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sasguru
3rd October 2017, 15:54
Priti Patel calls for May to slash spending and regulations after Brexit - Business Insider (http://uk.businessinsider.com/priti-patel-public-spending-regulations-after-brexit-2017-10)

If these ideas lead to the abolition of central funding for the NHS and the adoption of European-style private-public partnership, insurance-based health systems which have much better health outcomes, then something good may come of Brexit after all.

Mordac
3rd October 2017, 15:55
Priti Patel calls for May to slash spending and regulations after Brexit - Business Insider (http://uk.businessinsider.com/priti-patel-public-spending-regulations-after-brexit-2017-10)

If these ideas lead to the abolition of central funding for the NHS and the adoption of European-style private-public partnership, insurance-based health systems which have much better health outcomes, then something good may come of Brexit after all.

I can't wait to see what the Graun makes of this...:laugh

Bean
3rd October 2017, 16:10
Priti Patel calls for May to slash spending and regulations after Brexit - Business Insider (http://uk.businessinsider.com/priti-patel-public-spending-regulations-after-brexit-2017-10)

If these ideas lead to the abolition of central funding for the NHS and the adoption of European-style private-public partnership, insurance-based health systems which have much better health outcomes, then something good may come of Brexit after all.

Interesting considering;
NHS holds top spot (https://www.theguardian.com/society/2017/jul/14/nhs-holds-on-to-top-spot-in-healthcare-survey)

Cirrus
3rd October 2017, 16:20
The NHS comes out top (err, well...)


“The UK stands out as a top performer in most categories except for healthcare outcomes, where it ranks with the US near the bottom,” :facepalm:

sasguru
3rd October 2017, 16:29
The NHS comes out top (err, well...)

:facepalm:

Indeed. Not sure what the Commonwealth Fund thingy is - looks like a US lefty pressure group

Various studies show cancer outcomes in the UK are particularly poor, and have been for some years:

British cancer survival rates 'lag behind other countries' - Telegraph (http://www.telegraph.co.uk/news/health/news/8253838/British-cancer-survival-rates-lag-behind-other-countries.html)
UK cancer survival worst in western Europe - Telegraph (http://www.telegraph.co.uk/news/health/news/11891554/UK-cancer-survival-worst-in-western-Europe.html)
UK Lagging Behind Europe In Diagnosing And Treating Cancer | HuffPost UK (http://www.huffingtonpost.co.uk/entry/uk-lagging-behind-europe-in-diagnosing-and-treating-cancer_uk_596dc117e4b0b95f893dacd0)
https://www.kingsfund.org.uk/press/press-releases/cancer-performance-england-lags-behind-other-countries-confirms-new-review

sasguru
3rd October 2017, 16:46
Of course we could also have a US style Health system. Which I would say is better than the current shambles. If you're wealthy, which as IT contractors we are.

AtW
3rd October 2017, 17:06
Of course we could also have a US style Health system. Which I would say is better than the current shambles. If you're wealthy, which as IT contractors we are.

Do you think they would reduce NICs in this case?

Thought not. :eyes

sasguru
3rd October 2017, 17:08
Do you think they would reduce NICs in this case?

Thought not. :eyes

Well the idea is lower taxation, more of a US style economy, no regs, no work protection.
More onus in the individual, less on the state.
As contractors we're ideally placed to benefit, we don't get any work protection anyway and lower tax is great:happy

BrilloPad
3rd October 2017, 17:35
Agreed. Plus low corporation tax. And not just for GAFA....

xoggoth
3rd October 2017, 18:46
Sensible lady. When people question the NHS, people always suggest we'd get a US style system. The French or Australian health style systems would probably function a lot better.

SueEllen
4th October 2017, 04:41
Sensible lady. When people question the NHS, people always suggest we'd get a US style system. The French or Australian health style systems would probably function a lot better.

Don't they all pay more for healthcare provision?

This is why the UK government is unlikely to go there.

NotAllThere
4th October 2017, 05:27
Don't they all pay more for healthcare provision?

This is why the UK government is unlikely to go there.Well, yes. Because "something" is more than "nothing".

If a French or Australian style insurance was introduce, with a cut in NI that made the overall cost to the individual the same or less, even those people who were paying less would still feel they were having to pay for what used to be "free".

Bean
4th October 2017, 08:18
The NHS comes out top (err, well...)

:facepalm:

Worth noting that if you care to keep reading and follow other links;

"The only serious black mark against the NHS was its poor record on keeping people alive. On a composite "healthy lives" score, which includes deaths among infants and patients who would have survived had they received timely and effective healthcare, the UK came 10th. The authors say that the healthcare system cannot be solely blamed for this issue, which is strongly influenced by social and economic factors."
Source (https://www.theguardian.com/society/2014/jun/17/nhs-health)

but still, the UK came first out of the 11 countries in eight of the 11 measures of care the authors looked at and the 1 'black mark' against the UK is "strongly influenced by social and economic factors"

Overall, I'd say keep the NHS payment model like it is, just reform the layers of management.

sasguru
4th October 2017, 08:38
Worth noting that if you care to keep reading and follow other links;

"The only serious black mark against the NHS was its poor record on keeping people alive. On a composite "healthy lives" score, which includes deaths among infants and patients who would have survived had they received timely and effective healthcare, the UK came 10th. The authors say that the healthcare system cannot be solely blamed for this issue, which is strongly influenced by social and economic factors."
Source (https://www.theguardian.com/society/2014/jun/17/nhs-health)

but still, the UK came first out of the 11 countries in eight of the 11 measures of care the authors looked at and the 1 'black mark' against the UK is "strongly influenced by social and economic factors"

Overall, I'd say keep the NHS payment model like it is, just reform the layers of management.

So you're basing your conclusions on the one study (by a left-leaning think tank with an anti-US system bias) that rates the NHS top.
And even that study says in terms of "health outcomes" the UK isn't that good?
Health Outcomes are what matter, but it's typical of the left to ignore reality.
Got any other studies that back that up?
Ever heard of meta-analysis?
Care to comment on the poor NHS cancer survival rates that are found in study after study?
Like I said we have enough imbeciles on this forum.

northernladyuk
4th October 2017, 08:41
Priti Patel calls for May to slash spending and regulations after Brexit - Business Insider (http://uk.businessinsider.com/priti-patel-public-spending-regulations-after-brexit-2017-10)

If these ideas lead to the abolition of central funding for the NHS and the adoption of European-style private-public partnership, insurance-based health systems which have much better health outcomes, then something good may come of Brexit after all.

The NHS is probably too much of a political sacred cow to make this kind of change, and it's hard to see that the Tories have the political capital and stomach for this scale of structural change.

The really tough challenge (aka ticking bomb) is the aging population. The age profile for 2040 / 50 is scary, and will be worse if immigration is slowed down significantly. Social care and the interface between social care and healthcare (particularly long-term nursing care) are big areas that need to be addressed, and there is probably the potential (including the political potential) to put in place a compulsory insurance scheme (anyone remember National Insurance?) to fund this.

Another challenge (aka ticking bomb) is effective healthy living promotion. Smoking levels are coming down, but obesity levels are going up. Not sure what the answer is here, but there is a need to prevent unhealthy lifestyle related disease as much as possible, rather than rely on treating disease effectively as the numbers continue ti increase.

I'm not a health economist, just someone who has always worked in the area, so other opinions are available.

sasguru
4th October 2017, 08:44
The NHS is probably too much of a political sacred cow to make this kind of change, and it's hard to see that the Tories have the political capital and stomach for this scale of structural change.

The really tough challenge (aka ticking bomb) is the aging population. The age profile for 2040 / 50 is scary, and will be worse if immigration is slowed down significantly. Social care and the interface between social care and healthcare (particularly long-term nursing care) are big areas that need to be addressed, and there is probably the potential (including the political potential) to put in place a compulsory insurance scheme (anyone remember National Insurance?) to fund this.

Another challenge (aka ticking bomb) is effective healthy living promotion. Smoking levels are coming down, but obesity levels are going up. Not sure what the answer is here, but there is a need to prevent unhealthy lifestyle related disease as much as possible, rather than rely on treating disease effectively as the numbers continue ti increase.

I'm not a health economist, just someone who has always worked in the area, so other opinions are available.

I work in the HEOR space with health economists, epi people etc.
There is almost uniform acceptance that the NHS is unsustainable in its present form in the long term, for the reasons you describe.

Bean
4th October 2017, 08:59
So you're basing your conclusions on the one study (by a left-leaning think tank with an anti-US system bias) that rates the NHS top.
And even that study says in terms of "health outcomes" the UK isn't that good?
No, my conclusion is adaptable to new evidence, of which, plenty is and has become available over the years.
See below about influencing factors....


Health Outcomes are what matter, but it's typical of the left to ignore reality.
Erm, talking of ignoring, maybe you missed;

"The authors say that the healthcare system cannot be solely blamed for this issue, which is strongly influenced by social and economic factors."" - I'm not ignoring, I'm taking into account what the report authors say about strongly influencing factors.


Got any other studies that back that up?
Back what up? My opinion on the payment model of the NHS staying the same [no], or the UK having the best healthcare?


Ever heard of meta-analysis?
Yes. Although by using the WHO data - I'd say that's fairly decent, wouldn't you?


Care to comment on the poor NHS cancer survival rates that are found in study after study?
Not the worst, not the best;
Worldwide cancer mortality statistics | Cancer Research UK (http://www.cancerresearchuk.org/health-professional/cancer-statistics/worldwide-cancer/mortality#heading-Zero)

https://www.cdc.gov/cancer/dcpc/research/articles/concord-2.htm


Like I said we have enough imbeciles on this forum.
You prove it everyday that you post. HTH

sasguru
4th October 2017, 09:03
blah blah wibble wibble

Like all cretins you keep digging.
Fact is the NHS is mid-to-low table among comparable countries.
And unsustainable in its present form of funding, as will become apparent in a few years.

Bean
4th October 2017, 09:09
Like all cretins you keep digging.
Fact is the NHS is mid-to-low table among comparable countries.*
And unsustainable in its present form of funding, as will become apparent in a few years.

Who is ignoring stuff now? :laugh
Thanks for the ad-hominem :D

*citation required

Neither Lab nor Con have the political capital or will necessary to change the funding model. The structure/make-up of the NHS can be changed.

No amount of gnashing your teeth, wailing, or calling people cretins will change that, but as ever HTH BIDI

sasguru
4th October 2017, 09:18
Who is ignoring stuff now? :laugh
Thanks for the ad-hominem :D

*citation required

Neither Lab nor Con have the political capital or will necessary to change the funding model. The structure/make-up of the NHS can be changed.

No amount of gnashing your teeth, wailing, or calling people cretins will change that, but as ever HTH BIDI

I agree that the funding model will not be changed voluntarily, because the majority of people in this country are thick.
So it will bumble along to the final crisis, while slowly bankrupting the country.
If you really want to educate yourself rather than spouting complete tosh, knock youself out:


https://iea.org.uk/media/commonwealth-fund-study-wrongly-focuses-on-inputs-rather-than-health-outcomes/

NHS care 'among the worst in Europe' due to poor investment (http://www.telegraph.co.uk/news/2017/05/18/nhs-care-among-worst-europe/)

https://www.adamsmith.org/blog/healthcare/comparing-apples-to-apples-nhs-still-ranks-below-average

https://www.sochealth.co.uk/2015/01/18/international-comparisons-say-nhs/

The NHS is world class – if you ignore its woeful outcomes | City A.M. (http://www.cityam.com/270171/nhs-world-class-if-you-ignore-its-woeful-outcomes)

NHS is 'worse than healthcare in Ireland, Spain and Slovenia' in new global ranking (http://www.msn.com/en-gb/health/familyhealth/nhs-is-worse-than-healthcare-in-ireland-spain-and-slovenia-in-new-global-ranking/ar-BBBirqv)

Cirrus
4th October 2017, 09:33
Always bear in mind the Americans spend more than us per capita on state funded healthcare. Following America would not reduce NHS funding demands on that basis.

xoggoth
4th October 2017, 09:37
The NHS is probably too much of a political sacred cow to make this kind of change, and it's hard to see that the Tories have the political capital and stomach for this scale of structural change

Indeed. There are other political sacred cows like welfare and student funding. Sometimes wonder if it's possible to ever have sensible government and democracy at the same time.

Bean
4th October 2017, 09:41
I agree that the funding model will not be changed voluntarily, because the majority of people in this country are thick.
So it will bumble along to the final crisis, while slowly bankrupting the country.
If you really want to educate yourself rather than spouting complete tosh, knock youself out:


https://iea.org.uk/media/commonwealth-fund-study-wrongly-focuses-on-inputs-rather-than-health-outcomes/

NHS care 'among the worst in Europe' due to poor investment (http://www.telegraph.co.uk/news/2017/05/18/nhs-care-among-worst-europe/)

https://www.adamsmith.org/blog/healthcare/comparing-apples-to-apples-nhs-still-ranks-below-average

https://www.sochealth.co.uk/2015/01/18/international-comparisons-say-nhs/

The NHS is world class – if you ignore its woeful outcomes | City A.M. (http://www.cityam.com/270171/nhs-world-class-if-you-ignore-its-woeful-outcomes)

NHS is 'worse than healthcare in Ireland, Spain and Slovenia' in new global ranking (http://www.msn.com/en-gb/health/familyhealth/nhs-is-worse-than-healthcare-in-ireland-spain-and-slovenia-in-new-global-ranking/ar-BBBirqv)

Thanks, some useful info in there.

It still comes down to what in reality can take place, and since you agree the funding model won't change - all of it is currently moot.

Some high scoring countries (e.g. Norway) still perform very poorly in specific (e.g. Testicular) cancers btw...which surprised me!

sasguru
4th October 2017, 09:42
Always bear in mind the Americans spend more than us per capita on state funded healthcare. Following America would not reduce NHS funding demands on that basis.

Indeed they do but that's mostly private spending. If we had an American style system, the NHS wouldn't exist in its current form.
Getting back to the subject of this thread, perhaps Brexit is the shock the system needs

motoukenin
4th October 2017, 09:45
Priti Patel calls for May to slash spending and regulations after Brexit - Business Insider (http://uk.businessinsider.com/priti-patel-public-spending-regulations-after-brexit-2017-10)

If these ideas lead to the abolition of central funding for the NHS and the adoption of European-style private-public partnership, insurance-based health systems which have much better health outcomes, then something good may come of Brexit after all.

Do you think she will be in power that long ?

northernladyuk
4th October 2017, 10:01
Indeed. There are other political sacred cows like welfare and student funding. Sometimes wonder if it's possible to ever have sensible government and democracy at the same time.

The thing that pisses me off is the degradation of National Insurance. I am all for a safety net, but people who have paid in according to their income over many years should get a breathing space if they find themselves unemployed or sick. They should not face financial ruin when they get old and have social care needs. Social care is such a mess (including in its funding) that it presents a much easier opportunity (politically speaking) to set up something sustainable and effective.

Mordac
4th October 2017, 10:06
Like all cretins you keep digging.
Fact is the NHS is mid-to-low table among comparable countries.
And unsustainable in its present form of funding, as will become apparent in a few years.

Unusually, I agree with you on this one. Although I would say it is apparent NOW that the whole shebang is unsustainable.

Mordac
4th October 2017, 10:07
Do you think she will be in power that long ?

Good question. No, she won't.

northernladyuk
4th October 2017, 10:13
Indeed they do but that's mostly private spending. If we had an American style system, the NHS wouldn't exist in its current form.
Getting back to the subject of this thread, perhaps Brexit is the shock the system needs

Incredibly, the USA does spend more that the UK on state funded care (presumably mostly Medicare, Medicaid and Veterans).

But nobody wants to follow the US model.

sasguru
4th October 2017, 10:14
Incredibly, the USA does spend more that the UK on state funded care (presumably mostly Medicare, Medicaid and Veterans).

But nobody wants to follow the US model.

Per capita?*

Some Tories with business links to the US do want a US model.

*Just checked. Indeed they do. Amazing - they spend the most by far and yet have the worst outcomes of any developed country.
Something for the free market idealogues to ponder

OwlHoot
4th October 2017, 10:38
Always bear in mind the Americans spend more than us per capita on state funded healthcare. Following America would not reduce NHS funding demands on that basis.

Given their chronically litigious society, much of that is medical insurance.

If they limited liability, or had a fixed set of damages for any eventuality without absurdly vindictive jury-determined excess, their healthcare would be far cheaper.

I mean if King Ethelbert could do it in about 600AD (http://www.law.harvard.edu/faculty/cdonahue/courses/lhsemelh/materials/Mats2D_2F.pdf) I'm sure it's not beyond the wit of man today!

northernladyuk
4th October 2017, 10:47
Per capita?*

Some Tories with business links to the US do want a US model.

*Just checked. Indeed they do. Amazing - they spend the most by far and yet have the worst outcomes of any developed country.
Something for the free market idealogues to ponder

It is a massively inefficient system in terms of unnecessary investigations etc., partly because the payers and the providers have different incentives, and partly because of litigation risk.

Also, the NHS has such a dominance that it depresses clinical salaries against what they would be in a market system (or maybe that's received wisdom - happy to be corrected by someone who knows better).

Eirikur
4th October 2017, 10:52
Not sure why you need brexit to reform the NHS. Most other European countries have far superior health care systems without having a NHS equivalent and they are still in the EU

woohoo
4th October 2017, 11:07
Not sure why you need brexit to reform the NHS. Most other European countries have far superior health care systems without having a NHS equivalent and they are still in the EU

Really, most other European countries? I'm not one for praising the NHS, well I love the idea and would pay more tax to make it better but it has real issues.

But i'm sure only a few months ago I was arguing against the NHS being touted as the best health care provider. Not sure if this is the link or not.

https://www.theguardian.com/society/2017/jul/14/nhs-holds-on-to-top-spot-in-healthcare-survey

Eirikur
4th October 2017, 11:30
Really, most other European countries? I'm not one for praising the NHS, well I love the idea and would pay more tax to make it better but it has real issues.

But i'm sure only a few months ago I was arguing against the NHS being touted as the best health care provider. Not sure if this is the link or not.

https://www.theguardian.com/society/2017/jul/14/nhs-holds-on-to-top-spot-in-healthcare-survey

In stead of paying more tax, just take out private health insurance

woohoo
4th October 2017, 11:55
In stead of paying more tax, just take out private health insurance

I've had private health insurance. The problem with Bupa and I'm sure other providers is that they do their best to not pay for problems that you have. Is it chronic, well it's hit and miss if they will cover you.

I have a problem with my nose and polyps. So its chronic and for years Bupa have been great. Then they changed and now do their best to not cover consultations and operations. Nearly everything was an argument with them.

I now pay for private consultation, last time I was charged £600 for a 20 min consultation. When I complained to them they sent me a new bill for £200 less. No reason given.

So I do think private care is much better but I don't think it's the future, it's also limited.

I also know someone who works at Bupa and it's changed, cuttings costs and staff etc. I'm sure other providers are doing the same.

Also, you side-stepped my question, you made a statement about most other euro countries having better health care.

Cirrus
4th October 2017, 12:21
It is a massively inefficient system in terms of unnecessary investigations etc., This is true. From what I remember of the Economist article. it wasn't that things are expensive in America; it's that they 'run' massively more tests than we do.

northernladyuk
4th October 2017, 12:26
This is true. From what I remember of the Economist article. it wasn't that things are expensive in America; it's that they 'run' massively more tests than we do.

It all adds up.

http://assets.nerdwallet.com/blog/wp-content/uploads/2016/06/detailed-600x440.jpg

Bean
4th October 2017, 12:28
It all adds up.

http://assets.nerdwallet.com/blog/wp-content/uploads/2016/06/detailed-600x440.jpg

$1847.81 per night, for a semi-private room?

I know it's apples to oranges, but how much is a nearby Ritz or Savoy? What a joke!

northernladyuk
4th October 2017, 12:32
$1847.81 per night, for a semi-private room?

I know it's apples to oranges, but how much is a nearby Ritz or Savoy? What a joke!

Room charge will include monitoring equipment, 24 hour nursing care etc. (I expect).

Bean
4th October 2017, 12:39
Room charge will include monitoring equipment, 24 hour nursing care etc. (I expect).

On reflection, it seems logical to include those things - but it's still an eye-watering amount for a nightly charge.

and you have the bonus of paying almost $160 just to leave!

northernladyuk
4th October 2017, 12:40
On reflection, it seems logical to include those things - but it's still an eye-watering amount for a nightly charge.

and you have the bonus of paying almost $160 just to leave!

That was my favourite.

The cost of an NHS inpatient day is about £400. IIRC that includes everything except surgical costs (but that is from memory).

Mordac
4th October 2017, 13:58
That was my favourite.

The cost of an NHS inpatient day is about £400. IIRC that includes everything except surgical costs (but that is from memory).

What else is there? You get one of those papery shirt things which shows your arse off to the world, and that's about it. You don't get free parking and snacks. And if you're under the knife, they don't even have to give you a lunch that you wouldn't want to eat anyway, unless you'd walked for days across the desert eating nothing but a vulture's leftovers.

northernladyuk
4th October 2017, 14:01
What else is there? You get one of those papery shirt things which shows your arse off to the world, and that's about it. You don't get free parking and snacks. And if you're under the knife, they don't even have to give you a lunch that you wouldn't want to eat anyway, unless you'd walked for days across the desert eating nothing but a vulture's leftovers.

Trick with hospital food (if the option is available) is to order the Asian vegetarian menu.

Aside from that, the bed day cost includes meds, investigations, nursing care, disposables (swabs etc.) etc.

SueEllen
4th October 2017, 15:47
This is true. From what I remember of the Economist article. it wasn't that things are expensive in America; it's that they 'run' massively more tests than we do.

Read and watched other stuff on US system.

If you have insurance and your insurance pays for you to have treatment at that facility the price is less.

If you don't have insurance at all or your insurance company doesn't cover that facility the price is more.

The prices are made up to make it look like insurance companies who cover that facility get a discount.