Non-political Save our NHS

British doctors going over to Greece and working for free. A doctor in the North East has set up a company to get free medicines sent over there.

I'll ask about Denmark, whitewave. I know the hospitals are much better resourced and funded, but I do not know how. Care homes are much better staffed, and that comes under the health service, too.

GREECE - austerity has brought about a collapse. Doctors are working voluntarily, with medicines and equipment in short supply.

DENMARK 9.8% GDP. DJ you probably know more about this system?

This seems a relatively straightforward system similar to ours, but it seems that governments are less ideologically motivated, although I may be wrong.

Financed through income tax. Two divisions
1. Primary H ealth including GP etc.
2 Hospitals.
Universal and everyone covered. Has a good reputation

It's becomes complex, doesn't it. From my understanding, The CMU-C is a different strand to the CMU.

dj yes I agree. But I really fancy the idea of taking it out of the states hands though. Think about it. No more top down on a political whim, no more reorganisation without a mandate etc. I know this is being simplistic but the idea has its attractions

And enough money might be put in to facilitate better care?
And not so many scandals?
And the people have more control of health services than they do now?

Sorry whitewave, that was very esoteric and off topic. Excellent and fascinating thread.

So if you are in CMU C do you not pay top-up? The Brits in CMU do, though. And CMU is really the catch-all for anyone not in a different Caisse isn't it? My neighbours on the breadline will be in the MAFF caisse I think as they were agricultural workers.
Obviously the serious conditions are covered 100% but you don't really notice that if you have top-up do you?

Mamie I think this is what you were thinking about re. aid for those unable to afford top-up medical insurance:

The CMU Protection Complémentaire (CMU-C) provides free health insurance cover for those on low income, whether unemployed, employed or self-employed.

I couldn't find reference to how little one needs to earn before this is available.

We pay roughly the same amount as you per month in top-up, and also consider it as just being another monthly bill.

The state would be responsible for legislating with regard to what the insurance company could or couldn't do, but day to day running and care level would be left to the consumer via their insurance.
What I absolutely would not give way on would be say for example a two tier system according to what you could afford - everyone should get the same level. And it MUST be universal and comprehensive.

dj yes I agree. But I really fancy the idea of taking it out of the states hands though. Think about it. No more top down on a political whim, no more reorganisation without a mandate etc. I know this is being simplistic but the idea has its attractions

whitewave, thank you, you are working very hard on a really interesting topic!

DS and DiL are very happy with the Dutch health system but not some other things like maternity leave. I suppose all countries have something better and something less good.

Something I don't think has been covered is the waste within our NHS. All the talk is usually about doctors and nurses but the admin can be very wasteful. We have current experience of this which I won't detail here but it is entirely because of useless admin that DH has been waiting for his op since October when he was told it would be 'before March'. The latest info is that it will be mid-September.

I recently had a conversation with my GP and he agrees with the 6% of NHS budget which is spent on private healthcare. He says that if companies like Specsavers can do cheaper what the NHS does and just as efficiently that is OK with him. He thinks we need educating to take more care of ourselves and cited an example of a patient who turned up with diarrhoea and, when asked how long he had had it, replied '2 hours'. He also thought that too many people go to A & E not because they can't get appointments with their GP but because they can't get them just when they want them. I wonder if triage nurses were encouraged to send people away if they didn't really need to be there whether people would be educated to be more responsible?

The reason the government has to look at this is because they promised they would not raise taxes or NI. Many people said they would not mind an increase in NI if it went on the NHS.
What's the difference between the government collecting NI for the NHS and a not-for-profit insurance company collecting insurance for the NHS?

I know when I was admitted as an emergency in France with crushed vertibra it was an oasis of calm with gentle background music.

It isn't off-thread joy that is what the French do 18 Euros a day. They can take out an insurance to cover it. So worth a consideration.
Also I didn't mention it at the time but nurses in Spain don't do personal care like feeding and washing - that is left to the family - not sure if you haven't got family?

I don't know if there is a cut-off income where you are exempt from top-up insurance; do any of the other French resident posters have any info on that? I do know that glasses, hearing aids and dentistry are a worry for lots of the neighbours (average household income in our village is less that 12,000€ pa).
For us, the health insurance is just another regular bill like car insurance and house insurance. On balance the cost of living is about the same as the UK for us.
There is inefficiency in the system though I think. When I went for my four monthly prescription renewal I had a 30 minute full check from the doctor. She said she couldn't work in the UK with such brief consultations. I pointed out that a lot of what she had done would be done by a practice nurse (never come across one here) and she said yes, but this is all preventative medicine too. Maybe she is right?
The taxi system is a bit mad I think. My neighbours have taxis to regular medical appointments (20-50km away) about five times a week.
The over-prescribing is getting better especially with younger doctors. And nobody seems very stressed. When OH was in hospital there were lots of doctors, nurses and ancilleries around. If we go for an x-ray appointment they say, "When would you like to come?".

I believe that adult patients in NHS hospitals should contribute towards the cost of their food. I spent 6 weeks in an ante-natal ward before my third child was born and munched my way through a fair amount of food! Admittedly it wasn't gourmet quality, but the cost of it, and the labour to prepare and serve it, must have been considerable and I would have been happy to pay towards it. Does anybody know roughly how many people are in UK hospitals at any one time? A £5 (or even £3) a day contribution from patients (with some obvious exceptions) would generate a worthwhile amount towards the NHS income, even allowing for inevitable admin costs. Okay, it's a drop in a huge ocean, but better than nothing.

Sorry, this is a bit off-thread and doesn't really address the long term solution to be debated as in the OP, but I do feel it is a relevant issue and something which could be implemented in the shorter term while the overall answer is pursued. Being ill shouldn't automatically entitle us to free food in my opinion!

(Of course lots of people would claim they never touch hospital food and live off take-aways and the offerings of their visitors... hmmm . I noticed in one post that in France there is a charge for 'board and lodging' so maybe that is the answer... a sort of 'all-inclusive' deal to cover electricity for phones, loo rolls etc!)

I think to, that when I think of an insurance based system I think of the horror that is America, but clearly if the insurance companies are highly regulated non-profit making then it begins to make more sense to me.
What would be so good is if whilst the state ensured equal healthcare for all through its regulatory system, but the actual running was taken away from the state and therefore depoliticised that would in my opinion be an excellent way forward as all the ideology and continuous change would be got rid of.

Also before I am convinced I would be absolutely sure that the less privileged have exactly the same healthcare, and it would be comprehensive. I do like the idea of I think it is the Dutch which insures for long term care that would get the elderly sorted.

Don't know gg. Rather surprising to myself I am beginning to see that other systems may well be OK ,although this is only an overview and not a thorough comparison.

I am also aware that some are under pressure like the French system, although others as far as I am aware are functioning without problems like I think the German and Netherlands.

I find it interesting that although they are using insurance based models the companies providing the service are not for profit. Where we are using private companies this is by no means always the case.

I do not know but I wonder if the Christian exemption is because they can support nun run hospitals (?)

Yes It seems that most individuals in our countries so far pay quite a bit more than in the UK I will eventually return to compare.

Just to add to Bez's explanation. Our top-up insurance in France is about 150€ a month, so not insignificant.
We find that income tax is lower than in England but the equivalent of NI contributions are much much higher which, as Bez said, puts a huge constraint on businesses, especially small businesses who struggle to employ anyone (when we ran our gite business about 50% of our total income was taken.)
The service is excellent but the costs are quite high.

Oh! Meant to say that the Netherlands system was entirely overhauled in 2006. So something our government may be looking at.