NHS should be a co-pay system.

[PeonyPatch]

Who agrees? Other countries who use this model include France, Germany and the Netherlands and they are some of the highest ranked healthcare systems in the world. The NHS is no longer fit for purpose, and it hasn’t been for a long time. I am proud that we have a free at point of access system here but it’s no longer sustainable and has been mismanaged and inadequately funded for a very long time. The only way I think it could improve is by gradually making it co-pay - perhaps capping it like Germany does.

Did I say ALL? Are you representative of everyone in the UK?

Many, not all, NHS patients could improve outcomes and reduce avoidable strain on the system by managing their health more proactively.

Is what I said

@ThingsAreNotWhatTheyWere I don't like being made to feel like a burden to the NHS by strangers when I'm already well aware of the fact.

Then I suggest you address that to people who are saying that, not me.

Many smokers don't pay the tobacco duty because they buy knock off duty free from their mates down the pub or under the counter from dodgy convenience stores or go themselves across the channel to stock up on booze and fags if they live in the South East.

Lots of older people don't cost the NHS much at all - not everyone ends up with expensive treatments required in their old age - lots just live a pretty healthy retirement and drop dead after costing the NHS very little indeed.

Many smokers don't pay the tobacco duty because they buy knock off duty free from their mates down the pub or under the counter from dodgy convenience stores or go themselves across the channel to stock up on booze and fags if they live in the South East.

Completely irrelevant. The figures I’ve quoted are the revenue the Treasury actually receives from taxable tobacco sales, the fact that it could be more if there was no black market is neither here nor there.

A heavy smoker who develops lung cancer and keeps smoking is likely to cost the NHS considerably less because they’ll die much sooner.

Not all of them do. But all of them whether they live a short or a long time are costing time, resources and money. All of which are in short supply.

Alcoholism is an illness. George Best received a liver transplant and was warned to stop drinking. He didn't and died a year later. His treatment, cost time, money and valuable resources, which included a liver. A liver that could have gone to someone who did not or no longer consumer alcohol. Survival rates at 20 years, post transplant, are around 50%. Add to this that around 1 in 10 people die while waiting for a transplant or become too ill for a transplant. There are financial and non financials cost for personal choice.

Either way there’s little I can do about it. It’s in the lap of the gods. Or, of course, I might get diagnosed with cancer tomorrow, who knows?

You are not special, we all carry health risks, some you can’t control, like genetics or random chance. You might still end up with something like dementia or cancer. But there is a lot you can influence through how you live and manage your health, which can affect when illness shows up, how severe it becomes, and how much strain it puts on the NHS. That’s not about blame, it’s just reality or scarce resources, and why personal responsibility has to be part of the conversation.

@NorthXNorthWest

You are not special, we all carry health risks, some you can’t control, like genetics or random chance. You might still end up with something like dementia or cancer. But there is a lot you can influence through how you live and manage your health, which can affect when illness shows up, how severe it becomes, and how much strain it puts on the NHS. That’s not about blame, it’s just reality or scarce resources, and why personal responsibility has to be part of the conversation.

Another point is that being fit and healthy improves your chances of harsh treatments being tolerable and effective. Take one of the many cancers that doesn't have "lifestyle" causes. Being fit and healthy may well improve your tolerance of the chemotherapy and other drugs, may mean that you can tolerate a stronger dose to hit the cancer quicker and stronger, or even a "healthy" gut system may make some of the drugs more effective due to absorption etc.

My DH has a cancer with no known causes - his haematologist has often told him it is pure "luck" as to who gets it and who doesn't. She's been regularly amazed at how well his body responds to the treatment. His first course of chemotherapy should have been "at least" six rounds and he was started on the highest level of drugs to "hit it hard". The blood "markers" for his cancer halved after just the first round, then halved again after the second round and were negligible/trivial after the third round, so they didn't do rounds 4 to 6. Haematolologist said she'd never seen anything like it. And that was after they'd halved the chemo dose for the second and third rounds. DH was "super" fit, had always eaten healthily, never smoked nor drugs, very moderate alcohol (occasional, not even weekly), not overweight, plenty of exercise (walking, cycling, swimming, skiing, golf, squash etc). He was told that the first chemo session would "probably" last 18 months before the next major treatment cycle was needed (it's incurable, but treatable), but the very lose "maintenance" dose he's been on, has now lasted 7 years and is still keeping it under control, which again, the haematologist has never heard of before!

I do think people need to take their fitness and health more seriously. It really isn't just that so many diseases/illnesses are caused by poor lifestyle choices, it's that a healthier body can respond better to treatments for all the other diseases that don't have known causes.

Glad to hear that your DH has responded so well. These are the examples that people should be hearing more about. Not to give them false hope, to but to demonstrate how making certain lifestyle choices can impact outcomes. It's never to late to make those choices.

Guessing like us you don't have a severely disabled child !

Who is that directed at?

Canada attempted a co pay system some years back. It had to be scrapped because the administrative costs of running it were greater than the money it brought in. And no I don’t agree with the OP. It would never be run like any European system. It would be run along American insurance lines.

Look what happened to the student loan book. First run by the uk govt. with promises of capping interest rates etc. Students took out the loans on the basis of those conditions. Then the (Tory) govt decided it didn’t want the Student Loans on govt books so sold it to a private firm who would only buy it on the basis that interest rates could be set by the private company. The UK govt broke their social contract with the students and agreed. Rates are now double or triple baseline interest rates.

People are naive if they don’t think this exact same scenario wouldn’t happen to co-pay. Wait and see what happens if Reform get in. American health care companies are salivating at the thought of the UK market. Money to be made.