Postby redsturgeon » December 20th, 2017, 7:23 pm

Ashfordian wrote: The NHS could save nearly 10% of its budget if the population took responsibility for its actions. That is the yearly cost of type II diabetes on the NHS which is mostly self inflicted.


I agree with you, in fact I believe more than 10% could be saved...the question is how do you get the population to take responsibility?

IMHO more money should be spent on health education and encouraging "wellness" rather than fixing the end result of unhealthy lifestyles.

You still haven't answered how we might measure the success of a healthcare system though.

You have rubbished my suggestion but not given any of your own.

If a healthcare system is not designed to give people a longer and healthier life then what is it for?

John

Ashfordian
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Re: Who'd be a Millennial?

#105426

Postby Ashfordian » December 20th, 2017, 7:41 pm

redsturgeon wrote:
Ashfordian wrote: The NHS could save nearly 10% of its budget if the population took responsibility for its actions. That is the yearly cost of type II diabetes on the NHS which is mostly self inflicted.


I agree with you, in fact I believe more than 10% could be saved...the question is how do you get the population to take responsibility?

IMHO more money should be spent on health education and encouraging "wellness" rather than fixing the end result of unhealthy lifestyles.

You still haven't answered how we might measure the success of a healthcare system though.

You have rubbished my suggestion but not given any of your own.

If a healthcare system is not designed to give people a longer and healthier life then what is it for?

John


I agree more money could be spent on health education but it is not needed. The population know what is unhealthy to eat, that not getting enough exercise is bad for you, that drinking too much is damaging and smoking kills, but the population don't want to take responsibility for their actions.

The healthcare system is a safety net. That is what it is for.

I don't believe there is a valid measure for our healthcare system when the population are taking actions that are undoing the continued improvements of the healthcare system. The lack of responsibility is a new variable.

Urbandreamer
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Re: Who'd be a Millennial?

#105471

Postby Urbandreamer » December 20th, 2017, 11:14 pm

I am not sure that I dare reply to this thread.

However our firm provides a cheap (very chaep in what they pay, or you can claim) health insurance. It doesn't cover much in truth. However when introduced the point was made-, VISIT the DENTIST, VISIT the OPTI.. (eye doctor). Because they are likely to find that you have other issues early.

Now fogive me, I am old, but what are the two parts of the NHS that the governent have forced out of the NHS since I was a child?

We could discuss who should pay, but in the UK there is a assumption that the state should from National Insurance contributions.

So why, if true, have they decided that early detection and treatment is not a cost that they want to pay?

Dare I say that possibly facts have little to do with the situation?

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Re: Who'd be a Millennial?

#105476

Postby Lootman » December 21st, 2017, 12:54 am

Urbandreamer wrote:We could discuss who should pay, but in the UK there is a assumption that the state should from National Insurance contributions.

Actually, no, the basis of the NHS was that it would be funded from general taxation. NI in its original form was to fund pensions and death/disability payments for those who worked and contributed.

The idea of NI funds being a useful pot of money to raid for just about anything else is a more recent trend and, in my opinion, an unfortunate one.

The NHS as structured encourages people to neglect their health because fixing the resultant problems is perceived as being free. It's a form of moral hazard. Whereas in the US if you get sick and don't have insurance, then you are either bankrupted or dead. Not that that appears to incentivise many as the poorest Americans have the worst nutrition and exercise practices, but that is another matter.

Surely the optimal system is somewhere in the middle. A "free" healthcare system for the very young, old and poor. But a full-service insurance-based private alternative for the tens of millions who can afford to pay and surely should do. I'd like to see healthcare insurance for those with money and/or in work, with a much broader network of hospitals and doctors for them. And a baseline NHS for everyone else.

The NHS would not be "underfunded" if its target constituency was only those who can't afford to go private.

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Re: Who'd be a Millennial?

#105480

Postby supremetwo » December 21st, 2017, 1:44 am

Lootman wrote:
Urbandreamer wrote:We could discuss who should pay, but in the UK there is a assumption that the state should from National Insurance contributions.

I'd like to see healthcare insurance for those with money and/or in work, with a much broader network of hospitals and doctors for them. And a baseline NHS for everyone else. The NHS would not be "underfunded" if its target constituency was only those who can't afford to go private.

And like all insurances, the premium would be loaded according to such as an unhealthy weight, smoking, drinking and drug habits thus making the premium unaffordable. In many cases, insurance would be refused.

The NHS will still be left with the ones costing the most and probably staffed by second-tier staff as all the best ones will have left for your network of private insurance hospitals.

Lootman
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Re: Who'd be a Millennial?

#105558

Postby Lootman » December 21st, 2017, 2:29 pm

supremetwo wrote:The NHS will still be left with the ones costing the most and probably staffed by second-tier staff as all the best ones will have left for your network of private insurance hospitals.

Maybe so, but if millions are getting their healthcare outside of the NHS, then that will enable the NHS to focus on those who don't. It might end up being a second class system as a result, but still a lot better than nothing. And I think the NHS is doomed unless some kind of radical changes are made. The model is structurally flawed and, left as is, it will implode.

One was to phase something like this would be to carve out certain disciplines and modalities from the NHS, in much the same was as optical and dental is mostly private now. People are often happy to pay privately for cosmetic and dermatological work as well. Local private clinics who can perform basic procedures and minor treatments would be viable. The hardest parts to privatise would be A&E and complex cardiothoracic surgery, so that should be done last.

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Re: Who'd be a Millennial?

#113846

Postby meldrewlives » January 28th, 2018, 5:05 pm

An interesting thread - I feel that the NHS is a 'Gordian knot' and I have no idea how it is likely to get untied. The potential demand is infinite the resources far less so.

Politicians lack the vision and more importantly the will, to build something more suitable for the 21st Century. Too many of the public have an unreasonable expectation and take the NHS for granted. The 'medical mafia' are also part of the problem.

I suspect that until the public perception/expectation is adjusted, other alternatives to the current system will never be properly considered. But who will tackle that task I wonder - certainly not Corbyn and Co who just want to throw [other people's] money at it. Nor have the conservatives shown much initiative, perhaps understandably in the absence of any moderate cross-party willingness to have a serious debate without recourse to the ideological extremes.

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Re: Who'd be a Millennial?

#113870

Postby vrdiver » January 28th, 2018, 8:17 pm

Perhaps the first "small step" would be to move the NHS to a similar status as Gordon Brown did with the Bank of England?

An independent NHS with a "Governor of the NHS" (as opposed to a Minister) might open the discussion as to what its remit was, and who / how / what was going to pay for it.

As others have said, a holy cow that can't be criticised, a public expectation of everything-for-free and a Treasury that doesn't want to pay an infinite sum make for uncomfortable bedfellows.

If I speculate for a moment, I can see the Tories being taken down by a combined Brexit+NHS crisis in the Winter of 2021/22 which will be full ammunition to any and every opposition candidate. That will be followed by a tax hike, "a penny (or two) for the nurses" will be the rallying call. When nothing changes, and more money is demanded, perhaps a new perspective will materialise, along with a government elected to deal with it.

So, maybe the NHS will get "seen" by the Tories, not in this government, but the one following a spell of Labour: maybe 10 - 20 years from now?


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