Imagine life without the NHS?

Karmalady
I agree 100%

Grammareto
No matter how miniscule still eating into our NHS that people have & still paying into though

ExDancer

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

You die. ?‍♀️ Look at where the US is on the life expectancy charts. Given that they spend a massive amount of money on healthcare, the results are not good. en.wikipedia.org/wiki/List_of_countries_by_life_expectancy

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.

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

So would I (and probably lots of other people) but there is none at the moment.

So one can only go by what scant evidence there is. And that is we have been talking to US healthcare providers. At least, Rishi Sunak has.

Having searched, I cannot find any evidence that we are talking to our European-wide neighbours.

But - I'm not into hype or scaremongering, so here is the most unbiased report I can find on Sunak's Californian visit. Which does, to some extent, negate my assumptions, but in the interests of objectivity, here it is...

Rishi Sunak’s overture to US healthcare companies is likely to raise the alarm to many who have vehemently opposed American-style healthcare privatisation.

Images of US-style hospital bills have gone viral on social media in recent years, with life-saving treatments plunging patients into a future of debt.

While it is tempting to catastrophise – and political opponents will no doubt seize on the perceived threat to public healthcare within the UK – the meeting should be viewed in the wider context of health and science investment.

Mr Sunak’s “lines to take” (the talking points you often hear repeated by politicians) were based around investment into the UK life science sector, which has been a key tenet of championing Britain’s post-Brexit success around vaccines, with Cambridge-based AstraZeneca proving a success story exiting the pandemic.

It’s likely that the meeting was more of an encouragement to tempt investment, rather than a Machiavellian sell-off of the NHS behind closed doors.

Four out of five attendees of the meeting work in or around the social care market, which is already dominated by the private sector.

Four Seasons, one of the biggest operators in the UK, is owned by Terra Firma, a private equity firm founded by former EMI chairman Guy Hands.

It’s no secret that the Government is trying to reform the social care market and has been trying for years previously – Theresa May’s attempt to remedy the issue in 2017 with the “dementia tax” was considered to be the first step of her downfall as prime minister.

Chris Thomas, principal research fellow at the Institute for Public Policy Research, told i: “The evidence is clear – relying on big business and private equity to deliver social care services has failed.

“Publicly funded care is better quality for those who draw on it, more cost-effective overall, and means better pay and conditions for care workers.

“Health and care are in crisis. Millions are languishing on waiting lists – or going without the social care they need. Having failed in a bid for private investment from abroad, it’s time for the Chancellor to bring forward Government funding and a plan to revitalise these cherished public services.”

A Government spokesperson said: “We have a strong track record of promoting overseas investment to the UK to boost our economy and level up the country.

Somewhat reassuring. But I personally would prefer they (government) would also look at European models of health and social care.

One of the big differences between the US and UK business culture is the way that each defines "success". The US is noted for its love of capitalist enterprise, and this tradition affects the way Americans view and understand "success".

It's purely personal, but I'm not wedded to that ideology.

karmalady

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

We don't 'pay for the NHS'. The state, with our mandate (that is, the government that we chose, democratically, to run the country) invests public money, which is mostly created by the state, in public services.

So, if you vote for a government that proclaims it wants to limit or cut state spending on the NHS that is what you get, less spending, with the resulting decline in the quality and quantity of the service it offers. You have given it a mandate to reduce NHS funding.

You also get a declining domestic economy because there is less money available to pay salaries and buy goods and services..

State spending is limited by what is available to purchase, not by how much money it takes in taxation. If voters could understand that we might have much better national decision making

(Though, TBH, most countries subscribe to the taxation myth...)

Thanks, Dickens. Where is that Rishi stuff from, please? I'd like a link to the original if possible.

karmalady

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

Do you mean new born babies needing help karmalady or perhaps people like my late grandmother who like many of her generation did no psid work after she married and had her family? Or people who were born with conditions that left them unable to "contribute"?

Perhaps you could clarify your point?

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!

I envy you being able to find some sort of optimism about any plans this government have for me. If that’s doom laden sobeit.

HousePlantQueen
I am certain Karmalady doesn't mean new born babies, no doubt you knew that aswell ... health tourists come over not paid in & use the NHS ... yes my daughter told me people at her work they come here, then their relatives just pop over for operations their relatives ... this is surely wrong ... also years ago ladies didn't work as looked after their families it was men that worked , sure she didn't mean this either ... saying that I am not getting into a debate or argument, as people will or won't agree

Health tourism is thrown in as a distraction and accounts for very little. It's amazing how many people know someone who knows someone whose neighbour works with someone who had a relative who flew into UK just for medical treatment Perhaps I live a sheltered life

Baggs

Thanks, Dickens. Where is that Rishi stuff from, please? I'd like a link to the original if possible.

inews.co.uk/news/politics/rishi-sunak-met-private-us-healthcare-firms-uk-social-care-market-health-nhs-1702556

There are other reports, interpretations, etc but they were heavily biased (both ways) so I chose this as I thought it the most objective one.

Thank you!

HousePlantQueen

Health tourism is thrown in as a distraction and accounts for very little. It's amazing how many people know someone who knows someone whose neighbour works with someone who had a relative who flew into UK just for medical treatment Perhaps I live a sheltered life

Yes, there are so many who know someone who knows somebody else who knows about the final someone who flew into the UK for medical treatment. It's kind of amazing that we don't all know one of these someones, but I've not yet met anyone who does actually know, erm, someone who did.

If you see what I mean. And if you do, please tell me because I've now confused myself.

MaizieD

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.

I know that I'm incredibly thick but I do understand borrowing, quantitative easing etc but I still don't understand why, if spending s not funded by taxes, we pay any kind of tax at all.

What can be confusing re 'health tourism' is that anyone from a country with a reciprocal agreement can get certain healthcare here (depending on the agreement).
Anyone gets emergency & public health treatment (as in most countries around the world)
Depending on the agreement, the NHS (or strictly speaking, the Health Trust concerned) seeks redress from the country where the patient resides. It used to be thought that the administration costs were not worthwhile, but I know that before I retired (2010) that Trusts had set up systems of payment.
I certainly knew that some patients I cared for appeared to getting NHS care, but their home countries were paying for it.

Maybe, I am a little biased, having worked for 40 years for the NHS, but I prefer a system which treats according to need and not whether the insurance company is prepared to cover.

I believe that the proportion of the NI that is used for the NHS is less than the US insurance contributions. It also covers social care, statutory sick pay and state pensions, As I am retired, I no longer pay NI anyway.

Yes, of course we all pay towards everyone’s care, not just our own, but that is true of any insurance policy. I have (so far) never had to use my house or contents insurance but I know it is there if I need it. I also know there are people who have had to use it several times. I don’t resent that because the time could come when I do need it.

Because I have worked for the NHS, I am aware, perhaps more than some others, that there is plenty of room for improvement in the NHS administration. Until that happens, I am happy to rely on it for my care. I have had to use it twice for my care since I retired, once for a knee replacement and once for injuries sustained in a fall. I have had surgery, nursing care, X-rays, MRI scans, emergency paramedic care (in the latter case), physio, hydrotherapy, out-patients appointments— the list goes on. All I had to shell out were taxi fares, until I was able to drive myself again, petrol and car-parking.

Incidentally, at my local hospital, parking was only brought in originally to discourage the public from using the car park while they commuted for work leaving no space for patients or staff. It went towards paying for parking attendants too.

The government primarily funds its spending on the economy through tax revenues it earns. However, when revenue is insufficient to pay for expenditures, it resorts to borrowing. Borrowing can be short-term/long-term and involves selling government bonds/bills. Treasury bills are also issued into the money markets to help raise short-term cash.

corporatefinanceinstitute.com/resources/knowledge/economics/government-spending/

Is this incorrect, then?

Thank you Joy for reminding me of how lucky we all are.

Glorianny

I'd never thought of what it would really be like until I read Barbara Kingsolver's Unsheltered. It's the story of a middle class educated US couple whose world falls apart when he loses his job. Along with it goes their health insurance. But it was the fate of the husband's father, reliant on them, suffering from diabetes that shocked me. I realised how much we take for granted, the supply of equipment, the clinics which maintain health and the health professionals who provide care. Reading about having to watch someone slowly lose their feet and legs but be unable to get them treatment until your finances hit rock bottom and you qualify for state help was shocking. Are we really able to imagine life without our NHS or do we take it for granted because it has always been there?

The government have imagined it and decided that is what they want. There have been enough "Elizabeth's [27 Mon 29-Aug-22 12:34:28] to enable them it seems.

Not a single government has had a mandate to move away from the NHS model.

I am not sure we have to imagine it? A lot of people are having trouble accessing NHS care these days. And unlike the USA we don't really have a private system to fall back on. There are private health facilities but on the whole they are for elective treatment and do not have emergency care for things like heart attack and stroke.

The tories are doing exactly what they have done to NHS dentists to our ordinary GP services, its very difficult to get an appointment, the queue is long & drugs etc that used to be free are now charged for. Truss is planning to bring in costs to see a GP & whilst I can pay that now, I would have struggled in my younger days. I want me and everyone else, especially poor people, to get health care, the NHS is a magnificent thing.

I'm voting Labour next time, they set up the NHS & will help it recover asap.

We have all paid for it in our working lives ,I worked many unpaid hours for the NHS as a registered nurse for 25 years. I am now 77 with health needs that are not being addressed ! Feeling very angry ! Dont blame Covid the NHS has always been misused. Badly managed , and wasteful Staff except management are amazing. Underpaid and overworked. Rant over !

Yes but we are helping to look after those who can’t. That’s the basis of our national ‘personality’, as I used to understand it. My great-grandmother who looked after her parentless grandchildren and disabled daughter until she no longer could, at the end of her life had to be institutionalised in what was once the workhouse hospital for old people with dementia. As a nation, we all decided we wanted no more of this.

DS went to visit a relative in LA USA. He had a mouth infection easily treatable here in UK with over the counter medication from the chemist. Not in USA.
Doctors appointment needed so $100 then $80 at the pharmacy.
Here it would be less than £10 for identical medication.
So anyone in USA that can tell me are there any free charity hospitals or clinics for poor people that are free? And why doesn't the insurance cover everything- is it a huge excess on all the medical insurance that you get? Does the state help at all if you are unemployed? I'm interested in the system there as I see so many crowd funding from American citizens

Callistemon21

MaizieD

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.

I know that I'm incredibly thick but I do understand borrowing, quantitative easing etc but I still don't understand why, if spending s not funded by taxes, we pay any kind of tax at all.

Aha. Missed this one yesterday.

Richard Murphy has blogged about the 'National Debt' today. He likens it to a state overdraft with the Bank of England. He has this explanation of what taxation does:

When the government wants to spend the Bank of England will always (because the law requires it to) pay whatever it is told to do. It does not check the balance on the government’s bank account with it first. It simply creates an overdraft, if need be.

This is not a problem for two reasons. First, that’s because tax comes in pretty regularly, especially in a country like the UK where most people pay their taxes. Those taxes then help clear the government overdraft at the BoE.

I stress, those taxes do not pay for government spending. What they do is clear the overdraft created by the spending, which is something that is economically and politically quite different. Tax controls the overall money supply and inflation. It doesn’t fund spending.

I've tried before to explain that taxation acts to reduce the amount of money that the BoE has to create, but this seems to put it in a more understandable way.

What do you think?

www.taxresearch.org.uk/Blog/2022/08/30/leaving-debt-for-the-grandchildren/