To feel like actually, health care isn't really free at the point of service?

[RevoltingPeasant]

Would honestly appreciate thoughts on whether I am being precious/ demanding here, but..........

Today I went to a physio appointment. Private physio letting out rooms in an NHS GP practice. The GP practice is closed for a couple of hours or something, and he uses their rooms.

Sitting in the waiting room, I noticed these two posters next to each other:

'On a low income and need help with healthcare costs? Eye care, prescriptions (etc, it went on)'

Then an ad for the private physio I was seeing.

I'm seeing a private physio as I have no hope of getting one on the NHS and it helps me keep active (tendon injuries). I pay for private eye care, and obviously even NHS dentists charge. The posters made me think about how much most people can't get on the NHS 'free'.

I wish it weren't this way, but AIBU to think that actually, except for hospital admissions (which are a big thing of course!) much of the time it is really not true to say that healthcare is free at point of service?

The NHS provides healthcare free at the point of use. It subsidises and standardises drug charges through the prescription charge. If you choose to go outside that system you aren't accessing NHS care. You cannot be charged for NHS care except where specific charges are mandated - such as dental care.
In Ireland you have to pay for every single GP visit. When my dh developed a flare up of cellulitis in South Korea he had to present his credit card before being seen in the emergency room.

tomorrow You are exactly the sort of patient I was thinking of.

I had a comparable situation last year when an old 'permanent' retainer cracked and came loose in my mouth. I had a bit of wire sticking out into my mouth for weeks. I could not remove it myself. The advice was to go to a private orthodontist - potentially several hundred pounds

I do think that is pretty basic healthcare. Thankfully, a wonderful orthodontist at my local NHS hospital agreed to see me and removed it for a minimal charge. Staff like that - and I think most clinical staff are like that - are really working in the NHS spirit and I am so grateful.

But it makes me so sad to think that the NHS is being gradually 'privatised' like this - or effectively, as people are told to go private for certain things.

As someone who is lucky enough to have a comfortable income, I would pay higher tax/ NI in a heartbeat to have a more comprehensive or less overstretched service.

Northern yeah I know I'm not accessing NHS care, that's my point - I can't, really.

And believe me, I grew up in a country with no state healthcare - I know exactly what that's like and that's precisely why I wish the NHS were much better funded and provided stuff which I see as essential healthcare.

I wonder what people would think of sliding charges according to income? Like, good physio/ dental care is available on the NHS but people on a higher tax band pay more than now and people on benefits etc pay nothing?

Revolting we have sliding fees in France, where I live. There's universal health care but it's not free for everyone at point of service charges are capped, and everyone has some sort of insurance. If you are poor and on full benefits, you get a state insurance and don't pay for anything. We are low-income so we have private insurance and pay 1 euro to see the GP. Wealthy people pay more (up to 22 euro for a GP visit).

Personally I think it's a good idea, as it gets rid of the main problem with the US system (everyone pays a lot) and the UK system (where treatment can be decided based on quotas rather than patient need). French health care is generally rated the best in Europe and we've been really happy with it.

Actually speaking as a physio, if you need physio you will get it.

I don't sit behind my desk looking at referrals going hmmm earns more than me...no sorry won't see them!!

You get a referral, get prioritised and then get seen! Priority by condition not income.

In the past 2 years, I've had diagnosis by a rheumatologist, physio, including aquatherapy, OT and enough drugs to make me well and truly rattle, along with regular blood tests to make sure they're not doing me more harm than good. All I've had to pay for is the drugs, which come to around a tenner a month for a pre-payment certificate. I've never had to pay for anything else.

I'd call that free at the point of use.

Revolting - you do realise, I presume, that the more money you earn the more NI you pay? This means that those with the most money already pay more - you obviously want blood (somebody else's). And, please, do stop peddling this myth that the NHS is free, it most certainly isn't. Someone, somewhere is paying for every little treatment, pill, etc., that we are all taking. I am certainly not saying do away with the NHS, but we need to have a proper discussion about what it should be paying for - when it was set up treatment, and therefore costs, were quite basic compared with the marvellous things we can do now.

I'm temporarily in the US too and I miss the NHS! Yes, it's not perfect but you're not made to wait in a hospital corridor, bleeding and in pain until you pull out your insurance card!

I do see what people are saying about dental charges etc but the fees that exist now are so far below actual service costs, it's ridiculous. Yes, £50 may seem extortionate for a filling, but here it is a minimum $150 and crowns can be up to $5000. Yes, $5000, so just over £3000 - not the £200 cap or whatever exists in the UK at present.

And this isn't to say I'm not sympathetic to the plight of those who cannot afford to pay NHS charges, but there are thousands of Americans who would give anything for the healthcare opportunities we have in the UK.

DS1 takes a drug that costs £60 a packet, btw. For a while, when he was in between doses, he had to take tablets a day, meaning that his treatment was costing £120 a month. It costs us nothing, of course. I know people in the US are having to pay the full cost price for this sort of drug.

I pay for my eyes and my teeth and we have BUPA (which we have used once, but very importantly, to jump a ridiculous wait for a diagnostic echocardiogram when my dd had just nearly died from a common cold - we were seen immediately and would have had to have waited weeks otherwise). But then I think about everything I have had for free and it is buttons compared to what we would have had to pay in a country where there is no equivalent to the NHS. Just having my 3 dc would have cost a serious sum I imagine, plus my dd had heart surgery (for which we didn't use our private healthcare), not to mention every GP appointment, prescription, rush to A&E, we've had over the years. Contraception! Free contraception seems like such a little thing, but it undoubtedly makes a huge difference to people.

I agree peas - by the time I add in my contraception and c-section, I don't think I'll ever be able to pay in more than I've taken out.

I do think there's a debate to be had about what we really expect the NHS to be able to pay for though. As pp have said, when it was set up it was not set up for people to have physio to help them continue to walk or cycle (not getting at you op) more comfortably. What is primary healthcare these days? I suspect we all have different ideas on that...

tomorrow, I think fillings and extractions cost the same these days (they are both band 2, so about £50 for the full course of treatment).

Don't forget public health. Immunisations. Management of epidemics. Stop smoking and obesity services.

That said, that has been split and management if epidemic is now within central gov. Provision of the other services are still NHS though, and public healthcare ( not necessarily nhs) is still carried out

Wilson yes quite. I think you are right about that debate! Myself, I am a big fan of preventative medicine and public health as I think it leads to a happier, healthier population in the long run. This is probably pedantic but I have always thought that if it really is a primary care service then calling it the National Health Service is a misnomer.

I would love to see it better funded and bigger.

NUFC I'm really not sure what you mean by me being out for someone else's blood. As I said very clearly, I would happily pay higher taxes and NI than I do to fund a more comprehensive NHS. There was a thread on here earlier about a woman denied an epidural because of understaffing. I would happily pay more so that isn't the case. Or so that I don't have to wait 18 months for a kidney operation, as I did the other year.

Yes, thanks, I know people pay more NI the more they earn. DH and I would be amongst the higher earners I am thinking of as we have a household income of c. £65k.

This means I am lucky and can almost always afford health care. Not everyone can. I wish this were different.

And also yes, I appreciate how lucky we are to have any socialised medicine.

I grew up in the US and when my sister nearly died of cancer, my parents' health insurance paid out. Had they not been able to afford it, they would have been in a horrible mess.

However, I have also lived in France and other countries with different forms of socialised medicine and think it's possible to fund the health service better and make it more comprehensive.

Tis makes me think about getting health insurance. People mention bupa....any other recommendations. Do you just buy online?

We have had ours through work. Personal policies are scarily expensive.

Horry, not only are they expensive, they don't cover much compared to lots of other programmes in other countries.

We had health insurance arranged through my dad's work when I was a kid but I was able to keep it on at my own expense afterwards (I cancelled it when I returned to study). It was about £90 a month but covered everything-everything and they were not shitty about paying out.

I did at one point investigate BUPA policies and they basically send you through the NHS and just do anything 'extra' faster. So you are not that much better off and still taking up NHS resources (if that is a consideration).

I cancelled our private healthcare as no one ever seems to be ill. I have been to our GP myself about once in the last 8 years (I realise I am terribly terribly lucky that this is so) and when we have used the NHS it's been really good. Also if I needed to pay the full cost of anything privately if I wanted it done privately I could probably afford it.

I have paid for the odd thing privately for the children but that has cost nothing like the cost of paying for BUPA and some of that cost would be things private insurers do not cover anyway.

I suspect we are very lucky having good NHS dentists around here and our GP is a large group practice in new building with 7 day a week appointments.

As another person who cannot function at all without my glasses, that's the one that irritates me most. Because of safety driving and spotting glaucoma etc. I think people ought to get a free annual/biannual eye test like children can. DD still costs me money for glasses because she's a awkward fashion conscious madam.

I choose not to hunt high and low for an NHS dentist as ours is nice and good with DCs (who are still free)

okay, so £150 for three teeth.... Anyone got a pair of rusty pliers????

OP why won't your GP refer you for a block of physio sessions? The last to GP's I have had have done so.

That's the other thing of course - private insurance just entitles you to use NHS facilities and staff ahead of the queue and is very expensive. There isn't an affordable, comprehensive 'second stream'. For eg, I'm a freelance copywriter. If I get an RSI I don't think I'd get much help from the NHS, which is kinda fair enough - its hardly life threatening. But if it stops me from working...

But if, again, there was that honest debate that said, 'well the NHS is here for this and that, but if you think this is important you can buy some cheap insurance to help you access it', that would be a good thing IMO.

tomorrow - it's a one off cost for all of them. Not one cost for each tooth.