Teamhurtmore = the reasons the german system is more expensive to administer is because of the complex funding – which is what you propose. here – ie you want to make the system more complex to administer thus creating more costs.

Kings fund is a good place to learn a bit more

As the OECD points out in its report this week, the NHS has been changing, introducing innovative models of care that have been associated with some of the fastest improvements in health in any industrialised country. Our experience, and that of other researchers – such as those who have shown how hospital mergers set the new organisations back several years – confirms the OECD view that what is needed is institutional stability: and that this is what gives rise to effective innovation.

It’s a publicity campaign our governement ran a few years back, Crikey. The idea was to ask people to make responsible use of France’s health care system to keep costs down aand thus assure the survival of the system.

The problem with free health care is that it encourages bad habits that compromise the efficacity of treatments as well as increasing costs. The initial campaign has since been followed with more specific campaigns such as “les antibiotiques, c’est pas automatique”. French people now know that most colds are viral and that antibiotics won’t help. They also know it’s best to stay at home if they get flu for themselves and everybody else.

TJ – my final point tonight will be a more concillatory one – thanks for the link. Skelton’s comments are worth reading in that Guardian article.

{….especially for someone who never does any reading or research!}

The problem with free health care is that it encourages bad habits that compromise the efficacity of treatments as well as increasing costs.

Oooooooh yes, this I agree with completely. The clientele of A&E on a Friday night are a stunning self selected example of this, and in my town they even put on an inflatable tent, a kind of ersatz A&E during the ‘festive’ season, so people don’t even have to get to hospital for treatment.

A longer term idea would include cigarette consumption, alcohol, drug abuse, obesity and so on.

We do need to move away from a ‘It’ll be ok, the NHS will sort you out, so drink, shag, smoke, snort, drive, eat’ exactly what you want to idea.

A longer term idea would include cigarette consumption, alcohol, drug abuse, obesity and so on

Those very themes have been covered by more recent TV campaigns. Food adverts for junk food have to be legally accompanied by a warning like cigarettes “Pour votre santé, évitez de manger trop gras, trop sucré, trop salé”.

To answer the original question: “Say the NHS get privatised – what happens then?”

Kaiser Permanente say “jump” and the Secretary of State for Health asks “how high?” and then bends right over for them.

Be afraid, be very afraid everyone.

This is just the personal opinion of a Consultant Anaesthetist with 17 years service, so feel free to question my authoritaah (South Park mode).

TJ – just got in and couldn’t resist a bit of research from the Kings Fund and found the first quote on what we can learn from Europe quite illuminating:

The UK has a lot to learn from other countries. The most revealing index is the European Consumer Powerhouse Health Index. To say the UK has a ‘high-performing’ health system is misleading; we have a mediocre one – 13th out of 29 in Europe (2008). Holland is top 3 years in a row. All the top ten have insurance-based systems. As the report says, ‘Bismarck beats Beveridge every time’! We must wake up from this notion that we’re the envy of the world.

Only one point of view of course, but interesting nonetheless!

Thing is though, with this country’s record of privatising stuff, the last thing we should allow is the privatisation of the NHS! We pay more for stuff like transport, gas and leccy and telecommunications than most countries on Earth, yet get a poorer service than many other countries. With the greedy self-serving imperialist nature of our rulers, together with their far too cosy relationship with the US, means that any move to privatise our NHS will result in disaster.

It’s our NHS, it belongs to us. It’s not the Tory scum government’s to sell off.

A government introduced it and a different government can take it away….loving the emotive language people use when discussing ‘their’ NHS!

I work in the NHS and for what its worth some areas would benefit from a massive kick up the arse and the involvement of the private sector would/could achieve this….but a completely private health care system is something i’m against.

It is ‘our’ NHS though. We pay for it. Therefore it belongs to the people; it is not something a bunch of greedy self serving individuals can sell.

And if they try to, we should lynch the scum…

We pay for it because a government decided we should have it and fund it….their was no ‘people power’ revolution that led to the creation of the NHS….it was a decision taken by a government and if a government wants to remove a tax funded service or organisation then they can do so….put a consortium together and with others in your local area buy a part of the NHS or the primary care trust in your area, then it would be ‘your’ NHS.

their was no ‘people power’ revolution that led to the creation of the NHS….it was a decision taken by a government

Do you make that drivel up to wind people up, or are you really that clueless ?

Please tell me you do it to wind people up. It’s depressing to think that anyone can be that clueless.

buy a part of the NHS or the primary care trust in your area, then it would be ‘your’ NHS.

Eh? Buy something we’ve already paid for?

How does that work? Is it like if you buy a sandwich then get charged for eating it?

You’ve already paid for the roads too….go and claim a bit, see how that works out for you?

Tax funded services are not the same as owning a service….in reality the NHS would belong to the people far more if it was privatised and people held shares in it….not saying i want this to happen but it does make me laugh when people think that paying for a service via tax means they ‘own’ that service….while you’re at it why dont you go and claim some MoD property that you will have paid for through tax….in fact next time you’re cycling on MoD land and come across soldiers training on ‘your/our’ land tell them to leave….again, see how that works out for you.

Ernie lynch….the NHS came about from the EMS (emergency medical service) that was formed during the second world war, these EMS hospitals were dependent on government funding and would be in trouble once the war was over….the need to guarantee their existence after the war led to the reforms that created the NHS….effectively war led to the NHS.

it does make me laugh when people think that paying for a service via tax means they ‘own’ that service

Erm, I don’t know anyone who thinks they “own” the National Health Service. You know some strange people.

The NHS belongs to the nation/state/government/country whatever you want to call it. I think most people understand that. Except a few people you know, apparently.

.

Ernie lynch….the NHS came about blah, blah, blah,

The NHS came about because the British people gave a landslide victory in 1945 to a government which was committed (under intense pressure from the trade unions) to creating it, as part of a ‘cradle to grave’ welfare state.

well if some bastard comes along and **** with my MY nhs, which I truly think is one of the better parts of our bullshit society. then I don’t think anyone mostly will be aware or care. which is truly sad.

You’ve already paid for the roads too….go and claim a bit, see how that works out for you?

I can use them whenever I want.

Tax funded services are not the same as owning a service

The NHS belongs to us as a society. Not to us as individuals, which it would if it were privatised and shares sold. The difference is that currently it belongs to Britain, whereas privatising it could lead to all kinds of foreign interests having a stake in it, with the people of Britain, who have funded the entire project since it’s inception, no longer having any say in how it’s run. We do currently at least have some influence in this area, through our vote, and our right to lobby our MPs and that. Privatise it, and we won’t.

Cuba has a fully nationalised health care system, and in spite of Cuba’s economic difficulties, it still remains a model of how such a system can work very well.

It’s loads better than the US system in delivering necessary healthcare to all it’s citizens, as and when they need it, regardless of wealth.

The NHS was being planned long before 1945….like i said, voluntary hospitals that came about because of WW2 were going to go under once the war was over….creating a state funded NHS was seen as the best way to keep them once the war was over…the lead up to the 1945 election was about selling the idea to the electorate….hence the slogan about a welfare state that looks after people from cradle to grave….all politics, or maybe i’m too cynical?

Yeah but maybe, just maybe, some of those politicians back then actually gave a toss about the people they were elcted to represent in Parliament, unlike the vast majority of the current shower of scum, who quite frankly should be tried for treason. 😐

The NHS was being planned long before 1945

I don’t care if the NHS was first planned in 1645. You very clearly suggested that the decision to create the NHS was taken by a government without the support of the British people. Which is obviously complete bollox. Sorry.

(Some of) the important studies cited to support the idea that a company such as Kaiser Permanente can provide better healthcare for our population at a fraction of the cost of the NHS are fundamentally flawed.

Just to take one tiny detail, it was claimed (about 10 years ago) that the population that Kaiser “looks after” in the USA is equivalent to the population that the NHS looks after. From memory, the Kaiser cohort was around 9 million with the VAST majority being in social classes I and II. The NHS back then had 60 million punters and only a small percentage were in equivalent social classes.

I’m sure you can all see the obvious discrepancy here, and believe me there were even more “half truths” in the article. Such as the fact that Kaiser didn’t pick up the entirety of any prescribed medicines (this is called co-payment).

This is the kind of flawed thinking which has won over the minds of civil servants and politicians in Westminster and has allowed private health providers to really get their feet under the top table in the DOH. We really are going to be done over a barrel. These firms are only going to come in if they can make a profit for their share holders. They might come into the UK quietly and under budget, but once they’ve dismantled the NHS beyond recognition so there’s no way back for us then they’ll rack up the prices and squeeze us all.

Finally, can I just remind you all that currently when you consult a doctor in the NHS, our advice is as unbiased as it is possible to get. We have no vested interest in which line of treatment to recommend, we are paid the same whether you have drug A or drug B or no drug or an operation or no treatment at all or even if you don’t turn up for the consultation. You are genuinely getting a completely unbiased opinion. I can assure you that that is not always the case under the US system.

Teamhurtmore – the reason for the mediocre performance ( from your quote) is the underfunding – the NHS provides amongst the best care per £

The Netherlands is significantly more expensive

I suspect Dutch people look after themselves better also.
Much less obesity and they all ride bikes.
NHS poor outcomes partly due to uk population being the fattest in Europe?
(Although smoking is of course the biggest single contributory factor)
All comes down to public health interventions and I don’t see these being hugely profitable for the likes of Kaiser P etc.
In fact a healthy population would be less profitable for the private sector as less intervention will be needed.

TJ – my alter ego (the one who does read and research :wink:) told me about two interesting reads:

The first is short and easy:

http://www.guardian.co.uk/politics/2001/mar/14/past.education

The birth of the National Health Service in July 1948 remains Labour’s greatest monument. It was achieved only after two years of bitter resistance by the medical establishment, with consultants threatening strike action and the British Medical Association pouring out gloomy warnings about bureaucracy and expense.

Alas, those warnings proved to have more than a grain of truth, and the government was forced to retreat from its first grand vision of free, comprehensive health care for all. In the beginning, everything was provided: hospital accommodation, GP cover, medicine, dental care, and even spectacles. But with Britain showing few signs of economic take off, the budgetary burden was enormous. In 1951, chancellor of the exchequer Hugh Gaitskell was obliged to reintroduce charges for NHS false teeth and glasses. Aneurin Bevan, Harold Wilson and junior minister John Freeman stormed out of government, and Attlee’s goose was cooked.

As for the cost effectiveness of the NHS – ask why….we underpay the people who work in the service and we ration health care. Both would be improved by adopting the +ve aspects of tax plus social insurance funded by individuals

The second is a collection of essays – longer but fascinating exploration by Whiteside on the provision of health care between the wars. He notes the “heavy hand” of state intervention that inhibited the process (among other things)

http://www.civitas.org.uk/pdf/cw47.pdf

Doubt it will ever be privatised has a whole, but I reckon eventually it will
be a Two tier system. One where those who are not working
or benefits/social dependence will not pay
And those whom working will pay a small sum into an insurance plan
and together with your contributions will cover your costs.

Thats my Liberal values NOT whats in power now!

As for the cost effectiveness of the NHS – ask why….we underpay the people who work in the service and we ration health care. Both would be improved by adopting the +ve aspects of tax plus social insurance funded by individuals

Why would it? All that would happen is that you would vastly increase admin costs thus reducing cost efficeincy. that the lesson from countries that do this

Yes more money is needed – the most efficient way is to do it from tax

Civitas – really 🙄 neo con propaganda outfit.

teamhurtmore – I like how when using the “it’s in the Guardian therefore it must be true” strategy, you quote the opinion of a member of the Liberal Democrat Party, and a former LibDem general election candidate.

The Tories are able to do what they they are doing precisely because of support from the LibDems. Without LibDem support they would be buggered as they failed to receive a sufficient mandate from the British people.

The Tories are able to do what they they are doing precisely because of support from the LibDems. Without LibDem support they would be buggered as they failed to receive a sufficient mandate from the British people.

Yes One hopes they’ll pull out before they loose all credibility and Clegg pisses off.

Too late for the Lib Dems – they are destroyed as an electoral force now. their only hope is to hang on and hope things get better – they were weak at the beginning now they are absolutely toothless as an election now would see them wiped out

Ernie and TJ – I am happy to quote from a variety of sources. The key thing is to understand the bias and to take that into – rather than reject it out of hand. Its a basic skill for any historian.

I did smile at quoting civitas though, as I was anticipating just that reaction!!! But it is still worth a read. The whole debate about why the friendly societies died out – just whose fault was it – and the arguments about the fairness of means testing are all very interesting.

Ernie – but I can promise you, I do not believe that just because its in the Guardian (or any other paper) that it must be true. I am as happy reading the Adam Smith Institute as Socialist Worker!! Well that’s not strictly true!!

But on the Lib Dem issue – yes, but so? That is how our democracy works. No party was able to achieve and outright victory but that doesn’t mean that they should stop governing. Ditto, public sector strikes – at what level of turnout at the ballot, would you determine legitimacy – 10%, 30%, 51%, 75%, 100%.

Why would it? All that would happen is that you would vastly increase admin costs thus reducing cost efficeincy. that the lesson from countries that do this

Seriously TJ read the Whiteside article that I linked – (after taking in any perceived bias) examine the reasons why the friendly societies struggled with cost inefficiencies. Its an intriguing hypothesis that he puts forward.

Ernie – but I can promise you, I do not believe that just because its in the Guardian (or any other paper) that it must be true.

No of course you don’t. But you expect certain other people to. And you’re not far wrong – I know some people who think the Guardian is the Holy Book.

Teamhurtmore – its just nonsense.

All that you are doing is taking money out of the system by making admin more complex and if you have for profit organisations in there it makes it worse.

That article is nonsense as well- forgetting that many people in that period had little effective healthcare and that the quality of your care depended on your ability to pay or were you “deserving poor”.

If you set out with a end result in mind its very easy to cherry pick your data to fit. The reality of modern healthcare is the NHS as a monopoly provider with state funding is the most efficient way. Multiple funding streams and using for profit organisations decreases efficiency. This is the lesson from other systems such as the dutch and german.

Anyone know anything about the Japanese system? I know its very cheap but I don’t know why

Dutch mixed funding healthcare system – mainly charities run the providers. People below a certain level of income get most stuff paid for by the state. Above a certain level ( and its not high) you have to either pay for insurance at hundreds of pounds a month for a family or accept that you have to pay for some care. ( you must pay for the basic level of care still.)

My sister is in that position and did not pay for the higher level of insurance. Each of her children was an interventionist birth – cost her £3000 each My nephew broke his arm – emergency care free and very efficient, follow up cost a couple of thousand.

Remember the dutch pay significantly higher taxes than us and if you want not to pay healthcare as you need it you have to pay several hundred pounds a month insurance. Germany is similar.

The reality of modern healthcare is the NHS as a monopoly provider with state funding is the most efficient way

Not according to the WHO – they only rank us eighteenth for health care efficiency.

http://www.who.int/healthinfo/paper30.pdf

and to quote your good self in another thread

You know – I think I prefer what the experts say

😆

Zulu-Eleven – Member

Not according to the WHO – they only rank us eighteenth for health care efficiency.

And according to WHO, the USA, who’s healthcare your political guru Dan Hannan admires and wants to emulate, ranks 37.

Z-11 you urge everyone to read Dan Hannan’s book “The Plan”, so let’s remind ourselves what your political mentor thinks about the NHS.

Here is lying to the American people about the NHS

[video]http://www.youtube.com/watch?v=FiSPRkq28iU[/video]

You really should be more honest about how you want to replace the NHS with American style healthcare Z-11. I assume you do, as you and your mate think the American model is so much better.

Ernie – very poor straw man – Show me a single place where Hannan says we should follow the US model?

In fact, he says the US model has some strengths points, and the NHS has some significant weaknesses, and that if the Americans going to change then they should not follow our model.

Thats not the same thing as saying that the US model is the one to follow, and you well know it, but you keep repeating the same straw man argument that you know is bollocks, as its about the only thing you’ve got.

If you’d actually read the plan, you’d know that the model Hannan promotes is the Singapore model – which funnily enough the WHO report places significantly higher in the efficiency rankings than ours.

I can’t understand why Labby is still in the UK, such is his love for the US system, with it’s private healthcare, right-wing neo-con establishment and love for guns… 😕

Teamhurtmore – its just nonsense.

I am not sure what you are referring to

All that you are doing is taking money out of the system by making admin more complex and if you have for profit organisations in there it makes it worse.

On the contrary – the Uk experience was that central admin caused inefficient allocation of resources both pre and post Beveridge

That article is nonsense as well

If you say so,

– forgetting that many people in that period had little effective healthcare and that the quality of your care depended on your ability to pay or were you “deserving poor”.

Not that this is what its about?

If you set out with a end result in mind its very easy to cherry pick your data to fit.

100% true

The reality of modern healthcare is the NHS as a monopoly provider with state funding is the most efficient way.

100% untrue

Anyone know anything about the Japanese system? I know its very cheap but I don’t know why

When I lived there it was good provision but very expensive. Plus allegedly lots of {———} between drugs companies and doctors – but that was in the 1980s