The Tipping Point

I imagine all the people in the video are going to vote to stay in the EU.
All 150,000 of them.

www.thepeoplesassembly.org.uk/r?u=https%3A%2F%2Fwww.facebook.com%2FThePeoplesAssembly%2Fvideos%2F1077193889015167%2F&e=4f295de050c123204df7f4a5c79d8428&utm_source=thepeoplesassembly&utm_medium=email&utm_campaign=convoy2calais&n=6

This is worth watching. For those who want to feel heartened by the opposition to this government's authoritarian ways.

There was an article in yesterday's i from a medical student in his fourth year.
He has abandoned his plans to work in A&E.
He conducted a survey last November and over two thousand students responded.
89% said that when they first started they had hoped to end up working in England.
Only 4% hoped to work abroad.
Now 75% felt discouraged from selecting a speciality in the NHS.
81% will not apply for A&E because of the imposition of the contract.
85% said they would probably leave the NHS, either going abroad or working in a different area in the UK, outside medicine.

This should be worrying the NHS, and Hunt in particular.

I don't think that I advocated that Iam64, because I certainly don't think it. In any case how can anyone know what their health circumstances are going to be from month to month reference to how much or little you should pay?!! I agree it should be via taxation, but will this ever be enough without resorting to outside help?!

Of course we should all pay according to our means,that is through taxes etc towards the NHS. The notion that those who use it less should pay less is a real shocker. Those of us who are fortunate enough to live into our 80's before we're hit with serious or chronic health problems are very fortunate. If I was in that category I'd be very happy to be paying in and not needing a lot.

Like many others we have hardly used the NHS during our adult lives, but it was always there just in case! Now with the advent of Hpertension and Prostate Cancer we are using it more and more and we both feel extremely grateful for all the wonderful and compassionate care that we have and are getting without the worry of finance. However, affording an ever increasingly expensive institution is a serious worry for every thinking person in the UK. There are so many other organizations crying out for money, Education and the Prison Service to name but two, and keeping all these financial balls in the air must be well nigh impossible. No answer from me as I simply don't know!

That is exactly how the welfare state was set up, it wouldn't work any other way. There when needed, let's hope we are lucky enough never to need it. But like house insurance we are all covered and we all hope our house will never burn down, but we are not willing to take a risk and assume it won't and not have house insurance. At least with the NHS we all pay the same according to means, but with house insurance some poor souls have difficulty getting an affordable premium, because of flood risk etc.

Quite right, trisher. I've been lucky enough to have enjoyed good health and rarely needed the NHS, apart from giving birth. If I need more help now as I get older, I feel I've paid my dues. Either way, I'm more than happy to have paid towards those who need it more.

I really don't understand this business of the working population needing the NHS least. Some of the elderly need treatment some younger people do as well. My DIL is involved in removing decayed teeth from young children and the cost of that to the NHS is enormous. I have family who have had expensive and excellent treatment and they are working age. The point is that they receive prompt and good treatment that enables them to return to their working lives asap. Perhaps we should all have our family medical histories looked at and those of us who happen to be reasonably fit should pay less? Nonsense? Of course it is. The NHS is there to care for everyone and this idea that some of the population should have to pay more, or less, is ludicrous.

Have you had hip replacements in both countries to compare the two, annifrance? I know the NHS has its problems - as I'm sure all systems do - but my DBIL has had three hip replacements here. Two last year - one privately, one on the NHS - and the latter one was the best experience despite it being a very complicated procedure, with superb aftercare, including regular physiotherapy at his home which led to a very quick recovery. I can't imagine what you got for your 1000 Euro top up that made it worth every sou. But I'm sure others will have had bad experiences of the same operation, in the UK and on France.

Of course we need to look carefully at our failings and the plus points of other systems to improve our own, and I agree that the admin of the NHS can be dismal, but we have plenty to be grateful for too. Yes, the WHO ranking puts France at the top in Europe, and ours is only 15th - though interestingly this is higher than Germany, Denmark or Switzerland - but there are other ranking systems that put the UK and France much closer together. The Euro health consumer index, for example, which has them at 14 and 11 respectively.

I think there should be a referendum on the future of the NHS - it belongs to the people and not to the government of any shade to do whatever it wants at the time.

I have two cousins who live in Australia, and the one thing they miss and envy us for is our health service. (not our weather!!) One, now she is getting older is finding their system quite burdensome. Our Dutch friends are completely amazed at all the free health care we get. I couldn't quite gather what their system is, but I think it's a mixture of free, and private insurance. Dare I say it, but perhaps money could be saved on the cosmetic surgery front which is purely for vanity reasons? Perhaps people getting blind drunk and ending up in A&E.could incur a financial penalty? I know, how do you get them to pay?!! As has been said, a small raise in income tax specifically for the NHS would be preferable to Insurance premiums; but would it ever be enough?

Yes the answer is that we need to pay just a tiny bit more tax. Which would be a blessing compared to the alternative of paying for private insurance. Which of course gets more expensive the older you are.
I've been visiting family in NZ and Australia where they have more fragmented systems. In NZ people pay for GP visits, hospital treatment is free but a lot of tests etc seem to be privately run. e.g. blood test centre in city high st.
The Australian system is 2 tier - with a kind of NHS-light for poorer people while the rest pay very heavy insurance cover for the kind of level of care we have grown used to in the NHS.

Blimey rose that deserves a drink I'll meet you down the pub

It is a big problem niggly I admit, and probably taxes will need to go up at some point.

None of us know when we may need it, and it is not unfair that the ones who pay most ( working, and younger) are the ones who need it least. I agree with djen and Whitewave on this (maybe much to their surprise)

I agree totally in the original aim of the NHS, but not only was the expectation of people living into their 80's or 90's pretty minimal, but also the very expensive treatments that are now thankfully available were not even anticipated in 1948. Apart from taxation which I don't think would ever be enough, how else can this goliath be funded other than by private means? I really don't know what else you can do.

Not quite sure what you mean, ww. When it was set up, the original idea was for it to be an insurance scheme rather than one generation paying for the next, but it was realised that the elderly wouldn't be included. There wasn't enough money at the time to pay for the elderly who hadn't contributed, so that's we have the system we have.

Life expectancy has increased ten to fifteen years since 1948 and it wasn't expected that the NHS would have to be for people well into their 80s. About 40% of the NHS budget is spent on the over 65s, many of whom wouldn't have been expected to be alive when the NHS was set up.

To be honest, I just can't see that it's sustainable in its present form. Working people are being squeezed and I don't think they can contribute much more. If the NHS is going to remain free at the point of delivery, somebody is going to have to be taxed much more. If you look at Treasury figures, it's difficult to see where £20bn or so can come from. I don't know of any other country where pensioners don't pay for health care if they can afford it.

According to the IFS, median pensioner household income after housing costs is now higher than the median working household income.

www.ifs.org.uk/publications/8026

I don't earn enough to pay tax, but I pay NI. I don't mind paying for ill people, but I do mind paying for people who have a higher income than I do, but don't pay anything, didn't pay as much when they were of working age and retired earlier than I'll be able to do. Younger people will be even more badly affected. Sorry!

I think that is where we disagree daph I firmly believe in the original aim when the NHS was set up, indeed when the entire welfare state was formulated,

Nobody knows when they are going to need the NHS. That's why everyone pays into it when they are working, just in case they need it.
It is still supposed to be free at the point of need.
Those who need it least should just consider themselves lucky to not have needed it. It's like any other insurance.

I certainly agree with you about extending the upper limit. The lower threshold is £8060, so some people pay NI but not tax. Above £43,000 employees pay a lower rate of NI, so some higher earners, even those in the higher tax bracket, end up paying a lower combined percentage of tax/NI than low earners. Some (admittedly a few) pensioners have a higher income than low/average paid workers, who are the ones being squeezed.

I also agree with you that NI should be ring-fenced. Obviously pensioners wouldn't pay for the unemployment element or the pensions element, but I've always thought that it's unfair that the people who pay most for the NHS are the ones who use it least.

That is a thought daph If I thought the NI was ring fenced for welfare and the NHS then I would very much consider the proposition that everyone should pay within their means. How about the idea of no upper limit, or at least extending it?

Annifrance, I'm sure you're right about hip replacements. I've never had one, so I don't know. I do know that my daughter had an accident in a playground in France years ago and almost lost one of her toes. We had to wait hours for her to be treated and the bill came to over £300, even though we had a health card and insurance. We had to pay for dressings and antiobotics upfront. The paperwork to reclaim the money was so complicated that we gave up.

As a nation, France pays about 25% more for healthcare than the UK, so maybe it's no wonder it's better.

I'd better get my hard hat here, but pensioners in almost every country I know, except the UK, pay for health care and I wonder how much difference that makes. National Insurance in the UK is now 12% and pensioners don't pay, although they pay income tax. Successive governments have kept income tax low, but put up NI. For most working people the amount taken by the government has ended up being about the same, while the demands on the NHS from an ageing population have increased.

Daphnedill I didn't mean the GDP but the actual cost of medication, surgery etc. I can't remember the details without looking them up, but I had a schedule of costs for the hip replacement I had and it was considerably less than the cost under the NHS I am reliably informed. For said operation I paid a little under €1000 all told as I do not have a top up insurance. Worth every sou to have it here in France. So much better after care too.

Pensioners pay into the health service in France according to their income. I basically get it being on a British state pension, but pay taxes on the modest income from our gite.

Anya - re taxes in France - as you say, when working you have to be prepared to pay a lot for what you get out. Income tax plus our equivalent of NI can add up to more than half of your basic salary. And that's not just for the "rich."