To think a privatised health service would be an improvement?

[WhiteStars]

At the moment we all have to be grateful for the overstretched and often inefficient service we receive. I had a 9am appointment today with a nurse practitioner. At that time in the morning she was already running 25 mins late on her appointments- how?!

She also couldn't use her computer system so I had to then wait for a doctor to come and issue the standard repeat prescription (I couldn't get this over the phone as needed a blood pressure check). The doctor then issued the wrong medication and only corrected it when I noticed she had done the wrong thing on the screen.

All very minor but not a great service at all really. We all know how over stretched the service is and everyone says it's at breaking point. Why is everyone so against paying for health insurance and getting a better service or going private?

It's not uncommon to hear of people waiting weeks to get an appointment and not being able to book in advance. The government would save an inordinate amount of money that could be ploughed into schools whilst subsidising some health services but with people paying an annual health insurance fee. We already pay for prescriptions in England. I would rather have a better private service than the NHS as it is now- on it's last legs and not really fit for purpose any more. AIBU?

There seems less nursing staff and more clinical assistants in private hospital but I think the nhs needs more clinical assistants really (not less nurses though) My daughter had a major Neuro spinal surgery just over 12 months ago and the aftercare from nursing I felt was awful. She needed alot more washing, bathing etc but I did it all. I did the beds, sink, her bed area etc. She has a complex severe disability btw. The nursing staff wouldn't let me sleep at night (or her) as they didn't understand her seizure activity which tbh had changed anyway because of the surgery. We were discharged 2 weeks earlier than her planned post op stay and the care at home with carers etc was much more suitable. With what I am trying to say is, I don't think some people need a hospital setting for the whole post op recovery but all the places they could have been transferred to previously have closed. It puts a terrible amount of stress on parent/family/spouse carers.

pausing Actually the insurance companies here in the US don't do it anymore because there have been so many law suits. The insurance companies do question therapy visits (physical therapy and chiropractic visits are closely monitored) but if your primary doctor (equivalent to a GP) tells you to visit a specialist or to go to the ER the insurance company or state/federal program can not overrule the doctor.

This is another example of a process being implemented that has been lifted from the US but applied in a very different way than it is actually applied here in the US.

yabu

also, feel free to pay for private if you'd prefer

OP - I'm late to the party here, but you already do pay for the NHS! Also, many secondary care (hospital) and community services (like district nursing or occupational therapy) are run by private companies. Any healthcare company (private or NHS trust) can bid for NHS business, as long as the fulfil the criteria.

Do you actually think healthcare would improve if you paid on a pay as you go or some kind of insurance basis? Did you know a visit to your GP costs £45? Did you know a trip to A&E is at least £124? Diagnostic tests alone are very expensive. Our national health service funding crisis would no doubt deepen as so many of us need healthcare and so few of us could afford it on an individual basis. The values of the NHS are centred on fairness and equality of access and it would be awful for that to change.

The problems the NHS faces are so complex. Even if funding increased, there are huge cultural shifts needed to improve national health - for example, people should take more responsibility for their health by leading healthy lifestyles. This could lead to fewer avoidable procedures, such as knee and hip replacements.

No doubt the NHS could do with more money, but that won't solve everything. Also it's not going to happen anytime soon.

waves at daily fail

If you want private health care go ahead and pay for it you have that choice.

But I will not buy into the idea that it's better. It isn't and perpetuating that myth is helping the NHS be dismantled bit by bit.

maybe not better, but quicker.
and if I can't get a gp app for a sick note than I have no other option really.

No it wont be quicker. We have lots of GP vacancies. Most parts of the country do not have private GPs. Where I am I can get a GP appointment easily. Where I used to be was a nightmare because there were vacancies that had been there for years.

We just couldn't afford private healthcare due to illnesses in the family. Dd1s medicines for her severe asthma would cost close to £150 pounds a month on private script and thats just her standard meds, add in drs appointments, check ups and emergency treatment when she deteriorates

where I am gp app are 3-4 weeks. too late for that sick note...

I have asthma, eczema, a series of daft allergies and intolerances, hypertension, Reynaud's Phenomenon, a family history of premature death, cardiovascular, cerebrovascular and peripheral vascular disease and I have a series of soft tissue problems.

When I first got a mortgage, I got quotes for life insurance and the life, health and critical illness cover quote was so much more than my mortgage repayments, the combined cost was more than my nett wage.

We pay for the NHS through our NI contributions.

If you think we'd all be better off going private, YABVVVU.

You want to go where there's private health cover. Off you go to the USA. See how you get on there.

I think it's a bad idea. I think more people, especially the vulnerable, would end up dying sooner by not receiving treatment they would otherwise get free through the NHS, because they may not be able to afford insurance. People with drug / alcohol addictions don't necessarily have insurance top of their list of priorities due to the very nature of their addictions. We really are very lucky to have our NHS. The deficit has had a horrible effect on Government spending; what, with cutbacks left, right and centre - more work for less money/staff.

One blood screening costs £8,000.
I'm disabled with long term mental health issues, cannot work, and receive less than £9,500 a year.
I couldn't even afford the £8.40 per item per month prescription cost so wasn't taking my medications until i by chance read the back of the script and realised i qualified for the NHS to cover the prescription charge.
The prescription charge is a nominal amount compared to the actual cost of medicines so even those who "pay" for them have it almost completely covered by the NHS.
If our health system becomes privatised, anyone already disabled or ill won't be able to get coverage via insurance, OR the premiums would by sky high because they're high risk for needing insurance to pay out.

Health insurance companies work by taking on those least likely to ever need to claim, so their premiums end up higher than the pay outs, thus making the insurers money. It's not beneficial for them to take on somebody with a long term health complaint or a family history of certain diseases.
Thousands, if not hundreds of thousands of people would be left with no means to pay for their medications, hospital stays, required surgery etc. They'd be tens if not hundreds of thousands of pounds in debt within weeks, and many hospitals would refuse treatment unless paid up front. Who knows how many would die.
So, whilst you might have general good health, and be able to get coverage and afford the premiums, it certainly isn't that way for thousands of us. It's definitely much better to have an NHS and the inconvenience of a half hour wait and an occasional system malfunction than condemn thousands to die.

NI doesn't pay for the NHS, its 80% funded out of general taxation.

Think about it NI is far too small to cover everything that we want it to. Unemployment insurance, health insurance, pensions etc.

"maggiethemagpie Fri 06-Jan-17 15:56:59
I do wonder if the NHS could be helped financially if they started charging akin to when you go to the dentist, so at the dentist's its £18 odd to be seen, £50 odd for tier one treatment and £200 odd for tier two treatment which is capped. Those who are not working/on benefits/pre existing conditions etc could be exempt, like it is now with prescriptions"

Of course we can be 100% sure it wont become another stick to beat poorer people with if this actually happened

YABU. I strongly disagree with you. And am very heartened to see that the vast majority also disagree with you.
We've watched our railways, telecoms, water, gas, electricity, etc, etc all get privatised without much dissent - but perhaps we shall not let our NHS go without a fight.

throwing my two cents in.

OP did not qualify what kind of privatized insurance she wanted.

It sounds like the European semi-private systems are all well regulated by the governments in those countries, in which case there is less chance for abuse of people who can't afford to pay.

i've lived in UK as a kid, Canada as a kid and adult and now US as an adult. When I was a kid in the UK, from what I remember everything was free including glasses and dental.

In Canada, I was only covered for things like prescriptions, glasses and dental with a private insurance plan ie through an employer, and it was usually only 75-80% covered, or max cap on certain items (think only $125 towards glasses when my high prescriptions cost $350+). My FIL was diagnosed with cancer and paid $0 for any treatment, including aftercare prescriptions, because he is over 65. (If it was me I would have had to pay some costs for drugs but nothing for hospital/surgery/chemo).

In the US, many things are about deregulation and small government - so it's very easy for the system to become bloated for the benefit of insurance companies which are for-profit businesses. That's why Obamacare was such a big deal for many people - even though it can be very expensive for some (and yes there are people whose same plans went up in price for premiums, which i blame entirely on the insurance companies' drive for profit), it meant that some people who would never even have been approved for insurance could now get some. Example - you now cannot be denied insurance for having a pre-existing condition. By that I mean, people who had no insurance who were then diagnosed with anything (cancer, chronic conditions, asthma etc) could be denied insurance and then have no option but to pay the ridiculous out of pocket expenses for healthcare. Or.... insurance companies could claim you had a pre-existing condition if you went to the dr for a stomach ache before you signed up and it then turned out to be stomach cancer after you got insurance. Even old people in the US on medicare (medicaid?) still need supplementary insurance as a) many hcps don't take medicare, and b) it doesn't cover as much stuff as in UK or Canada. My retired neighbour is paying more for supplementary than we are for company subsidized full insurance, when she is entitled to medicare.

I had DS in the US. Due to the work insurance we were on, we had to pay cash up front and get reimbursed later. Took me weeks before the birth to find out from the various providers an estimate of the costs so we knew how much to budget for. My original hospital bill was $7500 - just for the giving birth part and staying 2 nights - $6 for one extra strength ibuprofen pill. This was reduced to $4500 because I was paying cash... The OBGYN bill was $3000 or so. The epidural cost around $2000, and there were various other charges. That was for a fairly uncomplicated natural birth. If you couldn't afford insurance that would be $10-12k out of pocket at a minimum - any complications and the price skyrockets. I've spoken to friends who were on a US based insurance plan and even with coverage out of pocket expenses for a birth is around $10k. Many of my friends have chosen not to have a second child because they cannot afford the initial cost.

Also the cash up front prices are not necessarily better than excess/copay costs under insurance because it's all fixed. Paying cash at the pharmacy for prescription drugs on our old plan (with reimbursement later) meant that I was paying $100, when on US based insurance, i would pay $1 and the insurance would pay $19. But they do try telling you you're getting a discount paying cash ...

Three more points and then I promise I'll stop.

1. www.washingtonpost.com/local/5-years-after-boy-dies-from-toothache-maryland-medicaid-dental-care-is-on-mend/2012/02/15/gIQANEJoGR_story.html?utm_term=.d91710e9b631

1. In network vs Out of Network in the US is a huge deal. www.nytimes.com/2014/09/21/us/drive-by-doctoring-surprise-medical-bills.html?_r=0 and www.nytimes.com/2016/11/17/upshot/first-comes-the-emergency-then-comes-the-surprise-out-of-network-bill.html.

1. Shrekli and the Epi-Pen price jacking. Even though that's drugs, the same kinds of things can happen in healthcare services.

These are the things that can happen if you go to a largely unregulated private healthcare system.

I've lived in a country with a partially subsidised medical system and even so you can end up simply not being able to afford the charges.

I've had to postpone much needed antibiotics or not had some checks which were quite basic, but not covered. It's not great and it made my mum feel absolutely shite even though, luckily, I wasn't too bad.

No, I don't want a private system.

The 111 system can be a bit of a joke.
Just 3 or 4 days after having a baby a dd rang 111 about a minor but uncomfortable problem.
She began by saying she had only just had a baby - the problem was birth-related.
And despite her repeating several times that she'd only just had a baby, the person on the other end asked her at least THREE times, 'Is there any chance you could be pregnant?'

I do realise that they have to follow a script, but you might think just a teensy bit of common sense could be used now and then.
Maybe they get the sack if they don't follow it to the letter - I dare say that's the case.

The 111 system is contracted out.

Initial contact staff tend not to be medically qualified and yes, there is a script they have to follow and yes, there is the prospect of disciplinary measures being invoked if they deviate from it.

To PPS stating that we have 'already paid for the NHS' via NI, that should state that those in employment have paid some contribution. There must be many who have paid nothing. Health tourists have also contributed nothing and the chance of the NHS being reimbursed by them is almost zero. That needs to be dealt with for a start. Perhaps more education ie more awareness of how much things cost such as detailed in PPS, so much for GP visit, so much for missed appointment, etc.

I'm terminally ill with a rare condition (not cancer) and belong to an online support group. There are about 1 in a million of us (I was never this lucky with the lottery!) so consequently the majority of the people in the support group are from the US.

I watch the people from across the water struggling to get their health care to provide X,Y or Z. The treatment for this illness isn't particularly expensive but the healthcare providers always seem to have rules about why it can't be provided, or they have to negotiate with them.

I don't have any of that crap. I see my consultant, we discuss what next and I point out things I've picked up that other people have tried. We discuss that then we do what needs doing. We then spend 10 minutes arguing about the cricket!

I don't know how long I have left on this earth but I don't want to spend it rowing with companies who are worried about the bottom line. I have time to do the important things in life. Like watch the cricket!!

YABU
HTH

I have come over from the USA and I would honestly prefer paying for the private healthcare. The attention and help you receive is so much different. When I had my DS I knew I was in labour, called the hospital and went in, they sent me home and told me to take paracetamol and said I wasn't in labour. I almost had my DS in the car because of them. They didn't understand that every women goes through labour differently and didn't listen to my needs and what I knew was going on and that just wouldn't have happened in America.