Is this a completely bonkers U-turn by the NHS?

[HappySecret]

My faster is well and truly flabbered. Can this be in any way reasonable? Justifiable?

From today's Times:

If it was developed into an insurance scheme and poorer ppl didnt have to pay it would be used as another stick to beat poorer ppl with on these very boards just like tax credits and social housing is now.

We already have a comment on this thread referring to the "unwashed"

Yes, that was me Helena and meant in the context of how BHS staff are disrespectful to people who they view as receiving a free service and who are therefore by default rude to all users of the service.

Please Don't quote out of context.

@ibgoria
What do you actually know about the Australian system vs the British system.
I was raised there and insurance most definitely pays for things like X-rays and consultants. What's more in Australia you are far more likely to actually be able to see a doctor when you need it and without worry about them killing you through sheer negligence. There are two reasons why the Australian system is better than the NHS.

1. Because those who can afford it pay. (It's called not being a free loader)
2. It's much easier to bring a claim for medical negligence so doctors are more careful and always err on the side of caution regarding referrals and tests.

In Britain you literally have to wait up to two weeks in some areas to see a GP (yes, this has happened to me personally in several locations). 2 months is considered a good wait time to see an ONCOLOGIST The NHS could kill you through sheer negligence (like performing the wrong surgery-happened to someone I knew) and you could still fail to win in court You are taxed at 10% for NI as opposed to 2% Medicare levy You really have it good. I was planning on becoming a doctor before moving to Britain where I gave it up. I have had absolutely hellish experiences giving birth, both of my children ended up requiring antibiotics because the hospital wouldn't enforce its own guildlines on safe birth practice and the midwives didn't care. My first pregnancy I didn't receive any medical attention at all until my second trimester because my insurance didn't cover it and my gp practice refused to see my despite my telling them that I was pregnant. Just look at the comparative mortality rates between Britain and Australia. Things are starting to become a bit stressed at the seams in Australia, we all know that, but it still works. In Britain it doesn't a lot of the time and people die as a result a lot of the time and nobody cares because you aren't allowed to deities the NHS.

Er... if it wasn't clear, I live here and have done for 15 years, and if you did, you would know what it's like TODAY. I TOLD you the specifics of costings.. things may have changed since you were here, I work in the private health sector here, and have friends in the public health sector, so yes, I was quoting exact, specific rules and costings as it is now.

I may come back at some point and fit through your post one by line to argue, but it wild probably be a waste of energy.

TTbb NI doesn't just pay for the NHS. What do you think pays for your pension and entitlement to benefits should you ever need them?

Freeloader, my arse. As you've already pointed out, we pay for the NHS, just not at point of use.

The systems you're talking about massively discriminate against those with longterm chronic conditions. Paying £20 or £30 for a GP visit is one thing if you go once a year, quite another if you're there once a month.

Flat rate prescription charges mean that those in more expensive medications aren't discriminated against. My son has had a very serious and rare illness since birth. His essential medication is rare and highly specialist and would destroy us financially if we had to pay for it. Look at the issues in America with the cost of epipens recently or HIV drugs. Americans pay far more for the same drugs than the NHS does due to bulk purchasing etc.

What do you actually think those on low incomes and with pre existing conditions would do?

The NHS is underfunded but it is also overused and abused. I have just been reading about a woman who moved into a new home and found the loft full of bags of prescription medicines. Pharmacy staff will all tell you about how many meds are wasted and returned unused. GP surgery staff will all tell you about missed appointments and unreasonable demands for prescriptions. Hospital staff will all tell you about timewasting patients in A&E and abuse of the system
There needs to be total changes both in how it is funded and in how it is used by the public

People think they pay for the NHS but they really don't. Living in America has enabled us to see what healthcare costs. We pay substantially less tax than we would in the UK but we then pay medical costs, property taxes and state taxes. If you include these other 'taxes' we pay about the same as what we would in the U.K.

The standard of care here is infinitely better than what is provided by the NHS. The NHS staff are holding together a completely broken system and are not the problem. It starts from the top and the funding. The management are mainly political appointees and the work ethic of many of the administration of the NHS is lacking.

You get what you pay for and the PFI deals should be renegotiated in addition to a charge for services. It would free up so much money for the NHS. Also even if everyone had to pay £1 for their appointment it would make them think twice about going. I'd also charge people full cost for medical care due to being drunk. One Friday night in A&E was enough for me. Its self inflicted and the NHS isn't there to pay for such foolishness.

I'm an Australian resident and currently live here, comparing the amount paid for Medicare to NI isn't fair. Medicare is low but superannuation is 9%. (Superannuation = pension)

want what you're missing is that healthcare costs more in America because its private. The American government spend a higher percentage of their GDP on healthcare than we do, because the costs are so massively inflated by the involvement of profit making companies, but they don't have the same level of income from the public to offset those costs as we do.

Have you seen Michael Moore's Sicko? Regardless of your opinions on him, the fact that everyone featured in that film - the ones who are homeless due to bankruptcy, the ones who've died because of insurance companies trying to get out of paying, the ones dead because insurance companies have found ways not to fund treatment - are insured. It doesn't even begin to cover those who have no insurance.

When I was in New York I overheard a shop worker telling a colleague she really had to go to the hospital. I asked if she was okay and she said she had burnt herself a week previously - she pulled up her sleeve and she had a severe untreated burn covering her forearm. It was truly horrific. We got chatting and she told me she would have to get another credit card to pay for it, and she already had lots of debt because her child has severe asthma.

So yeah, forgive me if I'm not overjoyed about the idea of PFIs taking over more and more of the NHS. We are heading for a very scary future where only those with means will be able to access the sort of timely healthcare you're talking about, and the rest will be lucky to access any healthcare at all.

Lost perhaps their hospital is, what about that trust in general? You know it's highly exceptional for any hospital to be in surplus these days - and of course its blamed on the tories. I work in an advisory role in my local CCG and both patients and staff are suffering as a result of cuts and changes. Our local A&E and maternity unit are being shut down and merged with those in the next town, which means a car journey of well over an hour for some residents - the local infrastructure is already close to breaking and the roads are gridlocked even before this change. Of course this is to do with the cuts.

Yes there are inefficiencies in the NHS.

However, any alternative system would cost more to administer.

Insurance? So you're setting up companies to administer all insurance payments, assess claims, etc (and make a profit to shareholders). Reduced payments for those on low income? Again it has to be assessed, rules decided and administered and some kind of voucher system/cross charging through the system. This is all administrative work that adds no improvement to service.

A lot of what we need is an attitude change. Stop running to A&E with things that don't need it for a start. Stop taking appointments and then not doing the treatment recommended (e.g. Physio exercises)

I do agree with streamlining the services that are offered. Although not ideal, I think it's better than alternatives. Fertility treatment shouldn't be on the NHS for example (and I say this as someone who lost the postcode lottery for treatment).

Confused as to why people want to change systems instead of just paying the same amount in as other countries do. As we are the more efficient system, logic means we would end up even better

I suspect people just dont like the 'free at point of delivery' concept. You want to see people paying directly, even if it ends up costing everyone including you more via taxes. Does it give you a warm, vicious feeling inside?

It'll be so much better when we start getting this £350 million per week into the NHS after brexit.

want what you're missing is that healthcare costs more in America because its private.

No, it's more expensive because of the stranglehold that the industry lobby has over Washington. For example, they don't permit interstate competition.

That Is also a factor, but not the only factor. How do you think companies make profits without charging more, and how many companies don't set out to make as much profit as possible? Insurance assessors being given bonuses for turning down a certain number of claims, drug companies spending a fortune on marketing that doesn't happen here, all these things are factors.

Right so privatisation works better because of competition - more likely to have a better service at a fair price?

Give me a break. That's not how it goes.
Train system
Energy companies
Royal Mail
Moving property from government ownership and eventually into the hands of property investors

Those things aren't really working out so well in terms of service or cost, are they?

"spiffed on staff pay"

Nearly all the NHS staff I have encountered have been wonderful, caring and overworked. My friend is about to leave the NHS after 15 years to a private service. She'd desperately wants to stay, but because they can't recruit properly qualified staff she has to do her own work and supervise people who don't know what they are doing. They won't even consider any better flexible working for her, she an never take AL her annual leave as they are too short staffed.
My GP and the perinatal mental health team have literally saved my life on several occasions. And the point at which I was admitted to a mother and baby psychiatric unit I wouldn't have even made an appointment and it was free. I definitely wouldn't have done it when I had to pay.

So which is it? Hospitals running at a surplus as if that's achievable for all, or there's not enough money?

There are plenty of ways to increase funding for the NHS. Could privitisation improve services? Potentially but ask those people whose GP services are now run by Virgin, or the people using the eye department where virgin massively undercut the NHS service to win the tender then admitted they had no idea how to run it or even what equipment they needed. Do you think they're getting a better service? Virgin have cut their bid to the bone to win it, and some of that money has to go to making profits, staff are less trained and often paid less, the same funding has to go further where profits are involved... how does that equate to better service?

If indeed train services have improved (questionable) but become inaccesible to many due to cost, is that a state of affairs we want for healthcare? Or do you just not care because you could afford it just fine?

There's no way I could afford private health insurance that would undoubtedly cost more due to my and my son's health conditions, and as people with serious health issues we need it more than most. But hey, not your problem right?

Lostmy mojo my DH is a Consultant and working himself into an early grave! Its Saturday morning and where is he? Oh doing another ward round and then off to the Endoscopy department to do a list! Tomorrow will be a repeat. He is in the middle of a 14 day stretch (he will have no extra days off to compensate for losing his weekend).

How the hell is your DH managing to take it easy?????

*I know it's not what you're used to hearing, but 72 million low income people in the US have government paid medical care just from this program.

www.medicaid.gov/medicaid/eligibility/

Another 12 million or so get private insurance subsidized under the ACA. So it is possible to be poor in the US and have healthcare.*

Except (I believe) that 19/32 states haven't expanded Medicaid coverage to certain sectors of the poor, including single adults. There are significant numbers of adults who don't have any insurance - around one in ten, I think? And let's not forget the co-pays and deductibles people have to meet each year. Many people with insurance are still paying a contribution to each appointment or for each prescription.

Plus insurance systems can be a bureaucratic nightmare, particularly if you have multiple health issues. Insurance companies are there to make money, it's in their interest to deny your claim.

I'm not saying the NHS is perfect, not by any means, but a private system along the American model isn't the way to go.

Here in NYC there are multiple free clinics where anyone can get free medical care. A shop worker is probably on minimum wage so will qualify for free medical and would have qualified 10 years ago too. The clinics I talk about are set up to provide medical care for the uninsured.

The reality is, and what I'm reading here, is that very few people on MN actually really know what the experience of medical care is here. You get what you pay for. The NHS is underfunded and badly managed.

Mental health care once you a diagnosed is excellent. Before a diagnosis its behavioral health with much lower coverage from the insurance company. After diagnosis it's considered medical. For DS, who as a diagnosis of ASD, we pay $30 for each therapy session. Once we spend $6k on him we don't pay anything extra. Yes our insurance costs $25k a year but if we were in the U.K. we would probably be still waiting for an appointment with s developmental paediatrician. My DC see a paediatrician for their regular appointments and it's been amazing to have out of hours care over the phone when our DC have been sick in the middle of the night.