2024 UK politics - now with Labour in charge
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It is the tempting line of thinking that leads to the US model. That has arisen because culturally it is everyone for themselves there. It isn't the right direction in my view, even having experienced the hybrid Canadian system (and I think I didn't experience hitting any coverage limits there). I would certainly want to completely rule out all of the options fixing our system first.
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I did try, but it was drowned out by an in depth debate about the ethics of military tactics.
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I think this touches upon the major issue with any proposed changes to NHS funding or models of delivery. The vast majority of people in the UK view that NHS as a fundamental right. It is embedded in our cultural psyche that you will receive free healthcare from 'cradle to grave'. As you suggest, any political party that starts trying to do anything that could even be perceived as affecting this i.e. increased private healthcare, would likely lose them an election.
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I would tend to agree, and I don't really see this changing.
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Can we start from funding per head and construct a coherent discussion from there?
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No major party has suggested abolishing private healthcare, and no suggested model (on here) has anything other than healthcare free at point of use with no penalties on premiums for pre-existing conditions. So it is just which specific structure returns the best value and best care isn't it? And this calculation has to take into account that moving to another system would involve dismantling the existing structures and constructing new.
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Does that support an insurance model, support an NHS model or neither?
Second plot suggests pushing up spending will put us mid pack or better, mind you.
And the US. Crikey.
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You need to plot it against healthcare outcomes obviosuly, but as per the link I gave upthread, the UK underperforms there.
The UK is very good at moneyballing healthcare - they're like the Oakland As of health systems. But is the point to be as efficient as possible or to reasonably maximise healthcare outcomes? There is a balance but I am convinced by leaving the state to run the health system you get an unbalanced system overly focused on efficiency and not on maximising health outcomes.
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I'm still struggling why a system keeping the main principle of treatment being free at the point of use would be better done through a private insurance system. It's far easier to just keep with what we have and raise the levels. If we went to a private insurance system would the payments be made pre or post tax?
Boris had proposed an increase in NI during the pandemic - I can't recall if that ever actually came in but it seemed to be relatively well received as people could see the sense in increasing funding to health (and social care). It was then reversed and ultimately cut and now we are out of the pandemic any talk of increasing it again is likely to be much harder politically especially when you have specifically ruled it out. However, if you are going to do something unpopular then I would argue doing it early in a parliament where you have an enormous majority is the ideal time, it gives you 5 years to get results and people can see they've had something in return.
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Not completely sure I follow the reasoning that the private sector will be less concerned with cost efficiencies.
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The evidence is that they compete as much on the quality of service and care outcomes as they do on cost.
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No it doesn't. It shows that if you spend more you get better outcomes.
I am also not convinced that any insurance based model in the UK would get implemented or regulated correctly. We haven't got a great record with that sort of things. If it is marginal, safety first suggests the current system.
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Part of me thinks the issue is not so much that the NHS is almost revered to the extent that there's a joke that it is the state religion, it's that other organizations don't have that feeling around them, so it makes the NHS stand out like a sore thumb.
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Yes. People will pay for *their own* better healthcare outcomes in a way they won't for other people. It's a psychological trick to get them to spend more.
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They presumably still need to make a profit so how do they deliver a better quality service without it costing more than doing it through tax and also make money? It sounds like the argument for privatising water and train companies.
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So if it's a well managed market there are options to use different providers. So if you're pissed off with one you can use another - which is not the case for water or train companies at the moment.
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Doesn't work that way in the US or Canada. People, when they are younger, skimp on insurance instead, because they can. On the other hand, If you mandate that the cost is based on incomes and decouple it from costs incurred, it's not really insurance. Or at best is such a heavily regulated system that you end up in a similar place to ours. The data seems to show this.
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Have you tried persuading under 30s to pay more than the statutory minimum into a pension?
1985 Mercian King of Mercia - work in progress (Hah! Who am I kidding?)
Pinnacle Monzonite
Part of the anti-growth coalition0 -
They still have to deliver a better service and make a profit - I don't see how you can do that whilst also being no more expensive than the current system especially when one of the big benefits the NHS has should be its size in bargaining.
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Private healthcare providers cherry pick the service they offer. So if it’s a new hip or knee they’ll do it but there’s no way they would want to provide A&E services or acute mental treatment as they are too unpredictable to cost effectively.
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My tuppence worth. We are in a transitional period on our way to Ricktopia. The NHS is in such a bad way that those who can afford it are moving to private already. This eventually will lead to less demand on the NHS.
Downside is that private really want the low hanging fruit, quick easy fixes. They do not want long term low profit care.
The above may be fact, or fiction, I may be serious, I may be jesting.
I am not sure. You have no chance.Veronese68 wrote:PB is the most sensible person on here.0 -
Yeah sure at the moment they do, because you have an NHS.
In a private model like you see in France, they're not allowed to cherry pick.
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It seems 6 and two 3s to me. And France has it's own public finance issues, arguably worse than ours.
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Exactly. Public finance is tricky. They're still surviving cancer and heart problems much more than Brits are.
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That's because they are spending more.
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Put figures on it - currently the government spends £240 bn per year on healthcare. About £4,000 per adult.
Out of pocket spending about £40bn, and voluntary insurance £7bn.
How does that look in the new world?
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aside from spending, there's diet and lifestyle
i've spent a fair amount of time in france, the relative svelteness of people must make a difference to long term health outcomes, overall i get the same impression in italy, spain, portugal
though according to...
https://en.wikipedia.org/wiki/List_of_countries_by_obesity_rate
...the uk is heading in the right direction
my bike - faster than god's and twice as shiny0 -
That's got "More or Less Podcast" written all over it, that data.
There are quite a lot of interesting fatties up near the top. Wouldn't have thought the middle east would be so bad - although there are a lot of nice desserts to be made with peanuts and sesame seeds.
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