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.

[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

[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.

[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.

[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.

[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.

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

[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.

[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.

[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]

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]

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).

[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]

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