The NHS v Private

[Gary]

Our hospital hits the national newspaper headlines with a slightly contrived story!

https://www.warrington-worldwide.co.uk/2019/06/21/warrington-halton-hospitals-nhs-trust-to-pay-or-not-to-pay-that-is-the-question/

Debate!

[asperity]

It's just another example of why the NHS needs sorting out. Unfortunately any attempt at making it more efficient is labled as an "attack on our NHS" and "privatisation by the back door".

[Stallard12]

An appointment within three days.   Any doctor any hospital.   No copay, no medication costs, unlimited hospital stay.  Costs me $180 per month.  Of course I am part of the 'retired' community, but still.  Tired of liberals insulting America.  Canadians have the U.K. system, but if they want quality care, they cross the border.   Youget what you pay for.

[Observer II]

or rather what you can afford.

[Latchford Locks]

 No.... not someone on social media being free and easy with photoshop. But a Labour election poster (circa .. 1950)

 

[Latchford Locks]

11 hours ago, Stallard12 said:

An appointment within three days.   Any doctor any hospital.   No copay, no medication costs, unlimited hospital stay.  Costs me $180 per month.  Of course I am part of the 'retired' community, but still.  Tired of liberals insulting America.  Canadians have the U.K. system, but if they want quality care, they cross the border.   You get what you pay for.

Prohibitively high cost is the primary reason Americans have problems accessing health care. Consulting company Gallup recorded that the uninsured rate among U.S. adults was 11.9% for the first quarter of 2015, continuing the decline of the uninsured rate outset by the Patient Protection and Affordable Care Act At over 27 million, the number of people without health insurance coverage in the United States is one of the primary concerns raised by advocates of health care reform. Lack of health insurance is associated with increased mortality, about sixty thousand preventable deaths per year, depending on the study.^[14] A study done at Harvard Medical School with Cambridge Health Alliance showed that nearly 45,000 annual deaths are associated with a lack of patient health insurance. The study also found that uninsured, working Americans have an approximately 40% higher mortality risk compared to privately insured working Americans.

[Observer II]

Right on Latch.   There are of course organisational difficulties with our NATIONAL Health Service -  1.  It has become International with health tourism and systems for ensuring payments for treatment appear wanting.   2.   Abuse appears prevalent EG: the case of the woman who now admits she faked depression in order to get a "nose job" on the NHS;  perhaps the NHS should now send her the bill ?   3.  The Trust system, undermines the concept of a "National" Service,  with seperate and incompatible IT systems.   4. But fundementally it's a victim of it's own success,  providing ever more cutting edge procedures, which can be extremely expensive.  What is required imo, is a national conversation to decide on the extent of provision - a mission statement - EG:  should it provide for "want" such as IVF or cosmetic surgery,  or solely for "need" ?.  Should it shoulder the responsibilties for social care,  causing problems of bed blocking by a growing elderly and infirm population ?  

[Stallard12]

First let me say, when you quote numbers you have to take into account that there are 55 million people in the U.K. and there are 330 million in the US, so obviously any number on any subject is going to be higher in comparisons.

Basically, all reasonably sized employers offer subsidized, affordable, private health insurance.  My son is an auto mechanic at a dealership and he has a very good package which includes dental and sight.   The only people with no chance of employer help, are people who work day labor jobs, usually by choice, or unemployed. If you do not have health insurance you can apply to the government for Medicaid, the only requirement being that you are unable to pay at all.  The Medicaid coverage is very basic and only about fifty percent of practices take it, so you may have to cross town to a facility that does.  

By law all hospitals have to treat medical emergencies, accidents, heart attacks etc and they cannot release you until you are stable and mobile.  The main reason for high hospital costs is because they have to add something to every paying customers bill to cover indigent care. There are many charitable organizations, Salvation Army for one, who will accept after care patients.

If you have paid your health deductions throughout your working life, at 65 you qualify for Medicare.  It will cost you about 70 BP a month for basic coverage and you can buy enhanced coverage for an extra payment.  You now have all the help you need til you die.

Obamacare, was a very poorly conceived, liberal failure in many ways.  However it mainly failed because of one overlooked factor, only sick people signed up for it.  It was offered for very low costs, they found that out of the thirty million with no insurance, twenty five million  were young people between 18 and 30 who were not willing to sign up because they still had no concept of falling sick - they were invincible and didn't see the need for medical coverage. The other five million covered the drop outs and drug addicts who live outside the normal population. The result was that they had to raise premiums to unacceptable levels.

In fifty years of life in Texas, I have never witnessed any person or family with no access to treatment.  Nor has any been on the news or in the papers.  I have not known nor has it been reported, that anyone has had to wait more than a couple of weeks for any kind of operation.

This is not a augumentive comparison, I'm not trying to say which system is best, I'm just explaining the US system cos fake news applies to everything.

 

[Davy51]

Stallard ,is the health provision in the US provided by a singular organisation or is it competitively provided my multiple health purveyors ?

[Stallard12]

I presume  you are thinking of individual personal insurance.   It's just like buying car insurance except that the companies are medical specialists.  However there are some laws which they have to abide by, like covering pre existing conditions etc.   If it comes as part of your employment package, the employer negotiates and selects the particular insurer.  You then pick the extent of coverage you want and pay extra if necessary.

Thesame applies when you retire.  The government plan comes with just a minimal monthly payment, but if you want a more comprehensive plan, you take out supplemental insurance on your own.  Some employers help here too.  My wife retired after 25years service and for that her employer pays the premium for top class coverage for both her and I.  We pay nothing for doctors visits, hospital visits, operations or treatment of any kind. Haven't put a hand in pocket since she retired.

[Observer II]

We have a similar scheme for pets over here Stall;   the insurance starts off cheap, when your dog's a pup;  then gradually increases with age and conditions.   Insurance cover for holidays, is another one; fine if your young a fit;  but almost unobtainable and expensive if your old with pre-existing conditions.  As with any insurance scheme;  they're in business to make money not to spend it, if they can help it.  At the end of the day we all pay - either as individuals through private insurance or collectively as tax-payers -  the latter based on ability to pay.

[Confused52]

On ‎6‎/‎21‎/‎2019 at 5:37 PM, Gary said:

Our hospital hits the national newspaper headlines with a slightly contrived story!

https://www.warrington-worldwide.co.uk/2019/06/21/warrington-halton-hospitals-nhs-trust-to-pay-or-not-to-pay-that-is-the-question/

Debate!

Yes it really is contrived and the response of our MPs is disgraceful. Mrs Jones: “It is outrageous for our local NHS Trust to restrict access to essential operations and then seek to charge amounts that no one on a normal wage can pay.”. The problem is that that it is not really true, as Mel Pickup says it is the CCG that applies the limit on supported procedures not the Hospital Trust. The Hospital Trust want to offer a sound way of getting round that as an alternative to losing cashflow to the private sector. As I understand what was on offer it was self-pay if the only reason the NHS would pay is because of the local CCG policy and there was a clear clinical need.

This complaint is the usual response from socialists who will not accept anything other than the lowest common denominator even if allowing this scheme actually increases Hospital funding. Seemingly they prefer the hospital to be underfunded if the alternative is private choice.

A further disgrace is that the Trust was so easily bullied by the Labour Party and its acolytes in to backing down even though they clearly intend to bring it back later if they can because it is the right answer for the trust.

[Stallard12]

There is a mountain of evidence, growing every day, showing that the government cannot run the most simple of operations, they are eternal screw ups. Therefore Obs, I'll take my chances with the private sector every time.

[Confused52]

21 minutes ago, Stallard12 said:

There is a mountain of evidence, growing every day, showing that the government cannot run the most simple of operations, they are eternal screw ups. Therefore Obs, I'll take my chances with the private sector every time.

Your remarks are of course worrying. The only real job of the public sector is to do things that the private sector cannot or should not do. Since this includes the defence of the realm/state you opinion of government is clearly of concern!

[P J]

14 hours ago, Stallard12 said:

I presume  you are thinking of individual personal insurance.   It's just like buying car insurance except that the companies are medical specialists.  However there are some laws which they have to abide by, like covering pre existing conditions etc.   If it comes as part of your employment package, the employer negotiates and selects the particular insurer.  You then pick the extent of coverage you want and pay extra if necessary.

Thesame applies when you retire.  The government plan comes with just a minimal monthly payment, but if you want a more comprehensive plan, you take out supplemental insurance on your own.  Some employers help here too.  My wife retired after 25years service and for that her employer pays the premium for top class coverage for both her and I.  We pay nothing for doctors visits, hospital visits, operations or treatment of any kind. Haven't put a hand in pocket since she retired.

Phew! Thank heavens you are alright Jack, sod the rest, if they are poor they don’t matter.  

[Milky]

I agree the NHS need reforming, moving towards the French or German system would be the way to go

interesting topic on American medical costs

 

[asperity]

The idea that any business in the USA would want to buy "Our NHS", complete with its untouchable "public service" workforce, vast annual losses and bottomless pit of liabilities, is hilarious. But the left wing find the threat of it a useful weapon to brandish against those "evil Tory child murderers".

[Observer II]

You'd be surprised at the private sector interests in the NHS - the drug companies for starters - but worse, organised crime is now buying up cheaper drugs in E/Europe and reselling them at a profit through various EU countries and finally to the NHS;  with some drugs being tainted by faulty storage.

[asperity]

What you're talking about there is people selling stuff TO the NHS, not buying the NHS with all its faults, one of which is buying over-priced drugs!

[Observer II]

The drug supply industry is private sector and profit led;   that means the NHS and thus the taxpayer, can be exploited by them.

[asperity]

This is a problem with the NHS management buying drugs at exorbitant prices instead of at market prices. Why do they buy Paracetomol at 10 times the price charged by supermarkets for example? Because they aren't interested in saving costs, no skin off their nose, the "Government" (us) are picking up the tab.

[Confused52]

2 hours ago, asperity said:

This is a problem with the NHS management buying drugs at exorbitant prices instead of at market prices. Why do they buy Paracetomol at 10 times the price charged by supermarkets for example? Because they aren't interested in saving costs, no skin off their nose, the "Government" (us) are picking up the tab.

ASDA charge 30p for 16 x 500mg paracetamol caplets. The NHS Drug Tariff says they pay 70p for 32x 500mg tablets. Looks like a loss leader for ASDA. Boots charge 75p for 32 caplets. What is the evidence for paying 10x by the NHS. I can see higher prices on the tariff but they are more complex products.

[asperity]

I might have got hold of the wrong end of the stick from this article Confused:

https://www.independent.co.uk/news/uk/politics/nhs-70-million-paracetamol-last-year-figures-department-of-health-painkillers-prescriptions-a7819661.html

[Confused52]

28 minutes ago, asperity said:

I might have got hold of the wrong end of the stick from this article Confused:

https://www.independent.co.uk/news/uk/politics/nhs-70-million-paracetamol-last-year-figures-department-of-health-painkillers-prescriptions-a7819661.html

Fair enough. I see that they were comparing it to reimbursement costs to the pharmacies, every bag and check it is right is duly paid for. The figure I gave you was what the NHS pay for the drugs alone and yes dispensing costs are on top and apparently rather large aren't they?

[asperity]

I use Pharmacy2U for my repeat tprescriptions. They claim that they save the NHS money, presumably by cutting out some of the bureaucracy involved.