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I’d not bother worrying about it
Not insulin dependent I presume?
Nope and I wasn’t being flippant either, no one really knows what Boris wants other than stay PM and as kelvin rightly points out blatant moves would be politically iffy and the timescales.
TBH I wasn’t thinking about them raising the end user prescription costs as that’s obviously bad politically but rather the internal costs to the nhs.
This is why trade deals are er complicated.
anyway, predictions:
- capital spending on projects that will make the Garden Bridge looks sensible.
Sort homelessness out in 5,4,3... no chance
kelvin
Subscriber
Tom, insulin becoming much more expensive for the NHS isn’t that likely, assuming we stick to current European suppliers. We’re not going to swap to USA suppliers.
Our prices are only low because of strong price controls, not because of who we buy from.
In the states, overseas suppliers cost the same as the domestic suppliers, even for products you can buy elsewhere for a few percent of the cost. Reason being, medicine isn't a normal market- it's easy to freeze out both products and supply lines. So it's a near perfect cartel environment, and the drug companies are an enthusiastic part of that. They still sell product to us here, since they can make a profit at these reduced rates, but they'd rather sell for more.
So we don't have to swap suppliers. We just have to reduce the strong market protections that we currently have in place that prevent them from ripping the arse out of us. Not take them away or anything, a minor change in price controls could double the price overnight, and they could still say "it's 500% more expensive in the USA for the same stuff, look at how well we look after you!". And of course call it fair, and pro-business, and common sense, and people'll lap it up.
Insulin is cheaper in every European health market than in the USA. The NHS will not suddenly be paying USA prices, unless it freezes out European supplies. And, importantly, individuals will not suddenly be bearing the cost of it. It’s important to have some perspective on this. Tom does not have to plan to have to pay substantially more for his supplies in the next 10-15 years. Of course, longer term, it depends on how cock sure the right wing anti-NHS players get… if we keep voting Tory, things will continue to move in the wrong direction, so who knows, 25 years from now, costs could be very different indeed.
My concern is one insulin will stay the same price (a bolas one, I reckon), but all the others (basal insulins, probably) will rocket. The NHS will continue to buy that insulin, and dish it out FOC, as normal.
They will then stop offering/funding all the others, so people will have to either get used to using the NHS one, or pay up. The reason it will be a bolas one that cheap, is thats what the pumps use.
(briefly, for those that don't know, different insulins work differently for different people, having differing effect on lowering blood sugars over differing amounts of time, so what works for one, may not work for another) ,
speculation of course, but I've heard of people moving to the states, getting the best insurance they can afford and them saying, 'Nah you don't pay enough for what you had in the UK, you get this one instead, get used to it.' Cue no end of issues.
It has also taken me 4 years of paying £100 a month for the freestyle libre blood testing sensors to be provided by the NHS. I imagine they will be for the chop much sooner than insulin.
This is what I think will happen across the whole 'industry'. One basic medicine will be provided by the NHS, but anything good will have to be self funded or insured against.
If you’re looking at a timescale of 10 years, there is no chance of our health system being transformed into the mess that the USA system is, and every chance that tools for controlling blood sugars will continue to improve in both usefulness and NHS availability.
Well, I’m continuing to hope so anyway.
Longer term, well let’s hope the current lot aren’t given that opportunity.
kelvin
Subscriber
Insulin is cheaper in every European health market than in the USA. The NHS will not suddenly be paying USA prices, unless it freezes out European supplies.
That's the trick- we don't have to freeze out supplies, we already have. Medication is (rightly) very controlled so there's no grey-import market. The US has european suppliers too, it's just that the exact same company that sells the NHS my novorapid, sells it for more in different markets. This isn't a US/EU thing, it's a price-controls-and-selling-things-for-the-maximum-price thing.
"Tom does not have to plan to have to pay substantially more for his supplies in the next 10-15 years."
Correct. But the NHS may well have to. And ramping up prescription costs won't worry this government in the slightest.
Correct. But the NHS may well have to. And ramping up prescription costs won’t worry this government in the slightest.
Nor will it give a second thought to reducing those exempt from said charges
[deleted]
Nor will it give a second thought to reducing those exempt from said charges
Not sure what the number is now but in 2014 the number of people who were exempt from paying for prescriptions was 90.6%
Always seemed very high to me and anecdotally didn't seem like an incorrect figure as I pay for quite a few prescriptions for my wife and I have never seen anyone else pay for a prescription in the queue in the last year (some may well pay in advance though!)
The charge also seems to increase by 20p every time I go. If the exemption was removed it would seriously impact a lot of ill poorer people at £9 each prescription but it may also help stop the stock piling of free repeat prescriptions that a very high number of old people do.
I pay for quite a few prescriptions for my wife and I have never seen anyone else pay for a prescription in the queue in the last year (some may well pay in advance though!
Prescription prepayment certificates Are £104 for a year well worth having if you need a couple of things a month.(30 something for 3 months if you don’t need a year)
Course you could ask why only England peeps actually have to pay for prescriptions 🙂
Anyway we should get back on track with wider predictions.
Freeports :- I think we’ll hear more about em.
Boris photo opportunities:
I think he’ll be blitzed all over the media laying foundation stones for hospitals an prisons and manufacturing and pretty much anything you can think.
In fact I reckon at least 85% of the U.K. will actually have a selfie taken with him.
I'll play along.
The the government will happily do over Scotland now.
I've a phone call today with two Scottish public bodies that fund some of our work, who should have had budget outlines in December. I suspect the outcome will be that they cannot set a budget, so cannot entertain us applying for next year's funding.
That means I'm writing letters of termination of employment by next week.
And Boris will be DILLIGAF.
https://www.bbc.co.uk/news/amp/uk-scotland-scotland-politics-51019926
Johnson has his first post-election meeting with the EU this afternoon
Word has been put out that he intends to tell them that the negotiations will not be extended beyond December. He is also going to tell them that the UK will be pursuing divergence, not regulatory alignment, from EU rules and standrds.
No surprises there then. That was always the long term plan. To tear up workers rights, environmental and food standards and then deregulate everything in a race to the bottom and alighnment with the US
I'd say that the EU will just tell us that if thats what we want to do then thats up to us, but they won't be ginvg us any trade deals on the back of it. Why on earth would they?
So it looks like they're actively pursuing a no deal/ WTO exit. It was just put on hold for a bit.
That'll hit their new voters in northern working class areas hardest, of course. I'm sure Dom and Dommer won't be losing any sleep over that
[strong]binners[/strong] wrote:
That’ll hit their new voters in northern working class areas hardest, of course.
Quite frankly - Good & I'll not shed a single bit of sorrow. They voted for this, they can take the biggest slice of misery pie.
While I agree that they deserve everything they get. Unfortunately an awful lot of us who didn't vote Tory are going to have to take the same economic hit and have to eat the same misery pie. Saying 'I told you so' isn't going to offer much consolation 🙁
It's not, but it's all we've got, really.
Good & I’ll not shed a single bit of sorrow.
Jesus. Back to this again I see! If it makes you feel any better, I can guarantee you the people who voted for it won't give a flying **** about your concern or lack of it, as long as they take everyone else down with them.
Jesus. Back to this again I see! If it makes you feel any better, I can guarantee you the people who voted for it won’t give a flying **** about your concern or lack of it, as long as they take everyone else down with them.
So now they're pretty minded and stupid, lashing out in jealousy? I thought they were salt of the earth white working class heroes? Or weren't they stupid last time? I am struggling to keep up.
Must be challenging having to constantly bend the rest of the world to fit, I guess.
So it looks like they’re actively pursuing a no deal/ WTO exit. It was just put on hold for a bit
This was obviously always the aim. Hence the atifical deadlines from Johnson. Thats so he can say " we tried but the EU would not play ball."
Bye bye UK - it was a good few hundred years but that is the end of the UK
Rather predictability Johnson is already backtracking on his election promises. How long before we can start saying ' we told you so'?
https://www.independent.co.uk/news/uk/politics/boris-johnson-social-care-plan-bbc-breakfast-election-latest-a9282611.html
I think we can probably do that already.
There's some chat in the tory press about some kind of mansion tax and getting rid of the upper rate tax relief on pension contributions.
Very interesting on the pension contributions - that would hit a lot of people (I think 14% of people pay tax at the higher rate).
The Tories had a manifesto commitment not to raise the income tax rate, this would seem like a very sneaky way of getting round that. It effectively increases the % of income tax paid by everyone in the 40% tax bracket. Also a kick in the balls for a generations that have lost final salary pensions and had their retirement kicked into the long grass anyway. There could also be some perverse incentives for people to reduce their working hours (this combined with loss of child benefit for those earning over £50k).
Labour got an absolute mauling for suggesting the same thing in the 2017 election. It's not a Marxist smash and grab when BoJo thinks it.
Always the party of stealth taxation. It's very much in keeping with attitude towards the electorate.
The Tories had a manifesto commitment not to raise the income tax rate, this would seem like a very sneaky way of getting round that. It effectively increases the % of income tax paid by everyone in the 40% tax bracket. Also a kick in the balls for a generations that have lost final salary pensions and had their retirement kicked into the long grass anyway. There could also be some perverse incentives for people to reduce their working hours (this combined with loss of child benefit for those earning over £50k)
That seems a good idea to me.If it affects 14% of people , that is the top earners who can afford a slight tax on their pension contributions. (From what Ive read, they are only going to be taxed on their pension contributions, so, they are still gaining by paying into a pension, rather than taking their wages as cash).
It has nothing to do with final salary schemes, that is down to individual companies stopping that entitlement.
People on 50k+ cutting their hours so that they can claim £20+ a week in child benefit.
Really?
You really think people will do that? Its fantasy, people on £50k+ a year are not bothered about £20 a week from the Govt.They can work an extra hour and get more from their employer.
You really think people will do that? Its fantasy, people on £50k+ a year are not bothered about £20 a week from the Govt.They can work an extra hour and get more from their employer.
With three children, the child benefit charge is a marginal tax rate of about 25% (on top of the 43% tax & NI). So yeah, when over two thirds of your extra hour goes to the government you might not work it or you might put in all in a pension to avoid paying tax on it. High marginal tax rates change behaviour.
getting rid of the upper rate tax relief on pension contributions.
I don't think this can be done fairly. If you apply it only to employee contributions, salary sacrifice and other non-contributory schemes escape scot free. If you apply it to employer contributions too, you have to PROPERLY value defined benefit schemes which is hard and won't go down well in the public sector. A lot of basic rate taxpayers would suddenly find that they are actually higher rate based on total employer contributions.
As above Alan it is a real issue, as in real people from my experience are dropping a day a week as it's a waste of time.
The final salary thing is relevant because there is increasing unfairness between generations and the government seems only too happy to heap the burden onto working people rather than go for great vast unearned wealth of the boomers.