Conservatives closing the gap on reform

Bringing Rishi back would kill the recovery of the Tory party. He was the main reason they lost the last election. The 3 million people he excluded for Covid support may well return to the Tories in due course, but certainly won't if Rishi returns to the top table. Also don't forget his flip flopping around tax/nic cuts/rises. He wasn't half as competent as people make him out to have been. A bit like Vince Cable who everyone thought was the second Messiah because he claimed to have forecast the 2008 crash, but scratch the surface and he was another useless politician who hadn't a clue, as seen with his performance in the coalition government. Kemi needs to move forward and not bring back the failures of the past.

I agree and an excellent observation on needing a decent shadow cabinet to back her. Yes I think she will be a credible candidate for PM but it can't just be her. Maybe time to bring Rishi back in?

Maybe you live in a bubble. Or don't read widely.

Nothing is forever.

Oh come now...I"m sure you say something sensible (very) occasionally that I may agree with? Don't lose hope that absolutely everything you say is rubbish?

I think WLI will help a bit, I have nothing against them they’re a game changer for health and prevention, where a worsening trajectory was the alternative.

On the last line idk there’s still a lot of invested opposition to it, although anyone with that system would keep it.

And even the Boer war , when it was found so many recruits were simply too unhealthy for active service.

@strawberrybubblegum No, we're not doomed but things will have to change no matter what Labour backbenchers want. There is no financial alternative.

I think the next 20 years will see a society that requires a lot more personal responsibility. Healthcare will involve some basic charges for anyone on minimum wage or above.

Pensioner benefits (free prescriptions, wfp etc) should be means tested at a sensible level - the same level as minimum wage?

Fewer benefits, a requirement for more people to work more hours. I think a full state pension will require 40 years of NI not 35.

And an Australian style immigration system.

Your comment, suppression of wages caught my eye.

I’ve always assumed that wages are low because productivity is low. So basically that wages are stagnating.

But you present another way to look at it. I am curious, what do you think is suppressing wages? (My first thought would be too much immigration, but you might have something else in mind that I am missing.)

Might be worth look at why people now think a cough is something AE is there for?

I think this is a very real problem. Lack of sensible personal responsibility, learned helplessmess (encouraged by our governments) and huge entitlement..

Unfortunately, you're right that benefit claimants - which now make up 50% of the population - wouldn't be expected to pay. So adding copayments wouldn't help. Depressing.

In France, you need to have an income of below about 7000 Euros a year in order for healthcare to be completely free. But we are far too redistributive in the UK to expect that kind of personal responsibility.

This is the kind of realisation that genuinely makes me worried for the UK's future. There are many possible solutions to our problems, but we've painted ourselves into a place that we can't get to any of them. We're doomed!

The tories will have to do something quite special to get my vote, but I will do anything except vote for Labour to keep Reform out.

I do think KB Is improving and has far more charisma than KS. Her timing is reasonable too. Three years to go, she has time to produce the fully costed plans that Labour so clearly didn't bother with.

She can make some easy gains by reversing some of Labour's most unpopular policies.

Yes, I think the Tories are recovering. Now they need a strong shadow cabinet. KB on her own will not be enough.

A healthcare system needs to get to healthier outcomes through behaviour too. I don’t think we have the best system for that.

But I also wonder if we’re past being able to get there now as whatever is done will have so many exemptions and too few lower users picking up that tab.

Regardless, the costs to businesses is large and i'm not arguing that we shouldn't have co payments or payments for AE/GP appointments BUT it would be seen as additional taxes (both for employer and employee) we simply do not have the disposable incomes other countries do, mostly due to our housing costs & suppression of wages.

Who presided over almost all of this over the last 14 years?

Payments to visit GP etc would almost certainly not apply to those on benefits, so would primarily just affect those in work/not on in work benefits and pensioners would be exempt too or hear the cries of Labour Hate Pensioners..... (WFP anyone?)

Number of patients going to AE (UK) for a heart attack/stroke has remained stable over the last 5 years but the numbers going to AE for a cough has gone up 10 fold.

Might be worth look at why people now think a cough is something AE is there for?

I agree that it wouldn't be trivial to set up that European model in the UK - and people wouldn't respect it.

I'm merely pointing out that there are many effective ways for governments to support healthcare. Our 'free at the point of use' system isn't the only way and it's important to be aware of the strengths and weaknesses of alternatives.

To me, the important thing is that everyone needs to be able to access healthcare affordably, and also without people taking the piss given that we all fund the subsidy.

Affordable is a sufficient goal - and may be easier to combine with 'not taking the piss' than free. I'd be more in favour of small co-payments than all-out reform - which would be expensive snd as you say, probably end up with different problems.

What we absolutely can't have is a free, all-singing-all-dancing system for one tier of people (Labour's favoured benefit recipients) paid for by people who don't have access to it and must pay for their own healthcare on top. That simply won't work.

And unfortunately, the NHS is moving that way by stealth - as long waiting lists mean that anyone who can pay for care themselves does, despite the huge cost they're already paying in taxes. That doesn't happen in France. The taxpayer subsidies are there for everyone.

A lot of healthcare is absolutely not free at point of use in France. As I said, for most healthcare you pay up front unless you are very low income. The government reimburses part of it. You can choose to pay for private insurance (mutuelle), which pays the rest. Some things aren't fully reimbursed, even by the mutuelle.

It creates a good balance where both patients and providers take the costs seriously.

Here in the UK, I once sat in a phone queue for more than an hour to cancel a specialist hospital appointment, which I'd had to wait months for (I chose to progress with a different hospital - less well-known for the specialty, but which didn't have the crazy waits). They were really surprised that I'd waited on the phone to cancel. Given the shortage of appointments, I felt a responsibility to do my bit - but clearly no-one else (either patients or hospital) felt the same.

If patients paid even a small contribution, you can be sure that wouldn't happen. £1billion per year is lost in hospital appointments, and £200million from missed GP appointments. A drop in the £231billion NHS budget, to be sure - but there are limited doctors, and that cavalier attitude makes care worse for everyone.

France has an effective Free at the point of use as the insurance pays the costs the state doesn't plus they prove free care for those without insurance.

Same with Germany.

These systems are admin heavy and well regulated to avoid profiteering (something, based on what we usually do, wouldn't be the case in the UK)

Countries like Portugal and Italy use a very similar model to the UK, with v small co payments.

Plus all these system rely on businesses paying a lot more in taxes, something that is apparently causing all our economic problems, according to you and other right wing posters on here.

I already gave an answer, in case you missed it: Singapore, Japan, Switzerland, France and many other European countries.

In those countries, healthcare is subsidised and supported out of taxes,, but not free at the point of use. Citizens are expected to pay up to 30% themselves, with support where needed,and sometimes covered by private medical insurance which citizens are requited to take out themselves

Yes it was odd, the pp was right.

I find it quite telling that just as you and blossomtoes were so dismissive of other posters debate and facts... it was your own link which was "full of confident assertions that turn out to be utter bollocks"

Gaslighting indeed...

An apology to @Notmymarmosets would be appropriate after your sleight of hand and dismissive tone, given that she is indeed right that "There are a lot of thriving economies where free healthcare is not universally accessible"

What a joke.

Not with an answer. Just twisted to fit.

In fact, @ArseInTheCoOpWindow is more of a contender for "confident assertions that turn out to be utter bollocks", with her article link.

I can see where that went wrong.

Everyone was talking about free, universal healthcare.
@Snowonground "Of course universal health care for absolutely everyone no matter their ability to pay is a luxury."
@blossomtoes "It’s not a luxury. It’s a necessity for economic health"
@Notmymarmosets "There are a lot of thriving economies where free healthcare is not universally accessible"

Then @ArseInTheCoOpWindow changed the goalposts

Despite saying "Where are they? This names the countries without it. " (clearly referring to the free universal healthcare everyone has been talking about) she instead posted a link to an article about universal healthcare. Which I'm guessing is about central organisation - but nothing about how it's paid for.

There are many, many successful countries where the healthcare isn't free. Exactly as @Notmymarmosets said.

Careless reading / verification by @ArseInTheCoOpWindow ?
Or an attempt to gaslight?

I guess only @ArseInTheCoOpWindow knows...

Oh give over!

But then she specified that most of that 30% NHS saving would "come from a reduction in obesity related illnesses - Type 2 diabetes, heart conditions etc."

She then went on to say that "40 years ago, lung cancer would kill quickly at around the age of 60-65 at the end of an economically active life and usually after children had become financially independent. So little or no burden on the state"
(my bold and underlining)

Which clearly indicates that she's also considering wider societal cost. In particular, lost productivity and social care - which are specifically mentioned in that £15-£17 billion total societal cost.

There's definitely some ambiguity, but t's a chat forum, not a dissertation. Certainly not accurate to say that this is an example of "confident assertions that turn out to be utter bollocks"

She did specify. She was discussing costs to the NHS. Moving the goalposts doesn’t make me wrong.

And we could reduce NHS spending by a good 30% plus if more people took responsibility for their own health: cut back on drinking and smoking,

And you did start your post with 'Exactly'.

What did that 'Exactly' refer to if not agreement with the previous post? (Given that the one before was an opposing view)

NHS cost was less than the tax income, but overall societal cost was about twice as much. I don't think the pp had specified which she meant.

I didn't actually argue with you, just gave more accurate facts.