Uk is in big trouble - what do you think will happen?

[hippysun]

Thames water on brink of collapse. All those CEOs getting fat bonuses. Water shortages and rising bills.

the cost of living is off the chart. Every bill has gone up. Pop in to Tesco for toothpaste, butter and chicken and it costs an insane amount for just a few items.

the government are crap and taxing the hell out of us.

my salary is stuck. I feel constantly poor now. 10 years ago when I earned significantly less, I felt ok money wise. Chatted today to a colleague about science graduate son who is stuck doing a minimum wage job as there are no jobs here. I’ve noticed this myself in my town. The council have a few, other companies outsourced to India years ago, the pharma company moved out years ago and the land will soon be a new housing estate.

the nhs is a total mess.

housing costs make me want to weep! No chance of moving. Feel bad for my kids. They just keep building expensive houses here all packed into poorly designed estates. Tiny gardens. But no infrastructure. The promised schools get cancelled and drs surgeries and hospitals are rammed with patients. My mortgage of course is up.

in my industry… everyone is obsessed with AI and I’m sad to say it has taken some jobs already. There is a huge push towards AI.

there seems to be underlying tension here re migrants. People getting increasingly annoyed.

this country feels like a right mess. Making rich people richer and poor people even poorer. The middle earners are getting squeezed. I hate it.

i don’t remember it being this bad ever before.

why is it so terrible? And what do you think will happen?

@smugmugg

Age of death doesn't actually change health spending that much. It's the last 10 years of life which are very expensive - whether that's your 60s or your 80s.

Note that the doubling in the graph was before 2020, so doesn't include Covid.

I've heard it said that AI should be treated like the young, over-enthusiastic intern. One should check over their work very carefully before publishing. There's a lot of slop about.

It's actually mainly because medical science has advanced so much

that's a given because people are been kept alive longer

It's not to do with staying alive longer. Like I said, someone who dies at 90 doesn't cost more than someone who does at 70.

It's that when they have that heart attack (whether at 65 or 85) it costs £40k instead of £1 for an aspirin and see if they're alive in the morning.

Age of death doesn't actually change health spending that much. It's the last 10 years of life which are very expensive - whether that's your 60s or your 80s.

The last year if your death is expensive but the idea that we don't spend more on an 60 yr old or an 80 yr old vs a 30 yr old is again nonsense. People start to develop chronic diseases in middle aged.

But you can disagree that an aging population doesn't increase healthcare costs 🤷🏻‍♀️

People die a reasonably consistent time after developing illness - and need a similar amount of care in that time. It doesn't make a difference how old you are when that ill health starts.

It's not to do with staying alive longer. Like I said, someone who dies at 90 doesn't cost more than someone who does at 70.

Can you link to this please? Because most 90 yrs olds will be on some form of medication and have more frequent emergency admissions.

It’s not as simple as that. There are more people over 65 with the consequent health implications and the population generally is sicker, there’s an epidemic of obesity and diabetes, leading to cardiac disease. The NHS spends 10% of its budget on diabetes. Rising health costs aren’t because patients are having groundbreaking treatment, they’re because people are needing treatment for entirely avoidable long term conditions.

People die a reasonably consistent time after developing illness - and need a similar amount of care in that time. It doesn't make a difference how old you are when that ill health starts.

This doesn't even make sense!

That’s nonsense. I’m 70, if I died tomorrow my last ten years would have cost virtually nothing, the same as the rest of my adult life.

I wonder where people will work when AI comes in. What's the point of having loads of unemployed people and AI doing a substandard job?

Look on the bright side. It could be worse…

There isn’t a war on.

When my grandparents were kids they were being bombed by the Nazis.

They’re all dead now but they would wonder what all the fuss was about.

They could also remember a time before the welfare state when there was real poverty (ie can’t afford shoes, having literally nothing to eat etc).

I don’t want to scapegoat anyone, but I do wonder how it can be that there are homeless veterans living on the streets while new arrivals get put up in hotels with everything provided for them.

Perhaps we could have a similar scheme for our homeless to make it fair and reduce the scapegoating?

We're talking population-level averages, in order to understand overall health spending changes.

https://ifs.org.uk/articles/how-does-spending-nhs-inpatient-care-change-last-years-life

You have to look at the numbers carefully - the cost at different ages depending on survival rate is particularly interesting

"an important reason as to why average health spending is so much higher at older ages is that individuals are much more likely to die in the next year at an older age."

A longer-lived population does of course increase health spending. But far, far less than the expensive new treatments we have available.

It's so inefficient it ends up costing more. You have to keep going back for the same condition because it wasn't dealt with adequately in the first place. The waiting times of a year or more, mean conditions get worse in that time and are then more difficult and expensive to fix.

@strawberrybubblegum did you even read that article?

"A well known consequence of increasing longevity and an ageing population is the upward pressure it places on health spending. Looking simply at the correlation between age and average spending there is an upward age profile in health spending, with older people costing more to treat on average than younger people. Growth in the size of the older population will therefore tend to increase total spending."

OK, let me word it differently.

If you start having heart problems at 60, in and out for diabetes related issues and COPD, had heart srgery at 69, you may die at 70.

If you start having heart problems at 80, in and out for mobility issues, had heart surgery at 89, you may die at 90.

The fact that you had heart problems - and some other less serious illnesses which were related to your general state of health - and needed care costs about the same. How old you were when it happened doesn't really matter.

Keep reading. It's not that simple.

And the effects are less than increased treatment options.

That data is six years old and pre covid.

If you start having heart problems at 60, in and out for diabetes related issues and COPD, had heart srgery at 69, you may die at 70.

If you start having heart problems at 80, in and out for mobility issues, had heart surgery at 89, you may die at 90.

What you are missing out is that you may not die at 70 & that it's very rare to get 80 without any kind of issue.

Where we clearly are is with a population going into retirement who benefited from more opportunities although that is not to say things were always easy. They are followed by generations without security of housing, increased debt and less in pensions. The proportion of people in work is too low and being asked to fund too large a state when they are struggling to keep own heads above water. Aging generations are in denial about their privilege and blaming younger generations consumer culture for all the issues. Lots of scapegoating of migrants. The reality is that house prices were last affordable decades ago and it is affecting everything in society with other contributing factors. This country never got over the credit crunch.

I get what you’re saying.

Keep reading. It's not that simple.

the basic premise is that simple. An ageing population leads to an increased healthcare spend.

And the older you are the more likely you are to develop dementia, it’s the leading cause of death in the UK and it takes years to kill you.

Anyway, regardless of cause, the tax that a UK person pays now has to cover twice as much health cost, as well as ballooning working age benefits costs, and yes higher pension costs. It doesn't work. The state needs to reduce what it provides.Even if that means people's lifestyles go closer to what they were a few decades ago (probably not even what they were in the 70s). Because that's how much we're producing, and how much we can afford. If we don't act, then it will be forced on us.

@strawberrybubblegum so what things would you reduce on the NHS?