Non-political Save our NHS

Sorry I should of said I was an American.

I confess I don't know a lot about the New Zealand healthcare system. I haven't had to use it much. I do know that we pay for each visit to a GP, we pay for prescriptions and we pay for some X-rays. This includes children of school age at the moment but there is movement to introduce free visits to the doctor for all children under ten. As the very poorest do not always have the spare cash, sometimes they cannot take a sick child to the doctor or have to choose between doing so and paying for adequate food, heating or some other necessity. I hope this change is implemented very soon and is extended to all children and young people in education.

There are some confusing anomalies. Mammograms are free, providing you are a citizen or resident, but you do pay for smear tests. Some immunisation is free or free to people of certain age groups; some you pay for. I think there are similar variations in the UK.

I am not sure what the situation is with pensioners, although I should find out as I have recently had my 65th birthday. I think there are some reductions but these may not apply to all pensioners.

Essential hospital treatment is free, whether as the result of an accident, illness or giving birth. Antenatal care is also free.

Some people here do take out health insurance. I think this is mostly because there are much stricter guidelines about what is and isn't essential. Waiting times are generally not long, although I imagine there are greater delays in Auckland and Wellington than there are in Nelson (my nearest city) simply because they are a lot more crowded.

Mamie thanks for your thoughts on my bit about problems with the French system. That it what really helps I.e. someone with knowledge. What I should have added to the expensive doctors is that this is largely happening in towns. I got the information from a paper published by a French academic.

Whitewave you have done a heroic job. It is really interesting, and probably something we were all aware of, that more money does not necessarily mean better or fairer - the USA percentage of GDP per capita as the example.

One thing I cannot see is what is called the "care" part of our healthcare system. Do we know if this is included in the other EU countries offering and do they discriminate between physical and mental health as we do?

I cannot imagine any system as bureaucratic as ours. I have someone coming out to visit me tomorrow to see if my mother has to pay for the alarms the local authority has put in for her - I wonder what that costs? These are not medicinal so come under the care system. However, they are preventative and the authority uses them because they should save money in the long run. My son has touched on how the Australian system works - I believe they either have to pay a percentage into a private company or they are taxed the same amount although I don't know the details. The thing that interested me is that, because they are using private companies they are offered quite a few preventative measures for "free" - a couple of dental inspections a year, etc.. I do think a private company, (preferably not for profit in my view) would be more geared towards preventative action.

NEW ZEALAND. 9.4% GDP

This system has gone from an entirely public s system to a mixed of private/ public during the past decades. It was quite difficult to find a brief overview on exactly what happens now but it appears that the re has been a large take up of various services by private companies. Hospitals are still public ally run but there have been various charges introduced for example visit to the Dr.
I get the impression that our system may well have looked at New Zealand.
PROBLEMS -taken from a report by the WHO

Lack of equity was highlighted. This is largely as a result of the system of payment required for various access. In 2013, 32% of Newzealanders said they put off going to the drs because of cost.
The New Zealand government is continuing to cut cost and one result is delay in surgery like cancer. The Maori health is not surprisingly worse than the immigrents. (By that I mean everyone else!)

Envious have you got an opinion about the European models compared to the USA model? Be good thing hear

From what I've read so far, it seems that most healthcare systems have their plus and minus points, but it appears that some do not serve the whole of the population equally well (such as in New Zealand). This is perhaps the crux of the issue - there may well be excellent healthcare for those who can easily afford to pay for, for instance, seeing their GP or having x-rays done. I believe some Americans have access to the most advanced and sophisticated treatments and procedures - but those who only have access to "emergency" treatment often cannot receive care for chronic conditions even when it will inevitably lead to those conditions becoming acute.

durhamjen believes that the Danish system is superior to our own but then points out that it costs considerably more than ours. This is the dilemma - is it possible to match the most up-to-date and efficient systems while at the same time paying in a lot less or denying some areas of healthcare to those that cannot pay?

The problems in the NHS have been greatly exacerbated by the cuts in funding but we have been encouraged to see them as an inherent and inevitable fault of the system. My feeling is that we may well need to pay higher taxes in order to maintain the NHS in its present form. I and I'm sure many people would be happy to pay more tax in order to protect our NHS provided the government pursues those - and sometimes they are the very wealthiest amongst us - who are not paying their fair share.

Are the wealthiest not the ones ' going private' over here? The ones who join BUPA or go to Harley St etc. There are plenty of private hospitals too. The private system seems to be thriving here.

Yes whitewave, expensive specialists definitely an urban thing. We did, on our GPs recommendation, pay an extra 100€ (well our top-up insurance did) for a very precious maxillo-facial surgeon when OH needed surgery very close to the eye, but ours is not a wealthy bit of France, so that was unusual. Our university hospital is in the top five in France for most things though and our cancer hospital is second to none.
It does all take a bit of getting used to though. For cardiograms we go to our local cardiologist who sees patients at his house. You wait in a very old-fashioned parlour and then go to his surgery out the back which is a mixture of old oak furniture and very high-tech equipment. The idea of the doctor's "cabinet" still has a strong hold here.
The cardiologist is pretty easy to see at short notice but the dermatologist always has a long wait of four or five months for non-urgent stuff.

AUSTRALIAN. 9.5%GDP

This seems to be the most complicated system I have looked at to date and I have not really got to grips with it, but this is what I do understand.
Multi-faceted

Mixed private/public. This is totally politically polarized.

Provision is as follows
100% public hospitals
75% GPS the rest must be made up out of patients pocket
85% specialist and made up as above

Problems

Inequitable, with those not accessing private care having to wait sometimes long periods.
The Aborigines die a full 20 years sooner than the immigrants. Disgraceful.

Private medicine in the UK is only able to function on the back of the NHS which trains most of the staff who may then be employed in the private sector. Many private clinics, hospitals and GP surgeries have very limited scope; if anything goes wrong, patients are shunted off immediately to more comprehensive NHS provision. Remember the scandal about the wrong sort of breast implants?

One thing I would like to see is the governmental role as being strictly regulatory but I would wonder if it is possible to keep government at arms length with regard to the economic side. So like the Dutch keep the system totally comprehensive and universal, but private insurance?

Open to being told I am talking rubbish?????

No not talking rubbish. Very interesting thread. Lots to think about but I suspect no easy answers. Living longer and more complex conditions treatable as well as some daft expectations of what NHS for make it difficult if not impossible to resolve to everyone's satisfaction. We should aspire to better than least worst!

No, I don't think you are talking rubbish whitewave, I was coming to the same conclusions. I would like the private providers to be not for profit, however.

Agreed, Gracesgran. The problem we have now is that we do not know how much is private in the NHS. We find out by freedom of information requests, except that lots of times are told it is covered by commercial confidentiality.

We need a more open system. Hunt wants to put the price on medication. I want to put the price on everything to do with the NHS. Not just the price, but who we are paying.

The Danish system is much more open and honest. They also have a good union system.
Eloethan, it costs more, but they are paid more.

Six years ago we had a German surgeon stay with us in our guest house. She was operating on hips in the nearby Nuffield hospital, which used to be part of the Rowntree factory. She did this one week and went back home the next. She said she could do it because she was paid twice as much in Britain as she would be paid in Germany. If anything went wrong she could call an emergency ambulance and have the patient transferred to the NHS hospital in the next road. She was paid by the NHS.
I do not know if it is still the same.

Yes definitely not for profit. I think some sort of constitution would be good which prevents future governments mucking around with the system without a full referendum. It isn't sufficient to say we got voted in so we can do what we like. We need a major and totally open discussion about the way forward, and I think it should start with basic principles likes
Fully comprehensive
Universal
Totally equitable

You mean like it was supposed to be before various governments started messing about with it?

Are we allowed to say who we think should be on the committee to discuss the constitution?

bit.ly/1Pl148p

You have to sign up for this economist report looking at how the NHS compares.

I can't in won't act when I submit?

That happened to me, too. But then I just put my email and password in the sign in boxes and it let me download.

I got the link from here.

nhap.org/join-us-nhs-fightback/facts-fingertips/

Lots more interesting links on it.

SWISS 11.4% GDP

It would seem that the Netherlands system is bases on this.

Report from Civita

Both uphold principles of universality and equality by mandating individuals to purchase health insurance on the private market, providing financial assistance to those on low incomes, and regulating the insurance market in order to protect those with poor health.
The result appears to be high quality care for all, excellent patient satisfaction, strong uptake of new technology and drugs, short waiting lists and impressive health care outcomes!!!
Sounds too good to be true. If not I think this definitely is worth considering

Thanks I will have a look in a minute,

Of course you get what you pay for I guess. I think there must be consideration relating to higher finances.

I have to admit that for the % of germans who have private health Insurance they do seem to get more attention but not where cancer or operations or child care is concerned. The rich do better in the UK as well you are not going to be able to rule that out.

Some sceptics in talk shows advise against going private because of the lucrative pickings doctors can have with them. They get more useless examinations offered get more unnecessary operations.

I am not privately insured but when I had to go into hospital I ordered extra a private room. There are more nurses and better food and in the end it cost me about the same as a weekend in a hotel and I was in the same hospital just in a different ward. This option is open to everyone who can pay for it and actually paying for your health care becomes the natural thing to do. Healthcare is worth paying for. Of course the basics, the old and the young are special cases but Germany has a special fund to provide for the old and everyone pays 2 % of their salary into this and old people then get cash to help with bills. All children up to the age of 16 ( and later if studying)are free. Their parents do not pay extra for them, just as the bread winner does not pay for a stay at home spouse.
retired people continue to pay for health insurance but much less monthly.