Privatising the NHS

[NormanH]

And this is what happens when the fat pigs  (cf WB's post about France) of the private sector get a sniff of the trough ...

NHS born 1945 Privatised by the Tories 2012

http://www.guardian.co.uk/business/2012/sep/16/health-firms-nhs

[idun]

Why couldn't it end up more like the french system with private and public working together?

A few years ago two different friends were sent to private clinics for different ailments, this by the NHS. They had less waiting time and were happy.

[woolybanana]

Norman, I think the jury is still out. But a mixed system might well deliver services better and lore economically. Let's wait and see shall we.

[Russethouse]

In this area the NHS have been using the capacity in the private system for some time.

Last week a friend had a consultation at the new Circle hospital which was considerably quicker than waiting for her local NHS appointment.

In the summer my god daughter had a ganglion removed from her foot at another private hospital even though she was a NHS patient...in this case the surgeon took a different approach to the NHS guy and as she has 3 active children this was better as it meant she was out of commission for a shorter time.

If the patient gets what they need, they won't complain, and in some cases it may be better value for the NHS to buy these services rather than provide them their selves

[Mr Ceour de Lion II]

For all the criticism the American healthcare system gets, it's bloody fast, so there is a lot to be said about private healthcare too.

[Théière]

Hmm, but truly private health care is for the wealthy, selective care is for the rest, where does the care start and stop?

A few years ago an American client had to inform me they had previously been bankrupt.  I had to ask for the full details and it turned out his wife gave birth to a still born baby which wasn't covered on their policy only live babies. the stress caused divorce and the bill had to be paid by selling the family home.  He said "Never let anyone take away your NHS it's a superb system!"

Another American lady who is currently working on the NHS part privatisation project and who knows the figures for the American system said "The NHS is amazing, it handles so many patients for a phenomenally low cost, No other country she had worked in/for has such an efficient cost/benefit service and you should take to the streets to defend it".

So I guess I will have to kill any MP who tries to undo the NHS as my lasting legacy for being so well looked after.  Bottom line is a couple of pennies on the N.I. contributions would ease the problems whereas many many pounds will line the pigs pockets as they gather round the food trough as has already been said.

[Frederick]

The NHS should be called the WHS the World  Health Service because so many from worldwide pitch up to use it having put so little money  in the pot first.. .

[JohnM]

[quote user="NormanH"]And this is what happens when the fat pigs  (cf WB's post about France) of the private sector get a sniff of the trough ...

NHS born 1945 Privatised by the Tories 2012

http://www.guardian.co.uk/business/2012/sep/16/health-firms-nhs

[/quote]

Thing is NormanH, the article is from the Guardian, a paper with a left bias, so they will have written it from that angle. Although the journalist will have researched the subject, they will have ignored any facts which don't quite fit the thrust of the story that they wanted to write. To get the whole story, people need to read something with a right bias as well (exercising both open mind and pinch of salt for both sources of information).

[Edward Trunk]

A company called Serco was given the contract to provide out-of-hours care for the whole of Cornwall. Its service has been appalling; at one point it had one GP available for the whole county. It has been caught out lying repeatedly to the regulator about its activities. It has, of course, being trying to stuff up its profits by cutting its staff. Is anyone surprised?  

[Mr Ceour de Lion II]

[quote user="idun"]

Why couldn't it end up more like the french system with private and public working together?

A few years ago two different friends were sent to private clinics for different ailments, this by the NHS. They had less waiting time and were happy.

[/quote]

I like the French system because puts responsibility on the patient too. If you don't have the top up insurance (like I never bothered with), then each trip to the docs costs money. You then ask yourself, how badly do I need to go, and then you don't. Saves a lot of wasted time, and expense.

[Rabbie]

[quote user="Mr Ceour de Lion II"][quote user="idun"]

Why couldn't it end up more like the french system with private and public working together?

A few years ago two different friends were sent to private clinics for different ailments, this by the NHS. They had less waiting time and were happy.

[/quote]

I like the French system because puts responsibility on the patient too. If you don't have the top up insurance (like I never bothered with), then each trip to the docs costs money. You then ask yourself, how badly do I need to go, and then you don't. Saves a lot of wasted time, and expense.
[/quote]Hear Hear!

I think that a small charge for visiting the doctor would cut down on unnecessary visits.

Private companies are always open to to suspicion that they are more interested in profit than the best interests of the patients.

[Russethouse]

We had Readidoc and also a GP surgery provision within the Berks, I've used both and been happy with them.

As for CdeL, my husband has type 2 diabetes and the difference in treatment between the 2 countries is a big one. In the Uk if you need testing kits etc you get them, plus all prescriptions are free, in the US Diabetes patients seem to be rationed.

Another friend was actually on the operating table with her surgeon and insurance company arguing about which procedure she was going to have on her neck, and the issue was cost.......

Nothing is perfect, and the NHS needs some renovating...but let's not throw the baby out with the bathwater

[Rabbie]

The NHS does need renovating. Not surprising after nearly 65 years. But lets make sure the changes are not made from party political ideological reasons but from a sensible analysis of what would be best for patients bearing in mind the inevitable restrictions on resources. Modern medicine has become more and more expensive to provide often due to the fact much more can now be done compared to 60 years ago. Drugs are more expensive to develop now especially with the rigorous testing that is required.

 

 

[Théière]

It might just help if we could get the Scotts to put their hands in their pockets and actually pay for some of the expensive drugs. [:D]

[YCCMB]

[quote user="Mr Ceour de Lion II"]

I like the French system because puts responsibility on the patient too. If you don't have the top up insurance (like I never bothered with), then each trip to the docs costs money. You then ask yourself, how badly do I need to go, and then you don't. Saves a lot of wasted time, and expense.

[/quote]

Or, as in the case of a thirty-eight year old man who lived just around the corner from me in France, you could die in the night in front of your wife, month-old daughter and eight year old son because you don't have any top-up insurance and you have weighed up the cost of calling out a doctor, or calling in on the doctor, and decided that you can't afford it.

[Rabbie]

[quote user="You can call me Betty"][quote user="Mr Ceour de Lion II"]

I like the French system because puts responsibility on the patient too. If you don't have the top up insurance (like I never bothered with), then each trip to the docs costs money. You then ask yourself, how badly do I need to go, and then you don't. Saves a lot of wasted time, and expense.
[/quote]

Or, as in the case of a thirty-eight year old man who lived just around the corner from me in France, you could die in the night in front of your wife, month-old daughter and eight year old son because you don't have any top-up insurance and you have weighed up the cost of calling out a doctor, or calling in on the doctor, and decided that you can't afford it.
[/quote]Perhaps this suggests that top-up insurance should be obligatory.

I was however suggesting a very modest charge for visiting the doctor not more than £5 or so which should not people who are genuinely ill from going. I am sure that it could be arranged so you did not pay for follow-up visits.

[YCCMB]

So, like many in the USA, it's going to come down to choosing between eating, clothing your family and having medical insurance top up cover? France also has unemployed people and those with no funds to pay for top up cover, and I'm sure there are folk in the UK who would baulk at having to pay to visit a GP when they're short of money as it is. Regrettably, it is often those who can least afford the luxury of paying to see a doctor who are most in need of medical help. Which is kind of where the NHS came in in the first place....

[Quillan]

[quote user="You can call me Betty"]

Or, as in the case of a thirty-eight year old man who lived just around the corner from me in France, you could die in the night in front of your wife, month-old daughter and eight year old son because you don't have any top-up insurance and you have weighed up the cost of calling out a doctor, or calling in on the doctor, and decided that you can't afford it.
[/quote]

I have heard, but never read in the papers, stories like this in the past. I was under the impression that if you are that poor you get 100% cover anyway. Was not that part of the issue with Expats coming to live in France? Didn't they used to get 100% cover even thought they had a couple of new cars parked on their drive, asset rich, cash poor? I was under the impression that was one of many reasons why they introduced the law change back in 2008 (or when ever). Indeed for the first few months we were here after registering with CPAM we received 100% cover yet we didn't need it but we were 'forced' to have it.

The other side of the coin is peoples attitudes. When I had my first heart attack (but didn't know I had one) I would have gone back to work if it were not for the company nurse who made me go to my doctor. If I had not have gone and dropped dead the next day what would people have said "he refused to go the doctor". Perhaps the chap your talking about didn't want to register for 100% cover, perhaps he felt there was some form of stigma attached to doing so. Sometimes reasons are cut and dry (which may well be correct in this case), other times there may be mitigating circumstances that don't come out straight away.

I think the biggest problem the NHS has is the same as owning a boat, you just keep throwing money at it and the money keeps disappearing with no sign of where its gone. When the NHS came in to existence there were only 10M people less than there are today in Britain (ONS) but the real difference is in people over 65 which is now for than 38% of the population. That percentage coupled with the percentage of the UK unemployed (8.9%) gives a total of around 47%. Take off the amount of people under 16 years (19%) that leaves only around 44%. You can take off another couple of percent because of those in universities so lets say 42% of the population actually contribute 'direct' tax in the UK which is simply not enough to maintain the NHS. Something clearly has to be done, you can't increase the direct tax people pay, their pockets are only so deep. I personally disagree with privatising the NHS (in part) but I really can't see any other way of sustaining it.

By the way ONS predicts that the number of people under 16 will decrease and that the number of people over 65 will increase. Young people need far less health care than old people so the costs of the NHS will only increase. One area, and I am in agreement with somebody else that mentioned it, is that there should be more control over what drug companies charge for their drugs. I am more in favour of a 'cost plus' system as used in private sector these days, 20% profit I think is quite acceptable.

[YCCMB]

[quote user="Quillan"][quote user="You can call me Betty"]

Or, as in the case of a thirty-eight year old man who lived just around the corner from me in France, you could die in the night in front of your wife, month-old daughter and eight year old son because you don't have any top-up insurance and you have weighed up the cost of calling out a doctor, or calling in on the doctor, and decided that you can't afford it.

[/quote]

I have heard, but never read in the papers, stories like this in the past. I was under the impression that if you are that poor you get 100% cover anyway. Was not that part of the issue with Expats coming to live in France? Didn't they used to get 100% cover even thought they had a couple of new cars parked on their drive, asset rich, cash poor? I was under the impression that was one of many reasons why they introduced the law change back in 2008 (or when ever). Indeed for the first few months we were here after registering with CPAM we received 100% cover yet we didn't need it but we were 'forced' to have it.

The other side of the coin is peoples attitudes. When I had my first heart attack (but didn't know I had one) I would have gone back to work if it were not for the company nurse who made me go to my doctor. If I had not have gone and dropped dead the next day what would people have said "he refused to go the doctor". Perhaps the chap your talking about didn't want to register for 100% cover, perhaps he felt there was some form of stigma attached to doing so. Sometimes reasons are cut and dry (which may well be correct in this case), other times there may be mitigating circumstances that don't come out straight away.

[/quote]

A family of 4 (as I said, one a baby a few weeks old) living in two rented rooms with an earth floor, aren't asset rich, that's for sure. AFAIK, the guy had recently lost his job, and although I'm not aware of all the circumstances, I imagine they were in that no-man's-land of no income-no cover-no aid because it hadn't yet kicked in. Add to that a fairly low level of education, a natural instinct to avoid trying to claim help because they didn't want to be stigmatised and were too proud to do so, and it's an example of how, whatever the system, there are people who slip through the gaps.So yes, attitudes do play a part. But if your system is one where medical care is not free at the point of delivery, then this is the sort of thing which can happen.

In a somewhat ironic twist, I accompanied a friend to the doctor in France only a few weeks back. There was a consultation, a prescription and so on, and on the way out, my friend asked the receptionist how much she owed. "Nothing, as far as I know" said the receptionist "Did the doctor say anything? I'll call him and check". My friend (who was previously resident in France but is no longer) explained that she wasn't resident. After a quick chat with the doctor, the receptionist advised that there would be no charge. "It's to much hassle to do the paperwork" she explained "So have this one on us".....

[Quillan]

See that's the thing in my mind, it's not the systems fault if the person does not register because they are proud and don't want to be stigmatised especially when they have young children. It's them they should have thought of and not themselves if you get my drift. There will always be those that slip through any net in any country. In several UK newspapers of the last couple of weeks  there have been horrendous stories about neglect, gross misconduct etc in the NHS and yes people are right when they say it would be rather naive to think it only happens in one country.

[NormanH]

There is the CMU-C, which should cover cases of hardship, and as I have often said before is what most French people think of when they refer to the CMU

Even the 1€ forfait is waived.

http://www.cmu.fr/cmu-complementaire.php

[Rabbie]

[quote user="You can call me Betty"]So, like many in the USA, it's going to come down to choosing between eating, clothing your family and having medical insurance top up cover? France also has unemployed people and those with no funds to pay for top up cover, and I'm sure there are folk in the UK who would baulk at having to pay to visit a GP when they're short of money as it is. Regrettably, it is often those who can least afford the luxury of paying to see a doctor who are most in need of medical help. Which is kind of where the NHS came in in the first place....
[/quote]It seems to work in Sweden where they have an extremely caring welfare system but people do have to pay a SMALL charge for visiting the doctor. There is no reported problem with people not asking for medical aid when they need it.

[NormanH]

There is a study on all this

[YCCMB]

I would have been quite interested to read it, too. Unfortunately, I was never much good at algebra, and I can't really make head nor tail of what the study is trying to tell me. Perhaps someone brighter could summarise it?

[Rabbie]

[quote user="You can call me Betty"]I would have been quite interested to read it, too. Unfortunately, I was never much good at algebra, and I can't really make head nor tail of what the study is trying to tell me. Perhaps someone brighter could summarise it?
[/quote]My reaction as well[:)]