Imagine life without the NHS?

shenanigans!

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

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.

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.

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 ?

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.

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.

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.

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.

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!

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'!

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/

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

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.

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 !

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.

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.

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

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.

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

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?

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.

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.

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.

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.

Thank you!