Charles Clarke has a good idea?

[jackstarbright]

Well I think it's interesting anyway. He's arguing for co-payment for services (even healthcare) More user charges would be effective and fair.

"The OECD suggests, for example, that in 1999, Government income from charges, fees and sales was about 0.2 per cent of GDP in the UK, compared with over 3 per cent for Austria, Finland and Denmark."

Warning to Tory girls - intro is (obligatory) Coalition bashing - then it gets controversial interesting.

[jackstarbright]

Scaryteacher - That's interesting. How do they get people to attend 'preventative check ups' doesn't the cost put them off?

[scaryteacher]

Yes, it's high taxes here, and healthcare has to be paid for to some extent by the customer, but it's excellent care and very thorough. They believe in prevention not cure here; ie brilliant diabetes checks for example every three to six months for monitoring and to prevent anything suddenly getting worse. This includes feet and eye checks.

[jackstarbright]

Trying to run an organisation in an effecient and optimum way using target setting, can result in unintended and harmful consequences.

You'd have thought by now humanity would have come up with a better way of allocating scarce resources .

(Not that I seriously think we should privatise the NHS).

[edam]

Re. people not turning up - sometimes this is because hospitals are playing silly buggers to meet waiting time targets, e.g. sending appointments when they know you will be on hols.

Sometimes sending letters to the wrong address or sending out after the appointment (some hospitals have backlogs of up to 12 weeks as the dictations pile up in the secretary's office - systems can be chaotic and grind to a halt if one person is on holiday). Or because it's impossible to get through on the phone and tell them you can't make the appointment.

My 76 yr old MIL missed a physio appointment yesterday because her lift (almost as elderly lady) wasn't confident about driving in the snow, and MIL wasn't feeling well.

If the NHS sorts all that out, maybe they can think about charging people. But they don't find it easy to charge overseas visitors who aren't entitled to NHS care, so I wouldn't hold out much hope.

[jackstarbright]

Scary - I think it was another Belgium resident on an old thread who mentioned that she paid high tax and made payments for the health service. Apparently, the health service is very good.

[edam]

French spend far more than us on health, though. Much higher proportion of GDP (and more doctors, too).

IIRC it's one of those pay up front and claim back systems, which clearly is a barrier to access. Could be wrong about that, though.

[scaryteacher]

JSB - I don't have to make co-payments for my health care as it is provided by the UK military.

I think we may need to look at co-payments at some stage; or stop providing appointments for those who persistently waste time by not turning up. Alternatively, charging those who do not turn up for stupid reasons via a Liability Order might be an idea as well.

[jackstarbright]

Edam - the French seem to manage health service co-payments ok. Maybe they have a more coherent, wide ranging and well managed list of exemptions.

[edam]

scary - good to hear Charles Clark was fine at education, he did have a habit of cocking up elsewhere though.

jackstar - there may be the potential to raise money but what about the impact on people who can't afford co-payments? The poor are more likely to suffer from ill-health and chronic disease. Prescription charges already put people off getting all their medicine - Citizens Advice Bureau have been arguing this, with solid evidence, for a decade. Current series of exemptions is chaotic and not based on any logic. I get free scrips because I have one chronic disease but dh doesn't because he has a different one.

I believe people on benefits get free scrips but that doesn't help the working poor on minimum wage.

[jackstarbright]

@Edam - I think Clarke's point is that whilst seemly sensible countries such as Finland and Denmark, get 3% of their income from co-payments, we get only 0.2% - so there is some income potential there for us.

@Scaryteacher - I think I remember you on a thread discussing Belgium's tax rate. If I recall correctly, In Belguim you have a high tax rate and have to make some co-payment (or have health insurance) for your health services.

To my mind - the problems with total free at the 'point of need' are:

People often have less respect for things they don't pay for (so, missed appointments, unnecessary prescriptions).

As resources will always be scarce - the more canny people will get the best of any 'free' service - the less able will often get a poorer service.

It's very inflexible to real demand (preparedness to pay is the best indicator of true demand).

Obviously there are risks - such as people put of seeing a doctor and a potential drop in preventative medicine.

But IMO, at some point our NHS will not be able to cope with the demographic changes and increased demands put upon it. Then someone might dust off Charles Clarke's ideas.

[scaryteacher]

Charles Clarke 'never impressed anyone when he was in the Cabinet anyway.'

I had time for him; he was very good as Education Sec - he left us alone to get on with it and was good for my subject area.

[scaryteacher]

Climate change is the latest thing to beat the public with - used to be religion, now it's global warming.

There is a co payment system in Belgium for health care and it seems to work very well. Health care here is far better than in the UK.

[claig]

yes the opinion polls show that the majority of the public don't believe the earnest talking heads on global warming. It goes to show that the old saying is true "You can fool some of the people all of the time, and all of the people some of the time, but you can't fool all of the people all of the time". But that won't stop the progressives, it is a long propaganda march and they will stay the course amd have the media on their side.

Edam is right about the NHS charges and particularly dentistry. It has been a scandal that so many people have to pay private and do not get NHS dentistry, when we have all paid our taxes for that. No party changed things. The socialists who pretend they care about the public changed nothing. There have been people who have pulled out their own teeth because of the pain, because they couldn't afford private treatment. Things got progressively worse under the progressives.

[newwave]

A million Countryside alliance march, problem is many millions detested what they stood for, as an ex huntsab I have seen those people at first hand.

I believe global warming is real and in truth most are turning to scepticism.

The NHS free at the point of delivery is sacrosanct to the British people, maybe a new "health tax" but can you see the headlines if someone dies because they are skint.

Nice having a discussion with you, most enjoyable.

Goodnight

[edam]

We already have some co-payments in the NHS. Prescription charges, charges for NHS dentistry.

Personally I think it's all wrong and we should stick to free at the point of need, paid for via general taxation where each contributes according to their means.

Btw, Charles Clarke is not only yesterdays' man, he's last century's man. And never impressed anyone when he was in the Cabinet anyway.

[claig]

They'll convince the public that the students are a bunch of anarchist Trots, and the public will eventually believe them.

[claig]

Do you think the progressives care about people? Millions marched against the war and they took no notice. They took no notice of the million countryside alliance, and they will take no notice of the students.

They will convince the public slowly, slowly just as they have managed to do with global warming.

[newwave]

In that case I have dodgy knees and ankles from far to much aerobics and have been in hospital because I fell off a mountain bike when coming down a very steep hill, would i be asked to pay ?.

Wont happen it would affect to many people.

[claig]

'Any party trying that on would be wiped out at a following election.'

Not if all parties agree, and there is no alternative. That's what happened with the increase in pension age, pushed by Harriet Harman and accelerated by Duncan Smith. Tuition fees are the same.

[claig]

As jackstarbright said, it was the progressives who brought in tuition fees. That was co-payment, but they didn't call it that in the early days. At first teh fees weren't excessively high, but they knew full well that one day they would be as high as they are now. they knew they would be ratcheted up bit by bit in a progressive manner.

[claig]

Slowly, slowly catchee monkey. Didn't you nitice all the earnest talking heads on TV discussing George Best and was it his fault, should the NHS pay for his liver, was he ireesponsible? Then there were radio chat shows were the public said it was George's fault. Remember that really fat man who couldn't hardly move out of bed who was on benefits because he couldn't work? Remember all the earnest talking heads saying it was his fault and he shouldn't get benefits?

They managed to ban smoking in public places, and smokers congregate outside in the cold. They fine pensioners for not closing their bin lids. There's nothing that the punitive progressives won't do to the public. It starts with co-payment.

[newwave]

claig, you come across as a sensible person but that last post is a trip into paranoia.

Any party trying that on would be wiped out at a following election.

[claig]

Their co-payment will soon mean that smokers should pay for their hospital treatment, and obese people should pay for their treatment, and alcoholics should pay for liver transplants (which of course they won't be able to afford). It's a long progressive propaganda march, but that's where they intend to go, but they are not telling us yet. It's called co-co-payment, and they use the plight of people like George Best to progressively change the public's attitude.

They are like spinners, tricksters and magicians, they pull these policies out of their hat, when they think the time is right.

[newwave]

Is Charles Clarke close to Ed M? I can't believe this has his endorsement - it'll be very interesting if it did.

Doubt it, Clarke is a dinosaur and Ed is looking for a new party image.

As for Clegg I will believe that if he votes against the fee rises, crocodile tears imo

[jackstarbright]

Of course, tuition fees were Labour's other main 'co-payment' policy. At the time the idea that those who benefit from HE should contribute to the cost - seemed reasonable to most people - not sure quite what happened .

Is Charles Clarke close to Ed M? I can't believe this has his endorsement - it'll be very interesting if it did.