Forum menu
Once again you show your total lack of understanding of how hospitals work
Expensively and ineffceintly.
As for the idea that american systems are cheaper – laughable
do you know anything about the American insurance and Medicare market place after Obamacare?
Don't dismiss things just because they don't fit with you view or ideology, it's very narrow minded and shows that you're resistant to new ideas. The US system is some of the best healthcare in the world (IF you can afford it) but their system for incentivising fast and direct access is also worth looking at as companies are incentivised to make saving by making sure that pats. see the right care at the right time. it's the profit motive....I'm not saying we have to have profit as a motive, but we can look at their systems of how they do that.
There’s no reason why they can’t do to another location ONCE a day
yes there is
1) currently they do other hospital based work before after and between OPD sessions
2) they need to be on the hospital site every day so cannot do a whole day in OPD
So thats 4 movements of staff daily at a minimum
then there are all the other issues. want an urgent MRI as a result of the OPD exam - now its " just go down the corridor" Under your plan thats not possible
Want a second opinion as the doc is not sure - now you can just bleep the other doc to come down - under your system that could not happen
etc etc etc
You call me out for ideology? Jeepers!
Unlike you I actually understand how hospitals work.
arggh...you see the big white building as the only answer...you do know there's literally thousands of docs working up and down the country that don't need to run down a corridor to get a second opinion, right? I mean, you do know that GPS don't do this as a matter of course...?
And this works in Spain right now, This is literally how their healthcare systems works; Consultants go to the pats, not the other way around, are you saying that Spanish healthcare doesn't exist?
I mean, you do know that GPS don’t do this as a matter of course…?
Actually they do. One of the advantages of multi gp practices. common practice
that big white building is the most efficent way to do it as weverything from expertise to equipment is all in one place available 24/7/365
consultants in spain have a very different role
Your ideas also mean huge duplication of equipment as every place would need all the equpmet
i really suggest you go read the research on costs. Hospitals are always significantly cheaper in actul costs that private clinic
is it reasonable for a single mum of two earning £28K a year, living in a rented house with no assets to pay more tax to fund the care of someone with £300K in the bank/shares, a £30k a year pension and a £250K house – so that the elderly person’s children will inherit £0.5M when the time comes?
yes, they’re paying more tax now, but the person with a 30k pension has paid more tax whilst accumulating their pension. THe single mum will also get a load of benefits the old person won’t.
A person with a £28k income will get **** all in benefits
While we are talking about funding the NHS and social care in the here and now, I see no reason why we can't have a small fee payable for GP appointments. As a minimum wage worker I would be happy to pay a nominal £10 (or other small fee) per appointment, or if numerous appointments over a period are needed then maybe £25 to cover them. It works for NHS dentists. I would also charge for missed appointments as these are a huge drain on time and resource. All payments should go straight into the "pot" for the overall NHS budget.
Someone a few pages back (CBA to find the comment) knocked back my point about taxing bonuses and share options saying theirs were taxed. They are not taxed the same as base pay was my point. If they were then executive renumeration would not be so bonus heavy (with bonuses guaranteed regardless of performance) in some cases. Share options are shamelessly offered as a way of avoiding tax and increasing "wealth". Any profit from selling these in the future should be taxed as if it was part of the employee's income, not "capital gains". Yes this would upset the high earners, but it would simply be closing a loophole by which they currently avoid paying due income tax, not hammering them with extra tax for being supposed "high achievers". I'll be honest... it pisses me off when execs get paid a huge bonus for making a load of people unemployed due to the company they run losing a load of money. If they are running it badly they don't deserve a bonus surely?
If the bonus is in cash it will taxable the same as other pay. FWIW I exceeded all my targets despite being new in the job and doing so durimg the pandemic. I was due a 10% bonus (i actually significantly increased the pay of my whole team and hired people), didn't get any bonus, same for everyone else including the Exec team, despite the business dojng a lot better than expected due to Covid. The general feeling was it wouldn't be appropriate to be paying bonuses whilst we were taking government money with staff on furlough.
It works for NHS dentists.
might work for the dentists, doesn’t work for the patients, unless you want to push people into paying for private care so they can actually get treatment.
While we are talking about funding the NHS and social care in the here and now, I see no reason why we can’t have a small fee payable for GP appointments.
Because it puts people off going to the doctor making their illnesses worse and costing the country more in the long run
one small cost cutting I would like to see is no more prescriptions for cheap over the counter meds. Want paracetamol? Buy it - its literally pennies
one small cost cutting I would like to see is no more prescriptions for cheap over the counter meds. Want paracetamol? Buy it – its literally pennies
I thought that was already the case?
Some gps might well suggest it strongly but its not official policy as far as I am aware
In England where you still have prescription charges the other thing GPs will do is point out its cheaper for you ( if you pay charges) to get it OTC rather than on prescription
Brian has no access to the capital and most final salary schemes are already in deficit. How is he to pay a wealth tax when earning 20k income. Much better to tax his estate and let him live in peace. We need to start taxing the dead, not the living!
He has no access to it now, but that doesn't mean the large invested sum cannot be accessed for tax purposes with a change in the law.
As for being in deficit, not all schemes are and those that are either have a plan in place with the Pension regulator to correct the shortfall or (worst case) will collapse into the Pension Protection Fund which reduces the payouts slightly but then they re-emerge solvent. NB One of my final salary pensions fell into the PPF and re-emerged. Still got a gob smacking return on investment equivalent to 20% annual interest over the life of the fund!
There is no reason why he can't contribute to a wealth tax given he has the best pension of the three scenarios as his 'wealth' is actually the greatest.
but the person with a 30k pension has paid more tax whilst accumulating their pension
Not on their pension they didn’t!
Pensions are incredibly tax efficient! You pay nothing on contributions because they're taxed when you take the pension. Except that you can take 25% of a pension tax free and most higher rate tax payers avoid 40% tax paying in, but will only pay 20% tax when taking their pension.
When I worked full time I was earning over £100k and paying less than 30% tax overall as I paid the full amount into my pension each year, so my taxable salary was only £60k, of which only £10k or so of that fell into the higher rate tax band. I am, however, going to have an almighty tax bill when I start drawing down my pension....
I really hope we never live in a world where pensioners on modest pensions are forced to surrender, against FCA advice, their benefits to pay a wealth tax. To my mind that is targeting exactly the wrong people, not to mention the impact the mass forced sales of assets would have on share prices and the economy. I’m not against higher taxes to fund public services but surely better to tax his estate.
allanoleary
Full MemberWhile we are talking about funding the NHS and social care in the here and now, I see no reason why we can’t have a small fee payable for GP appointments.
Because most health issues are best dealt with quickly, having people put things off for any reason can lead to a big negative impact on health, and that generally means increased costs for the NHS/country. Obviously some people take the piss but I reckon on average it'd be better if UK people went to the GP quicker.
And also because a small fee for one person isn't so small for the next.
Also, in general opening any doors to monetarisation and barriers to healthcare is a really bad idea in the current climate.
I'm in a strange situation where when this thread started my dad going into care was only a theoretical possibility (he had eye sight issues and was left frail but largely recovered from a couple of strokes in 2019 but was coping well living alone at his home). Saturday before last I got a call that his vision had gone downhill rapidly and he was now blind so could I come over to look after him (I did and fortunately could get the following week off work). He went from saying he'd rather go to Dignitas than a care home to being understandably scared of his situation and wanting to go into residential care (well he'd still prefer to just die but that's not a realistic self-determined option...).
Firstly - he's lucky in the sense he has a healthy bank account and a generous pension so he doesn't immediately need to look at selling his home (on the outside chance once he adjusts he thinks he can return to live at home with care being provided there). I can't imagine how much more stressful the situation is for families that have to look at selling the home asap just to afford care (before the assets are spent and government funding take over).
Secondly - care homes are eye-wateringly expensive. It looked like he would only need residential care (£600/week at a nearby well-regarded one), which is pretty reasonable (although still only self-fundable to a small minority I'd have thought). The local nursing home option would be £1350/week - that's pretty crazy to me (although once you break it down assuming 24/7 care it's not so outlandish). Even his savings & house are going to disappear pretty quickly at that rate (which he sadly may now need as his health deteriorated further over the last few days and he's now in hospital where we can't even visit 🙁 - we suspected another stroke but apparently they can't find evidence on an MRI scan).
I do though have to agree with TJ though:
on using the house to pay for care.
If you do not do this a large tax increase would be needed.
The only people to benefit from not selling a house to pay for care are the children of middle class parents who still get their inheritance.Why should my taxes pay for someone else to inherit?
It would have been a small light at the end of the tunnel to be able to pay off my mortgage with the inheritance but I can't in any way justify that being more fair than someone working full time struggling to make ends meet paying more tax instead.
Its one of those issues that whichever way you look at it is unfair to someone.