BBC news saying Scotland discussed possibility of wealthy being expected to pay for nhs treatment

[Ruizy]

Feeling a bit horrified at the prospect of this proposal. Surely it would just mean those above a certain wage would have to take out bupa style insurance. But not sure what would happen to emergency care.

It's well accepted the world over that people use healthcare more as they age. That's why many countries (even America brought this in with Obamacare) make insurance compulsory.
It's the fit healthy people in their 20s and 30s paying into the system but hardly using it that helps pay for those in their 70s and 80s who are using it a lot. Then their time will come.

Whether it's giving the money for our healthcare directly to the Gov as we do here, or paying it to an insurance company the important thing is we need EVERYONE paying.

I do wonder if the asylum seekers being placed in hotels at 1k a week there's a few near us. That model couldn't be adopted for bed blockers. Carers could then be placed there to aid those needing assistance the others could eat three meals a day, have ensuite facilities and recover in pleasant surroundings.

My MIL hip OP done was in a cottage hospital for her recovery. She walked everywhere after that

The issue isn't a lack of physical beds. It's lack of staff to provide the care.

"Carers could then be placed there..." - which carers? Where are they going to come from?

Also, those who don't need any assistance would be sent home, not left in hospital.

The thorny issue of making the 'rich' pay is with regards to assets versus salaries e.g. should a young person who earns 45k but rents pay more than a pensioner who is cash poor but live in an expensive house?

It's not about the NHS paying to IVF or other treatments for the young. We need to rename the NHS - geriatric care and are back to the question of how do we care for the elderly and who pays for it. Most adults remain pretty fit while they work - almost everyone needs some form of healthcare past 70.

In terms of expense - if you are feeling you are most expensive when you have kids and over 70..for men it's over 70.

At least in Europe some of that conversation is easier if people are renting i.e. paying for healthcare doesnt come out of selling their house. However in the UK - no party wants to touch the pensioners because they vote.

Ask any GP - most of their time they are doing geriatric care - thats what the NHS is mostly focused on nowadays

Assuming that by 'wealthy', they're not just including the multi-millionaires, what happens if somebody who is comfortably off gets an illness that ends up costing a colossal amount of money - and maybe they're excluded from getting health insurance because of a serious pre-existing condition?

You could easily end up with a 'rich' person on £100,000 a year (before tax) being expected to find tens of thousands of pounds - or more - for their essential treatment; whereas a 'poorer' person on £30,000 gets all of theirs free. Would the idea be to punish people unlucky enough to suffer very poor health by financially destroying them until they end up far poorer than a person with an average income? Make them spend every penny until they end up having to beg the council not to leave them on the streets?

This idea is nasty - and I say that as somebody who earns too little to pay any income tax. Why do we always have to be looking for another country to emulate when we already have a system that should be the envy of the world?

We didn't live so long back in the day, also, as my Mum worked in a Geriatric ward, packed full of the elderly, i don't think looking after Granny was such a widespread thing from the 50s or 60s onward.

You lived in a MC area if people had a car, in the 40s and 50s it wasn't the norm for many, just 3m cars in 1955.

Almost all EU healthcare systems are tax payer funded models and they seem to cope far better, despite changing demographics too, lack of investment in UK and no FOM, is the biggest difference for the UK.

In my amateur judgement some of the problems arise from the wider context. The cost of social care must be one of the biggest problems. I feel sorry for lonely elderly people in care homes or even in their own homes. Maybe I'm looking through rose-tinted spectacles, but I think in the fairly recent past elderly people were more likely to have more help from their own family members. Life -expectancy was lower of course. Nowadays almost nobody has the space in their home or the financial ability to afford to give unpaid care to elderly parents.

I blame this on the housing market. Back in the day lots of families survived relatively comfortably on one wage and the partner - usually the woman was more likely to take on more unpaid caring. If housing wasn't so ridiculously expensive couples could do less work between the two of them and provide more unpaid care for family members when they need it. The money we have to pay on housing must be a huge loss to the economy- it doesn't 'go' anywhere if you buy with a mortgage except to the banks or private landlords.

We also have a huge problem with our drinking culture. I'd like to see a campaign to change our culture to one where people don't routinely have binge drinking sessions where it's not odd to not drink or to go out for an evening and have just one or two drinks. The cost of drink related accidents and the health effects of alcohol, and other substance misuse must be astronomical.

Obesity needs to be tackled too.

And we need more education on what's treatable at home and doesn't need antibiotics.

Tackling air pollution would save the NHS money.

I'm sure there are lots of other things that would save the NHS money if there was a will to tackle them. Prevention is presumably cheaper than cure and better for everyone.

Ahh kind of x-posted.

We need a discussion around lots of uncomfortable and unpopular topics.

Because we are currently sleepwalking into disaster.

Try Benenden health

@Suzi888 i think we are already there, tbh the UK doesn't really have a functioning health service.

I agree that conversations need to be had at a government and national level on this. Whilst I appreciate that this was debated by senior officials in the nhs, who understandably are looking at it solely from the nhs perspective, we must also seriously discuss the ongoing issues with social care.

We keep hearing reports of bed blocking by the elderly which is in part due to underfunding in social care and with an ever increasing ageing population we really need sort this out in conjunction with the nhs.

Here is the average spend so you can see an ageing population will create strain year on year. What’s the answer - if people expect others to pay more what is the increase and who is taking the higher burden?

We all have to pay more. I accept that. The answer is not to expect everyone to pay an excess for every treatment though. It will lead to many people dying who can't afford to.

Agreed we do need to be honest with ourselves. Elderly people rattling around in large homes on limited income need to downsize. I bit the bullet and prodded, pushed OH into downsizing from a big house with a couple of acres into a dormer bungalow, small garden when he was 65 he moaned, blamed me threatened to go back to the isolation village we had enjoyed for decades. Six years on his health has declined, some big ops. Arthritis set in. We and the house would have rotted together if we'd stayed. Energy bills were £3.5k back then. Oil heating and fireplace for heating.

Our neighbours still in big family home. They only live down stairs now. Hang onto the house so children and grandchildren can visit twice a year. It's nuts. Downsize and look into Airbnb.

And health spending is always highest for babies and the very elderly. That is partly because social care is so poor. My mother cost the NHS more money than needed as she died in a hospital as nothing could be arranged in time. She could not return to her council house without some equipment and adaptations even if I had cared for her. And it all took too long.
If you want to reduce the spending on elderly people, sorry social care. That is the elephant in the room that no one wants to address.

Seriously this just annoys me. Bungalows cost more than houses. My DH and DD are disabled with declining mobility. We live in a terraced house. I would love to be able to afford a dormer bungalow. Even my friend who is in a semi detached house in a decent area can not afford a bungalow. She has tried, but anytime she found somewhere cheap enough she was outbid.

Why do you think so many elderly people end up buying those rip off serviced elderly apartments? We desperately need housing suitable for elderly people at an affordable price. Provide that and people will choose it. Most people are rational.

And I will be working till at least 67. I need somewhere near my work.

I read a couple of years ago the biggest users of the NHS are people in their last 6 months of life.

But whatever its in everyone's interest to have a good health service and good education.

It doesn't matter if its insurance funded or tax funded it needs proper funding and more staff on a decent wages to encourage more staff to train and be retained by the NHS

We did have the NI increase - I can’t even remember if it remained cancelled or not. I was pro that but even other parties said no.

I wasn’t that high again can’t recall, but if people want higher funding how much more than that and who pays?

@Dinoteeth That is because so many people end up in hospitals sometimes for months, while they try and sort out social care. This is the case even if the elderly person is paying for that social care. If someone needs two carers because they can't stand at all, then it can be very difficult to find two carers who can take on someone else.
Social care needs sorted first. And insurance companies are not going to pay for people who need social care to stay in hospital. So people will be literally dumped on families.

The issue with NI is that it's only working people who pay it.

A tax rise on Income or Vat means those with higher incomes or who spend more on luxuries would be the payers - including thd wealthy business owners and pensioners.

I agree. A tax would be paid by wealthy pensioners as well. Especially as our population ages, an NI increase to fund NHS costs is crazy. It leaves out a large section of the population who should pay increased tax. Why should wealthy pensioners be exempt?

They shouldn't