Can anyone explain how Reform’s Insurance based health system will work?

[BurntBroccoli]

I’ve looked at the manifesto and it’s confusing? A lot of Reform voters are now saying Farage will keep the NHS for poorer people but if you aren’t, you will have to go private. A bit like dentists or vets I suppose.

What is point you are classed as better off? How will the “NHS” be funded if no one wealthy is paying in?

Anyone?

There's always a silence when you move away from "small boats", then just more ranting about "small boats".

Some people were shaking their fists at Dover over the weekend. Apparently, if we stop the boats, everything is sorted. Sound familiar?

This. I have a few chronic, fairly serious illnesses and I might as well consider it a part time job. Luckily it is one I can do, having worked in the NHS, but it is so frustrating because it is one way traffic. I try to line up my appointments and blood tests, but they cancel the appointments, don't send me the lab forms, refuse to prescribe my medication in a timely fashion, won't tell me which pharmacy they have sent the drugs to, forget to order my IV meds so I turn up for my infusion and there isn't one. Or they tell me my appointment is booked, I turn up and they tell me I should have booked it myself. They cancel one appointment, book another, but the new one is for the wrong clinic. It is like constant gas lighting and it is exhausting. You can't speak to anyone who actually knows anything. I can't plan anything because the goal posts are always moving. Heaven forbid I might actually want to go on holiday or visit my family. How anybody copes with it all is beyond me. Yet, when things do work, I am grateful for everything. It is just so badly run.

The main cost would be the army of administrators and accountants chasing payments and issuing invoices. It would be a nightmare. It genuinely is much cheaper not to charge for healthcare.

The NHS has been massively underfunded for 14 years and it will take time for the additional funding to filter through and be seen by the average voter. I was told in October that I was on a two year waiting list. Now it's likely to be done in July and would be earlier if it weren't for certain circumstances.

Once more people get seen quicker and the buildings are refurbished or rebuilt, voters will feel better about it.

Australia isn't really insurance based. It is Medicare which is a single payer system with private top ups.

the insurance based systems on the continent work very well and the competition does help. However they spend a lot more money than the UK. I would say France and Germany are certainly getting a lot for what they pay and if the choices on offer were France or the NHS I would choose France. But there's not a chance in hell Farage is going to fund it like France.

(The Netherlands has mandatory private insurance and apparently it's all quite tight fisted, but that is also cultural.)

They are hoping a lack of intelligence and critical thinking will gift them council seats. To be followed by Parliamentary ones.
there’s a really horrible mixture of racists / people against ULEZ / use cash only and 15 minute city lunatics who are exploiting certain communities . It’s awful to see - that said - the government is doing what I thought it would (roll out unpopular policy in the first year with the hope things will be better for the many in a few years).
this is absolutely going to have impact on local elections (maybe not this year but certainly the mid term cllrs up in a couple of years).
the Tories are a mess, Labour have forgotten how to tell a story - Farage and his motley crew of football hooligans (I was at a by-election when a coach load of neck tattooed peaky blinders arrived) they’ll get some seats - before imploding.

Or blame everyone and everything else. While still cheering on NF and voting for whatever his next thing is (mass deportations I would guess).

People arent flocking to Reform because they think the NHS is going to be solved by this non plan, they're flocking to Reform because they're racist.

Frankly, I think one reason health services around the world (not just ours) are on their knees is because of demographic changes and (ironically) advances in healthcare. We can keep many, many people alive now, needing vastly expensive healthcare, sometimesfor a whole lifetime, who would have just died in the past. No health service could keep up.

He's in BBC news right now doing that....not ranting as Nigel doesn't really rant but blethering on about immigration and being fed of being told what to do.

Edit to correct typo 🙄

People with private health insurance are normally middle class due to the way it's set up as it's mainly a certain type of employees and self-employed.
I am not saying that these people have lots of money stashed away but we aren't talking about low income workers.

For bills, you can send them to the insurance before paying if you have a decent length of payment period. Things like prescriptions you have to pay upfront.

With my mum - she had a bad fall last year and her hospital bill for surgery and 3 week rehab was nearly €20k. We paid that in lots of installments, the hospitals are very aware of the issue that most people don't have that kind of money sitting around.

She pays each months around €100-150 on prescribtion medication and €400 on physical therapy every 2 months.

But - the insurance pays you so you have to be very careful with your organisation.

My FiL had some health issues, went to GP, blood and stool tests, 2 weeks later in for diags, 1 week later, results done, treatment administered... about 6 weeks start to finish.. this is Cancer related.

Line manager diagnosed with Hodgkinson's during Covid, diags and on going treatments done quickly and efficiently.

Cousin in remission some 10 years later, she was originally given months to live, the treatment she received literally has saved her life.

Not so long ago, i had an accident, femur and other bone fractures, in AE within minutes, on a ward inside 2 hours, treatment and on going fracture clinic treatment was brilliant.

The NHS treats millions of people with serious illnesses every year, is it perfect? no, but waiting lists ARE coming down, my DD own ones were 12 weeks, now 4, same with her friends who work in other areas.
They can now expand treatments to areas they had to ignore just months ago.

What the NHS needs is funding to match European HC services, money is what pays for staff, equipment etc....

The admin involved in an insurance based system is massive, claims, refunds, top ups..... the additional money would also go to director bonuses, share options etc etc.

Why people think the NHS needs replacing is beyond me, it needs some reform but whole sale replacement? when has that sort of thing ever worked?

https://stopreformuk.vote/?link_id=5&can_id=183543dff66ab53694aa01fe13a4fa6c&source=email-nigel-farage-doesnt-want-you-to-open-this-email-3&email_referrer=email_2713387___subject_3215855&email_subject=nigel-farage-doesnt-want-you-to-open-this-email&&

For anyone who hasn't seen the tactical voting tool from Movement Forward. You can find out how best to vote tactically in your area. Not all areas have data but hopefully yours does. I know some will already have voted via postal vote (I have) but others will be going to the polls in person.

I agree with what you say. I think though that we are going to have to start paying for more ourselves as the NHS just can’t cope. At the moment that’s happening on an unplanned basis

but agree that I don’t trust reform to do this

There’s already a 2 tier system in this country. Yes I agree the NHS is great if you have an urgent or emergency condition.

I have severe allergies and I pay for my appointments with the consultants because the waiting lists are so long. I know I am lucky that I can do this. I also have a skin condition and I pay to see a dermatologist. Allergies have a more than 12 months waiting list where I am and dermatologists are not easy to see either. I’d prefer not to pay but I would also rather be treated than not. ‘Normal’ day to day conditions tend to have longer waiting lists.

I went to see my GP about getting prescriptions for inhalers in advance of the hayfever season for me as I tend to suffer badly. He didn’t want to prescribe anything until I was ill and for me, that sums up the problems with the NHS. I’m trying to prevent myself having a condition where I end up in A and E (which I have done twice in the last 2 years) and he doesn’t want to prescribe me something ‘in case I don’t need it’.

@soupyspoon Of course - people voting for Reform haven’t looked at a breadth of their policies. They are people who would have been on the far right of the Cons or closet right on a few issues but always voted Labour because - they always voted Labour and so did their parents. Now they are not looking at a broader spectrum of policies - immigration makes them angry so they look at Nige and like his views. After all “he tells it like it is”.

If such policies on the nhs come in, it’s like turkeys voting for Christmas. Like voting for Brexit. These people don’t learn that you don’t trust a snake oil salesman twice. However the not very bright will trust a salesman, as has been shown in the USA.

Voters are very very easy to manipulate. Tell them hard line policies on something they care about and you can slide everything else in under the carpet. Did poorer Republicans know what tariffs really meant for them and importers of goods? Did they understand about price rises and inflation? Basically most voters don’t understand basic economics so ignore what they don’t know about. Hence the rise of the nationalist right and protectionism. The angry are easy to manipulate. They feel they are not listened to - but there’s a reason for that. I can afford health insurance, they can’t. Bigger fools them.

I also live in Germany, so have been in the insurance system for nearly 40 years.
At the beginning I belonged to one of the legally required health insurance schemes (Gesetzliche Krankenkasse). I paid a proportion of the premium from my earnings and my employer also paid a proportion. In those days you just went to a doctor or dentist, who billed your insurer. I do not remember there being any kind of "excess" that you had to pay personally.
However, things have changed.
Once you earn over a certain amount, you can opt for private insurance - again, if working, you are reimbursed up to a certain amount of your premiums by your employer. Typically the cost of private insurance can be up to 50% less than paying into one of the legally required schemes.
Depending on the plan you select, you may have an annual excess before you can claim on the insurance. Mine is currently €1200. This is all well and good, if you are in good health and generally do not need to visit the doctor frequently, of at all. You do need to ensure that you have savings or income to cover the excess.
I think that people in the UK do not appreciate the actual cost of treatment. To give 2 examples, from my own experience:

1. I fell down the stairs at my house. Had to call an ambulance as I was unable to drive. Got taken to hospital, x-rayed from top to toe (nothing broken) and had the cut in my scalp stitched up. 12 external and 3 internal stitches. They wanted to admit me (money-making ploy by hospitals in those days) but I refused as an "open" wound in a hospital setting didn't seem sensible. Got a 20 minute lecture by a young, female doctor, but was "allowed" to leave. Do not know what the cost of the treatment was, but I can tell you that I had to shell out €300 for the ambulance (in 2007), which was reimbursed by my insurance.
2. Visited the UK for Christmas in 2023. Caught something on the journey. Was ill all over Christmas, mostly temperature. Returned to Germany just before New Year. Still ill. Decided I needed to see a doctor as I had been ill for more than 10 days. Managed to get a home visit. Cost €345.

Having a tooth out costs about €50 to €60.
Yes, it is "expensive" if you have to pay €700 a month from your earnings, but it makes you take more care of yourself and enhances your common sense as to whether you are really ill or not.
However, I cannot see this system being implemented in the UK as it would be just too complicated. What I could see is some kind of nominal charge per person per month, so a health tax, if you like. I do not think that would solve any of the problems currently faced by the NHS as it would just make certain people feel "more entitled".
What I do think should be examined and changed, is the range of more advanced treatments and research, which were never part of the original NHS offering.
Finally, my best friend was working in Switzerland, where the system is similar to Germany. He developed cancer (and died), but told me that his insurance would only cover treatment up to CHF 2 million.

Yes, "bigger fools them" but we all pay the price when they gain traction or get voted in. Even if it's overseas it affects domestically- global economy in the toilet, normalising/emboldening and the rise of fascism, interference in elections, geopolitical instability and increasing risk of violence, terrorism and war.

The UK system isn’t set up like the US where the president/prime minister can wave a signed form around and MPs have to pass it.

What Reform say, and what they can actually do, are poles apart.

Dumb fucks think if they get brown people out the country they can get a council house and stop women going to work so they have to find a man to look after, and his elderly relatives so he can keep their house, and of course provide sexual services on tap.

The good old days eh! Britain at its finest!

Finally, my best friend was working in Switzerland, where the system is similar to Germany. He developed cancer (and died), but told me that his insurance would only cover treatment up to CHF 2 million

Yes a friend of ours, in France, had a skiing accident, his leg became infected, leg amputated, his rehab was restricted due to the French insurance base system and this also restricted the type of prosthetic he could have, there was also a substantial amount of money he had to pay towards treatment.

But how much of that is due to complacency, because people have no idea how much healthcare costs and knowing you can just ring an ambulance, or go to the doctors for medication ( albeit moaning about late ambulances and no doctors appointments)? People ringing ambulances because they've run out of tampons, not turning up to doctors appointments etc. I agree with the principle of the NHS but I think it's made people very complacent about their health. I include myself and my family in that.

@BalladOfBarryAndFreda Agree. But how do you stop it? FPTP does help of course. It’s stopped UKIP and Reform up until now. Local elections might be a protest vote. Gaining a majority in a GE might be a step too far. However if too many defect from main parties (and younger people don’t vote!) they could gain councils. Depends on geography of council areas.

I think our poor health as a nation is mainly cultural. You see the us with very patchy public healthcare is even worse in terms of lifestyle issues

No. I can’t explain it and neither can anyone else. Including Reform. Because it isn’t a properly thought through policy, it’s a campaign slogan. And Farage being the opportunist politician he is, he will ditch it the moment he decides it’s a political liability.

BUT at least Reform are brave enough to actually admit that the current NHS is dysfunctional & failing & broken. To admit that the NHS is not ‘the envy of the world’, and that throwing ever more enormous sums of money into the bottomless pit will change nothing. To admit that we need to look at other countries who have better universal healthcare systems than the U.K. ( eg Israel, Germany) and we need to learn from them.

Yes we seem to track to the US in terms of nutrition more than Europeans, maybe because of the language, but the French for example seem to try harder to protect their culture and food from US influence, whereas we have just taken it on wholesale. A lot of our health problems come from poor nutrition and filling up on food with low nutritional value. That's not British culture. It's happened over the last 40 years. You can track the obesity crisis from the proliferation of ready meals in the 80's, and Deliveroo etc are going to make it a hell of a lot worse.

There is certainly a attitude of "A pill for every ill" look at weight loss drugs for example?
No personal responsibility, its the "State can pay for my greedy eating habits" these drugs will cost the NHS billions.

Or the hatred towards people who do take care of themselves, look on MN? runners & cyclists all regular get peoples backs up, well, its worse than that.

Jeremy Vine has had to give up his campaign for safer roads due to the online hatred he has received most along the lines "i hope you get crushed under a lorry"
I guess these sorts of people also vote Reform....