Can the UK afford the NHS (in its current form)?

GwylimT

HappyMJ wrote: »

If you're paying NI it's highly likely you would not qualify for free prescriptions and therefore not require a prepayment certificate.

Paying NI contributions isn't a pre-requisite to use the NHS. I'm a company director and do not pay NI yet I can use it.

Could your hayfever tablet's be purchased over the counter. Telfast for instance is prescription only but in other countries it can be purchased over the counter. Some of these non dangerous drugs should be allowed to be purchased at a pharmacy.

No ones mentioned pre-payment cerificates, it has just been suggested that those of us (like me) with certain conditions or who receive dla should pay even more to get basic health care.

Personally I wouldn't be willing to gain from the NHS if I wasn't financially supporting it all of my working life.

I did already say my medication is prescription only.

Generali

It's probably worth pointing out that NICs don't cover the costs of the NHS let alone the cost of the welfare state.

NICs in 2015-6 raised £113bn vs a budget of £116bn for the NHS. Just because you pay your stamp doesn't mean you pay your way. Unless you earn a fair bit over the median income of £27,000/year it is highly unlikely that you pay in more than is spent in your name. If you have kids it's pretty unlikely that you are a net payer at all unless you earn a heck of a lot of money.

michaels

Generali wrote: »

It's probably worth pointing out that NICs don't cover the costs of the NHS let alone the cost of the welfare state.

NICs in 2015-6 raised £113bn vs a budget of £116bn for the NHS. Just because you pay your stamp doesn't mean you pay your way. Unless you earn a fair bit over the median income of £27,000/year it is highly unlikely that you pay in more than is spent in your name. If you have kids it's pretty unlikely that you are a net payer at all unless you earn a heck of a lot of money.

Are those the same NICs that allegedly also pay for the 'triple-locked' state pension on a PAYG basis

GwylimT

Generali wrote: »

It's probably worth pointing out that NICs don't cover the costs of the NHS let alone the cost of the welfare state.

NICs in 2015-6 raised £113bn vs a budget of £116bn for the NHS. Just because you pay your stamp doesn't mean you pay your way. Unless you earn a fair bit over the median income of £27,000/year it is highly unlikely that you pay in more than is spent in your name. If you have kids it's pretty unlikely that you are a net payer at all unless you earn a heck of a lot of money.

We both earn quite a bit more than that, we also have to heavily rely on private healthcare as we can't get the treatment my wife needs as NICE deems it too expensive for the NHS to provide, despite it being necessary to keep her alive. I cost the NHS three prescriptions per year, which don't require an appointment, just a phone call. My wife almost entirely relies on private health care, the exception is her NHS dentist.

She even had to girl birth privately as in our area her only option was a c-section under a general, where as by going private she had the option of a more natural birth, or if needed a c-section with a block.

Our daughter has cost a small amount of vaccines, our sons were included in his birth package. Our son is disabled by is treated privately as it is the only way we can get appointments outside of our working hours, which makes it cheaper than using the NHS ans frequently losing a days wage.

zagubov

michaels wrote: »

Didn't the 'public' human genome mapping project end up getting overtaken by a much cheaper private sector competitor? I think that says a lot about the relative effectiveness of huge centrally planned research efforts compared to for profit research.

The private sector joined in after the public sector had published most of their results. It was ambivalent about publishing its results so the public sector raced to beat them to publication and managed to get the info into the public domain for the scientific community to use before the private team could claim it.

michaels wrote: »

I don't understand why we in this country denigrate organising things properly 'put the doctors in charge of the NHS' is often the cry. Personally I would like my doctor to be an expert in health care not an expert in logistics and supply chain management and I would like modern management techniques applied to maximising the output from limited NHS resource rather than just the organisation supplying what the doctors fancy doing. I believe in the past there was under provision for geriatrics because it wasn't a 'sexy' area for doctors to go into.

I'm skeptical a perfect structure exists for any organisation, let alone one as complex as a health service. I do believe there is a massive capacity for harm if we let outsiders tinker with it for ideological reasons, just simply because a minister has been given a new brief and wants to be seen to be busy.

antrobus

michaels wrote: »

Are those the same NICs that allegedly also pay for the 'triple-locked' state pension on a PAYG basis

No.

NICs are a total of two separate bits; the bit that goes into the National Insurance Fund, and the bit that goes to the NHS (the NHS allocation).

That was Gordon Brown's idea. Circa 2002. Basically an answer to the conundrum of how to raise more tax to pay for the NHS when you'd promised not to raise taxes.

Pennywise

Needs better organisation. A classic case. A while ago, my GP told me that I needed to go back to see him to check my ears were clear before he could refer me for a hearing aid. What an absolute waste of an appointment - surely the practice nurse or nurse practitioner could have checked my ears??

Around the same time, my OH got severe pains in the stomach and tried to get a GP appointment - the usual "none available" for weeks, so booked into the nurse practitioner instead, who just asked some questions, did a few checks and then said a GP appointment was needed - again a complete waste of an appointment that achieve nothing.

There needs to be some way of patients being able to see the most appropriate person - I shudder to think how many appointments are wasted because of some arbitrary rules imposed on the receptionists as to who sees who for what!

antrobus

Generali wrote: »

It's probably worth pointing out that NICs don't cover the costs of the NHS let alone the cost of the welfare state......

It was never intended that NICs pay for the welfare state. It only funds certain benefits, mainly the state pension, that's over 90% of it. Everything else comes out of general taxation.

[Deleted User]

Pennywise wrote: »

There needs to be some way of patients being able to see the most appropriate person - I shudder to think how many appointments are wasted because of some arbitrary rules imposed on the receptionists as to who sees who for what!

The question is who decides who is the most appropriate person to see? Some people think 999 is an appropriate place to turn to if their Chinese takeaway hasn't arrived on time.

BobQ

Mistermeaner wrote: »

You mean people pay the real cost of their care?

BTW I think the federal spend stats (or antrobuses) are skewed by Obama care which I would not advocate

I think the issue is that it is perfectly sustainable to have the NHS provided that people are willing to pay the taxes to fund it. There are other models and the US represents one of them.

As a nation the US spends far more per capita on healthcare than the UK. The advantage of their system is that those who can afford to pay get good treatment but pay a lot for it, those who cannot afford to pay get a modest level of care and are denied some treatment by affordability.

So you have a choice, Tax funding that delivers good treatment for all, rationed by affordability to a degree based on need or a US system that rations care on ability to pay and costs much more, but delivers better care if you can afford it.

There are other models like France and Australia, but they cost about the same as the UK. Pesonally I am happy to pay taxes for the NHS. If I thought that paying private insurance would give me the same care and a reduction in taxes I would not mind.