Why should healthcare be 'free'?

Generali

StevieJ wrote: »

There certainly is, I think it was euphemism for a thief pirate or brigand in the 16th century

Sort of.

AIUI, it was a government authorized private navy that was allowed to take loot to pay for their military actions. So the King might authorize an investor group to act against the ships of a particular country. They'd be expected to attack and sink or capture vessels from the other country's navy and in return could keep the spoils from capturing merchant ships from that country.

It saved the King from having to raise a navy of his own.

A._Badger

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.

I can't accept your comment about the 'Tea Party' movement and strongly suggest you read more about it. The TP isn't about health care: it's a broad church, mostly concerned about government control and taxation. Health care is a small aspect of that. To stigmatise it as being on the 'lunatic' extreme Right is really misleading - it is more a creature of the libertarian Right.

Under the US health system (in a nutshell) around 15 per cent of the population isn't covered. For the most they are the self-employed, people who are employed by companies that don't offer health care - minimum wage jobs, for example - and the like.

In reality, this is more a lower Middle Class issue than one of the genuine poor. They, whatever the BBC likes to pretend. are covered by Medicaid. The retired are covered by Medicare, incidentally, not left to die in the gutter - sorry, Guardian readers!

There was always room for a debate about how cover could be provided for that 15 per cent, but Obama decided instead to impose a universal coverage programme, for ideological reasons.

Had he simply proposed a way of providing coverage for those who do not currently have it - and who won't be able to afford it under his plans anyway - he is unlikely to have met with such visceral opposition.

It is a common complaint about Americans that they have little knowledge about the UK and how our system works. In many ways it's an accurate observation. What we tend not to realise, however, is that just because our airwaves are filled with American TV programmes, that doesn't make our knowledge of the USA much greater.

This is rarely so obvious as when Brits start opining about the US health care system. Or they ours.

zagubov

I 'd seen figures that we spent 6% of our GDP on healthcare compared with 15% for America, but we had better outcomes (when averaged-out). Intriguingly, out of 160 countries in one study, Singapore had the 20th from the top in terms of outcomes (beating the UK and US) while spending was 20th from the bottom - 3% of their GDP. Pretty remarkable

They don't have one simple answer for providing cheap good healthcare as it has a mixed structure. For catastrophic diseases heart disease, cancer, it's free like the NHS (the government bulk-buys treatment for the whole country).

For anything less serious you have to pay from a compulsory savings account (called the Central Provident Fund) that's like a tax/NI system but it actually is a pot of money you can use to buy basic (easyjet -style) healthcare or better facilities if you choose to spend more (and there's a charge for everything though it's capped by law).

This link has some useful info but I don't know how much I trust the site's political bias. Anyway it's at neither end of the public/private spectrum and conspicuously doing well.

Mr_Mumble

zagubov wrote: »

I 'd seen figures that we spent 6% of our GDP on healthcare compared with 15% for America

Your UK number is way too low. The NHS will cost £126bn this year with British GDP at an estimated £1,521bn, so that's 8.3% excluding private healthcare. Also, on outcomes: Britain doing better than the US seems a very dubious suggestion given cancer survival rates in the UK and US . (also see this Economist chart that shows the variance in prostate survival rates is far higher than breast). 1 in 3 people get cancer so you'd need a lot of 'averaging out' for overall outcomes to be better here.

prosaver

Plater wrote: »

Its a good question, and why should people get paid when they do not work, or why should people get their rent and mortgage interest paid when they are on low income?

and why should people pay for mp's?

Generali

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.

I agree, healthcare isn't free.

What I don't understand is what is unique about healthcare (rather than medicine, food, water and shelter) that means it shouldn't be charged for by any cash means whatsoever when it was consumed.

Are we saying it's ok to starve but not to be denied access to a podiatrist?

zagubov

Mr_Mumble wrote: »

Your UK number is way too low. The NHS will cost £126bn this year with British GDP at an estimated £1,521bn, so that's 8.3% excluding private healthcare. Also, on outcomes: Britain doing better than the US seems a very dubious suggestion given cancer survival rates in the UK and US . (also see this Economist chart that shows the variance in prostate survival rates is far higher than breast). 1 in 3 people get cancer so you'd need a lot of 'averaging out' for overall outcomes to be better here.

My figures may be years out of date (read it years ago and it was in a book so add at least another two years because of that!) The figures do include averaging out to include those without healthcare. It's very disturbing.

We need to look beyond cancer which is dreaded and focussed on strongly in the US. People in the US are way more cancer-prone than people here (not as low as our 1 in 3 but not quite at Danish levels I believe) but are on average less-long-lived which speaks volumes for ther non-cancer healthcare.

Middle class professionals (e.g university lecturers) decide which of thir family illnesses can be treated or investigated on a year-by-year basis. Big gaps in the middle of the social spectrum.

ash28

Mr_Mumble wrote: »

Your UK number is way too low. The NHS will cost £126bn this year with British GDP at an estimated £1,521bn, so that's 8.3% excluding private healthcare. Also, on outcomes: Britain doing better than the US seems a very dubious suggestion given cancer survival rates in the UK and US . (also see this Economist chart that shows the variance in prostate survival rates is far higher than breast). 1 in 3 people get cancer so you'd need a lot of 'averaging out' for overall outcomes to be better here.

You need to look a bit further than just some cancer survival rates. In the OECD health data for 2011 for mortality the UK was 17th out of 34 and the US was 27th out of 34.

Infant mortality is worse in the US.

Survival rates from road traffic accidents are much better in the UK - in fact 3rd in the OECD where the US is near the bottom.

Some things have better outcomes in the US and others in the UK - you are less likely to die from a heart attack in the UK but more likely to die from a stroke.

The US spends over 17% of it's GDP on health care - the biggest spender in the world and it doesn't have the best outcomes
.
http://www.oecd.org/dataoecd/6/28/49105858.pdf

[Deleted User]

Generali wrote: »

I agree, healthcare isn't free.

What I don't understand is what is unique about healthcare (rather than medicine, food, water and shelter) that means it shouldn't be charged for by any cash means whatsoever when it was consumed.

Are we saying it's ok to starve but not to be denied access to a podiatrist?

I think it's the issue of 'consistent requirement'. I will always have a constant need for food, water and shelter. There are universal minimums that an individual can get by on.

However, healthcare can be sporadic, vary in cost and duration per individual. You could go most of your life without a hospital admission and suddenly get a condition in later life that requires a large amount of care. Alternatively, you could have a child born with a lifelong condition.

Effectively - healthcare isn't 'fair'. However there are few people who escape medical care in their lives so it should be expected that we all pay a minimum amount. Balancing the cost across the entire population is an attempt to make it more 'fair'

WhiteHorse

ruggedtoast wrote: »

It seems to 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 ...

Yes, the NHS is the last nationalised industry, with all the abuses, incompetence and corruption that implies.