Viewing 40 posts - 1 through 40 (of 52 total)
  • Life expectancy vs Per capita Healthcare funding
  • footflaps
    Full Member

    For all those who hark on about privatisation and a US centric model. The NHS is doing pretty well as it is!

    https://twitter.com/Wu_Tang_Finance/status/439907109639962624/photo/1

    geoffj
    Full Member

    Looking at that distribution, you could almost fit a curve which is steeper earlier on, but then begins to dip around AUS and actually reduces towards USA, giving a sweet spot at around the 3,000 mark

    molgrips
    Free Member

    LOOOTS of factors involved here though!

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    ninfan
    Free Member

    For all those who hark on about privatisation and a US centric model.

    Forgive me, but I don’t think I’ve ever actually heard anyone, anywhere, proposing a U.S. centric model of healthcare for the UK

    Can you point us to any sources for such a claim please?

    kimbers
    Full Member

    ninfan is right youd never find someone stupid enough to think that was a good idea,
    no one would vote for it and even if you searched for the most corrupt corporate shills in the land I doubt youd even be able to find 2 such politicians , unless……………………………………

    [video]http://www.youtube.com/watch?v=bpda3l2ri0Y[/video]

    [video]http://www.youtube.com/watch?v=RK0S1RYYBqc[/video]

    CaptJon
    Free Member

    ninfan – Member
    Forgive me, but I don’t think I’ve ever actually heard anyone, anywhere, proposing a U.S. centric model of healthcare for the UK

    Can you point us to any sources for such a claim please?

    I presume FF’s point was more subtle than that and more about creeping privatisation of the NHS. On the US model, Simon Steven is currently head of the NHS and he used to (amongst other things, including advising the Labour Govt) be high up in United Health Group, a massive private healthcare provider in the US.

    binners
    Full Member

    Forgive me, but I don’t think I’ve ever actually heard anyone, anywhere, proposing a U.S. centric model of healthcare for the UK

    Just because they’re not publicly stating thats what they’re doing, doesn’t mean its not exactly what they’re actually doing

    As with any politician – don’t listen to what they say, look at what they do.

    footflaps
    Full Member

    Can you point us to any sources for such a claim please?

    http://www.mirror.co.uk/news/ampp3d/nigel-farage-wants-ditch-nhs-4620726

    I also suspect that most of the Tories would like to move towards a US model, but won’t say so in public as they’re not that stupid.

    Just because they’re not publicly stating thats what they’re doing, doesn’t mean its not exactly what they’re actually doing

    +1

    eckinspain
    Free Member

    Gapminder is a wonderful resource for these sort of graphs – showing them over time as well.

    ninfan
    Free Member

    So nobody actually seems to be saying what was claimed in the first place!

    Regardless, it remains a non sequitur to suggest that any talk of “creeping privatisation” or “insurance based model” means any parallel with the U.S. whatsoever

    If you look on the graph at that cluster around Britain there are a whole myriad of differing systems, with various levels of privatisation of supply and delivery of healthcare, and national or private health insurance, all of them much of a muchness, and the NHS, for all its benefits, does not stand out as any sort of miraculous outlier from the rest of the pack, so what does it have over and above ereywhere else?

    Yeah, the American system is crap for a whole variety of reasons, but the NHS seems to be no better that most of the rest….

    jambalaya
    Free Member

    That chart doesn’t actually “say” anything

    You’d be wrong to try and correlate spending with life expectancy. The US has for example very high death rates from firearms and road deaths as well as more medical conditions like hearth disease, primarily due to poor diet. Also for example in India you have a very poor country which explains high mortality especially amongst children, however it’s not the fact they spend less on medicine which causes, its simple things like clean water and food quality.

    The French have an insurance based model by the way. As for the US system being “crap” they certainly don;t think so and regard their health provision as far superior to ours. I am not saying they are right but you have to accept that they have world class health care available to many.

    Lifer
    Free Member

    😆

    jambalaya
    Free Member

    @kimbers, by the way explain to me the reason for the stat quoted on the Fox piece

    5yr survival rate for prostate cancer: US 100%, Canada 99%, UK 70%

    Lets be clear I am not in favour of a full blown US system here but we don’t have the right solution either, as per the piece again (and common knowledge) the NHS is 3rd largest employer in the world after the Chinese Army and the Indian Railways. It’s bloated and inefficient with far too many administrators and does not enjoy the economies of scale that it should.

    footflaps
    Full Member

    You’d be wrong to try and correlate spending with life expectancy

    You can’t be wrong correlating things. You just need to be careful drawing conclusions as a good correlation is not necessarily the same as proving causation.

    the NHS is 3rd largest employer in the world

    I really don’t see the relevance of this. Being a large organisation does not automatically imply anything, unless you are ideologically opposed to large organisations…

    dragon
    Free Member

    Looking at that graph you could easily argue that an almost 50% reduction in spending, would result in very little (any!) difference in Life Expectancy. So there we go, lets cut some NHS budgets.

    Reality is it doesn’t tell you much at all, because as previously mentioned the wider environment has a huge impact on health.

    footflaps
    Full Member

    Looking at that graph you could easily argue that an almost 50% reduction in spending, would result in very little (any!) difference in Life Expectancy.

    Would you expect anything else? The most common serious diseases always get dealt with first. No one is going to worry about 5 year survival rates from rare cancers when people are still dying of tetanus etc…

    gonefishin
    Free Member

    5yr survival rate for prostate cancer: US 100%, Canada 99%, UK 70%

    Given the (rather well documented) difficulty that some people have in finding health insurance in the US I find that figure of 100% survival rate beyond five years highly dubious.

    Edit. A very quick google search indicates that the 100% rate is for those who have the cancer diagnosed. Given the number of people who don’t have health insurance then a comparison between the UK and the US is meaningless as by definition in the US you are not going be treating “poor people” as they won’t get a diagnosis in the first place.

    footflaps
    Full Member

    Given the (rather well documented) difficulty that some people have in finding health insurance in the US I find that figure of 100% survival rate beyond five years highly dubious.

    It may well be of those diagnosed which ignores all the homeless who just die on the streets and never get diagnosed with cancer or never live long enough to get cancer…

    binners
    Full Member

    Do these figures include Glasgow?

    chrismac
    Full Member

    “Forgive me, but I don’t think I’ve ever actually heard anyone, anywhere, proposing a U.S. centric model of healthcare for the UK

    Can you point us to any sources for such a claim please? “

    Section 75 of the Health and Social Care Act explicitly removes the exemption from competition that the Lisbon Treaty provided to health care provision.

    All GP services in the UK are provided by the private sector. There is no such thing as an NHS GP

    THe ISIS reguslations within the Health and Social Care Act are there specifically to enable US companies to bid for NHS work. Thats how Lockheed Martin are currently bidding to provide Family Healthcare services.

    Drac
    Full Member

    grum
    Free Member

    The French have an insurance based model by the way. As for the US system being “crap” they certainly don;t think so and regard their health provision as far superior to ours. I am not saying they are right but you have to accept that they have world class health care available to many.

    Well they’re definitely not right are they – what a weird argument.

    kimbers
    Full Member

    @kimbers, by the way explain to me the reason for the stat quoted on the Fox piece

    5yr survival rate for prostate cancer: US 100%, Canada 99%, UK 70%

    its fox news and its all made up? the 100% figure shouldve been a clue

    fortunately jambalaya Ive spent the last 15 years working in cancer research so should be able to help you

    1st of all, there is no way its 100%, that is quite obviously rounded up i believe the actual touted figure is about 98*%?
    2ndly the USA has by far the highest diagnosis rates of prostate cancer anywhere in the world
    but why??

    the main test for prostate cancer is a serum test for Prostate Specific Antigen and while it is a very useful tool it is not very accurate and also picks up several other benign prostate conditions and prostate cancer itself is very poorly understood, famously on autopsy 80% of all men over 70 are seen to have prostate cancer yet most (70%) are asymptomatic
    and there is much scientific debate about the usefulness of serum PSA as a screening method
    Cancer treatment is not pleasant and false +ve PSA tests lead to a lot of distress uneccesarily
    infact several major studies have shown that PSA screening as its carried out in the USA has no health benefits whatsoever
    just search PSA screening on pubmed, filter for reviews only;
    http://www.ncbi.nlm.nih.gov/pubmed

    of course in a system where the healthcare industry is all about making the providers rich is there an incentive for treating people for scary diseases that dont they dont have?

    * Ive also worked in america with welfare kids from the inner city and am sure that a large chunk of the population is excluded from those statistics, considering how hard it was for them to get access to antibiotics or even diagnosis for simple ailments like ringworm

    binners
    Full Member

    As for the US system being “crap” they certainly don;t think so and regard their health provision as far superior to ours

    Who exactly are they asking there then? I reckon if you asked the (poorer) 50% of the American population that has no health insurance, if they thought it was far superior to a system funded by universal taxation to provide for everybody, you might get a slightly different answer. Even bearing in mind that a lot of them are half-wits who actually believe what they see on Fox News!

    Face facts… as with most things the Tory’s do, they want to base it absolutely and completely on the American Model. They don’t know any different. Its their idaelogical default position. Its American Capitalism, therefore by definition it must be absolutely bloody wonderful!!!!

    Well, yeah… it tends to be if you’re rich. If not…..

    They simply want to monetarise the provision of healthcare, so themselves and their chums can funnel off yet more public money into their own grasping parasitic pockets, and if healthcare system as we presently know it (free at the point of delivery) suffers, or even falls apart, then who really cares? Not us! We’ve all got expensive private care and will get the best treatment whatever happens

    thisisnotaspoon
    Free Member

    Looking at that distribution, you could almost fit a curve which is steeper earlier on, but then begins to dip around AUS and actually reduces towards USA, giving a sweet spot at around the 3,000 mark

    I dunno, I’d put it steeper and flatten off sooner, but that would put us well under the line.

    Well they’re definitely not right are they – what a weird argument.

    I’ve got a couple of American coleagues who’ve imigrated. Both had health plans through their employers which is pretty much the default over there. Both aknowlage that the NHS is good, but they reckon they paid less* in the USA and got better service**.

    Given the (rather well documented) difficulty that some people have in finding health insurance in the US I find that figure of 100% survival rate beyond five years highly dubious.

    The impression I got was that everyone get’s it through their employer, and those that don’t can buy it. The unemployed, retired etc get it the government and they’re no longer allowed to refuse (or charge extra for) pre existing conditions.

    *difficult to calculate, as our tax is paying for the NHS for ~18 years before and ~25 years after we work and pay tax, so the tax is probably ~double.

    ** same day appointments, no waiting lists and nice fresh hospitals.

    kimbers
    Full Member

    http://www.economist.com/news/books-and-arts/21598622-furious-debate-over-screening-prostate-cancer-help-or-harm

    http://nypost.com/2014/03/01/why-the-prostate-cancer-test-is-useless/

    you can see why prostate cancer is the perfect political scare story for amoral scumbags like Glen Beck and Daniel Hannan

    binners
    Full Member

    Both had health plans through their employers which is pretty much the default over there.

    Not for half the population, it isn’t.

    dragon
    Free Member

    Would you expect anything else? The most common serious diseases always get dealt with first. No one is going to worry about 5 year survival rates from rare cancers when people are still dying of tetanus etc…

    Looking at your graph I could save 50% of the total health care bill and get a worst a 1 year reduction in Life Expectancy. Think what we could do with Life Expectancy if we took that money, and used it to improve education and build bike lanes.

    All the graph really shows to me is that generally it matters little in Western Countries how healthcare is funded. If anything it proves the NHS isn’t remotely sacrosanct and there is room for improvements.

    teamhurtmore
    Free Member

    FF, are sure you posted the correct graph? The one posted doesn’t seem to relate to your opening point.

    Binners, whose manifesto or behaviour are you referring to? You did see the news this week that contradicts this view. When other departments face stringent cuts because health is ring-fenced, remember these comments.

    But the observation re actions versus words is an important one – just look at the Scottish referendum debate for a good example of that.

    nickc
    Full Member

    The idea that the NHS has got to be either wholly private or wholly public is a non starter. Never has been, never will be.

    One of the biggest threats to the NHS is the fact that it has this enormous body of static expensive hospitals that are fast become redundant. Hospitals are great for acute instances of disease. Shame then that the health care needs of the population are fast become completely the opposite of that, chronic lifestyle derived ill health. People smoke, drunk, eat too much and take little exersize. These things are best prevented and cured in a primary setting, by GP services and therapists, and nurses and so on. GPs have now got control over their budgets, do you a) tell your patient he needs an ultrasound, make an appt with the local hospital, wait 6 weeks, or b) engage the services of a private firm that will come to the practice every couple of weeks, and do the test and hand back the result there and then…

    The acid test for any private provision is: does it improve the outcome significantly for my patients and the wider community whilst costing the same or less.

    Giant local “do everything” hospitals should be consigned to the bin. Most care should be preventative, with specialised National treatment of specifics ailments. If that’s a mix of private and public care, then so be it, as long as it costs about the same, and the outcome for patients is better, who the hell cares.

    Currently the NHS spends more on Bariatric surgery than it spends on prevention of obseity. Madness.

    kimbers
    Full Member

    but its obviously not ringfenced thm

    http://www.bmj.com/content/348/bmj.g2274

    waiting times accross the board have increased
    the cost £3bn top down reorganisation has to come from somewhere
    and the farming out of more work to private providers means that profit is being taken off the top of that money thats allegdly going into healthcare
    and osbornes pledges are just pre-election sweetners thatll never happen

    gonefishin
    Free Member

    The acid test for any private provision is: does it improve the outcome significantly for my patients and the wider community whilst costing the same or less.

    …and not reducing the availability of care to anyone.

    binners
    Full Member

    THM – I’m extremely suspicious about them putting that much money in, while at the same time fundamentally altering it’s structure. So that a lot more of that money will, instead of going to public provision, be skimmed off in profits instead. In a lot of cases by companies with some pretty dodgy links to the Tory Party.

    nickc
    Full Member

    gonefishin, in reality waiting times are down, non attendance rates are lower (give people an appt when they want rather than when you can see them, and surprise surprise they turn up). There’s no incentive to turn away patients, as most private care within the GP services is contract, rather than fee based, we offer a better service than private (but in reality NHS) consultants can do, and there’s no wealth discrimination or separate queuing.

    dragon
    Free Member

    Don’t get me started on ultrasound. Why is that stuck in hospitals, it’s not a complex technique nor expensive or need long wait times.

    Ultrasound is the type of technique that should be routine in GP surgeries.

    br
    Free Member

    It’s bloated and inefficient with far too many administrators and does not enjoy the economies of scale that it should.

    I won’t disagree with the initial part of that sentence but having just worked in the NHS for a year (after a lifetime of the private sector) can I suggest that the standard ‘too many Managers and Administrators’ comment is a far too simplistic and just jumps on the usual Red-Top headline as IME/IMO it’s major failings are political interference, inability of clinicians to see past their own noses, annual budgets, dead-mans-shoe recruitment/promotion policies and GP’s feathering their nests.

    nemesis
    Free Member

    The impression I got was that everyone get’s it through their employer, and those that don’t can buy it. The unemployed, retired etc get it the government and they’re no longer allowed to refuse (or charge extra for) pre existing conditions.
    *difficult to calculate, as our tax is paying for the NHS for ~18 years before and ~25 years after we work and pay tax, so the tax is probably ~double.

    ** same day appointments, no waiting lists and nice fresh hospitals.

    Load of people in the US, even fully employed, have no health insurance. I’ve met mtbers over there who’ve had broken collar bones fail to heal properly because they didn’t have insurance and just left them to heal alone. That sort of thing is not uncommon. Similarly, insurance companies often refuse to treat specific condiitons for a range of reasons leaving the person without treatment.

    The US is a great place to be if you have money. Much less so if you don’t.

    Oh and talking about what insurance actually costs, I’ve looked into working there and while cost of living is cheap, insurance isn’t – again, fine if you’re well off, not if you’re not.

    ninfan
    Free Member

    The profit issue is another straw man though

    A lot of the biggest private healthcare providers in the US (and indeed the biggest one in the UK too) are run on a not for profit basis

    nemesis
    Free Member

    ‘Not for profit’ doesn’t mean that people’s pockets don’t get lined.

    MrNice
    Free Member

    one of the issues with treatment costs in US is pricing models. If you pay for your own care it costs far more than if it was billed to your insurer (they get preferential rates). I suspect that insurance via an employer costs them less than it would cost an individual. All comes back to the point that it’s a great system if you’re in a good job and well paid but many people don’t get the same level of service.

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