Private education and healthcare

[LeafUsAlone]

I'm just curious as to why they are considered morally indefensible when people being able to afford better quality clothing, houses, safer cars etc aren't commented on in the same way?

Considering both private healthcare and education doesn't necessarily mean a better quality, why do people get so annoyed over them?

There are quite a few logical problems with your argument here, not least your sleight of hand in equating the OP's statement about public goods with the concept of a universal right, and the pretence that "human rights" is not a term with a widely understood meaning as a single concept (which is how it made its entry to the thread with some hilarious intercapping).

The reductio ad absurdum on Congo is properly funny though, so please do crack on.

Both healthcare and education systems are a shambles, but If private health and educational services were dismantled tomorrow it wouldn’t make the state systems one bit better.

I think there is a need for private sector in both healthcare and education. In education I think people should be able to opt out from the one size fits all approach of the state sector. Mine are privately educated in part due to SEN that is very poorly catered to in state, but also due to philosophical differences in what education should look like. I don’t particularly care for the English system, and have found a lovely non-selective independent that provides a robust education but also better aligns with my values.

in healthcare I do believe thoughtful privatisation is required to dig us out of the NHS crisis. We are seeing a big surge in private healthcare in response to the utter inadequacy of the NHS, and that genii isn’t going back in the bottle. A healthy and well regulated / integrated private system has the potential to grow the total healthcare offering as it attracts more clinicians to stay in the UK, stay working, work more, etc. The system of barring private and state cross referral is idiocy imo, as I know several people who have gotten private assessments for adhd / autism due to a 3year wait in my area for assessment. Because the NHS won’t take them back after diagnosis, the advice is to remain in the NHS queue while they pay for private treatment in the meantime- making the queue unnecessarily long for those that have no other option than to wait for the NHS. The NHS is cutting off its nose to spite its face.

Because it is rationing essential services by price - and a return to the days when decent healthcare and education were only available to those who could afford them and everyone else was left to make do with a second-class service.

Because private healthcare and private education do not free up resources - they cannibalise public services and leave them short of doctors, nurses teachers etc. There is a finite number of these staff (mostly trained at the taxpayers' expense) and as more leave the public sector to work in the private sector, that leaves fewer staff for the public sector.

As for the Conservatives' usual arguement about the Free Market, this clearly only applies when it benefits them and their supporters. When doctors and nurses decide to organise and strike in order to negotiate a better pay deal they are vilified for "putting patients' lives at risk" and have pay deals imposed on them.

The present government has deliberately and systematically underfunded the NHS and schools to the point where both are at breaking point. No other advanced country has over 10% of the population waiting for a hospital appointment. In no other country are 250 people a week needlessly dying because of delays at A&E. The UK ranks amongst the lowest of all OECD countries for the ratio of doctors and nurses to patients - the impact of which is glaringly obvious in the problems of even seeing a GP, accessing a hospital appointment and then waiting again for treatment to commence.

Austria has twice the number of doctors per 1000 population that the UK has. This means that a GP can be accessed simply by walking in and waiting a maximum of 30 minutes. An appointment with a Consultant can be booked within 7-10 days. This is what healthcare should look like in the 5th/6th/7th wealthiest country on the planet - not the shambles that exists in the UK.

I think being able to own your own property (as opposed to council or renting) confers more advantage for a child than a private education - short term and longer term. Security and quality of housing is fairly key in the hierarchy of needs. Yet nobody is demonised for wanting to privately own property, as opposed to living in whatever the LA would otherwise provide.

Also, nobody is demonised for being able to buy homes in catchment areas for the best state schools.

Yep, communism doesn’t work too well either.

I understand that though. I am against private education in theory but as I work in a state secondary I know how bad the behaviour is and also see the extra opportunities they get at private - if you can’t beat ‘em, join ‘em.

No body here has called for an immediate dismantling of these private services and nobody is claiming an immediate dismantling would improve public service. That does not mean that those services benefit society.

Yes, people are demonised for obtaining those things in excess and to the detriment of others.

It's an interesting one and I wonder if it's even possible to disaggregate the impacts, given the large crossovers between the privately educated children owner and children growing up in owner occupied homes.

It would be fascinating to see research on this if anyone has it - it feels like such a complex mix of security of tenure leading to greater stability in education (owner occupation and social rental), accumulation of wealth and potential for intergenerational wealth transfer (owner occupation only) and then the rapidly shifting dynamics of private rental. But we do need a combination of many more houses, many more houses with secure tenures, and private rental reform to improve baseline security of tenure as a key part of tackling inequality, for sure.

I haven't sleighted anything. I'm arguing that these things aren't human rights and broadening the concept to demonstrate the point. That's about it, and you're misusing your Latin.

Feel free to point out the other logical problems rather than simply alluding to them.

So eloquent.

Oh, you genuinely believe that public goods and human rights are the same thing, and weren't making a knowingly dishonest argument? Cool, good to know.

May well have my Latin terms wrong, my philosophical and rhetorical education was a while back and I'm a little rusty without sufficient coffee. Apologies and all that!

@Havanananana Austria has a two tier healthcare system by design, has a thriving private sector and ability to use private health insurance in public settings to access quicker or more convenient appointments, enhanced services, etc

But if getting rid of them wouldn’t improve public services, why object to their existence? Why do do you think private service has to improve society?

fwiw, I do think robust private sector can have a net benefit for society depending on how it is structured, but I don’t think private entities have a public obligation.

Removing private education will not even make a minor dent in the attainment gap. Parents who can afford and are prepared to pay for private education will pay for tutors, extracurricular sports, music lessons and a whole host of enrichment activity, trips etc. A warm house, a quiet place fo do homework, full fridges, no responsibilities to look after younger siblings.

@ThePure Thank you for your measured post. I know that NHS staff are leaving for the private sector and thank you for holding the line. Why the NHS takes the prize colts and fillies of our youth and turns them into carthorses, I have never understood. I deplore state school teachers who do private tuition, but your pay is so bad, I get the transfer to from the NHS private employers completely.

Theoretically, a transfer to private healthcare and health insurance is a good idea IMO. Too much of the burden on the NHS and mental health services is due to lifestyle choices: drugs, alcohol, alcohol consumption during pregnancy (that's a timebomb no one will admit has gone off), obesity, lack of exercise, bad foods, poor parenting, social media and screens.

People do not respect stuff given to them for free. Your taxes haven't even paid for your share of your local hospital's heating bill and staff, let alone your kid's brace. If we had to pay, even a token amount (called insurance), people would be forced to take better care of their own health. Those who didn't take care of their own health would no longer be subsidised.

However, in practice, I know that a decent level of insurance cover would be priced out of most people's budget. The regional health inequalities would persist, as individuals have no agency over education, unemployment rates and affordable housing, fuel and quality food. The basic free level of cover would be unacceptable.

We will continue to abuse the NHS as a way to mitigate our poor lifestyles until people start to die en masse. In the meantime, private healthcare services will continue to grow. I'm not sure what will happen then.

“Getting rid” is a rather vague term. I said this thread wasn’t supporting ‘immediate dismantling’ or claiming it would be beneficial. I think the current use and set up of private education and healthcare actively degrades public services and such institutions should be scrutinised and reformed so that their impact on the overall good to society is far less.

And that’s why things like this begin and end with the redistribution of wealth.

Surely it is the poorly functioning public sectors (90% of each sector) that require reform, not the tiny but (mostly) functional private operators?

nothing stopping you from redistributing your own wealth…

It’s nothing to do with abusing it because it’s free - if that were the case, the US population would be the healthiest in the world, not a nation of fat fentanyl addicts.

@Labraradabrador Austria has compulsory health insurance through the Krankenkasse system. While it is possible to take out private insurance, few people bother because a GP can be seen just by walking in, Consultants are usually seen within a few days (the receptionists actually apologise if appointments cannot be obtained within 2 weeks) and I've had surgery within 5 or 6 weeks of initially seeing my GP. This is the norm. This is what public healthcare in modern wealthy countries like Austria, Germany and the Scandinavian countries looks like.

Unlike in the UK, the two tier system does not result in the neglect of the public sector system. After WW2 and once the economy had improved, Austria (and Germany too) decided that the default standard of healthcare offered by the public sector should be at the level previously only affordable by the rich. First class medical services should be available to everyone, paid for through ringfenced contributions from employees, employers and the government. The Krankenkasse money is ringfenced - unlike the UK "National Insurance" which began with the same good intentions but which has been hi-jacked and abused by governments and the Treasury for the last 50 years or more.

My wage slip shows how much income tax I pay, but also a separate amount for my health insurance, and another separate amount for my pension. Everyone grumbles about how much they pay - but at least they can see what they get for their contributions. A situation where people cannot see a GP or where they have to wait months or years for a hospital appointment would simply not be tolerated. In the UK though, those who can afford to simply shrug their shoulders and pay another few hundred pounds a month to a private healthcare subscription that benefits them, but baulk at being asked to pay a little more in tax or NI that would benefit everyone.

I wouldn’t baulk at paying higher tax if i knew exactly what my money was going towards and how it was being used. I think a major issue we have with education and healthcare in the uk is the government promise for ‘more funding’ but the money isn’t being used properly to make actual change. Policies and processes need to change as well. I’m not sure extra funding would have stopped the boys at my state primary attacking me.

I do. But thank you for checking.

I think they both require reform for very different reasons.