Why should healthcare be 'free'?

Carl31

i think part of the problem with the NHS is, as its 'free' people are inclined to use it when its not required. For example, many people seem to run to the docs over the slightest thing, leading to over worked GPs, Hospitals A+E rooms filled with people that dont really need treatment
Complex procedures, however, can cost thousands of pounds, people dont realise the cost of healthcare as they have been shielded from it, hence the abuse. I think there needs to be a balance between assistance where needed, and a charge made for things like doctor visits. Not a large cost, like £5 or something, it might make people think twice about whether they need to see a doctor or not
Obviously, this change should be reflected in NI contributions

LydiaJ

I think there are two reasons for the general opinion that healthcare should be free at point of use.

One is that a lot of heath issues are better and more easily dealt with if they are dealt with early (with preventative medicine like vaccinations being the ultimate in early treatment), so that in the interests of having a healthy population, you do not want people putting off treatment because of the cost - either because they themselves will then get worse, or because (if it's something infectious) they may then infect lots of other people.

But the main reason, I think, is because healthcare is not like food, water, shelter etc. We all need much the same amounts of food, water, shelter and so on, but some people need massively more healthcare than others, and this is frequently through no fault or choice of their own. Some people develop cancer, or are born with cystic fibrosis, or get brain-injured in an accident, or whatever. These things are bad enough without having to worry about going bankrupt because of the cost of treatment, or dying for lack of money to pay for the treatment that's needed. Therefore it is best if everyone - not just most people, or people who are employed, or whatever - is insured, and insured for healthcare in general, not healthcare with some exceptions or limitations. Any system where people have to organise their own health insurance inevitably allows some people with some conditions to fall through the gaps, and it also wastes huge numbers of work-hours administrating the claims. It is much more straightforward if the "insurance" side of things is done through the taxation side of things - hence NI - and then everyone is covered, and at the point of use the focus can be on the clinical side of things and not the form-filling and claim-filing and "Am I covered for this or not?" business.

It's rather like car insurance. Because anyone driving a car may (without prior warning) cause an accident and be liable for hundreds of thousands of pounds of damages, we do not allow people to drive cars unless they are covered by car insurance. But anyone being alive may (without prior warning) find themselves needing healthcare costing hundreds of thousands of pounds, so we do not allow people to be alive unless they are covered by health insurance - hence the universal nature of NI and taxation, and the consequent "free at the point of use" nature of healthcare. Then those who can't pay for their own insurance - whether that's their "fault" or not - are still covered.

I agree with lir that we should periodically re-examine which things ought to be available on the NHS and which should not. A small charge for visiting a GP would function in much the same way as the prescription charge, I imagine, and wouldn't change the basic principle. I also think there would be something to be said for closing some of the loopholes that allow people to avoid paying NI by turning themselves in to a company and paying themselves dividends rather than a salary, although I don't know enough about it to know how that could be done.

ETA I'm not trying to imply that I think NI is kept separately and pays for the NHS. I don't actually care whether it's collected under a separate "NI" label or just as part of taxation generally. I just think the NHS should be funded out of something that's compulsorily collected from everyone, and the NHS should then be available to everyone.

Intoodeep

jamespir wrote: »

Healthcare isnt free you pay for it using national insurance
we just dont pay everytime were treated unlike other countries unless you go private

The biggest phallacy in the known universe that there is a seperate pot with everyones Ni contributions in.

It ends up in one pot called TAX

chewmylegoff

Intoodeep wrote: »

The biggest phallacy in the known universe that there is a seperate pot with everyones Ni contributions in.

It ends up in one pot called TAX

plus there are plenty of people who don't pay any NI (or tax), but still get unlimited free care from the NHS. so the NHS is actually free for a lot of people (who no doubt are some of the heaviest users of its services).

mazza111

Missed appointments are not usually a problem at my practice. They usually over book them with "emergencies" and doctors are likely to run 30-60 minutes late. So would we get our money back if the doctor is running so late? Opens a big can of worms. £5 may not be a lot if you're fit and well most of the time. Didn't think anything of spending a fiver when I was out working, now every penny counts.

I am thankful we have the NHS. But I think charging people for appointments (even with exemptions) would stop people in need visiting their GP. After all, how much in benefits is not claimed every year because people don't know they are entitled to it, I fear the same thing would happen if you started charging to visit the GP.

A._Badger

chewmylegoff wrote: »

i
the people who would keep the NHS free at point of use at any cost are just as nuts as the right wing americans who think that any provision of healthcare by the state is evil socialism which must be prevented at any cost.

You really do need to cast your net a little wider than the BBC and the Guardian.

Most 'right wing americans' (sic) of my acquaintance do not object to a safety net - indeed, at various times, on a state by state basis, safety nets have operated well. What they object to is Obama's probably unconstitutional imposition of mandatory coverage.

The reason they object to it is because it wrecks the existing system which (whatever the shroud wavers at the BBC like to claim) works pretty well for most Americans and provides clinical outcomes better, in many areas, than often the shoddy NHS.

Just smearing people as 'right wing' when you don't even take the trouble to listen to what they say is, sadly, all too typical of the hysterical British attitude to health provision.

[Deleted User]

LydiaJ wrote: »

A small charge for visiting a GP would function in much the same way as the prescription charge, I imagine, and wouldn't change the basic principle.

So.. those who contribute least to the system, yet take most from it would be unlikely to have to pay such a charge?

I did always wonder why it's free to visit a GP yet costs to visit a dentist.

lostinrates

Generali wrote: »

My point is that most people in the UK think that healthcare should be free when they use it. The unemployed aren't given free food or water AFAIK.

mazza111 wrote: »

Missed appointments are not usually a problem at my practice. They usually over book them with "emergencies" and doctors are likely to run 30-60 minutes late. So would we get our money back if the doctor is running so late? Opens a big can of worms. £5 may not be a lot if you're fit and well most of the time. Didn't think anything of spending a fiver when I was out working, now every penny counts.

I am thankful we have the NHS. But I think charging people for appointments (even with exemptions) would stop people in need visiting their GP. After all, how much in benefits is not claimed every year because people don't know they are entitled to it, I fear the same thing would happen if you started charging to visit the GP.

The issue of those who couldn't afford five pounds would be, i imagine, dealt with much the same as prescription charges, with exemptions.

As regards money back if they are running late,no: the payment would almost certainlybe legally worded as being for an appt on that day, not a given time. Not ulike taking your cars in for a tyre change at a busy place.....you wait till they have done it.

Fwiw, i think the nhs is a Good Thing. But is far from the best healthcare i have had. My experiences of other european systems ...i have used french and italian, were better for the patient..but france's system aiui is a massive finanical burden. And, for me now the american system would be prohibitive, but the treatment i had there as a child and my mother had there as an adult (three ops, two for injury one for health) were good. I remember my mother having a repeat of the healthcare type op in uk some years later, ina. Private hospital, and it was no where near as good an experience for her. She later had a third on nhs, which was as good from her p.o.v. as private uk had been those years earlier..though it was in an nhs funded business hospital...our experience over several treatments has been the best of all uk healthcare at one of those.

Wookster

To my mind I don't see a problem with free (at the point of use) healthcare but there are problems associated with providing free healthcare indefinitely.

1. I some instances free healthcare means that people stop taking their health seriously as they feel someone else will pick up the tab. This is quite evident in how people with bad health habits are molly coddled. Why should someone else take care of you if you can't be bothered to do basic things yourself.
2. Money is spent very very inefficiently
3. Providing more things for free encourages an attitude of entitlement.

So, I suppose I have argued myself into taking the view that free to use healthcare isn't long term helpful.

ILW

LydiaJ wrote: »

Because if you are put off going to the dentist because of the cost, the worst that can happen is all your teeth fall out. If you put off going to the GP because of the cost, you can die unnecessarily, or infect lots of other people with something nasty.

Most mouth cancers are picked up by dentists.