Extend the uncertainty?

lisyloo

LHW99 wrote: »

But that's not a status quo, because the hairiness will then continue to increase ad infinitum

I can assure you mine doesn’t :eek::eek:

lisyloo

It's probably cheaper to let people die on waiting lists than build extra capacity in one or the other.

Chronically ill elderly people aren’t more likely to die in hospital, the opposite is true.
Those on waiting lists e.g. waiting for a hip replacement will be suffering for longer and we might also be losing their productivity too if a working age person is off work for longer than necessary.

Yes I understand people want other people to pay for it.

Sailtheworld

lisyloo wrote: »

Chronically ill elderly people aren’t more likely to die in hospital, the opposite is true.
Those on waiting lists e.g. waiting for a hip replacement will be suffering for longer and we might also be losing their productivity too if a working age person is off work for longer than necessary.

Chronically ill people are expensive to treat - it shows the cost effectiveness of rationing that they're unlikely to die in a hospital.

Hip replacements? They're worth rationing because people who need a new hip will tend to be at the steep part of the mortality curve. Probably don't have to wait too long for them to drop off the waiting list.

Nobody really wants to pay and a 'free' health care system encourages inefficiency. The 'solution' as far as I can see is to hasten the departure of the boomers and their parents and then see what happens.

Herzlos

Or we could just execute anyone who gets to 80.


Back in the real world, we should be looking at the stitch-in-time or penny wise pound foolish stuff we used to do. If it's cheaper to house people in care homes in some capacity, than have them bed block - why don't we get on with building those care homes?
If it's cheaper to provide in-home care than care home care, why don't we hire more staff and ramp up that care?
That'd then hopefully clear up some hospital capacity to treat the people who need to be there, faster, and whilst there are less complications.


It's all down to short-minded nice and split budgets - we can save the care budget £100m by restricting spaces and make that director happy, ignoring the fact that it directly costs the NHS £300m more to handle the blocked beds.

Sailtheworld

Herzlos wrote: »

Or we could just execute anyone who gets to 80.

By rationing access to healthcare the NHS is hastening the demise of citizens. Execution by another name - plus if your final years are made a bit more miserable because you can't get a hip operation you can throw a bit of torture in too.

Herzlos wrote: »

If it's cheaper to house people in care homes in some capacity, than have them bed block - why don't we get on with building those care homes?

On paper it might be cheaper for person A to be housed in a care home rather than a hospital but, if they're in hospital, they're preventing person B from using that bed. Person B might die waiting to use it. That's saved treating person B and we didn't need to pay to build a care home place for either person A or B.

Herzlos wrote: »

It's all down to short-minded nice and split budgets - we can save the care budget £100m by restricting spaces and make that director happy, ignoring the fact that it directly costs the NHS £300m more to handle the blocked beds.

You've plucked those figures from thin air to make the point that we'd save money if we provided more care homes.

Who wouldn't vote for a government that invested heavily in elderly care that treated people with dignity and actually saved the taxpayer money in the process? Given it would be such a vote winner why haven't recent governments done this? It's because the idea that increasing healthcare capacity will save money is a fallacy.

When a research body points out that obesity dramatically increases the risk of cancer and the takeaway point is that they're fat shaming then I think we're some way off finding a solution.

lisyloo

plus if your final years are made a bit more miserable because you can't get a hip operation you can throw a bit of torture in too.

Some people in their 50s need new hips and knees.
They may be of working age and still able to contribute to the economy.


In fact if you're in your 90s it may be too late to have it done (clinically I mean).


You are talking about denying healthcare to the very elderly and dying.
There are plenty of younger people in their 50 and 60s who need healthcare to keep them economically productive.

lisyloo

Person B might die waiting to use it.

This is really unlikely.
Whilst the system does exist in a state of chaos we also prioritise and people who are dying get treatment even if they are in a corridor.
If they are dying they get priority.


What I was talking about was someone who has a painful knee or hip.
If you delay their operation then apart from the pain, you reduce their potential to continue to be economically active.
At the extreme end of the scale if their muscles wasted whilst waiting too long then they might never be able to be have the operation or be economically active.


Unfortunately they are not going to conveniently die, they are going to be a big expense if they can't work in their 50s and can neither save up a full pension either due to having to medically retire early.


I don't think your idea of rationaing will cause people to conveniently die.
Be less economically productive possibly permanently in some cases and thats a false economy.


The employers that I work for pay for private medical cover.
This is not out of pure geneosity.
If both for their convenience and to get people back to being productive as quickly as possible.
So there is an example where organisations do volunteer to pay more.

Sailtheworld

lisyloo wrote: »

There are plenty of younger people in their 50 and 60s who need healthcare to keep them economically productive.

Don't worry. If you're in your 50's or 60s' and need a hip replacement or hernia repair you can still go to work - you'll just have to live with being miserable.

The Guardian suggests that 4.5 million people are waiting for non-urgent care such as hip replacements and hernia repairs. Many of these people will be economically productive. I think there's a 18 week limit before the wait becomes a 'breach'.

Can you imagine just how stupendously inefficient the NHS must be as a method of delivering healthcare?

Sailtheworld

lisyloo wrote: »

This is really unlikely.
Whilst the system does exist in a state of chaos we also prioritise and people who are dying get treatment even if they are in a corridor. If they are dying they get priority.

What I was talking about was someone who has a painful knee or hip. If you delay their operation then apart from the pain, you reduce their potential to continue to be economically active.
At the extreme end of the scale if their muscles wasted whilst waiting too long then they might never be able to be have the operation or be economically active.

You only get priority if you are about to die. If person B is chronically rather than acutely ill then they're way down the list. Probably above the person with the gammy knee still.

lisyloo wrote: »

I don't think your idea of rationaing will cause people to conveniently die. Be less economically productive possibly permanently in some cases and thats a false economy.

Let me be clear here. I'm not suggesting that rationing is my idea to 'solve' healthcare. I'm suggesting that rationing is already the method the NHS use to allocate care. It might be a false economy in some cases but, overall, it's cheaper than increasing capacity. And, given the taxpayer doesn't want to increase capacity, it's a moot point.

lisyloo wrote: »

The employers that I work for pay for private medical cover. This is not out of pure geneosity. If both for their convenience and to get people back to being productive as quickly as possible. So there is an example where organisations do volunteer to pay more.

The NHS can't prioritise delivery of care according to how productive you are but your employer is able to do so. Keep fit, be productive, get insurance, get some cash in the bank are all helpful solutions but most people prefer to believe that politicians have magic wands. Believing in fairy stories is a cause of a lot of problems.

Malthusian

Herzlos wrote: »

Back in the real world, we should be looking at the stitch-in-time or penny wise pound foolish stuff we used to do. If it's cheaper to house people in care homes in some capacity, than have them bed block - why don't we get on with building those care homes?

Because for as long as those care homes are supposed to provide care that is free, high quality, and universal, it's a completely pointless waste of money.

If you build more care homes then more people will let granny go into one of the new care homes instead of trying to look after them themselves, more people will be moved into them who would otherwise die in hospital, those in them will live longer, and demand will rise until equilibrium crisis is restored.

If you built care wards with sufficient beds to look after all the elderly people in the area who are unable to care for themselves and have no means it would be a different matter. But that's politically untenable.