[Closed] What to cut to fund the NHS?

Whats the problem with charging based on lifestyle?

My wife pays thosuands more to use the NHs than you lot simply because she's an immigrant, even though shes a higher band taxpayer and has private cover.

Totally fine to tax the **** out of immigrants but not the fat jobless ****s that are the ones placing a burden on the system.

[u]NI[/u] should be like actual insurance, the British have shown that they are not responsible enough for proper socialised medicine. I want to see [u]contributions[/u] go up based on age and lifestyle factors

but not the fat [u]jobless[/u] ****

I'm thinking you didn't quite think this plan all the way through

Tom_W1987 - Member

Whats the problem with charging based on lifestyle?

My wife pays thosuands more to use the NHs than you lot simply because she's an immigrant, even though shes a higher band taxpayer and has private cover.

Totally fine to tax the * out of immigrants but not the fat jobless * that are the ones placing a burden on the system.

Sometimes I look at a post and really feel that I want to say something, but the whole post is so ridiculous that I just don't know where to start.

In the end I can't be bothered.

This is a good example.

Ok. Fat, lower tax band, lower NI contributing Northern Brexiteers that shit out too many kids.

Oh you're upping the pleasantries, how nice.

Whats the problem with charging based on lifestyle?

Can you think about how it would work for 20 seconds and then come back and tell us what you think the problems trying to implement it would be.

Tax aircraft fuel and put VAT on airline tickets.

Tax aircraft fuel

Problem with that is that other countries don't. If you start doing it, all your short haul flights will arrive in the UK with half full tanks and not take any on. And aircraft routings will be adjusted to limit the amount of UK fuel used.

Changing taxes mostly changes behaviours and only sometimes raises money.

Also, drop in the ocean compared to NHS funding.

Also, drop in the ocean compared to NHS funding.

Are you sure? IIRC a few years back it was calculated at being worth £10bn per year, which would give the NHS a very healthy boost.

[i]Problem with that is that other countries don't. If you start doing it, all your short haul flights will arrive in the UK with half full tanks and not take any on. And aircraft routings will be adjusted to limit the amount of UK fuel used.[/I]

The idea proposed that resulted in this answer is yet another in a long list of reasons for why you CANNOT allow the general public to be involved in actually policy decisions - otherwise you end up with ideas like this, Brexit and no doubt capital punishment. 😉

if you want a healthier society you need a fairer society.
We seem to be going in the opposite direction.
Wasn't it midday last Wednesday when ftse 100 ceo's had earned the same as their employees will earn all year?
And to all the healthy middle class educated folks banging on about penalising poor fat smokers for their lifestyle "choices", google "social determinants of health". Not everyone has the same choices to make, and if you are one of the unlucky ones, there is f-all you can do to change that.

Kerley, Sweden is already trialling it in a way by not paying for certain operations until the patient has lost weight.

I don't see why I should be paying for other peoples poor choices or bad genetics, seeing as Britain has collectively decided to punish me and my wife financially because I married a foreigner. And I damn well don't see why I should be paying for hospital maternity bills if people argue it's because we increased the population of the UK.

Theresa May has been calling for an end to division in the UK, well her voters voted for division by giving them a mandate to bring in discriminatory immigration policies. Why is sivision only bad if its poor white people that feel hurt?

The cheapest way to deliver healthcare is to do it instantly without too much prevarication like conditions to treatment or charging arguments (before or after the treatment) but of course that becomes expensive when it collides with charged model like the drug businesses that are global and interact with different methods

If we wanted to pay for the NHS and all the other stuff we do on the cheap (schools, prisons, transport) we need to take an axe to the tons of daft tax laws that exist only to provide economic stimulus to business sectors (which is daft anyway) but all it does is provide loopholes for the likes of Barclays wealth to create tax dodge schemes. Hence everything is avoidance and HMRC are never confident of the line between avoid vs evade.

You mean the drug development model that requires crap loads of capital and investment to produce new types of drugs? Yeah sure, that could be nationalized world wide....hahah.....also.....Britain doesnt like experts so I doubt they'd like to see more government money ploughed into those ivory tower timewasting academics.

Separation of public health from NHS has not helped - health prevention is now driven by councils not NHS - cheaper to prevent many problems than treat.

Separation of health and social care budgets not bright - incentive to keep elderly in hospital to save budget but at a far greater cost to UK plc.

Lack of joined up working doesn't help - competition and the internal market has not helped in many ways as that market has to be administered.

Ultimately though, the issue isn't just an NHS one - healthcare for the whole of planet earth is predicted to become unaffordable if current trends continue - arguing over which country then becomes irrelevant.

Problem with that is that other countries don't. If you start doing it, all your short haul flights will arrive in the UK with half full tanks and not take any on. And aircraft routings will be adjusted to limit the amount of UK fuel used.

The idea proposed that resulted in this answer is yet another in a long list of reasons for why you CANNOT allow the general public to be involved in actually policy decisions - otherwise you end up with ideas like this, Brexit and no doubt capital punishment.

Doh! I'd never thought of that 🙄
Suppose it could be achieved if we were in an international trading and political organisation with the same rules and where most of the short haul flights began and ended ...now there's an idea 😉 Wasn't the EU being praised in the Brexit thread for deregulating the national airline cartel/monoplies?? CBA checking back.

Suppose we should give up on trying to regulate tax avoidance and offshore tax havens too because countries will never agree to that either.

or we could just give in to vested business interests to the detriment of the world's environment

Getting shot of a load of inert 'managers' in the public sector in general would help. (As TJ inferred)
Don't get me started on made up jobs in the prison service.

Stop hospital treatment for anyone over 80. Maybe have a big tar pit to throw them into on their 80th birthday.. Big celebration, big send off party and into the tar pit you go old people.

Maybe fat people can be sacrificed and rendered down to heating oil if they top 30 stone. Right flashy.. You knew what would happen if you carried on eating at Gregg's.. Into the rendering plant you go to keep the racing snakes warm.

I have more if anyone is interested.

Separation of public health from NHS has not helped - health prevention is now driven by councils not NHS - cheaper to prevent many problems than treat.

Separation of health and social care budgets not bright - incentive to keep elderly in hospital to save budget but at a far greater cost to UK plc.

It's like anything, spending more and more brings increasingly dimishing returns in terms of advancing lifespan. We now have loads and loads of old people, who can live for two decades of needing care. I have a gran who had mild alzheimers and she had anti-cancer drugs thrown at her, she survived cancer but she had basically lost it by the time the treatment finished...whyyyy?

What we need to do is spend the serious money on improving peoples quality of life and useful working lifespan. Society needs to think about death more, realize that they are one day going to die and spend more time thinking about how their lives could be improved instead of always trying to delay the inevitable.

The thought of private health insurance working this way terrifies me. Life would become full of decisions based on whether you could financially afford the consequences based on what level of cover you have.

Understood. The alternative is taking little or no responsibility for your actions (in extreme). Eat as much unhealthy food as you want and the state will pay for the consequences. Life insurance works this way too, there is a questionaire it's reasonable for them to decline you if you are a BASE jumper. Anyway in practice we would just have proper health insurace allowing pre-existing conditions and working together with the State provision.

Tom yes indeed. Elderly care is something we really need to think about. Also the type of health care people are offered. If you step back and look at costs without emotion a huge amount is spent on treatments at end of life which offer no real extension of life and/or no improvement in quality. In many cases the patients don't really want them.

This is the charity which my neighbour who is an ex nurse aProfessor and CBE works with

http://myhomelife.org.uk

What about cutting the salaries of the chief exec's and stopping the supply chain from ripping off hospitals and doctors surgeries. This issue has two sides, it needs proper funding but it also need s good and responsible management. I feel we are part way on the first step but a long way off the second and until that's addressed we are just putting more and more money into the hands of people that waste it on our behalf.

The ceo is one of the positions that I would really want some of the best in. It's the key leadership role of the organisation.
How are the supply chain ripping people off? Big paharma are not rolling in cash from drug development these days.

Charge drunks for their treatment in A&E. Not alcoholics, but people who go out get rat-arsed and have a fight.

How are the supply chain ripping people off? Big paharma are not rolling in cash from drug development these days.

+1

My old company, developed a first of it's kind drug - Imlygic - a genetically modified herpes virus designed to infect and kill skin cancer cells - really bleeding edge stuff.

Oh but after decades of research, it turns out that it's not very good at extending lifespan (last time I checked, as they didn't have enough data on patients with lower grade more survivable skin cancer). Thus, I'm not sure whether they will actually ever turn a profit on the drug - getting these lofty treatments to market is a massive, massive risk financially to companies.

Then the drugs that we do manage to get out there, get pissed up the wall by governments, clinical staff and the general public - through poor or over use - eg antibiotics - we even have people on here who demand extended treatment for lyme disease who cannot show any evidence of it's efficiacy and who don't mind that by using these drugs they are contributing to their eventual obsolesence. Whilst we have millions throughout the world who don't have access to good healthcare or antibiotics?

now that will fix things, how drunk is drunk? Was it sitting in a pub and getting attacked?
Sorry to sound so negative about some of these ideas but I just got knocked back from my range of chocolate cookwear.
The police can fine people for their behaviour already.

IMO, three things need to happen:

1) The NHS needs to stop getting used as a political football that gets booted into different directions every election cycle. We need all parties to commit to a 20 year mission statement so that NHS Snr management aren't dealing with goalposts that shift every 5 minutes.

2) We need to invest in professional healthcare management for the future. People talk derogatorily about "managers" or "back room staff" within the NHS.... but what they are actually talking about is bad management. The NHS needs talented managers just like any other big organisation, so they need to define the roles and train for them at the higher education level.

3) We need to challenge the general public's perception of the NHS. People need to understand that it is NOT FREE, and if we want a world-class heathcare system.... we are going to need to pay for it.

Of the three, the third is probably the most tricky to achieve: We just haven't got the appetite for charging at the "point of delivery" in the UK (yet?). Imagine the uproar about the first little old lady that dies because she couldn't afford to pay for the ambulance/GP visit/A&E charge.

The Australian healthcare system is a complete mess too, but one thing that they get right is an additional tax that is levied (after you reach a certain earnings threshold) if you don't have private cover to a particular level.

The solutions are out there....

The Australian healthcare system is a complete mess too, but one thing that they get right is an additional tax that is levied (after you reach a certain earnings threshold) if you don't have private cover to a particular level.

Tom_W1987 - Member

Then the drugs that we do manage to get out there, get pissed up the wall by governments, clinical staff and the general public - through poor or over use - eg antibiotics - we even have people on here who demand extended treatment for lyme disease who cannot show any evidence of it's efficiacy and who don't mind that by using these drugs they are contributing to their eventual obsolesence. Whilst we have millions throughout the world who don't have access to good healthcare or antibiotics?

A bit of a false comparison there Tom?

As someone who has gone from being able to cycle 200miles a week six months ago to barely being able to get off the sofa because I was bitten by a tick on a cycle tour, I hope you're modest ego might take a second to consider that there's not much evidence out there to say that antibiotic treatment longer than the NHS's current advice of anything from 5-30 days (at varying dosages of varying antibiotics depending on the consultant) won't cure Lyme because frankly, the NHS and other medical research agencies simply haven't done the research yet.

What I can tell you is that the NHS's current position on it and their treatment is absolutely shocking, and it's placing people like me in a position where we're having to spend a great deal of time and money of our own to seek out treatment elsewhere where the medical community is a bit more open minded to the fact that there is still much that hasn't been researched or understood about the illness. As someone who pays tax like everyone else, leads a healthy lifestyle and enjoys my independence I find your comparison deeply insulting not to mention incredibly short sighted. There might be some out there gobbling antibiotics every time they get a cold, but if you're suffering increasingly pronounced and worrying neurological and physical effects and so-called experts are dismissing it as stress because NICE guidelines written ten years ago don't correspond to reality, then you'd probably suck bigfoot's cock for a cure before you listen to some disinterested Dr who surprisingly enough, doesn't actually have access to the research he needs to make that judgement.

I'd politely suggest you take a minute to educate yourself by either visiting the Lymeaid or caudwell-lyme websites before holding Lyme up as some kind of symbol of medical over-zealousness, or else put your money where your mouth is and take a cycle tour up in the Highlands for a week, get a tick bite and then go see for yourself how well your GP and local hospital acquit themselves.

@batfink, well said especially that the solutions are out there. We need a grown up conversation about material change. The idea of 20yr plan approved by all sides is great.

The Australian healthcare system is a complete mess too, but one thing that they get right is an additional tax that is levied (after you reach a certain earnings threshold) if you don't have private cover to a particular level.

Yes, but even that is still a political football, remember the MP who just couldn't believe the average GP visits in a year.
In many ways I like the Australian system but I'd hate it coming from a poor background. Not being able to afford decent insurance certainly limits options.

Quite. Like lots of things in Australia.... it's a great place to live if you have money!

I am a staunch supporter of a public healthcare service, mostly because anytime you add cost as a factor to the healthcare equation - the ethics gets very complicated. Charge for ambulances, and people will die at the roadside because they can't afford to call one. Charge for GP appointments and be prepared for a massive reduction in the proportion of cancers caught early.

I would rather 10 people go to their GP unnecessarily, that 1 who needs to go, but doesn't because they don't think they can afford it.

Obviously cost IS a factor in healthcare delivery, but we should seek to keep it as far away from clinical derision making as possible.

Absolutly Batfink, was a pleasure last year to be involved in some more forward thinking helth delivery moving away from the introverted fire fighting approach that happens in so many places. These threads with their "interesting" suggestions remind me why both the individual and the front line HC professionals are not the people to be making the decisons mostly due to having a very limited view of the overall process and system. Unfortunatly politicians are also not the most qualified as typified by the bragging rights as to who promised more at elections and the desire to bend the facts to suit your brag regardless of the impact that has.

Tom_W1987 - Member
I don't see why I should be paying for other peoples poor choices

It's not quite as clear cut as that. Some choices which help health - let's use the example of a physical activity like cycling, can also lead to injury. So do we support the activity or not?

bad genetics

I'm sorry Tom, but that is to say the least distasteful. Do you really want to effectively penalise people based on something they cannot change. Your situation at birth already has a huge influence on your opportunities. Do you really want to add health to that list any more than it already is...?

seeing as Britain has collectively decided to punish me and my wife financially because I married a foreigner. And I damn well don't see why I should be paying for hospital maternity bills if people argue it's because we increased the population of the UK.

Whilst disagreeing with the argument people use regarding population growth from immigration - this now sounds like sour grapes.

i am a regular user of the nhs my mrs works in the nhs. i see folk on a merry go round of been passed from one dr/consultant to another.. when in reality a frank conversation is needed..lose weight stop drinking start excercising and even.. stop wasting our time and yours.. there is not a cure for everything like my mates spotty face 6 years and dozens of hospital visits no change..

save the nhs for people that are ill and seeking a treatment that is available that will make a difference

the a&E issue is easily solved.. theres a big sign above the door giving a big clue.. its for accidents and life threatening emergencies end of.. there should be a triage at the door.. either a welcome mat or get to the gp, pharmacy mrs has hundreds of folk come to her pharmacy with issues she offers drug and they say.. oh i ll go to dr s or a and e and get a prescription..

we even have people on here who demand extended treatment for lyme disease who cannot show any evidence of it's efficiacy and who don't mind that by using these drugs they are contributing to their eventual obsolesence.

Who's that then Tom?

@chompy - good post with pertinent points, thanks for being so eloquent.

NHS's current advice of anything from 5-30 days (at varying dosages of varying antibiotics depending on the consultant) won't cure Lyme because frankly, the NHS and other medical research agencies simply haven't done the research yet

Yes. Yes there really is. This is like saying that there has been no research done into man made climate change.

It's not quite as clear cut as that. Some choices which help health - let's use the example of a physical activity like cycling, can also lead to injury. So do we support the activity or not

I don't think it would be too hard to look at the accident rates and then decide if cycling had enough of a public health benefit to be exempt from any risk calculation...

mikewsmith - Member
The ceo is one of the positions that I would really want some of the best in. It's the key leadership role of the organisation.
How are the supply chain ripping people off? Big paharma are not rolling in cash from drug development these days.

I agree you want good people running these facilities but do they need to be paid £400K plus? More than double the PM's salary?

Supply chain is a lot more than drugs/pharma. Stationary, definitely overcharged (and signed up to long contracts), cleaners, caterers, maintenance, logistics etc etc. In such a big organisation every small overspend ends up adding to a huge amount overall. Which is why I want a better performance from those managing the budgets.

1) The NHS needs to stop getting used as a political football that gets booted into different directions every election cycle. We need all parties to commit to a 20 year mission statement so that NHS Snr management aren't dealing with goalposts that shift every 5 minutes.

I think that this is probably the biggest thing that could change the NHS for the better.
Sadly, it'll never happen.

The NHS needs to stop getting used as a political football

I don't think you really understand what the term political football means, the NHS is not being used as a political football. When in opposition the Tories do not particularly attack Labour governments over their handling of the NHS.

In fact while in opposition the Tories made an electoral promise of [i]"No more pointless reorganisations"[/i] of the NHS, to quote David Cameron. Of course a Tory-led Government then went on to impose the biggest top-down reorganisation in NHS history.

The problem which has occurred is that, despite people not wanting to admit it, the Tories have progressively become more and more right-wing over the decades, as a consequence the NHS is now under threat like never before.

Today we have a Tory Health Secretary committed to dismantling the NHS as we know it and replacing it with profit driven providers. Is it really surprising that the NHS is in crises?

[url= http://www.independent.co.uk/news/uk/politics/jeremy-hunt-privatise-nhs-tories-privatising-private-insurance-market-replacement-direct-democracy-a6865306.html ]Jeremy Hunt co-authored book calling for NHS to be replaced with private insurance[/url]

[i][b] “Our ambition should be to break down the barriers between private and public provision, in effect denationalising the provision of health care in Britain.”[/i][/b]

The Labour Party is attacking the Tories handling of the NHS not because they are using it as a political football, but because the NHS is under attack from the Tories like never before.

I don't see why I should be paying for other peoples poor choices or bad genetics, seeing as Britain has collectively decided to punish me and my wife financially because I married a foreigner.

That sort of bitter, I'm alright jack attitude is the opposite of what the NHS is. You have completely missed the point.

Count yourself luck to be genetically blessed...

Count yourself luck to be genetically blessed...

So far...

I knew someone who consistently argued the case Tom is arguing, till Parkinson's Disease manifested itself (not sure its something you catch). Remarkably he suddenly realised that poor health can be as much down to luck as poor choices

Tom you can't lump all cycling into the same bucket in terms of health risks

ernie your post is exactly why the NHS / Health provision is suffering from a woefull lack of funding, a situation which is getting and worse. The NHS was under funded under Labour and it's under funded under the Tories.

As soon as anyone mentions private contributions to healthcare we get a knee jerk reaction about "privatising the NHS"

As I posted before, people are selfish and will not pay the extra taxes requred to properly fund the NHS. As @batfink says the solutions are out there and we need to acknowledge we pay less per head on private healthcare than just about anyone. That's our issue the private contributions are not integrtaed into public provison as they are elsewhere.

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As soon as anyone mentions private contributions to healthcare we get a knee jerk reaction about "privatising the NHS"

Yeah, every time someone talks about privatising we get a "knee jerk" reaction about privatisation of the NHS 🙄 Have you any idea how absurd your comment is?

.

ernie your post is exactly why the NHS / Health provision is suffering from a woefull lack of funding, a situation which is getting and worse. The NHS was under funded under Labour and it's under funded under the Tories.

Have you actually read my post? I don't mention anything about funding. What I do mention though is how Jeremy Hunt, the present Tory Health Secretary, has talked about "denationalising" the NHS.

Of course only a "knee jerk" reaction would cause someone to think that denationalisation means privatisation 🙄

More weasel words and less "knee jerk" reactions eh?

As I posted before, people are selfish and will not pay the extra taxes requred to properly fund the NHS. As @batfink says the solutions are out there and we need to acknowledge we pay less per head on private healthcare than just about anyone. That's our issue the private contributions are not integrtaed into public provison as they are elsewhere.