Why should healthcare be 'free'?

mazza111

lostinrates wrote: »

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.

I disagree with you completely. There are many people who are entitled to free prescriptions on low income who don't claim. Just like there are many who don't claim other benefits. Is it the stigma attached? Is it the ignorance? I don't know.

BTW prescriptions are free in Scotland (and Wales I think) does that mean we can get free trips to the doc/hosp.

IMHO the NHS is one of the finest establishments in the world. Don't get ill in Spain if you can avoid it.

Let's take my daughter. Ignorant of what she can and can't claim. An innocent who doesn't know, nor should she, play the system. But last month she was at the GP on 5 occasions. 3 Appointments at the hospital for fracture clinic. Appointment with Dermatologist at hospital. So that's 9 appointments. Mainly to get her painkillers on prescription I may add. Because they only want to prescribe them a week at a time. She's been in cast for 17 weeks now, should she have to pay for each of these visits? Keeping in mind that she will be starting light treatment (that's what they usually start after a couple of weeks of topical treatment for her psoriasis), which will be every 2 days for a number of weeks. Should she pay for each of these appointments too?

The way I see it, the NHS is there when you need it. To force people to pay to see their GP would mean that people weren't getting the treatment they need. God knows it took me long enough to get her referred.

Edit to add: Why not charge those who are making appointments and not keeping them, rather than charging those who are sick.

StevieJ

mazza111 wrote: »

I disagree with you completely. There are many people who are entitled to free prescriptions on low income who don't claim. Just like there are many who don't claim other benefits. Is it the stigma attached? Is it the ignorance? I don't know.

BTW prescriptions are free in Scotland (and Wales I think) does that mean we can get free trips to the doc/hosp.

.

They are free in England as well if you can get to a Welsh/Scottish surgery and pharmacy :beer:

chewmylegoff

A._Badger wrote: »

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.

i should have inserted an additional pejorative in there somewhere - i don't mean "all right wing americans" but simply the lunatics on the fridges (i.e. the tea party) who are at the opposite end of the debate, and would smear any suggestion that the state should provide any sort of healthcare to anyone in any circumstances as evil communism.

my point is that the ideologists at either extreme are as stupid as each other, and that the funding of healthcare should not be decided on ideological grounds.

lostinrates

mazza111 wrote: »

Let's take my daughter. Ignorant of what she can and can't claim. An innocent who doesn't know, nor should she, play the system. But last month she was at the GP on 5 occasions. 3 Appointments at the hospital for fracture clinic. Appointment with Dermatologist at hospital. So that's 9 appointments. Mainly to get her painkillers on prescription I may add. Because they only want to prescribe them a week at a time. She's been in cast for 17 weeks now, should she have to pay for each of these visits? Keeping in mind that she will be starting light treatment (that's what they usually start after a couple of weeks of topical treatment for her psoriasis), which will be every 2 days for a number of weeks. Should she pay for each of these appointments too?
Making the comparison again to prescriptions she could get a prepaid card so covering all costs with in a time period.....as i originally said i would not envisage it feasible to propose charging those with a long term condition, there are existing exemptions for these that that could be reviewed and expanded under such a scheme
The way I see it, the NHS is there when you need it. To force people to pay to see their GP would mean that people weren't getting the treatment they need. God knows it took me long enough to get her referred.



]To be absolutley clear, i do understand the implication of long term ill health, There NO referral for me under nhs. I went private, sponsered in part by a benefactor. A system less open to abuse and neglect might get better, swiftly, less hard fout for referrals for those who need them
Edit to add: Why not charge those who are making appointments and not keeping them, rather than charging those who are sick.

I also suggestted your last point. I would charge them more.

I hope your daughters health improves soon.:)

chewmylegoff

Mr_Mumble wrote: »

Also, there is a lot of support for making other people pay for healthcare. E.g. charging drunks for their A&E visits or turning up late for a GP appointment or being fat or smoking or.... all this could be solved by introducing voluntary cost into the system.

i've been to A&E when i was drunk. i was violently mugged when walking down the street, minding my own business. i might not have been mugged if i wasn't drunk, but i wouldn't be too impressed at being given a bill for effectively acting recklessly in letting someone bounce my face off the pavement.

i've also been to A&E for stupidly going to the gym when i had a virus and should have been in bed. i wouldn't object at all to paying for that, as it was all my own fault.

practically it's going to be pretty difficult to introduce a "fair" system (which isn't ludicrously expensive to administer) that charges people when they are at fault.

yellowmonkey

jamespir wrote: »

geez theres some morons on this site recently

:T Lot of the reason I dont post much nowadays

lostinrates

chewmylegoff wrote: »

i should have inserted an additional pejorative in there somewhere - i don't mean "all right wing americans" but simply the lunatics on the fridges (i.e. the tea party) who are at the opposite end of the debate, and would smear any suggestion that the state should provide any sort of healthcare to anyone in any circumstances as evil communism.

my point is that the ideologists at either extreme are as stupid as each other, and that the funding of healthcare should not be decided on ideological grounds.

How can it not be down to someones ideology, or a compromise of peoples idealogy? Even efficiency or value for money as a decider are an ideology for some. I don't get it chewy? Do you ideology different to the one you and i seem to somewhat share?

docjames_2

Kennyboy66 wrote: »

Really ?

The last OECD report seemed to disagree with you.

The main problem is that too much of the huge increase in health spending during Labour's period was spent on increased pay - rather than improved treatment.
GP's being the most overpaid by international comparisons.

This is not however "being inefficient" - a canard, you seem obsessed with.

Whilst your statement about a lot of money being spent on wages is correct...this is due to several reasons. Partly due to an expansion in consultant numbers to take into account a reduction in junior doctor working hours. Secondly due to a recruitment crisis in the medical profession. GPs had a contract renegotiation which meant that their practice funding increased and also they received a 14% transfer to take into account that they now have to pay their own employers contribution for tax rather than the NHS paying it. This instantly made it appear as though there was a large pay rise and is quoted as such but remember this is money in and money out. Also remember consultants still earn significantly more than GPs - primary care (All GPs and community nurses put together) only cost 8% of the total NHS budget but actually account for 92% of ALL NHS contacts. Tnerefore its the part of the NHS leading to most efficiencies.

Also, if you look at GP pay on an hourly rate, you will find GPs in Australia, Canada, France and the USA are paid more - on an hourly rate that is! Its just that the average working week of a GP here is significantly longer than in those countries. Also an interesting point is that the hourly rate is also lower than your local Dentist, Accountant and Lawyer - so pretty good all in all i would say!

ruggedtoast

Generali wrote: »

I don't understand what is unique about healthcare that pretty much everyone in the UK thinks that it should be free at the point of use.

I've been on the planet for about 15,000 days and have needed to drink water on pretty much all of those days, eat food at least a couple of times a week, have shelter and warmth and yet it is considered normal for me to pay for those things which keep me alive.

I've only really had one lot of life saving medical treatment in those 15,000 and even that is debatable. I guess to that you should add vaccination and prophylactic drugs against malaria (both of which are incredibly cheap to buy). Most of the healthcare I had was to make my life a bit easier or nicer, even just to get a medical certificate so the boss didn't sack me for having a particularly nasty cold (or 'the flu' as it seems to be known these days).

Surely if there is an argument for anything being free at the point of use it should be these greater essentials. So why pick out healthcare? I don't get it.

I've travelled to a lot of countries and the only one where they don't arbitrarily think universal healthcare is a good thing was the States.

There are plenty of countries of course where there isn't universal cover, but generally people still assume that they are working towards it and look forward to government clinics and wotnot opening.

One of Thaksin Shinawatra's coups (if you'll excuse the phrase) was offering a form of NHS to rural dwelling Thais who had never experienced it before. I've experienced the Thai NHS at a big government hospital in Bangkok, and it was pretty good. If you look at the vast differential in expenditure between Thailand and us, it was exceptional, and Thais are very loathe to give it up.

Generally people assume that healthcare is the one thing you can't cut your cloth to. If you don't have much money you can eat cheap food, buy rice and beans, stick to staples. And in fact we do guarantee people food through benefits; its just that we leave it to them to decide what and where they procure it.

If you want to blow all your benefits on steak night at a good restaurant and then have nothing for a week, thats your fault. You'll probably decide to buy cheaper staples the following week, and there may be an underlying suspicion that being jobless is your fault too. Benefits are controversial until we know the person who needs them when suddenly its a scandal that they are so low.

However if you have a brain tumour, it's definitely not your fault, and you can't very well find a value neurosurgeon for £10.99 a treatment as opposed to £10,000.

In my opinion this is where the system with the NHS breaks down. Poor people have money so supermarkets vie for their business. That's why value ranges exist, its not great, but its ok, and its very cheap.

If supermarkets were nationalised and just mandated to provide "food" in return for tokens, they'd act in a stupid wasteful way, would probably provide bad food at high cost, and it would all cost the government a fortune. Just like the NHS does.

A more enlightened way of providing care would the the continental model, where people have guaranteed insurance cover from the state, and the market has to vie for their business with the funds they have available.

Just because the NHS doesn't work doesn't mean universal healthcare doesn't work.

BobQ

Generali wrote: »

I don't understand what is unique about healthcare that pretty much everyone in the UK thinks that it should be free at the point of use.

I've been on the planet for about 15,000 days and have needed to drink water on pretty much all of those days, eat food at least a couple of times a week, have shelter and warmth and yet it is considered normal for me to pay for those things which keep me alive.

I've only really had one lot of life saving medical treatment in those 15,000 and even that is debatable. I guess to that you should add vaccination and prophylactic drugs against malaria (both of which are incredibly cheap to buy). Most of the healthcare I had was to make my life a bit easier or nicer, even just to get a medical certificate so the boss didn't sack me for having a particularly nasty cold (or 'the flu' as it seems to be known these days).

Surely if there is an argument for anything being free at the point of use it should be these greater essentials. So why pick out healthcare? I don't get it.

Healthcare is not free. In the US they (on average) pay 16% of GDP for healthcare. We pay about 8% of GDP. The difference is that those who are insurable in the US can get a really good service and those that are not insurable trust to luck that they can afford to pay for the treatment they need. Personally I find this offensive and do not want to live in such a society. But you are right we could chose to pay in other ways. Its a political decision and the selfish approach is to treat the fit and wealthy and not those with longer term expensive conditions or those who cannot afford the insurance.