Why should healthcare be 'free'?

chewmylegoff

antrobus wrote: »

Which would be counter-productive if you wanted to cut overall healthcare costs.

Chip eating smokers who spend their free time sitting on the sofa stuffing their faces with crisps washed down with supermarket lager will drop dead from a heart attack at 57 and cost the NHS very little. It's the healthy-diet-and-regular-exercise mob that you have to worry about; they're the ones that will coast to 97 and cost the NHS a fortune.

Whilst the morbidly obese might die earlier, they dont usually work, so it costs a lot to pay them benefits to pay for all the crisps they eat before you even start to add up the healthcare costs. I've seen some estimates that put the total cost at something north of £20 billion a year, and the cost is going up sharply as more and more people spend more and more time eating crisps dipped in mayonnaise.

James_N

Generali wrote: »

If you think that NI covers the cost of the welfare state then you should retake your maths GCSE,

Er. I don't think i said that.
Maybe YOU should retake the English Language GCSE?

Loughton_Monkey

The debate about healthy v unhealthy, tax levels v what you draw out is interesting....

But when it comes to the great British NHS system, I feel the problem is far deeper than that.

Draw a parallel, if you will, with the old USSR communist regime. Look in particular at the supply of food and basic household goods. OK, the mass population were poor, but they could afford basic food and clothing. They considered these things expensive, but could just about manage.

The problems, as we know, were more about the management and supply of these raw essentials. People would queue at the empty shop at 8 a.m. and wait for what came in. If it were shoes and beetroot, then they would eat beetroot that night, and possibly buy some shoes if they thought they might need them before the next delivery.

In short, there was not enough and what little there was, was distributed in a haphazard way. A degree of rationing was inevitable, and the only way the inept state could handle that was by adopting mediochre quality and making people wait.

Meanwhile, I am guessing but think I'm right, the overall cost of the whole distribution system - such as it was - was probably much higher than a 'Western' food and clothing distribution system based upon a more 'commercial' and market-led system.

Well this is exactly how I perceive the NHS. OK it is not overtly 'communist' but it demonstrates the same hallmarks. There is not quite enough, but the 'costs' of rationing and poor quality exacerbate the problem enormously.

What's the answer? Sadly I don't know. But just as the USSR 'State' simply cannot 'control' a perfect distribution system manually, a 'National' Health service - the size it is - equally cannot possibly 'manage' a distribution system when demand exceeds supply.

All I know is that the good health systems identified by the WHO tend to have two things that don't exist in our NHS.

1. An element (however small) of payment at the time of use - helping to get rid of time wasters, helping to get extra revenue from those that can afford it, and giving heavy users some incentive to get healthier.

2. Full recognition that that when Mrs Biggins needs a hernia operation, then doing the hernia operation now [like this week] is by far the cheapest way all round. It saves the cost of 'managing' a waiting list. It avoids the costs of dealing with pain/suffering meanwhile, and avoid the extra costs associated with the condition getting worse while waiting.

I believe that until UK recognises these two things, our NHS can only get worse.

chewmylegoff

James_N wrote: »

I am glad you have had such an easy time of it, healthwise. Others have not.
I am surprised you cannot see the benefits to society generally, or to the individual of free-at-point of need healthcare. The rise of society's ability to stand well in terms of health since 1947 brings economic and social benefits to all.

What are the benefits of free at point of use healthcare which make it better than the systems used in pretty much every other developed country in the world. What are the specific economic and social benefits of our system compared to, say, Australia or France?

And you misunderstand free-at-point of need. Look at your pay slip. See that entry for NI? That's a part insurance / part assurance compact with the government to provide various services, some of which you will use and some you may be lucky enough not to use. You don't have a pay-slip perhaps? That means ** I ** am paying for you too.

Total NICs (incl employers) are approx £100 billion a year so just about match the NHS budget. So that just leaves the annual benefits bill as a shortfall. What's that nowadays? Must be close to £200 billion.

I doubt you pay for generali's healthcare as he lives in Australia.

lostinrates

I don't know that it should be impossible to handle a nation sized health system.

What i do see is that it must be hard to manage units or hospitals with different spending requirements. E.g. A childrens hospital might well have a different spending plan and expenses requirement to a general hospital.

Generali

chewmylegoff wrote: »

Total NICs (incl employers) are approx £100 billion a year so just about match the NHS budget. So that just leaves the annual benefits bill as a shortfall. What's that nowadays? Must be close to £200 billion.

NICS = £102,000,000,000 (link)
Department of health + Depatrment of work and Pensions spending = £338,000,000,000 (including devolved spending by NI, Scotland and Wales, tax credits, pensions and child benefits but excluding education - link).

lostinrates

StevieJ wrote: »

From all the adverts I see around, I get the impression that people don't visit the doctors enough, and when they do it has often turned critical.

I have been thinking about this and think that a small contributary payment might in some groups of low attendance IMPROVE the time in which people seek help. Some people do not like to receive something for what they wrongly perceive as nothing. A small payment might make them feel less 'silly' aout 'bothering' their GP with something 'that's probably nothing'.


It might also boost the role of nurses and nurse practioners who could handle a lot of what people who do not suffer this reserve feel they need to see a GP for.

adouglasmhor

antrobus wrote: »

Which would be counter-productive if you wanted to cut overall healthcare costs.

Chip eating smokers who spend their free time sitting on the sofa stuffing their faces with crisps washed down with supermarket lager will drop dead from a heart attack at 57 and cost the NHS very little. It's the healthy-diet-and-regular-exercise mob that you have to worry about; they're the ones that will coast to 97 and cost the NHS a fortune.

Do they really? From my observations (anecdotal I know) the junk food junkies, smokers etc. Bounce back time after time, e.g. one guy I know has been brought by air ambulance from Jura to the mainland twice with a collapsed lung, the !!!!er still smokes! Others require insulin, heart surgery, bypasses, bariatric care etc. Health junkies may live longer but require much less health care in general and when they do recover faster. I was back at work one week after having my gallbladder removed and only needed a prescription painkiller on the day of my op, over the counter stuff after that.

Of course if you can link to a study that proves me wrong I will accept you were posting facts and not repeating ill informed spoutings you have heard from other people.

adouglasmhor

chewmylegoff wrote: »

What are the benefits of free at point of use healthcare which make it better than the systems used in pretty much every other developed country in the world. What are the specific economic and social benefits of our system compared to, say, Australia or France?



Total NICs (incl employers) are approx £100 billion a year so just about match the NHS budget. So that just leaves the annual benefits bill as a shortfall. What's that nowadays? Must be close to £200 billion.

I doubt you pay for generali's healthcare as he lives in Australia.

You do understand what the words part, assurance and insurance mean don't you?

vivatifosi

I read an interesting article on google news this morning about the rising cost of dementia care, saying there has been a huge growth in people with dementia (due to living longer) and that there won't be enough care homes to cope. It's from the Independent:

http://www.independent.co.uk/life-style/health-and-families/health-news/britain-unprepared-for-tsunami-of-dementia-patients-8142462.html