Why should healthcare be 'free'?

lostinrates

BobQ wrote: »

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.

We do just the same. Post code drug lotteries and decisions on what drugs and treatments we are going to apply or not. Well known ones like cancer treatments and alzheimers ones are heard of all the time, others exist. You do live in a society that has to make hard choices, just we are prissy and hypocritical in our observation of it.

chewmylegoff

lostinrates wrote: »

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?

It should be pragmatic and practical, looking at how to get the best outcomes using both the private and public sector rather than saying "all healthcare should be free at point of use regardless of what the outcome is", or the opposite "healthcare is not the job of the state, the individual must chose whether they pay for it"

BobQ

abaxas wrote: »

There is a simple rule in primary care.

White doctor - if you want to be referred
Black doctor - if you want a simple problem fixed.

Different backgrounds tend to lead to differing ways of providing healthcare.

Sorry if I offended anyone, but the stats speak for themselves.

Which stats do you refer to?

WhiteHorse

When the NHS scheme was mooted, Richard Crossman (Labour, Coventry East), said that it shouldn't be entirely free.

He proposed a nominal charge - just enough to sting - as a way of discouraging abuse and the growth of a sense of entitlement.

Prescient words.

WhiteHorse

ruggedtoast wrote: »

A more enlightened way of providing care would be 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.

Persuasive.

The marketplace would however need ruthless policing and draconian penalties for offenders.

lostinrates

chewmylegoff wrote: »

It should be pragmatic and practical, looking at how to get the best outcomes using both the private and public sector rather than saying "all healthcare should be free at point of use regardless of what the outcome is", or the opposite "healthcare is not the job of the state, the individual must chose whether they pay for it"

Hmm. Whilst i agree with You that it should be pragmatic etc i feel that that is an ideological positioto take, albeit a central one between two extremes.

BobQ

lostinrates wrote: »

We do just the same. Post code drug lotteries and decisions on what drugs and treatments we are going to apply or not. Well known ones like cancer treatments and alzheimers ones are heard of all the time, others exist. You do live in a society that has to make hard choices, just we are prissy and hypocritical in our observation of it.

Yes we do make choices, I never said we did not. Also, we could make those choices in a better way. However, I do not think ability to pay for treatment is a fair way of making these choices.

I think we should do our best to make the NHS as efficient as possible. Whether the Cameron way is best way I doubt, mainly because his party is full of people funded by the private health care providers who will profit from the changes. But maybe it or other measures can get better value for money.

But however efficient we can make it I think these difficult choices are best made by increasing or decreasing the funding to achieve these choices. There is a lot of difference between the cost of the NHS and the cost of French and US HealthCare systems.

ruggedtoast

WhiteHorse wrote: »

Persuasive.

The marketplace would however need ruthless policing and draconian penalties for offenders.

It seems to work in Holland and France. It is based on the assumption that there isn't unlimited free care for everything at all times.

This is the reality the NHS politically can't face up to.

If you want to go and see the doctor 20 times a month its going to cost you; but by that virtue as well, if you have a useless and ineffective GP you aren't stuck with them; you can just pay your 20 euros or whatever it is and and go to a more competent practise, rather than having to see the same ineffective clinician multiple times.

Many GPs just don't act like they care whether you get better or not, and thats because professionally it doesn't matter to them whether you do or not. They still get their £100k a year for their 4 day week, no one assesses them on how many of their patients get better, whether their patients are happy or not. In many cases they are actually penalised for rising above NICE mandated mediocrity.

Its the same with the teaching profession, though obviously without the salaries.

lostinrates

BobQ wrote: »

Yes we do make choices, I never said we did not. Also, we could make those choices in a better way. However, I do not think ability to pay for treatment is a fair way of making these choices.

I think we should do our best to make the NHS as efficient as possible. Whether the Cameron way is best way I doubt, mainly because his party is full of people funded by the private health care providers who will profit from the changes. But maybe it or other measures can get better value for money.

But however efficient we can make it I think these difficult choices are best made by increasing or decreasing the funding to achieve these choices. There is a lot of difference between the cost of the NHS and the cost of French and US HealthCare systems.

In you reasonale and interesting post there is, imo and i hope you will forgive me, a lot of emtional rhetoric.

As has been discussed, there are ways of mitigating the impact of charges on those who cannot afford it. Much in the same way we do in the comparison already made with prescriptions. I doubt anyone proposing charges proses them to block access to health care.

Fwiw. I really would like better integration with the private system. I belive it could take strain off the nhs and i know it provides better access for me personally, to treatment.

lostinrates

ruggedtoast wrote: »

It seems to work in Holland and France. It is based on the assumption that there isn't unlimited free care for everything at all times.

This is the reality the NHS politically can't face up to.

If you want to go and see the doctor 20 times a month its going to cost you; but by that virtue as well, if you have a useless and ineffective GP you aren't stuck with them; you can just pay your 20 euros or whatever it is and and go to a more competent practise, rather than having to see the same ineffective clinician multiple times.

Many GPs just don't act like they care whether you get better or not, and thats because professionally it doesn't matter to them whether you do or not. They still get their £100k a year for their 4 day week, no one assesses them on how many of their patients get better, whether their patients are happy or not. In many cases they are actually penalised for rising above NICE mandated mediocrity.

Its the same with the teaching profession, though obviously without the salaries.

I do not know what the current position in frnace is, butsome years ago, about twelve, fifteen, it was struggling under the pressure and as current a topic there and the nhs reforms now are here. Its fair to point out reformers were looking at the nhs as exame for reform. It was not a terribly popular proposition.