Imagine life without the NHS?

I’m reminded of a very disturbing book I read many years ago.
It centred on a hospital. The private medical company were killing people who were costing them too much.
Pure fiction, of course.

My sister in the US (widowed, self employed) was paying over $800 a month for health insurance for herself and her young dd years ago - I don’t know about now - niece is grown up and independent.

But Dsis still had to pay a $2500 excess for treatment of a badly cut finger. I was ? when she told me that.

HousePlantQueen

*Beautiful*, the NHS is free at the point of use. I am saddened by comments such as those made by Elizabeth27, private medical insurance is all well and good if (a) you can afford it and (b) you are basically using it to queue jump/get your hip replaced/varicose veins stripped, but private medical companies only provide services which can be costed; they do not have A&E, do not have ICU, and heaven help anyone who develops a life changing condition such as MS.

Even the best private medical insurance will not necessarily prevent you from eventually becoming bankrupt if you are unfortunate enough to have more than one family member with a life-changing disease. It happened to a friend of mine. He ultimately lost his home because of the bills racked up through co-pays, excess premiums, etc, which became overwhelming.

I think we are eventually heading down he USA route to healthcare, certainly with this government... they are not going to touch the 'European' model.

The drawback with private healthcare is that basically everyone needs the most comprehensive cover - because no one knows what's round the corner. If you only purchase the plan you can afford, then you will be in trouble if it doesn't cover your needs - which you obviously can't anticipate.

There will of course be a 'safety net' for the impoverished and the elderly with multiple health problems - one that will prevent you from dying on the street, so to speak. But I know for a fact that my somewhat risky NHS surgery at age 79 which gave me a new lease on life and possibly many more good years of it, will be a thing of the past. And I know because my surgeon told me that I'd be unlikely to undergo such a procedure privately because I would not be able to afford it and private surgeons build up a register-of-reputation, mostly be performing surgery that is fairly uncomplicated with low risk. You'll find many desperate patients in the US looking for surgeons to perform similar kinds of surgery that are more risky, but are turned down, frequently. My consultant / surgeon has 20 years experience in the field and has honed his skills in the same discipline, thanks to the NHS.

How the impoverished here in the UK are ever going to afford healthcare, goodness only knows. Even without the energy hikes, they're struggling.

MayBee70

Baggs

Several geographically European (so not just EU) countries have systems that seem to work pretty well so I imagine that if we didn't have the NHS we'd have sorted out something similar. My optimistic side thinks we could still do this.

So what happens to those of us that have paid into the NHS throughout our working lives? Will that money be transferred to the new system. Also, most of the talks regarding NHS privatisation seem to have been with US companies so I would assume that any new system will be based on theirs. We seem to follow them in most things. Someone’s husband was in talks with the US regarding NHS privatisation recently but I can’t remember who it was? Was it Dido Hardings? It was someone like that.

My post was in the past tense, MayBee, and then the hypothetical. I've no more idea about possible future details than anyone else – probably less idea than most people.

My point was that there are lots of health care systems in other similar countries that seem to work well. I can imagine that gradual changes could give the NHS some similarities to them.

The thread did appear to be asking for what people imagined. Sorry if my inadequate imaginings weren't doom-laden enough or political enough for you!

I warn you not to be ordinary, I warn you not to be young, I warn you not to fall ill, and I warn you not to grow old.

Neil Kinnock, in this instance, was right.

Baggs

MayBee70

Baggs

Several geographically European (so not just EU) countries have systems that seem to work pretty well so I imagine that if we didn't have the NHS we'd have sorted out something similar. My optimistic side thinks we could still do this.

So what happens to those of us that have paid into the NHS throughout our working lives? Will that money be transferred to the new system. Also, most of the talks regarding NHS privatisation seem to have been with US companies so I would assume that any new system will be based on theirs. We seem to follow them in most things. Someone’s husband was in talks with the US regarding NHS privatisation recently but I can’t remember who it was? Was it Dido Hardings? It was someone like that.

My post was in the past tense, MayBee, and then the hypothetical. I've no more idea about possible future details than anyone else – probably less idea than most people.

My point was that there are lots of health care systems in other similar countries that seem to work well. I can imagine that gradual changes could give the NHS some similarities to them.

The thread did appear to be asking for what people imagined. Sorry if my inadequate imaginings weren't doom-laden enough or political enough for you!

Unfortunately, as said above, the UK Conservatives are looking to a system akin to the one in the USA - and that will leave many out, either due to low salaries, unemployment, invalidity, chronic disease, and because those systems (are currently BUPA/Spire, Nuffield- exclude pre-existing conditions, and go up with age, and exclude some conditions, including those they treated in the past.

Many European systems are based on the premise that there is a safety net for all.

ExDancer

I can't help asking Glorianny what happens if you can't, or don't, pay?

Do you know I have no idea. The fact that someone could die and their next of kin could be saddled with a huge debt just shocked me so much. I assume it's the same process as any other debt in the US

As I do not know any Americans, I have watched videos on You Tube about American healthcare and other aspects of their way of life. The cost of health insurance is awful and then there is the co-pay aspect plus you may not be covered at your nearest hospital because a particular insurance is used there as opposed to the one you are insured with!

Many Americans who have left the USA are so grateful that the country they have chosen to live in provides better services for less outlay than they have been used to.

Unfortunately, many Conservatives and especially the current far-right batch of incompetents seem to think the USA way of doing a lot of things is the way to go. It is not.

The Tories have a different way of looking at the world and, try as I might, I cannot understand their way of thinking.

fleurpepper said: Unfortunately, as said above, the UK Conservatives are looking to a system akin to the one in the USA - and that will leave many out, either due to low salaries, unemployment, invalidity, chronic disease, and because those systems (are currently BUPA/Spire, Nuffield- exclude pre-existing conditions, and go up with age, and exclude some conditions, including those they treated in the past. Many European systems are based on the premise that there is a safety net for all.

How do (presumably non–Tory) people know about what the UK Conservatives are trying to establish? I'd love some links if anyone has any.

The safety net premise should certainly be kept. I don't think any UK government would get away with not including that – not for long anyhow.

On the inherited medical debt issue: as far as I understand it, it's not (as with all healthcare things in the States) there isn't a single or straightforward answer. It depends on who the debt is to, and who the next of kin is, and which state you live in. But, generally, if you have healthcare debt, it's taken from your estate. If you were on Medicaid (so state funded) insurance, they can reclaim every penny from when you were 55. If it's a private insurer, they can claim the debt.

If you don't have enough in the estate, and leave a spouse, s/he can be sued for the money, and sometime are, but it is probably less likely with Medicaid (mainly because you'd have to be poor to have been on Medicaid). If you only have adult children, in theory they could be held liable, but it's rare in practice.

If you have children under 21, and certain other extenuating factors, they can't even take the debt from your estate.

Baggs

Several geographically European (so not just EU) countries have systems that seem to work pretty well so I imagine that if we didn't have the NHS we'd have sorted out something similar. My optimistic side thinks we could still do this.

We could, most definitely, in theory.

But is this the model that the current government have in mind? We seem to be talking to US healthcare representatives, namely "Grail" owned by "Illumina" (David Cameron is, or was, a paid advisor).

Are we 'talking' to anyone in Europe?

Having lived and worked under the Scandinavian model, I would not blanch if we ended up going down that route. There are 'co-payments', but they are affordable - in Norway - but then Norwegian wages are considerably higher than here in the UK. There is a ceiling for these co-payments which, once reached, ends the requirement. So no-one is penalised for having a complex or chronic condition. And, 'the markets' have a low level of influence on the functioning of healthcare systems. On a per person basis, Norwegian expenditure on healthcare is the highest in the world.

I very much doubt this type of healthcare model is the one the government have in mind. It is based on entirely different principles of government.

But is this the model that the current government have in mind? We seem to be talking to US healthcare representatives, namely "Grail" owned by "Illumina" (David Cameron is, or was, a paid advisor).

seem is very vague. I'd love some solid evidence.

Are we 'talking' to anyone in Europe?

Nobody seems to know. It would seem silly not to.

Oh heck, more seems.

HousePlantQueen

*Beautiful*, the NHS is free at the point of use. I am saddened by comments such as those made by Elizabeth27, private medical insurance is all well and good if (a) you can afford it and (b) you are basically using it to queue jump/get your hip replaced/varicose veins stripped, but private medical companies only provide services which can be costed; they do not have A&E, do not have ICU, and heaven help anyone who develops a life changing condition such as MS.

you couldn't be more right Houseplant Queen. People take for granted our NHS. Another illness which private health care will not cover you for is Kidney disease or any thing related to dialysis. People who do not have have Kidney problems can develop them at any time through an other illness or even pregnancy.
Also at one time private hospitals would carry out major operations and they did not have blood banks on site and blood had to be brought from the NHS hospitals. This might have changed now but it is something to ask if you are having a major operation privately.Something we should all be aware of as well as the ones mentioned.

nanna8

Yes the NHS is wonderful. We have a version of it but I think it is not as good as yours and we are usually out of pocket with doctor appointments and scripts. Not as bad as the USA though.

I think yours is better than ours now; my Australian family have been shocked by what is happening here with the NHS when they were over.

The NHS wasn’t ‘always there’. It started when I was 8. When I was 9 I was very ill with mastoiditis, operated on as an emergency and in hospital. My parents were always saying afterwards how grateful they had been for the NHS. Of course, being a child I had no idea what they were talking about. I did just take it for granted then. No longer.

So what happens to those of us that have paid into the NHS throughout our working lives? Will that money be transferred to the new system

I didn't think it worked like that, MayBee

We don't each pay into our own pot for NHS healthcare.
What we paid years ago funded the provision then, what we and others pay now funds current provision.

SomeTory MPs have links to US health firms and some contracts have been awarded to them with no competition www.everydoctor.org.uk/blog/private-healthcare-politicians

Glorianny

ExDancer

I can't help asking Glorianny what happens if you can't, or don't, pay?

Do you know I have no idea. The fact that someone could die and their next of kin could be saddled with a huge debt just shocked me so much. I assume it's the same process as any other debt in the US

What happened pre-NHS?
I know home visits by the doctor had to be paid for but my DM was in hospital for months when I was tiny. The family could not have funded that, I know.

Baggs

*But is this the model that the current government have in mind? We seem to be talking to US healthcare representatives, namely "Grail" owned by "Illumina" (David Cameron is, or was, a paid advisor).*

seem is very vague. I'd love some solid evidence.

Are we 'talking' to anyone in Europe?

Nobody seems to know. It would seem silly not to.

Oh heck, more seems.

Plenty of evidence linked to Trump at the time. But can't find any recent evidence, especially as we don't know who will be PM in a couple fo weeks' time.

We can but hope, but all the signs are there that those in the know in the Conservative Party are looking at some sort of US system, which is based on corporate profits, not humanism

Most European have a two or multiple tier system- but where those who can't pay have a safety net, and where all conditions, including pre-existing, and age related, etc, are covered.

The difference between different private levels should be a single room, private TV and Wi-Fi- food menus and a glass fo wine if suitable, choice of surgeon and hospital - it should never be between 'health care' or 'bad or none'. Same for education!

What happened pre NHS was that you paid for doctor's visits and for medication. I have no doubt that there would be a number of charities which would help the poor but on the whole, the less well off struggled, probably going through a shortened life with conditions which would have been treated by the NHS and given them a better quality of life.

To those who think the US system is fine, just remember that the US population has lower average life expectancy than does than that the UK.

And that 10% of a population of 335 + million is an awful lot of people.

I'll get on my hobby horse and remind you, again, that taxation doesn't fund spending and that state investment in the NHS is probably better for the domestic economy than a privatised service as no money is taken out of the economy by the way of profit.

And, while we're at it, the current dire state of the NHS is entirely due to tory governments since 2010 cutting its funding on ideological grounds.

My husband has been a type 1 diabetic for many years and we have a granddaughter with very specific chronic physical disabilities for which she receives treatment both locally and in a national childrens hospital. Thank goodness the NHS is there to support them when their need is greatest.

My DM told me of the horrors pre NHS. How, mostly mothers, put up with things which nowadays would be seen to right away, because they daren't call the doctor unless the condition was life threatening or if a child was very sick.

Recently American friends were involved in a dreadful car crash far from home. They all survived but their medical insurance did not cover the air ambulance or the weeks of staying in a hotel so that the family weren't separated. The mother had the worst injuries and she was breastfeeding.
This couple are well off by most standards but they were very frightened by the huge bills.

I agree that our NHS is underfunded and could be much improved but please let's not throw it away.

we all pay for the nhs, it is certainly not free but is used and abused by people who have never paid a penny into the system

I would guess that number is miniscule karmalady
Most of us pay NI and taxes which I like to think pay for health care and education for all.