To think the time has come to abolish the NHS healthcare model

What relevance has San Fran got? There are many successful models of healthcare, why would we look are the failed American version?

I'm guessing because it adds a level of competition. I have seen far too much complacency in the nhs, staff doing just enough work to keep their jobs, bad attitudes to patients.
And patients also behaving badly, but we can't discharge as no alternatives. But a business can ask a person to leave if they treat their staff badly. So if there are alternatives, we can refuse to treat an abusive patient.

I agree Op, I like the idea of it. But not enough people pay into it to balance the amount taken out of it.
It just doesn’t work. There’s a reason hardly any countries have our model.

I also think it needs to be run a LOT better, that would save us some cash, but our governments (any flavour), seem unable to do this.

This link not only shows different countries’ healthcare spending, but also the split between public and private funding:

https://www.statista.com/statistics/283221/per-capita-health-expenditure-by-country/

YANBU.

Problem is finding someone prepared to take on the job. It's too huge and includes of middle management and secretarial staff losing their jobs which is impossible under their current system cos of legal, nobody in their right mind wants to do it.

You think it would be any different with a different model?

Why do you think another model wouldn’t have the same issue? Do you think some models contain every type of drug, treatment and are at an affordablw tax and co-pay rate for all residents?

Why are you paying for ADHD medication, mine was free when I lived in the UK. Again NICE approves herpes medication for longterm use rather than just during outbreaks.

Absolutely agree.

I understand different healthcare systems around the world.
Free at the point of use saves lives. It isn’t perfect, but it’s the best system in the world.

Unfortunately you are paying for those that don’t pay in , most of us under 60 pay ( ok I’m older).
Be glad you can pay, sorry about your parents, if you have the money, pay for them?

Sure, privatisation’s worked so well for the railways, water, utilities, hasn’t it? We already as a country can’t ‘afford’ the NHS, where’s the profits that private companies require gonna come from? That’s right, cuts to services and staff pay and conditions.

We need a system similar to France or Germany.

European healthcare systems aren't perfect either, many are 2 tier depending on if your work pays top ups, they have similar issues with staff shortages in some countries too. American healthcare is a nightmare for all but the most affluent, I know 2 people who lost their homes and life savings because them in one case, and a dc in the other got cancer and they had to pay 10% of the bill! Australia has significant top ups, if you rely just on the state it isn't great and so on. Healthcare is expensive and just because a drug has been developed it doesn't mean it's worth using at a society level - 3 months extra life, 6 months slower deterioration etc has to be looked at whether that really is worth it for the quality of life and cost to us all. The same applies I should add to most American healthcare too, only the rich get everything!

Private healthcare has always been available in the UK. It was part of the deal Bevan made to convince consultants to join the NHS. And it is why the agreed to NHS payscales - so they can make more money privately.

The NHS is a monopoly and medics - like most professionals value autonomy. Of course they should be able to be self-employed and provide their services to anyone who can afford it. In return, they provide their service at a subsidised rate to the taxpayer

No. My brother died in America because of the cost of healthcare.

If we had an insurance based model you probably wouldn’t get the drugs NICE won’t approve anyway unless you were rich enough for gold-plated insurance. But there would be no fuss about it because it would be “your fault” for buying the wrong insurance product. Also health insurance isn’t cheap - just back from mainland Europe where our healthcare was £800/ month even with the kids’ package being heavily subsidised. You also get weird anomalies in an insurance-based system. The doctors are effectively free agents so some give you a tonne of antibiotics even if you don’t want them, others refused to ever give them even if you’re suffering with a nasty bacterial infection and ask if you’ve considered echinacea. The NHS provides a good “line in the sand” about what sensible healthcare is

Can someone please explain to me the mechanism by which adding insurance companies into the mix leads to better care?

Surely it is just another layer of admin to suck up money that could be spent on care? Even if the insurance companies are state-run?

Genuine question as I always feel I am missing something here. I am inclined to think e.g. the german system is simply better because more money is put into it - but do the insurance companies have any role in that?

The nhs is post coded, which is wrong, national it is, it seems to largely focus on diabetes, cancer , epilepsy and dementia, when in reality nuro conditions don’t get much funding or new drugs.
Take MND, Parkinson’s ( which I have) MS to name a few.
Maternity and A &E also suffer, a consequence of under funding, prob bad management, it seems responsible to set limits of costs in certain areas.
Should ivf be funded, or un needed domestic surgery?
As it is, lots take more out than they put in, clearly not good money wise

Have you noticed the same in countries in Europe?
No country is perfect but many countries have a better system than the UK.

@StaunchMomma

Well seeing as though the Royal family is a net contributor at an estimated £1.7bn per year (Investment monitor) and the NHS is a massive drain at £181.7 bn , I'm not sure that's a good idea.

The issue in SanFran is the opioid crisis. I go often too. Sadly - there are many reasons for that including greedy medics, greedy pharma execs, inadequate governance and yes - poor rehab services. Rehab services are extremely poorly funded in the UK too - we are just fortunate we don't have the other factors to create that perfect storm.

Medics are not incentivised financially to prescribe in the UK. But neither are they in Europe - so the US examples are not valid here. Just scaremongering

Any system can be improved or updated to deliver better outcomes - it is worth a serious evaluation of the NHS funding model

Working for the nhs I fully agree that it doesn't work. The principle is amazing and honourable, but the reality is that it is incredibly inefficient, with lots of wastage, bottlenecks - it's like a load of jigsaw pieces that don't quite fit together, there are overlaps and gaps, and it's too huge to figure it out, like a rubix cube, you fix one bit and mess up another. Lots of incompetent staff which nhs hrs processes make it almost impossible to get rid of.
And then there are patient attitudes, the missed appointments, abuse of nhs equipment, rudeness and aggression towards us. There seems to be this attitude that because it doesn't cost the patient anything. I advised a patient that a specific treatment was not suitable for their child, their response was 'well I want it, other children have got it so I am entitled to it, it's not as if you are paying for it so why are you being so awkward'. This sums it all up, a level of entitlement, lack of respect for our professional opinions and thinking that it's free, when it not, someone has to pay.