There is nothing special about the nhs

badgerhead

Mistermeaner wrote: »

I could flip the assertion round and ask why (some) people think its OK to demonise those who have done well for themselves in wanting to keep as much of their hard earned wealth to spend as they see fit, rather than having it forceably taken off them and spent in ways others deem more worthy.

Because in this case it would harm the most vunerable in our society.

Nasqueron

seven-day-weekend wrote: »

There are other models than the American one.

I think that the NHS is expected to do a lot of things it was never intended to. Certain things such as IVF, Gender Reassignment, Elective Cosmetic Surgery and other lifestyle choices should not be available on the NHS. There should be a hefty fine for missing appointments without a cast-iron reason.

I think it should still be free at the point of use.

You're classifying a genuine medical condition as "elective". Transgender people are not seeking treatment for lifestyle choices, they have a genuine, recognised, condition that, in part, needs surgery and other treatments.

I agree that cosmetic surgery should be used sparingly, boob jobs should only be given for cancer patients (or similar conditions), not for "psychological" reasons where someone's low self worth could be treated through other means.

IVF I fully agree with, the world is over populated as it is, many children need to be adopted or fostered and there should be no right to your "own" child unless you want to pay for it.

Carl31

I think a big part of the strain of the NHS would be relieved by bringing forward the prescription charge

Charge that for the appointment, but nothing for medication. If you are truly ill, you will be thinking that you would come away with a prescription cost anyway. If not, it might make you second think

spadoosh

badgerhead wrote: »

Because in this case it would harm the most vunerable in our society.

This is an assumption.

Im libertarian as opposed to a neo liberal.

In my ideal world the people responsible for social welfare would be society. So youve got someone who is super rich, theyre being all douchey with the money they have, buying yachts, hoes and artwork. Youre not happy with that. So you go online, google the person, find out the business they own and how they make their money and you boycott it. If society deems them as 'bad' they wont get the money. If they deem them as good, society can choose to buy more of the things thats making them money.

This take responsibility out of a very select few and directly thrusts it in to everyones hands. Youd have to think twice before buying that particularly cheap item, is it cheap because they treat their labour unfairly, they dont put their fair share in to the local community, they dont pay their suppliers enough, or is it because theyre particularly efficient.

Its like everyone thinking state pensions are great. Well of course they are the reason theyre great is because about £5 trillion of future pension contributions is completely unfunded. Im getting told ive got an IOU, theyve yet to decide on the pay out date though or work out who or how its being paid by.

badgerhead

How would that work for health care? Do you boycott the drugs you need?

michaels

Nasqueron wrote: »

You're classifying a genuine medical condition as "elective". Transgender people are not seeking treatment for lifestyle choices, they have a genuine, recognised, condition that, in part, needs surgery and other treatments.

I agree that cosmetic surgery should be used sparingly, boob jobs should only be given for cancer patients (or similar conditions), not for "psychological" reasons where someone's low self worth could be treated through other means.

IVF I fully agree with, the world is over populated as it is, many children need to be adopted or fostered and there should be no right to your "own" child unless you want to pay for it.

But we are having to prioritise and to me if we have to choose between treating cancer sufferers and transgender then the big c should come first.

Mrsn

For someone who has 2 possibly 3 auto immune conditions at the age of 35 I am truly grateful for the NHS. Things have and do go wrong with my care but I could never afford a private system.

It’s a very emotive subject and as no two patients are the same there will always be differing views of what people feel is important. I’ve lost 3 members of family to various sorts of cancer which is unreal in this day and age but if I needed IVF to help have a child would I expect the NHS to help fund that I honestly do not know.... lines have to be drawn and someone will always lose out

Nasqueron

michaels wrote: »

But we are having to prioritise and to me if we have to choose between treating cancer sufferers and transgender then the big c should come first.

On what basis / rules do you treat cancer though?

All treatments?
Treatments where a cure is possible?
Just treatments where someone is likely to live (what % chance?)
No treatments to extend life (where death is still inevitable)?

It should not be about choosing or prioritising when it comes to actual medical conditions, elective things where a person is not suffering e.g. IVF or boob enlargement should go long before treatments that can help safe a life or ease pain.

Or we just get realistic and change the NHS properly

A separate progressive tax on top of NI directly for the NHS
End all PFI contracts, government lend money to buy them out early if needed
No prescriptions where the drugs can be bought cheaper off prescription or cheap alternatives are available
Charges for missing appointments
Proper billing of foreign users of services (e.g. claiming off travel insurance) and being mindful of people coming here who are likely to need it e.g. someone 8 months pregnant flying in or someone already ill with a condition
etc

Mistermeaner

badgerhead wrote: »

Because in this case it would harm the most vunerable in our society.

Not disagreeing

But

How do we judge who is most vulnerable ?

In a world where the state provides a safety net for the most vulnerable this would not be an issue

I would say the present safety net is too wide and caters for too many - plenty who are not vulnerable and could self help are incentivised not to as the net will catch them

Mistermeaner

Nasqueron wrote: »

On what basis / rules do you treat cancer though?

All treatments?
Treatments where a cure is possible?
Just treatments where someone is likely to live (what % chance?)
No treatments to extend life (where death is still inevitable)?

It should not be about choosing or prioritising when it comes to actual medical conditions, elective things where a person is not suffering e.g. IVF or boob enlargement should go long before treatments that can help safe a life or ease pain.

Or we just get realistic and change the NHS properly

A separate progressive tax on top of NI directly for the NHS
End all PFI contracts, government lend money to buy them out early if needed
No prescriptions where the drugs can be bought cheaper off prescription or cheap alternatives are available
Charges for missing appointments
Proper billing of foreign users of services (e.g. claiming off travel insurance) and being mindful of people coming here who are likely to need it e.g. someone 8 months pregnant flying in or someone already ill with a condition
etc

All but the top point in your list are not even scratching the surface

And the contention would be more taxes - you appear to have decided that a few people should pay more taxes to fund this behemoth even more - is that correct?


One of the things I would look at (in addition to reducing size and scope) is to abolish the final salary pensions (or care of whatever they are now) and also look at pay generally

There's no shortage of skilled and unskilled workers want to enter the profession

I would also overhaul the bma who have for too long controlled the training of doctors such as to deliberately limit supply and inflate wages