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MarillionFan
27th January 2016, 13:45
And what is a fair share?


Well, you're going to find out in April. Loads more. Mwuhahahaha!

seanraaron
27th January 2016, 13:59
Yes. Fair is whatever the rate is that applies to your actual earnings as opposed to what you think you can get away with. I know I'll be in the minority in thinking that, but whatever.

FatLazyContractor
27th January 2016, 14:00
And what is a fair share?


Well, you're going to find out in April. Loads more. Mwuhahahaha!

And we will still take home more than those morbidly obese permies :laugh :laugh :laugh

Unix
27th January 2016, 14:05
Yes 10%

MarillionFan
27th January 2016, 14:14
And we will still take home more than those morbidly obese permies :laugh :laugh :laugh


Ho ho ho.


If only that we're true.


I guarantee no contractor is taking home more than me unless they're on more than 7k a week.

Lost It
27th January 2016, 14:16
Yes. Fair is whatever the rate is that applies to your actual earnings as opposed to what you think you can get away with. I know I'll be in the minority in thinking that, but whatever.

I agree. I don't mind paying tax. We wouldn't have the NHS etc. that we have without this funding. What bothers me is when the government think it's "their" money. It isn't.

SlipTheJab
27th January 2016, 14:18
Ho ho ho.


If only that we're true.


I guarantee no contractor is taking home more than me unless they're on more than 7k a week.

Bet you were sweating chip fat when the Pastie Tax was being proposed!

DodgyAgent
27th January 2016, 14:19
Do the same rules apply to contractors as applied to Google?

d000hg
27th January 2016, 14:27
Fair: yes
Being shafted: no

DimPrawn
27th January 2016, 14:35
Fair would be a flat rate of tax.

Say 25% of whatever you earn, whether it be £20K or £2M p.a.

But we all know, those in the middle pay the most.

d000hg
27th January 2016, 14:36
Fair stupid would be a flat rate of tax..FTFY

AtW
27th January 2016, 15:06
Fair would be a flat rate of tax. Say 25% of whatever you earn, whether it be £20K or £2M p.a. But we all know, those in the middle pay the most.

Germany has got 25% flat dividends tax... beats near 40% mark in this country from April :mad

NotAllThere
27th January 2016, 15:13
Yes 10%Unfair! 1% seems fairer - and then we could laugh at all the scheme users paying such high tax rates.

PurpleGorilla
27th January 2016, 15:21
I pay more tax as a ltd co (VAT & Corp tax) than when I was a permie.

NotAllThere
27th January 2016, 15:24
I pay more tax as a ltd co (VAT & Corp tax) than when I was a permie.

As a ltd co, you don't pay VAT. You just collect it and hand it over.

d000hg
27th January 2016, 15:29
I pay more tax as a ltd co (VAT & Corp tax) than when I was a permie.

You probably earn a lot more too, so what is your point? Google pay more tax than your company, so that's all OK too?

VectraMan
27th January 2016, 15:30
I pay more tax as a ltd co (VAT & Corp tax) than when I was a permie.

You pay more VAT & Corporation Tax than when you were a permie?

Well I'm shocked.

jamesbrown
27th January 2016, 15:31
I pay more tax as a ltd co (VAT & Corp tax) than when I was a permie.

You collect and remit VAT and it's doubtful whether more tax was paid overall. Your employer was paying CT on any profits you generated, as well Employer's NI etc. These comparisons always strike me as being fatally flawed. It's like comparing contract income w/ a permie salary, apples and pears.

AtW
27th January 2016, 15:40
You collect and remit VAT and it's doubtful whether more tax was paid overall. Your employer was paying CT on any profits you generated, as well Employer's NI etc. These comparisons always strike me as being fatally flawed. It's like comparing contract income w/ a permie salary, apples and pears.

No, they are not fatally flawed - businesses help generate more activity and result in more tax paid, that should be taken into account when taking them directly via corp tax, and also when taxing dividends. VAT is big revenue stream for the budget, much more so than corp tax actually.

FatLazyContractor
27th January 2016, 15:41
I guarantee no contractor is taking home more than me unless they're on more than 7k a week.

What? Chips?

You fat fu<k :laugh

AtW
27th January 2016, 15:46
Ho ho ho.


If only that we're true.


I guarantee no contractor is taking home more than me unless they're on more than 7k a week.

No denials regarding the "morbidly obese permies" bit...

and where is Mordac, did you eat him??? :eek

diseasex
27th January 2016, 15:48
If there was a party that would propose no tax for contractors would you vote them ?

I still remember a poll that asked internauts if they would want internet for free.... surprise surprise 98% said yes!

tl;dr dumb question!

jamesbrown
27th January 2016, 15:50
No, they are not fatally flawed - businesses help generate more activity and result in more tax paid, that should be taken into account when taking them directly via corp tax, and also when taxing dividends. VAT is big revenue stream for the budget, much more so than corp tax actually.

Yes, they are fatally flawed because, among other things, they fail to account for the CT and VAT being generated indirectly by an employee.

AtW
27th January 2016, 16:10
Yes, they are fatally flawed because, among other things, they fail to account for the CT and VAT being generated indirectly by an employee.

CT and VAT generated by the company, and people who take credit for it are the owners of the company, they should be getting credit for tax paid by employees in the business - that's the most fair way: all taxes generated by the company - CT, VAT, duties, PAYE should be used to offset any dividend taxation. Now that would be fair.

seanraaron
27th January 2016, 16:23
I agree. I don't mind paying tax. We wouldn't have the NHS etc. that we have without this funding. What bothers me is when the government think it's "their" money. It isn't.

No argument there. Pay rises and cutting budgets whilst funding useless weapons we won't use seems like a poor way to manage it. Might as well dump the concept of money and move on, really, but I doubt that's going to happen without a societal collapse.

Churchill
27th January 2016, 19:29
3% - Google can get away with it legally, why can't we?

AtW
27th January 2016, 19:48
3% - Google can get away with it legally, why can't we?

You can't make one phone call to get Obama to call Cameoron and Gidiot to ask them if they like orange jumpsuits...

SpontaneousOrder
27th January 2016, 19:58
I know I'll be in the minority in thinking that, but whatever.

That's because you're full-on moron.

seanraaron
28th January 2016, 10:52
That's because you're full-on moron.

You must be a highly paid IT contractor with wit like that...

SpontaneousOrder
28th January 2016, 11:19
You must be a highly paid IT contractor with wit like that...

You must be a highly paid IT contractor with wit like that...

DimPrawn
28th January 2016, 11:36
3% - Google can get away with it legally, why can't we?

3%! **** right off.

https://en.wikipedia.org/wiki/Vodafone

In 2011, Private Eye magazine and The Bureau of Investigative Journalism alleged that Vodafone's Swiss branches were run by a single part-time bookkeeper. The report claimed hardly any business was done from there, indicating that the main purpose of the Zug office was tax avoidance. The report claimed the money was borrowed from the Swiss branch of the Luxembourg company, allowing it to take advantage of Luxembourg’s laws, which exempts foreign branches of companies from tax, and Swiss laws, which almost completely exempt local branches of foreign companies. According to the expose, this would have otherwise generated a British tax bill on a little over £2 billion. It said Vodafone publishes a single, combined set of accounts for its Luxembourg subsidiaries and their Swiss branches. For the one company, profits worth £1.6 billion were taxed at less than one per cent in 2011, and the profits are likely to have been attributed to Switzerland.

I would suggest a flat rate of 1% of profits seems "fair"

VectraMan
28th January 2016, 12:17
How Apple Reduces What It Pays In Taxes - Business Insider (http://www.businessinsider.com/how-apple-reduces-what-it-pays-in-taxes-2013-5?IR=T)


Apple explained that, although AOI has been incorporated in Ireland since 1980, it has not declared a tax residency in Ireland or any other country and so has not paid any corporate income tax to any national government in the past 5 years. Apple has exploited a difference between Irish and U.S. tax residency rules. Ireland uses a management and control test to determine tax residency, while the United States determines tax residency based upon the entity’s place of formation. Apple explained that, although AOI is incorporated in Ireland, it is not tax resident in Ireland, because AOI is neither managed nor controlled in Ireland. Apple also maintained that, because AOI was not incorporated in the United States, AOI is not a U.S. tax resident under U.S. tax law either.

Only mugs pay 1%. Or be resident anywhere.

gables
28th January 2016, 12:57
If there was a party that would propose no tax for contractors would you vote them ?



No

OwlHoot
28th January 2016, 13:48
I agree. I don't mind paying tax. We wouldn't have the NHS etc ...

Sigh, another brainwashee

No, you'd have a cheaper more effective privatised equivalent

(provided compensation payments were strictly limited and prescribed so that medical indemnity insurance didn't balloon as it does in the ridiculously vindictive, legalistic US system, which is probably worse than ever now with ObamaCare).

seanraaron
28th January 2016, 13:51
Sigh, another brainwashee

No, you'd have a cheaper more effective privatised equivalent

(provided compensation payments were strictly limited and prescribed so that medical indemnity insurance didn't balloon as it does in the ridiculously vindictive, legalistic US system, which is probably worse than ever now with ObamaCare).

By all means follow the Americans into the abyss they're trying to crawl out of - no doubt everyone would be automatically eligible for affordable health care in this new privatised utopia of profit-making hospitals.

SpontaneousOrder
28th January 2016, 13:58
By all means follow the Americans into the abyss they're trying to crawl out of - no doubt everyone would be automatically eligible for affordable health care in this new privatised utopia of profit-making hospitals.

He's talking about privatised healthcare. The US has very little of that.

seanraaron
28th January 2016, 13:59
He's talking about privatised healthcare. The US has very little of that.

I assume you're using a different definition of privatised than I am. Nearly all American healthcare is provided by profit-making enterprises - even Obamacare.

diseasex
28th January 2016, 14:02
Actually we are good with NHS and i wouldnt change it much

SpontaneousOrder
28th January 2016, 14:02
I assume you're using a different definition of privatised than I am. Nearly all American healthcare is provided by profit-making enterprises - even Obamacare.

Obamacare can't exist without the state as prime mover. And that's a private enterprise?

seanraaron
28th January 2016, 14:05
Obamacare can't exist without the state as prime mover. And that's a private enterprise?

The state makes the rules stating insurers cannot exclude people for a pre-existing medical condition (which meant millions were without any health insurance) and provision an affordable policy, but the entities providing the insurance/care are the same old greedy insurance companies and HMOs.

LondonManc
28th January 2016, 14:12
Yes, they are fatally flawed because, among other things, they fail to account for the CT and VAT being generated indirectly by an employee.

And, conversely, the CT and VAT being generated indirectly by the contractor with their contribution to the hiring company.

d000hg
28th January 2016, 14:27
Sigh, another brainwashee

No, you'd have a cheaper more effective privatised equivalentDoubtful. Private healthcare can only work if it's so heavily regulated and monitored that we end up back where we are now, or some approximation. Look at the rest of Europe - you pay quite a lot for health insurance AND taxes are still high.

SpontaneousOrder
28th January 2016, 15:05
The state makes the rules stating insurers cannot exclude people for a pre-existing medical condition (which meant millions were without any health insurance) and provision an affordable policy, but the entities providing the insurance/care are the same old greedy insurance companies and HMOs.

How about the rest of the rules you chose to omit?

SpontaneousOrder
28th January 2016, 15:06
Private healthcare can only work if it's so heavily regulated and monitored...


Why's that?

seanraaron
28th January 2016, 15:42
How about the rest of the rules you chose to omit?

Like what, the requirement that working adults have some kind of health insurance? Still not sure how that means private enterprises aren't providing the care.

Look, if you're happy to see a two-week hospital stay cost your insurance company £1.5million and to have a lifetime cap on what you can get paid knock yourself out. I'll tolerate waiting times and keep the NHS, thanks.

OwlHoot
28th January 2016, 16:05
Actually we are good with NHS and i wouldnt change it much

It's a bottomless pit, and a millstone round our collective necks!

You could literally double NHS spending and in no time demand would also double!

So by the same token it would probably make little difference if NHS spending was halved. :rolleyes:

d000hg
28th January 2016, 16:52
How about the rest of the rules you chose to omit?

Because if it's private it's run for profit, and the temptation will always be to make savings and degrade the service to improve profits - we see this fairly inexorably in large companies. However unlike your phone company outsourcing support to Uzbekistan being an inconvenience, when it's healthcare this will affect people's health and ultimately lives.

So we have to have a private company which is prevented from profiteering from the sick... you simply cannot rely on the people running it to "be decent".

LondonManc
28th January 2016, 17:20
NHS should remain as a free public service, with chargebacks for foreign nationals to their country of origin.

No problem with parts of the NHS being sub-franchised to third parties so long as the overall quality of delivery does not suffer.

Waldorf
28th January 2016, 18:12
Germany has got 25% flat dividends tax... beats near 40% mark in this country from April :mad

But the corporation tax rates in Germany are much higher (30 - 35%), so even with the new rates on dividends from April, the overall tax is less in the UK than Germany.

AtW
28th January 2016, 18:22
But the corporation tax rates in Germany are much higher (30 - 35%), so even with the new rates on dividends from April, the overall tax is less in the UK than Germany.

Corp tax in German is 15% federal + 14-17% local, so 29-32%, I say 30% is good - Deloitte says it's 30-33% including "solidarity" charge - https://www2.deloitte.com/content/dam/Deloitte/global/Documents/Tax/dttl-tax-corporate-tax-rates-2015.pdf, and I'd take their word for it, rather than yours, so 30% max rate then (get incorporated in the right place, since there is a choice there).

£1 mln profit -

Germany: £300k CT, £700k divs paid - 25% tax on that is £175k = 47.5% total.

UK: £200k CT, £800k divs paid, 38.1% tax on that is £304.8k = 50.5% total.

So yes, Germany is lower taxation even if you include 30% corp tax.

More importantly, as individual one would be more concerned with rate of tax on dividends, if you got pension and it's nicely invested then why do you care what corp tax is? What matters to you is that in Germany you'll pay 25% tax flat rate and in UK you'd pay 38.1% tax (highest band obviously) - how about that for a difference? 52% higher dividend tax in UK!!! :eek

And this is under "pro-business" Tory Govt! What will Labour do when they inevitably come to power, cut taxes??? No! They'll increase them further and overall tax burden will be up again thanks to Tory Scum who, instead of cutting taxes, increased them - something they had no mandate for.

Oh, the best part is that with LOWER taxes Germany actually balances their books!!!

AtW
28th January 2016, 18:40
Oh, under Labour corp tax will go up, probably back to 30% - it's a lot easier to increase taxes when previous Tory administration already done most of the job for them, thanks Gidiot!

Waldorf
28th January 2016, 20:35
Corp tax in German is 15% federal + 14-17% local, so 29-32%, I say 30% is good - Deloitte says it's 30-33% including "solidarity" charge - https://www2.deloitte.com/content/dam/Deloitte/global/Documents/Tax/dttl-tax-corporate-tax-rates-2015.pdf, and I'd take their word for it, rather than yours, so 30% max rate then (get incorporated in the right place, since there is a choice there).

£1 mln profit -

Germany: £300k CT, £700k divs paid - 25% tax on that is £175k = 47.5% total.

UK: £200k CT, £800k divs paid, 38.1% tax on that is £304.8k = 50.5% total.

So yes, Germany is lower taxation even if you include 30% corp tax.

More importantly, as individual one would be more concerned with rate of tax on dividends, if you got pension and it's nicely invested then why do you care what corp tax is? What matters to you is that in Germany you'll pay 25% tax flat rate and in UK you'd pay 38.1% tax (highest band obviously) - how about that for a difference? 52% higher dividend tax in UK!!! :eek

Oh, the best part is that with LOWER taxes Germany actually balances their books!!!

I was basing my figures on the proposed 18% CT rate and not using the very lowest German rate, however my point was that you were not looking at the whole picture, the overall rate is pretty similar, whatever assumptions you make.

Of course the CT rate is important, if this rate is high it reduces the amount available for dividends so this will affect anyone who has dividends for income.

Germany does indeed balance its books but overall levels of taxation are higher, they have a higher income per capita (and so raises more tax), their economy is subsidised by being in the Euro, they didn't have Gordon Brown for then years as Chancellor and their industrial capacity was not shrunk by ruinous unions.

AtW
28th January 2016, 20:55
I was basing my figures on the proposed 18% CT rate and not using the very lowest German rate, however my point was that you were not looking at the whole picture, the overall rate is pretty similar, whatever assumptions you make.

18% will come into play in April 2020, a month (!) before elections, in which Labour will win by a massive landslide, new emergency budget after that and corp tax rate will be reversed back to at least 25%, obviously there will be no cut in dividend tax rates. So let's not base our calculations on it, ok?


Of course the CT rate is important, if this rate is high it reduces the amount available for dividends so this will affect anyone who has dividends for income.

No, it's not THAT important because money can be invested in a company that is located in a low corp tax country, like say UK with the recipient living in Germany.

The fact is that UK got 50% higher tax on dividends from this April. The fact is that supposedly "pro-business" Tory Govt increased dividend tax by 30%+, it was high enough.


Germany does indeed balance its books but overall levels of taxation are higher, they have a higher income per capita (and so raises more tax), their economy is subsidised by being in the Euro, they didn't have Gordon Brown for then years as Chancellor and their industrial capacity was not shrunk by ruinous unions.

They had East fooking Germany to reintegrate after around 50 years of Soviet occupation - that's 16 mln people!

Waldorf
28th January 2016, 20:59
in which Labour will win by a massive landslide!

How can I possibly debate with someone who has made this statement? What a plonker!

SpontaneousOrder
28th January 2016, 21:06
Like what, the requirement that working adults have some kind of health insurance? Still not sure how that means private enterprises aren't providing the care.

"some kind" is a very specific minimum. But that alone, apart from anything else, floods the market with young healthy 'customers' who are there by force, thereby presenting providers with a situation where it's in their best interest to dis-incentivise people who really need care, in favour of people who don't but are forced to have it. I.e. making the whole thing shitty only dissuades the people who actually need it, who also happen to be the financial burdens.

If you think that is private enterprise then you're part of the problem.




Look, if you're happy to see a two-week hospital stay cost your insurance company £1.5million and to have a lifetime cap on what you can get paid knock yourself out. I'll tolerate waiting times and keep the NHS, thanks.

Repeating an un-founded assertion doesn't make it founded.

AtW
28th January 2016, 21:07
How can I possibly debate with someone who has made this statement? What a plonker!

Ok.

Let's say Osborne wins by a landslide, budget hits proficit as he plans.

Will he cut the taxes down materially???

No, that won't happen, it's the new permanent level for many decades.

Will Labour increase taxes further? You bet!

So, fooking Tories massively increase taxation burden that will never come down, all for the same of hitting specific timeframe for Gidiot to get elected as PM.

---

btw, how good is equivalent of NHS in Germany??? I can't seem to remember reading many stories about how bad it is there. What about trains in Germany? Cheaper and quicker, certainly more punctual. What about roads? Enough said - they are a lower tax country too!

SpontaneousOrder
28th January 2016, 21:10
Because if it's private it's run for profit, and the temptation will always be to make savings and degrade the service to improve profits - we see this fairly inexorably in large companies. However unlike your phone company outsourcing support to Uzbekistan being an inconvenience, when it's healthcare this will affect people's health and ultimately lives.

So we have to have a private company which is prevented from profiteering from the sick... you simply cannot rely on the people running it to "be decent".

I assume you meant to quote the other post. But I don't buy any of that. In an environment that isn't so horrendously regulated and licensed, that the scenarios you describe will follow just doesn't make any logical sense from an economics perspective.

seanraaron
29th January 2016, 09:37
"some kind" is a very specific minimum. But that alone, apart from anything else, floods the market with young healthy 'customers' who are there by force, thereby presenting providers with a situation where it's in their best interest to dis-incentivise people who really need care, in favour of people who don't but are forced to have it. I.e. making the whole thing tulipty only dissuades the people who actually need it, who also happen to be the financial burdens.

If you think that is private enterprise then you're part of the problem.




Repeating an un-founded assertion doesn't make it founded.

And you call other people morons? American health care was a broke-ass mess run by corporations long before Obama came into office. He's actually made it possible for millions to obtain health care who were previously denied.

Regarding my "un-founded" assertion there are vast quantities of stories to support that assertion including a personal one. You being deliberately thick doesn't invalidate any of them. But by all means join the Fox News brigade, jackass.

DodgyAgent
29th January 2016, 09:57
I assume you meant to quote the other post. But I don't buy any of that. In an environment that isn't so horrendously regulated and licensed, that the scenarios you describe will follow just doesn't make any logical sense from an economics perspective.

So a state run business run on trust as a monopoly is the answer to delivering healthcare is it?

seanraaron
29th January 2016, 10:01
So a state run business run on trust as a monopoly is the answer to delivering healthcare is it?

As opposed to profit-driven entities whose first order of business is delivering dividends to shareholders? Yes.

d000hg
29th January 2016, 10:15
I assume you meant to quote the other post. But I don't buy any of that. In an environment that isn't so horrendously regulated and licensed, that the scenarios you describe will follow just doesn't make any logical sense from an economics perspective.

Really? Companies don't cut corners at the expense of customer satisfaction for short-term /short-sighted reasons? Even in the NHS we see this happening because they still have budgets.

DodgyAgent
29th January 2016, 10:21
As opposed to profit-driven entities whose first order of business is delivering dividends to shareholders? Yes.

At least these are efficient and work

d000hg
29th January 2016, 10:26
At least these are efficient and work

They work in the sense they deliver profit to shareholders. Not necessarily in the sense they provide effective, efficient, affordable health-care to everyone who needs it.

fullyautomatix
29th January 2016, 10:26
What amazes me is that when contractors go permie they will willingly pay the max tax rate and don't moan about it but when they go contracting and earn twice they suddenly want to pay 0% tax. What changed ?

seanraaron
29th January 2016, 10:28
At least these are efficient and work

If you happen to have care which is regarded as cost-effective (oddly enough this isn't substantially different from the NHS, just that the motive is ensuring greater profits rather than limiting costs) and you can afford your policy. But hey, don't take my word for it, I'm just an American expat who lived with the system for most of my life.

Universal coverage in the private sector is unlikely to provide better coverage or be cheaper. In most privatisation exercises, the people who benefit most are unlikely to be service users - you have your pick in the UK if you want an example. Of course I suspect the people who push for it the most are in the "I've got mine" camp.

@fullyautomatix I've been wondering the same thing. Unless I'm getting shafted by an umbrella I really can't see the value-add of an LLC outside of tax-dodging...

d000hg
29th January 2016, 10:31
Why are we talking about the NHS anyway, this is a thread about contractors. Who are all BUPA members, right?

NigelJK
29th January 2016, 11:26
There was an interesting discussion on R4 yesterday evening. One the one hand there as a 'private' group of GP's who'd hit on the idea of a 24/7 telephone consultancy for minor ailments. It was £5 for a 5 mins consolation which would mean that you wouldn't have to take any time off work for a 15 min (maximum) consultation with your GP. I felt sorry for the GP on the opposing team who ended up justifying their position by saying that some of their customers liked to 'chat'.

seanraaron
29th January 2016, 11:32
There was an interesting discussion on R4 yesterday evening. One the one hand there as a 'private' group of GP's who'd hit on the idea of a 24/7 telephone consultancy for minor ailments. It was £5 for a 5 mins consolation which would mean that you wouldn't have to take any time off work for a 15 min (maximum) consultation with your GP. I felt sorry for the GP on the opposing team who ended up justifying their position by saying that some of their customers liked to 'chat'.

That is what NHS24 is supposed to be, but it didn't exactly get executed well and then there's the lack of inspiration behind getting told for anything that sounds remotely like it could be something serious "better talk to your GP - especially if children are involved."

I'd wonder how long it would be before the private GP helpline was offshored to people using a medical database myself...

The fact that I can actually get an appointment with a GP is something of a novelty. When I was with Kaiser Permanente in the States (one of the largest and better regarded HMOs) and tried to get an appointment I was told that wasn't possible and I should just go to the first-come-first-served drop-in clinic instead, which basically meant taking the entire day off since I had no idea when (or if) I'd end up seeing anyone. When I did see the doc I basically had what I'd told them parroted back at me and was given an ineffective prescription.

The NHS has issues, but the grass isn't necessarily greener on the other side.

NigelJK
29th January 2016, 11:47
I'd wonder how long it would be before the private GP helpline was offshored to people using a medical database myself
That will be never then as the whole point is you talk to an actual (UK) based GP who have their own 'brain based' database. For minor ailments this is OK for me, if they clock anything more serious they tell you it's worth making an appt with your GP.

Recent history of the 101 line does not bode well, but given the infant that died as a result of the less than accurate diagnosis via the number had presented at the GP's a number of times and a chest infection was missed multiple times after a physical examination then that does not bode well for the normal service either.

seanraaron
29th January 2016, 11:51
That will be never then as the whole point is you talk to an actual (UK) based GP who have their own 'brain based' database. For minor ailments this is OK for me, if they clock anything more serious they tell you it's worth making an appt with your GP.

Recent history of the 101 line does not bode well, but given the infant that died as a result of the less than accurate diagnosis via the number had presented at the GP's a number of times and a chest infection was missed multiple times after a physical examination then that does not bode well for the normal service either.

None of it is going to be perfect, but I think having a state-run non-profit-driven service is going to be more trustworthy about having the well-being of patients as the first priority.

Some kind of computer-based live chat service in addition to being able to escalate to a GP over the phone would probably be a good idea. I'm not as big a fan of the pay-to-play model, but some kind of means-tested co-pay may end up being necessary for the NHS.

DodgyAgent
29th January 2016, 11:52
If you happen to have care which is regarded as cost-effective (oddly enough this isn't substantially different from the NHS, just that the motive is ensuring greater profits rather than limiting costs) and you can afford your policy. But hey, don't take my word for it, I'm just an American expat who lived with the system for most of my life.

Universal coverage in the private sector is unlikely to provide better coverage or be cheaper. In most privatisation exercises, the people who benefit most are unlikely to be service users - you have your pick in the UK if you want an example. Of course I suspect the people who push for it the most are in the "I've got mine" camp.

@fullyautomatix I've been wondering the same thing. Unless I'm getting shafted by an umbrella I really can't see the value-add of an LLC outside of tax-dodging...

The point is the debate should be about implementing the best possible solution to healthcare for everyone - whether private or public or a combination of the two. I happen to agree that running the NHS in a profit motivated environment would be a disaster just as operating it as public service would also be a disaster. The problem is that people like you and the left in general are polarised "out of principle" in how you think the health service should be run.
The dynamics that make institutions run efficiently should be introduced where they are appropriate. Dynamics that create negative outcomes for patients - restrictive practices, profit motivated processes should be weaned out. For example nurses, paramedics and other clinical skills are in short supply. Pay for these jobs is less than £30 k per year yet hospitals are constrained by National pay scales that prevent trusts from paying market rates to workers. What happens? these people leave the NHS and work as locums/banks earning more than twice as much and costing even more (thanks to huge agency margins :o ) thus creating a vicious spiral of escalating costs. if any trust tried to break free and pay more for clinical staff the wailing Unions and left would start crying "not fair" "everyone should get the same"

NigelJK
29th January 2016, 11:57
well-being of patients as the first priority

That's what the Hippocratic oath is for isn't it?

seanraaron
29th January 2016, 12:03
The problem is that people like you and the left in general are polarised "out of principle" in how you think the health service should be run.

Of course. That's because most of the time basic services aren't in and of themselves money-making enterprises so you end up with either having the state subsidising private companies (public transport) or allowing prices to spiral in the pursuit of profit without any enhanced services (utilities). Ultimately the only thing the lawmakers get out of it is not having to take any responsibility for problems in those formerly public-owned industries.

Looking at the NHS a lot of the problems are down to poor managment at the trust level: failure to plan long-term and relying upon too few staff to provision service. Emphasis on lower costs versus quality of care and work environment probably doesn't help either.

I think the private sector can help pick up the slack, but given the past record of privatisation which ended up having the primary effect of enriching a few businesspeople without enhancing services, I'm sure you can understand why there would be a strong resistance to anything that smacks of privatising the NHS.

seanraaron
29th January 2016, 12:05
That's what the Hippocratic oath is for isn't it?

You'd think so, but given the privately run hospitals in the States that charge outrageous fees for the most basic services and have a history of denying care to poor people are administered by doctors, it doesn't seem to be enough.

That's assuming you weren't being snarky of course ;-)