Imagine life without the NHS?

My father (gone now, born 1911) remembered his parents being visited by Dr Hastings Banda (later PM of Malawi) in Liverpool. He did not do any doctoring until after he had received payment. This was just the way it was. Apart from the obvious money upfront problem my worry (and with dental) is that private actually gives the practitioner an incentive to get you nearly better so you return often! They do say 'buyer beware'!

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 can't queue jump if you don't join the queue!

That sounds easier to understand, thank you.

So those nice pie charts telling us how our tax is spent which are sent out once a year are pretty meaningless, then.

Tax is used primarily to redistribute wealth.

So Truss who intends to cut tax is showing her belief of small state and no move towards greater equality.

In 2007 I felt ‘peculiar’ and phoned 111. They sent an ambulance and a paramedic. So began a 3month stay in hospital. I had what was referred to as a catastrophic pulmonary embolism. I was in surgery almost all night and received the last rights. When they could do no more for me my family were approached and asked if they would agree to a then experimental treatment. They did. I spent three weeks in intensive care, unconscious and then weeks recovering. The staff did everything they could going above and beyond. The cost of my treatment must have been astronomical. I am alive because of the NHS. Under a privatised system such as that in the USA Iwould be dead. I hate this government for their persistent under funding of the NHS as well as there lack of investment in training new doctors and nurses.

Whitewavemark2

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

Sadly, it hasn't stopped them WhiteWave. They have lied.

However, the country shouldn't believe we don't need to update how it works. We will have to accept the use of communication technology for instance.

The one thing we have to keep repeating is that we paid for a service that would be "free at the point of delivery". It is no longer the case. The worst is that the initial or simple treatments are what governments have chosen as "paid for" treatment. This system will store up many more expensive problems for the NHS and those who cannot afford to pay.

Not sure if anyone's already mentioned it but Lionel Schrivers book So Much For That gives a shocking insight into how quickly a family in the USA can spiral into debt when a family member suddenly falls ill.
Not all medical insurances are equal. Some only cover the basics.
It's a good read as well ?

CountessFosco

Under the French system, we paid 25.00 Euros for each GP visit. This was then reimbursed from the State after ca. 6 weeks. For specialist care, a referral is needed. This sometimes costs 50.00, a portion of which is reimbursed but not a great deal. However, it does tend to stop malingerers who have to pay up-front. System by and large works well. If you are indigenous, then the State picks up the tab. Same applied to Belgium, but definitely not to Switzerland, where the cost of health insurance is horrendous!

I agree with you that this seems to work well, but wonder what the true cost of billing and reimbursing the charges actually is? I suspect that, although it may deter some malingerers, it may not actually save much money.

icanhandthemback

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 can't queue jump if you don't join the queue!

Actually yes, you can. The shananigans that go on are just unbelievable. And mostly the same surgeons too.

shenanigans!

If y surgeon tells you he has a 16 months waiting list, but can operate next week at Spire or Nuffield?

What a fantastic story Mouse, so glad the NHS gave you that chance and for you to enjoy life and tell the tale. Wonderful.

Callistemon21

^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?

It's incorrect.

Here's the abstract from a recent academic study of government financing. A bit more technical than Murphy's explanation.

Abstract
This paper constitutes a first detailed institutional analysis of the UK Government’s expenditure, revenue collection and debt issuance processes. We find, first, that the UK Government creates new money and purchasing power when it undertakes expenditure, rather than spending being financed by taxation from, or debt issuance to, the private sector. The spending process is initiated by the government drawing on a sovereign line of credit from the core legal and accounting structure known as the Consolidated Fund (CF). Under directions from the UK finance ministry, the Bank of England debits the CF’s account at the Bank and credits other accounts at the Bank held by government entities; a practice mandated in law. This creates new public deposits which are used to settle spending by government departments into the economy via the commercial banking sector. Parliament, rather than the Treasury or central bank, is the sole authority under which expenditures from the Consolidated Fund arise. Revenue collection, including taxation, involves the reverse process, crediting the CF’s account at the Bank. With regard to debt issuance, under the current conditions of excess reserve liquidity, the function of debt issuance is best understood as a way of providing safe assets and a reliable source of collateral to the non-bank private sector, insofar as these are not withdrawn by the state via quantitative easing by the Bank of England. The findings support neo-chartalist accounts of the workings of sovereign currency-issuing nations and provide additional institutional detail regarding the apex of the monetary hierarchy in the UK case.

The findings also suggest recent debates in the UK around monetary financing and central bank independence need to be reconsidered given the central role of the Consolidated Fund.

www.ucl.ac.uk/bartlett/public-purpose/sites/bartlett_public_purpose/files/the_self-financing_state_an_institutional_analysis_of_government_expenditure_revenue_collection_and_debt_issuance_operations_in_the_united_kingdom.pdf

Taxation did use to finance spending but since sovereign money (i.e money issued by a government) is no longer backed by gold or silver this no longer applies. But old beliefs die hard...

The NHS is not perfect but it's a lot better than the US system and a lot of other countries outside the EU. France has an excellent system similar to the NHS except one pays a modest, partly reclaimable fee to see the GP (and in my experience it's often a same day appointment) and a co-payment for hospital treatment but most French people have a mutual, nonprofit insurance policy for a modest monthly outlay which covers the co-payment. Before the NHS only the rich could afford hospital treatment and the GP; the very poor - if lucky - were treated free by charitable GPs and local hospitals set up by charities and some local authorities but the people in the middle - the working class and much of the middle class could not afford to pay. My grandfather had two fingers amputated on the kitchen table by the GP. We do not want to go back to those days or to a system driven by profit.

Yammy

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.

This is not strictly true. My DiL has kidney problems and has had private treatment through her employers' health insurance. However she had found that the NHS treatment at a specialist centre was far better.

I’m sitting on a ward right now, waiting to have my second hip replacement. I have osteoarthritis. I’m 56 and I know that other joints may need replacing too.

Two of my family have epilepsy.

No, I can’t imagine life without the NHS, because our insurance premiums would be sky high.

Fleurpepper

No, I can't imagine, as it is (well, was) the best system in the world.

What happens under the French system about pre-exisiting conditions? If we have to move to a Health Insurance system, it has to ensure 2 things a) that those who can't afford it are covered by a safety net. Having 10% of the population not covered as in the USA is just NOT acceptable. And b) that Insurers cannot refuse or exclude pre-exisiting conditions or some conditions.

A woman we know was refused permission to emigrate permanently to Canada (where she had a home and a small business) because she has a chronic health condition. This was despite the fact that they made it clear that they would pay for private health insurance.

The one thing we have to keep repeating is that we paid for a service that would be "free at the point of delivery".

The thing is that we haven't paid for a service, DaisyAnne. What we have done is consistently mandate governments to provide and pay for the service from money they can issue into the economy on our behalf.

If we were all a bit less accepting of this 'taxation funds government spending' mantra we might not accept the 'we can't afford to pay for it' lie that we're given.

See my post at 12.36.

Before the NHS I remember hearing my parents discuss whether or not they could afford to call the doctor to come to the house. If I remember correctly, the cost was 3 shillings and sixpence a visit. We are very fortunate that we can call the doctor to come to visit a sick relative without having to worry about the cost,

My daughter and her family emigrated to the USA and have top of the range health insurance. Even so, there's always a bill to pay for any medical procedure, however small. They have also found the system quite difficult to navigate, as they can only go to doctors, dentists, hospitals, etc, that are specified by their insurers.

Four years ago, I was extremely ill in hospital and the doctors had to try several different drugs to try to stabilise my heart. My daughter said later that, if I had been in the USA, the doctors would have had to get authorisation from the insurance company before they could try the different drugs.

She had a friend who was dying of breast cancer and there was a drug which would hopefully prolong her life, giving her more time with her young children. The insurance company refused to pay for it. Her husband had to go through a legal battle to get them to authorise it, which they eventually did but the cancer had, of course, got more of a grip by then.

The NHS isn't perfect, by any means. Last year, our other daughter had to have an operation for thyroid cancer and needed another to remove the rest of her thyroid in case it had spread. The waiting list was so long that we ended up paying £6,500 for her to have a private operation, because we were scared for her to have to wait. My daughter in the USA said that her sister wouldn't have had to wait if she lived there - but the operation could have cost ten times as much or even more.

I asked her how people managed if they had no insurance, or if they had a long illness and their insurance ran out. She said that she had no idea, and that she thought they didn't manage. They went bankrupt and often lost their homes.

It horrifies her to see that the UK seems to be sleepwalking towards a USA - style health care system. She says that we don't know what we're losing.

I have been considering growing opium poppies in my garden. It would be easy to make a simple tincture of the seed oil.

I'm with GreyKnitter . I am the mother of an insulin dependent diabetic, and the godmother of a child with severe and complex needs. Neither of these would be insurable in America. Thank heaven for the NHS.

MaizieD

^The one thing we have to keep repeating is that we paid for a service that would be "free at the point of delivery".^

The thing is that we haven't paid for a service, DaisyAnne. What we have done is consistently mandate governments to provide and pay for the service from money they can issue into the economy on our behalf.

If we were all a bit less accepting of this 'taxation funds government spending' mantra we might not accept the 'we can't afford to pay for it' lie that we're given.

See my post at 12.36.

Oh dear Maizie, we can't all be purists. You are right, we were told we had paid for it.

Not that you aren't right to keep saying it. I applaud the work you are doing.

I don’t agree - the NHS is a total failure and after over 15 years has failed to diagnose that I have genetic HAEMOCHROMATOSIS aka ‘ The Celtic curse ‘ as I’VE discovered that I have more than 75% Celtic genes ! And sadly most GPs haven’t a clue what they’re talking about and as my wondeful oncologist says do ‘ diagnosis by Google ‘ ! Ask around how many people are TOTALLY misdiagnosed by UK GPs ! BTW, many moons ago I got a 1st Class Honours degree in Biology and genetics, so I DO not what I’m saying !

I can imagine life without NHS. I can't see a doctor, lucky if I get a phone call. My prescriptions are the only thing I benefit from, oh, plus a once a year eye test and a check-up at the dentist . . . which still costs!