Would a mixed NHS / Private model work?

ruggedtoast

They have a state health insurance model with private treatment in Holland, and it seems to work very well.

However, their model is actually designed to provide the maximum benefits to ordinary Dutch people and provide good value for them as tax payers.

Unfortunately, I don't think I am being overly pessimistic to predict that any such simulacrum in the UK , introduced by any government we are likely to have in the next decade, would be introduced primarily as a means to slosh more taxpayers cash into the hands of private enterprise.

Patient care would be rather far down the list of an NHS PPI, and for that reason I am strongly opposed to letting the Tories, or Milliband for that matter, begin privatising the NHS.

Although if this new EU / US trade agreement comes into effect in it's current form, we may not have any choice in the matter at all, because the Americans will be forcing us to use their health services whether we want them or not.

http://www.newstatesman.com/politics/2014/02/andy-burnham-nhs-must-be-exempted-eu-us-free-trade-agreement

lostinrates

I think a big problem with us adopting a US or even some places in Europe healthcare model is Our attitude to healthcare knowledge. Not many people go with an informed attitude to their drugs or health situation. My consultants in this country are surprised and indeed sometimes put out when I ask questions that IME would be considered normal elsewhere.

I think its an extension of a sort of expectation that the state/ authority/ this case doctor knows best or will sort it out and shouldn't be asked why or what happens should that not work.

One of the reasons private healthcare works for me is that its more accepted by most consultants that I might ask questions and for other options.

Southend1

lostinrates wrote: »

I think a big problem with us adopting a US or even some places in Europe healthcare model is Our attitude to healthcare knowledge. Not many people go with an informed attitude to their drugs or health situation. My consultants in this country are surprised and indeed sometimes put out when I ask questions that IME would be considered normal elsewhere.

I think its an extension of a sort of expectation that the state/ authority/ this case doctor knows best or will sort it out and shouldn't be asked why or what happens should that not work.

One of the reasons private healthcare works for me is that its more accepted by most consultants that I might ask questions and for other options.

One reason the NHS is such a great institution is that doctor does know best and I don't need to worry that I am not a medical expert in order to benefit from one of the best healthcare systems in the world.

If patient choice is put at the centre of healthcare it's bound to lead to worse outcomes.

That's why the current model works pretty well. Those who can afford it and think they know better than trained and experienced doctors can go private. For those of us who want to put decisions about our treatment in the hands of those who know best there is the NHS.

lostinrates

Southend1 wrote: »

One reason the NHS is such a great institution is that doctor does know best and I don't need to worry that I am not a medical expert in order to benefit from one of the best healthcare systems in the world.

If patient choice is put at the centre of healthcare it's bound to lead to worse outcomes.

That's why the current model works pretty well. Those who can afford it and think they know better than trained and experienced doctors can go private. For those of us who want to put decisions about our treatment in the hands of those who know best there is the NHS.

I believe I haven't phrased myself well.

I mean that consultants etc are often impatient and reluctant to answer questions and patients don't feel the need to understand their health and medication well.


Sadly doctors do not always know best. I am lucky that I had private as an option where relying on NHs would have been the literal death of me. I'm glad that even relying on private I have read, questioned and read and questioned. I believe this has been important several times.

Southend1

lostinrates wrote: »

I believe I haven't phrased myself well.

I mean that consultants etc are often impatient and reluctant to answer questions and patients don't feel the need to understand their health and medication well.


Sadly doctors do not always know best. I am lucky that I had private as an option where relying on NHs would have been the literal death of me. I'm glad that even relying on private I have read, questioned and read and questioned. I believe this has been important several times.

That's great if you have good medical knowledge but for an average joe like me I would much rather trust the doctor than something possibly irrelevant I found on Google or in the library and probably don't fully understand. On that basis I leave myself entirely in the hands of the professionals. However I would be worried that I wasn't receiving the best treatment if motives/targets etc were strongly influenced by private companies seeking to maximise profits

PasturesNew

I've paid in since I was about 15, via NI payments.... and I would be aggrieved if I had to pay, say, a whole week or month's disposable income to be seen/tested, for an actual medical issue, whereas idle needy people have had cosmetic boob jobs on the NHS willy nilly.... and endless kids at about £3k cost/go just to get bigger free houses.

Southend1

PasturesNew wrote: »

I've paid in since I was about 15, via NI payments.... and I would be aggrieved if I had to pay, say, a whole week or month's disposable income to be seen/tested, for an actual medical issue, whereas idle needy people have had cosmetic boob jobs on the NHS willy nilly.... and endless kids at about £3k cost/go just to get bigger free houses.

Do you have any evidence such people exist other than in the daily Mail?

ruggedtoast

Southend1 wrote: »

One reason the NHS is such a great institution is that doctor does know best and I don't need to worry that I am not a medical expert in order to benefit from one of the best healthcare systems in the world.

If patient choice is put at the centre of healthcare it's bound to lead to worse outcomes.

That's why the current model works pretty well. Those who can afford it and think they know better than trained and experienced doctors can go private. For those of us who want to put decisions about our treatment in the hands of those who know best there is the NHS.

It's the same attitude that universities used to have, not even a decade ago. You are getting something 'for free' so you had better pipe down and not complain.

Students now are extremely demanding and expect much more for their £9k than undergraduates expected when their LEA's were paying their £9k.

In_For_A_Penny_2

Generali wrote: »

By being operated on privately I took myself out of the public queue meaning that patients in the public system were also seen sooner. I paid for everything I was allowed to pay for which meant I was seen quicker but also meant that someone in the public system got my place in the queue.

I'm afraid it doesn't quite work like that.

The same numbers of patients need seen by the same number of doctors. In the time that a patient is being seen in a private clinic, that consultant specialist is not available to see patients on the NHS.

It might be argued that private clinics are undertaken in a consultants "free-time". Very often that is not the case and they have merely delegated work to a more junior colleague in their absence.

LydiaJ

Flugelhorn wrote: »

I could afford private education but feel that the state version locally is better and have saved the money to help the kids at uni.
Re private / NHS - causes havoc mixing the 2, some of the work in our GP practice is private (eg reports / medicals etc etc ) but costs a packet in admin. If we saw patients privately they would still all be seen same day.

Of course. I wasn't denying the girl's parents' right to choose to send their daughter to the state school if they chose to. I just felt a bit sad for the less privileged child who might have had her place at that amazing school if she hadn't been occupying it.

IronWolf wrote: »

Rubbish, the US private healthcare system is among the best in the world.

In the US there are plenty of people who go bankrupt because they get expensive health problems (often but by no means always cancer) that are not fully covered by their insurance, if they have any. In a rich country such as here or the US, nobody, whether rich or poor by the standards of the nation, should have to go bust just because they get ill.

PasturesNew wrote: »

I've paid in since I was about 15, via NI payments.... and I would be aggrieved if I had to pay, say, a whole week or month's disposable income to be seen/tested, for an actual medical issue, whereas idle needy people have had cosmetic boob jobs on the NHS willy nilly.... and endless kids at about £3k cost/go just to get bigger free houses.

AFAIK, boob jobs are only available on the NHS if (a) your boobs are so heavy they are knackering your back, or causing similar actual health problems, or (b) for reconstruction after having one or both boobs removed for the treatment (or, I think, prevention if you've got the v high risk gene) of cancer etc. You can't just get them resized on the NHS because you happen to fancy it.