[Closed] Say the NHS gets privatised - what happens then?

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 [b][i]care per £[/i][/b]

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)

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

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.

[img] [/img]

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.

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

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 [b]we[/b] 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

Tell you what - for avoidance of doubt - here's exactly what Hannan Says:

[i]So, if not the NHS, what? which countries do better? the united States is often said to have a market-based healthcare system. Does it have anything to teach us?
uS healthcare is nothing like as bad as is sometimes believed in europe. It is a myth, for example, that it does not provide for the poor. the uS government spends more per capita on healthcare than any major european government apart from Germany. [u]A far more serious objection is the sheer cost of uS healthcare: 16 per cent of GDP. the uS system is burdened by too much litigation, regulation and producer capture. we can do better.[/u]
So how about europe? while there are several models of healthcare on the Continent, most of them tend to involve a mixture of private and state provision and to be founded on health insurance. Insurance-based systems are demonstrably better than the NHS, but they, too, are expensive. Defenders of the NHS claim that the expenditure on the Continent is the only reason why the NHS performs so badly in comparison. Actually, we do not need to look across the Channel to see that there is no simple correlation between spending and outcomes: the NHS in Scotland performs worse than that in england on almost every measure, despite considerably higher spending (£2,313 per head in the former compared with £1,915 in the latter in 2006–07).
A system seldom looked at is that of Singapore, a wealthy, developed, Commonwealth nation. Singapore boasts health outcomes that surpass those of many european nations, yet spends only 3.5 per cent of GDP on health compared with Britain’s 8.4 per cent.
Singapore operates a system of health savings accounts which puts ultimate power in the hands of doctors and patients. Instead of relying on a government-funded or insurance-based scheme, Singaporeans save money in accounts dedicated for personal healthcare. Combined with low-cost catastrophic insurance cover, health expenditure is managed by the individual in association with his or her doctor. ?is avoids the rationing and waiting lists intrinsic in the NHS, as well as the bureaucracy characteristic of insurance-based systems. of course, the state acts as a safety net for those unable to save enough to meet their heath needs, but most people are able to manage their health needs without the government. the Singaporean government pays for only 31 per cent of health expenditure.
when people need treatment, they go directly to the healthcare provider they wish to see. they pay for this treatment from their savings accounts. In the event of catastrophic illness that would overwhelm a savings account, the insurance system pays the bill. Catastrophic insurance differs from traditional health insurance in that it is not accessed every time you see a medical professional. Catastrophic insurance is seldom, if ever, activated, so premiums are kept low.
once Singaporeans have enough in their savings accounts to meet future expected needs, they no longer have to pay into their account and so have an incentive not to overspend. Because Singaporeans benefit if they moderate their health spending, they are cost-conscious and will shop around for a medical provider who offers good value for money. this price sensitivity reduces health costs more effectively than rationing agencies such as the uk’s National Institute for Health and Clinical evidence (NICe).
Amazingly, Singapore provides this great health system with fewer doctors, nurses and bureaucrats per capita than most developed nations, suggesting an efficiency that is lacking in centrally-planned or insurance- based models. this is a health system for patients, not doctors’ unions.[/i]

Which, quite categorically, does not support your claim that he worships the US system, or that he wants us to emulate it.... and guess what, his claim that the Singapore model is more efficient is supported by the WHO report linked to above! 😆

Now, I've commented on here before that I personally think that the way forward for the UK is that we go back to the model of a national insurance system without centralised/state delivery - which is left in the hands of the private and mutual sector - however regardless of my opinions, the fact is that the claim by either Ernie or Fred that either I or Hannan want to see a US model, can be seen to be utter bollocks 😉

And what happens if Singapore's economy collapses and the people can no longer afford health insurance?

Hannan's rubbish is full of holes. He really does not in any way have a clue about the reality of US health care, as he's never experienced things from the bottom end of it. He's just a privileged blinkered knob who thinks cos he went to a good school he has the right to speak on matters which affect the lives of people whose lives he has no knowledge of. Bit like some people on here then, in threads like this....

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

Well he told his American audience that our system was crap, whilst their system was much better - did you see the video ?

That's despite the fact that according to evidence which you apparently approve of, the US was ranked 37 against the UK's 18. You think 37 is better than 18 ?

.

the model Hannan promotes is the Singapore model

He never told his American audience that - why not ? In fact if you watch the video he doesn't suggest that there is anything wrong with the US healthcare system.

He had the perfect platform to express his opinions on healthcare - that's what he was there to discuss.

You really need to be a bit more honest Z-11.

[i]Right, I'm off.....tat-tar[/i]

And what a load of pish it is.

uS healthcare is nothing like as bad as is sometimes believed in europe. It is a myth, for example, that it does not provide for the poor.

Provision for chronic healthcare is very poor -try being unemployed and diabetic - here you get state of the art care for free - in the US you do not

So how about europe? while there are several models of healthcare on the Continent, most of them tend to involve a mixture of private and state provision and to be founded on health insurance. Insurance-based systems are demonstrably better than the NHS,

Actually, we do not need to look across the Channel to see that there is no simple correlation between spending and outcomes: the NHS in Scotland performs worse than that in england on almost every measure, despite considerably higher spending (£2,313 per head in the former compared with £1,915 in the latter in 2006–07).

singapore - the poor get little heathcare and singapore relys on an underclass of migrant workers with no access to healthcare. Being ill in singapore is a very expensive business and there is no comprehensive cover

Zulu - really you should know better that to believe this guff - even by your standards its very poor

[b]Ernie:[/b]

I've quite categorically disproved your claim that Hannan says we should follow the US model.

[b]TJ: [/b]

The WHO report quite categorically disproves your claim that the NHS is the most efficient system.

If I can disprove your claims so easily, why should anyone believe anything else you say?

Elfin - I am not a great fan of Hannan's either - he looked pretty lightweight on QT this week - but what does...

He's just a privileged blinkered knob who thinks cos he went to a good school he has the right to speak on matters which affect the lives of people whose lives he has no knowledge of.

...add to the debate? How would that be different from Z11 or anyone else replying, "He's just a under-privileged ,blinkered knob who thinks cos he went to a bad school he has the right to speak on matters which affect the lives of people whose lives he has no knowledge of. "?

... a certain former deputy PM springs to mind, not sure why? 😉

EDIT: Can't be bothered.

but what does...

He's just a privileged blinkered knob who thinks cos he went to a good school he has the right to speak on matters which affect the lives of people whose lives he has no knowledge of.
...add to the debate?

He knows bugger all about how policies affect people outside of his tiny bubble of personal experience, is what. People like him have no right to be speaking about such issues. It's like me talking about issues affecting poultry farmers in Peru and presenting myself as an authority on things ffs.

Or someone who's never bin to a Harvester before commenting on the standard of food on offer there.

[img] [/img]

EDIT: Can't be bothered with this bit either.

No you haven't

Fine DD - no problem at all - can you please show me a single reference where the "Evil dan the man Hannan" says that we should follow the US model?

Either he's said it, or he hasn't.

LOL At DD40 bravissimo

Fine DD - no problem at all - can you please show me a single reference where the "Evil dan the man Hannan" says that we should follow the US model?

See my edit Labby.

It's too nice out to be not walking the dog today. It does unnerve me though to see people so publicly idolise Dan like you do. I would have though it was something did in the privacy of their own homes, in which case it's no business of mine.

Yeah, I must get meself ready for me pootle. If we all go out to ride our bikes, then Labby can sit here and talk to himself. That way, he might actually get someone to agree with him.. 😀

So, well, erm, basically you're admitting that you were wrong then DD 😆

😉

So, well, erm, basically you're admitting that you were wrong then DD

That's it Labby. 🙂

(Sssshhhh everyone)

Elfinsafety - on the basis of your criteria, it is basically impossible to find anyone who is qualified to be a politician. On that point, I wholeheartedly agree, hence my natural bias towards limited state intervention in most areas of economic and political life.

The fact that they are mostly incapable is probably due to the completely unrealistic assumption that we make about any of them in the first place.

The problem with PFI is that the Trusts they were offered to didn't understand them

There was a lot of strong-arming (and fiddling of financial comparators) involved in foisting PFI upon the NHS, despite widespread opposition. Plenty of people (e.g. [url= http://en.wikipedia.org/wiki/Allyson_Pollock ]Allyson Pollock[/url] could see what was coming - and lo, it came to pass.

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.

Well said - and it bears repeating. Add in the management-con.sultancy feeding frenzy that will be the new consortia and... well, it's pretty obvious where we are headed. Whatever their pompous 'credo', the nicely-timed Circle venture will be running Hinchingbrooke as as a loss-leading stalking horse, paving the way for other 'failing' hospitals to be taken over. Why else would an ex-Goldman-Sachs banker suddenly be so keen to play at doctors and nurses?

It makes me seethe - not only because services are being fragmented, but also because of the way inwhich the political rhetoric of 'choice and competition' is being used to disguise a whole raft of measures that will (IMO) result in nothing of the sort. Even CMD himself cited the (fundamentally-flawed) [url= http://www.allysonpollock.co.uk/administrator/components/com_article/attach/2011-10-10/Lancet_2011_Pollock_NoEvidence_Cooper.pdf ]Cooper[/url] paper in support of the notion that "competition saves lives, [i]right[/i]" - despite the fact that it seriously mis-handles data relating to AMI-related (i.e. heart attack) mortality. And while the NHS gets slagged off, there are circling corporate interests which [i]more[/i] than understand its actual value (and the current pensions T & C battle forms one aspect of this - the workforce is being softened up, imo). They will be making serious hay, but I doubt there will be commensurate improvements in frontline care.

My dad has just retired after a lifetime in public health - a loooong trek from army medic to Consultant Paediatrician. Thank Gawd he's out of it, and so won't have to deal with the coming clusterfug - I'd like to see some Mckinsey & Co tool explain to him how competition 'works' in PICU...

Bottom line: if we want a French/German style healthcare system, then we will have to invest like our continental cousins, coupled with proper (i.e. non-refusal) insurance regulation (and, as a nation, we will probably have to knock binge drinking on the head). But, for pity's sake, don't let us screw up good and effective services for the sake of having a big ol' yard sale to Serco. You don't know what you've got, till it's gone. 😕

You know what? I haven't read all of this thread, but here's what I think. How much do bombs cost? How much for bullets and tanks and armoured cars and the salaries of our troops?

How come we can apparently afford to go round the world poking our nose into other countries' business but we can't afford our own health service?

The British Bulldog is old now, his teeth have fallen out and his fur is a bit patchy. All he really wants to do these days is sit by the fire and rest.

Politicians! Wind your necks in! We aren't a world power any longer, bring the troops home and sort out what's going on here. We need to mind our own business and get this country back on its feet.

Edit: I have some American friends, they have seen the US health system in real life (not the pseudo world politicians live in) - it sucks. If you are poor and ill, you are stuffed.

The British Bulldog is old now, his teeth have fallen out and his fur is a bit patchy

I resemble that remark.

LOL, nice comfy bed by the fire for you then! Lots of cuddles and (soft) treats 🙂

Lots of cuddles and (soft) treats

...before I get put down.

Zulu-Eleven - Member

Ernie:

I've quite categorically disproved your claim that Hannan says we should follow the US model.

Zulu-Eleven, you can huff and puff and stamp your feet as much as you want, but everyone knows, right across the political spectrum, that Dan Hannan publicly claimed that the US healthcare model was superior to the British NHS.

Even the Daily Telegraph, for which Hannan is a journalist and former leader writer and therefore not naturally hostile towards him, clearly understood what he was saying :

[url= http://www.telegraph.co.uk/journalists/david-millward/6027945/Daniel-Hannan-is-wrong-about-the-NHS-America-has-it-much-worse.html ]Daniel Hannan is wrong about the NHS, America has it much worse[/url]

So why on earth should anyone trust someone who believes that US healthcare model is superior to the British NHS ? It really doesn't matter what subsequent things he's said about Singapore or anything else, the man fell at the first hurdle by claiming that the US healthcare model was superior to the British NHS and can't be trusted.

Now I don't doubt for a minute that the Peruvian halfwit deeply regrets what he said publicly on Fox News to his American buddies.

And I also don't doubt that he only succumbed because he found the stroking and massaging of his overinflated ego by a sycophantic and grovelling Fox News anchorman too irresistible to ignore.

But however much damage limitation exercises he attempts, and there's been plenty of backtracking, it's all too late - the public now knows what he really thinks.

And you need to be more honest too Zulu-Eleven. You steam into these healthcare debates on STW without giving the slightest hint that you believe the US healthcare model is superior to the British NHS.

Why don't you nail your colours firmly to the mast before you proceed to divulge your opinions on healthcare ? I think it's only fair.

Or is this the one issue, and it's a biggy, that you actually completely disagree with your political guru ?

...before I get put down.

Can we stuff you Noteeth? Put you in the hall?

[img] [/img]

Hannan/Beck Fox interview Transcript:

http://www.foxnews.com/story/0,2933,538690,00.html

There's no need to post a link of the transcript Zulu-Eleven, I've seen the video many times, and so has the Daily Telegraph editor who wrote :

[b]"Daniel Hannan is wrong about the NHS, America has it much worse"[/b]

And if the man was so wrong, concerning something as important as that, then he can't be trusted with anything.