To think the time has come to abolish the NHS healthcare model

[OptimismvsRealism]

Free at the point of use also means denial of care to a lot of people. What torture to know that new medications are arriving regularly (eg lecanemab) but it's only for the very wealthy.

The UK is different from how it was in 1948. We should be brave enough to move on from then.

The NHS is one of the worst systems in the developed world and it is responsible for the UK's really poor productivity.

Based on what statistics?

Where only those wealthy enough and who don't already have a pre-existing condition can get and afford insurance to fund the fancy drugs.

Now we are getting there - you resent paying taxes for the NHS when you have private health insurance.

The NHS, for its size, is one of the most under managed organisations there is. It had huge satisfaction levels until the Tories gutted it. It needs proper funding to return to its glory days and if that means more tax for you and me, so be it.

There is nothing more unedifying than wealthy people whining about tax.

You would think that, wouldn't you OP?

The NHS could do with a rethink, starting with the social care whose failings wind up burdening hospitals. This will inevitably involve us as a country paying a lot more.

But when it comes to high ticket price drugs, the NHS's massive consolidated bargaining power gives it a huge advantage over less centralised systems.

I agree. We need a mixed funding model like in many European countries. Some finding from direct taxation and some from insurance payments; but state run ones not for profit, not the American model. The NHS is actively killing people at this point due to delays in care etc and yet people won't hear of an alternative. It's baffling. Do they just not know how poor it is compared to most of Europe?

Amen

European insurance model with free healthcare for the poorest

How about this funding model - wealthy people pay more taxes.

Agree fund this model properly for a start.. I wouldn't trust any government to change the current model as I would be worried that they would attempt to make money out of any changes - and heath care would be become about profit over care and that is not a society I want to live in thanks!

You can see what happens when they attempt to change the model - look at dentistry for example, what a mess that is in!

Then we will have people moaning about free healthcare like they do "free" housing and posts and news items like "my neighbour is committing free healthcare fraud.

Yep! There’s a reason no other country in the developed world has it, it doesn’t work. France, Germany, Australia, Canada and so many other countries all have systems way better than ours that would absolutely be doable. There are a lot of stages between the nhs and USA models but everyone always goes straight to the USA as if it is the only option. No politician will ever be brave enough to do it though so we’ll be stuck forever

Whilst Lecanemab may not be the magic bullet - there are many more Alzheimer's treatments in various phases of clinical trials. We can expect (and hope and pray), that one or 2 deliver even more efficacy. Many have failed and 100s of millions spent to get us to this stage.

When this more efficacious drug/treatment comes along, the NHS will not be able to fund it - unless something is done now to fund it better. Or to fund healthcare better. Looking at the European/Canadian models is smart as we need to respond to the times - an aging population, increase in ultra-processed foods, more sedentary lives and expensive R&D.

Investing in UK pharma and home-grown research also needs to be factored in - hence we now have a life science minister (science and research), office of life sciences etx

Genius idea....except their numbers are dwindling and expected to reduce further.

We can chase the rest away though - and then just tax the rest of us. There should be some people left. Let's hope that covers it!

And which funding model would provide this drug?

Answer = none

The nhs needs to be completely overhauled before u put more money in.

Yes the NHS needs radical reform. I know the NHS up close and it’s an inefficient money pit. So much money wasted on “managers” who are not clinical or medical and therefore send 7 doctors to a quiet medically stable ward, and then send 1 junior doctor to a busy ambulatory unit. Stupid. These managers should be made up of ex
/retired doctors but arnt. There is also so much bureaucracy. Also so much money wasted on foreign medical doctors including consultants - who frankly some of which are not up to UK standards and outright dangerous. It’s hard to criticise the NHS because it has been almost cannonized/sanctified.

It might have had 'huge satisfaction levels', but that's irrelevant really. What actually matters is outcomes. NHS outcomes are, and always have been, worse than many other countries.

We should set our sights higher, not be satisfied with an inferior service. Deification of the NHS has led us to being pathetically grateful for a healthcare system that lags behind other countries. I say that as someonlne who has worked in the NHS for decades.

I just looked up the tax rates for the Netherlands.

As a higher (not even additional) rate taxpayer, I’d pay about the same tax there as I do here, when everything’s included.

it’s average earners who seem to pay more. I think the issue with the UK is that we have too few net contributors.

I’m terms of new medication not being available my brother died because of this reason. It was sat in the shelves and 2 weeks after he died it was released for NHS patient, complete rage and heartbreak

I've just been to San Francisco. You certainly see the result of a healthcare system that isn't free at the point of entry.

Women standing in the streets taking their clothes off , men with broken wheelchairs. It's absolutely awful.

Go yourself and have a look at what our future could be!

It is a predictable part of ageing that needs to be planned for in the same way that people should plan for children.

The thing is, an average person cannot plan for it in advance - there is no such thing as a long-term care insurance policy you can take out, so you are left either selling your home or ploughing through savings (obviously people have different views on whether this is fair or not) or your local council has to fund it for you.

My dad's care was £1,645 per week, he was in care for 2 years and 7 months. He paid a total of £230,300. Who has the ability to save this up and keep it to one side in case they need social care when they're older?

My own wildly controversial view is that social care should be funded out of taxation and this particular tax should come from people's estates. That way the burden is collective, so society is fairly sharing the risk. There would obviously have to be a sliding scale, like stamp duty, so if your estate is less than a certain amount you'd pay nothing, and above a certain amount you'd pay between 5-10%. I'm plucking these figures out of thin air but you get the gist.

Eg, you have an estate of £300,000. When you die, you pay £15,000 social care tax. You still get to leave £285,000. But the care you needed in your final years was free.

I'm sure it's all way more complicated than this and people will offer reasons why this is a terrible idea. But later life care is a lottery. Need care due to something like liver or lung disease? You probably won't pay. Need it for a brain disease like dementia? You'll probably pay a fortune. Spreading the burden across the whole of society removes that lottery, with a small impact on your estate that won't even affect you as you'll be dead.

Sure, this is idealistic and doesn't solve the other issues like lack of facilities and trained staff, but unless social care is sorted, and people can be discharged from hospitals in a timely way rather than clogging up beds, the NHS will never get on an even keel. THIS is the main issue blighting the NHS, and if it was resolved we could then start tackling waiting lists and all the other reasons why people are not currently getting the care they deserve.

It’s not a Tory issue or a labour issue- it’s a government issue. It’s been awful for many years even when Gordon brown was in.

Meaning locum doctors. *

I'm in an EU country. I pay between 6000 and 7000/year for my statutory (i.e. not private) health and social care insurance, as a % of my (modest to middling) pre-tax income. I'm self-employed; if I were employed, my employer would cover half of this. It's a huge expense - looked at like that, it does cost me 'thousands', and - as most years I probably don't cost as much as I pay - I'm partially subsidising others. I get relatively speedy access to the healthcare I need (certainly no waiting months to years for necessary ops or investigations), can see my GP whenever I need to, and would also get sick pay for 1.5 years at 70% of previous income. If I earned less I would get all that and pay proportionally less. There's also an upper limit/cap in the other direction. So it doesn't cost nothing, but it's fair.

Until relatively recently our system was the envy of the world... BUT 14 years of under funding has damaged the system so much. You really can't underestimate how badly the Tories screwed the NHS up...I want politicians to be brave enough to admit that failure and say they will fund it properly. There should be no need for private health care in the UK but politicians are afraid to say that because of this.... Private health firms donated £800,000 to Conservative Party | openDemocracy