Would a mixed NHS / Private model work?

Generali

BobQ wrote: »

Is this not just another example of a private care system cherry picking what it will do and so not providing a comprehensive service? I think this is the sort of thing that some people in the UK fear for the NHS with the NHS picking up the things the private sector do not see as profitable or see as too risky.

Private health insurance is banned from paying for certain treatments and diagnoses. The major private hospitals also come to agreements with the state health system as to what they should and should not provide.

Public and private care is viewed as an overall system and the public sector works closely with the private sector to try to ensure that the private sector doesn't end up providing services that are under-utilised.

My health insurance, apparently the best scheme in Australia, is a mutual scheme so nobody makes a profit from it as such. Private hospitals do make a profit however.

LydiaJ

Graham_Devon wrote: »

I didn't bother replying to the rest of your post considering I'm not worth listening too.... presumably why you mssed out what I suggested about a state funded insurance?

Sorry Graham. That was rude of me. I apologise.

I still think the kind of distinctions you were drawing between a first ever asthma attack, an attack in a person who'd been taking their meds, and an attack in a person who hadn't been bothering to take them would be impossible to implement fairly, and a monumentally expensive bureaucratic nightmare to implement at all. Medical staff are trained to treat people without having to make judgements about who deserves treatment and who doesn't. I wouldn't want that to change, and it would have to, because people would need to be told up front whether the proposed treatment was chargeable or not. I also think state funded insurance unnecessarily introduces a whole extra layer of administration to the system.

But I should have said so a lot more politely.

Generali

JencParker wrote: »

But it doesn't make it better for all, it only makes it better for those who can afford to pay.

If that is the case, why does the public hospital put up signs asking you to go private if you are insured?

http://www.seslhd.health.nsw.gov.au/powh/documents/Patients/PH_BROCHURES_POWH_A.PDF

The benefits of using your private health insurance at Prince of Wales Hospitalw I may nominate the doctor of my choice.


wI will not be charged any excess on my private health
insurance for booked or emergency admissions.

w


I can rely on the Patient Liaison Office staff to look

after the claims on my behalf.


w If I am admitted via Emergency and take advantage
of the "no gap" billing arrangement for private patients,

I will be guaranteed no out of pocket expenses.

w


By using my private health insurance I help Prince

of Wales Hospital maintain existing services and

continue to grow and better serve the local

community.

Thank you for supporting Prince of Wales

Hospital by choosing to use your private

health insurance.

Me going private results in faster treatment for those in the public system as I am not using their scarce resources.

Generali

BobQ wrote: »

Gen, out of interest, are there statistics that show it actually happens?

I can't find any but per my post above, NSW Health are convinced that there are benefits to me and to the public system if I use insurance.

jamesd

Andy_L wrote: »

Emergency care is, despite stories of ambulances checking credit cards, free in the US.

Emergency care is not free in the US. If you can pay, you will pay, either yourself of by your insurance policy or its co-payment. The charges typically start at about £250 for an initial emergency or not screening examination and escalate from there.

An NIH study found that the most expensive visits were for retires covered by the Medicare system, then privately insured patients and cheapest, uninsured patients, all for the same conditions. Average cost was £1,600 but the price difference for the same condition were huge, making actual cost a lottery. The fortunate patients have medical insurance with low copay requirements and might get by with it costing no more than their annual insurance policy cost.

Emergency room care is only effectively free for those who have no way to pay, like those who have no income or assets to seize during debt collection. That's paid for by the other patients indirectly and by assorted tax funding.

Andy_L

jamesd wrote: »

Emergency care is not free in the US. If you can pay, you will pay, either yourself of by your insurance policy or its co-payment. The charges typically start at about £250 for an initial emergency or not screening examination and escalate from there.

An NIH study found that the most expensive visits were for retires covered by the Medicare system, then privately insured patients and cheapest, uninsured patients, all for the same conditions. Average cost was £1,600 but the price difference for the same condition were huge, making actual cost a lottery. The fortunate patients have medical insurance with low copay requirements and might get by with it costing no more than their annual insurance policy cost.

Emergency room care is only effectively free for those who have no way to pay, like those who have no income or assets to seize during debt collection. That's paid for by the other patients indirectly and by assorted tax funding.

How embarassing, I appear to have misundersttod the article I read. There are obliged to treat regardless of ability to pay but the bit I missed is that they can then sue to recover the costs. As you say its the people in the middle who get hammered.

In_For_A_Penny_2

Generali wrote: »

Actually, it works exactly like that.

By going private, I am adding extra cash into the Australian health system which allows for more operations to be carried out.

Apologies, I assumed we were debating the NHS. It doesn't work like that in the UK.

jamesd

Andy_L wrote: »

How embarassing, I appear to have misundersttod the article I read. There are obliged to treat regardless of ability to pay but the bit I missed is that they can then sue to recover the costs. As you say its the people in the middle who get hammered.

Thanks. Yes, they are obliged to treat at least to certain standards. Discharge can be early than desirable or patients can be transferred to cheaper places sometimes.

In China there's an interesting approach that effectively combines a normal doctor's surgery with A&E. This is because there it is customary for people to go to the hospital for many more normal conditions and not to have GPs in the way we have them here.

michaels

In_For_A_Penny wrote: »

Apologies, I assumed we were debating the NHS. It doesn't work like that in the UK.

But it is worth looking at different international options, it always seems that any criticism of the NHS is met with a 'but look what happens in the US' but actually there are lots of different international models.

The NHS is probably at the extreme of state funded plus state provision but does not seem to achieve the best health outcomes although it may do per £ spent, but being fully state funded it is at the whim of politicians and competing spending priorities. I am not sure if I am alone in thinking that at times I would be willing to pay a top up to benefit from an enhanced service and looking at the better outcomes in Australia and France where more provision is private even if funding is state provided with an insurance element.

Generali

michaels wrote: »

But it is worth looking at different international options, it always seems that any criticism of the NHS is met with a 'but look what happens in the UK' but actually there are lots of different international models.

The NHS is probably at the extreme of state funded plus state provision but does not seem to achieve the best health outcomes although it may do per £ spent, but being fully state funded it is at the whim of politicians and competing spending priorities. I am not sure if I am alone in thinking that at times I would be willing to pay a top up to benefit from an enhanced service and looking at the better outcomes in Australia and France where more provision is private even if funding is state provided with an insurance element.

There would be outrage in Australia if you couldn't get a same/next day appointment with a GP in all but the most rural areas. There just aren't anything like the same sort of waits for an appointment that you have with the NHS.