There is nothing special about the nhs

zagubov

Herzlos wrote: »

I'm not sure, but it's at least partially because there's no incentive for a US style medical system to be cost effective - quite the opposite. Potentially you're paying more for the excess (co-pay) under the US system than similar treatment is available for privately elsewhere in the world. Often it's cheaper to travel to somewhere else like Canada or Cuba and pay for treatment.



What you are paying for there, and not here, is all of the overhead of the insurance system and you can be certain the health insurance companies are making plenty of profit.

I think the US medical system is a particularly poor model as America transitions from being a manufacturing and service economy to a litigation-based economy.

kabayiri

The only way (IMO) to control health care costs is to change the societal view about our health.

The local Maccy D restaurant often has queues of cars at all manner of hour.

People are clearly willing to put the instant hit of poor dietary food; excess drink; and lack of exercise high on their priority list, and then expect the NHS to pick up the tab later.

It's quite a selfish attitude, when you think about it.

People will always fall victim to illness due to bad fortune, and a safety blanket must exist for this.

But somehow, we need to push the importance of health back onto the individual, and reduce the strain on a national service.

theoretica

I think there are two different things here - I really like and support the idea of a National Health Service, rather than private organisations trying to make a profit. I also think the current way it is set up and being run is far from perfect.



I don't want to live in a country with more desperate poverty, and more people with untreated illnesses who unnecessarily cease to be an active part of society and the workforce.

Cakeguts

lisyloo wrote: »

Yes psycological impacts are treated by the NHS (not on just a claim or request but when verified by a health professional).
That’s not the same as cosmetic preferences.

Are you claiming that (for example) horrific burns don’t have a physcological impact or that it simply shouldn’t be funded?

If you had a daughter with a deformed boob or burnt face which affected her physiologically are you saying that treatment should not be funded?

I agree that bigger boobs and nose straightening for vanity reasons should not be funded (and isn’t), but shouldn’t physical or mental suffering be treated? Or is there a prejudice against mental health here?

There does seem to be an element of nastiness to this thread in that people aren’t trying to rally against those who’ve done well (increased taxes) but against those who are actually suffering.

The problem is that the mental bit is very very selective. They will argue that someone needs IVF or an operation because their mental health is at risk but should you get a serious mental illness that appears to not have a cause and then they often leave it until it is either too late (someone has died) or until someone seriously self harms or tries to kill themselves. I have personal experience of this having suffered from severe depression. You get passed round and no department talks to any other.





I would prefer them to treat people with life threatening illnesses equally and not to do things like IVF because if their mental health treatment was good enough people shouldn't become mentally ill from not having children or having one boob bigger than another etc. As a society we need to stop people from thinking that everyone has a right to a perfect body because it just alienates those who through illness or disability can't get that.



Mental illnesses still have some really terrible old fashioned with really nasty side effects medication and of course it continues to be used because unlike cancer treatments people with a mental illness are often not well enough to complain about their treatment.



Some mental illnesses have now been proved to have neurological causes but they still are not being treated by neurologists.


If you have ever suffered from a mental illness that needs a hospital stay you will know that you are a 3rd class citizen at the NHS. From outdated medication to leaving the illness as long as possible without the right treatment to the point where it becomes life threatening. People die because they can't get treatment in time but the treatment that would save them is there and it isn't one of the new expensive treatments just a normal one but no one to prescribe it.



For physical illnesses the NHS does quite well. For mental illness it appears to be universally awful.

lisyloo

Cakeguts wrote: »

For physical illnesses the NHS does quite well. For mental illness it appears to be universally awful.

I agree with a lot of what you say.
I’m just not sure that less money or even re-prioritising (which means taking away from some sufferers) is the answer.

Yes sure, clamp down on all waste and inefficiency, but with the ageing population it’s likely we need to put more money in not less.

One area I think they should cut is free travel vaccinations.
However I’m torn on that because it could result in more disease and expensive treatment if some people won’t pay.

westernpromise

GreatApe wrote: »

I am pretty right wing but I like the NHS because it is a counter to the medical profession taking the !!!! which given half a chance they definitely will do

A doctor in the UK is paid what? £35-50k a year?
A doctor in the USA is paid what? $200,000 - $300,000 a year?

The reason is primarily thanks to the NHS monopoly it can dictate wages and because it is such a behemoth the government and the NHS can keep and have to keep the uk medical profession more honest than it ideally wants to be (except GPs which managed to slip though the net and bag huge wages)

Sometimes you need monopoly to counter the monopoly of professional groups banding together to limit numbers and competition to drive their own wages sky high

So long live the NHS
Until the robots take over 20-30 years form now

Strictly then it's a monopsony.

Caitykinss

I think there's something to be said about being charged to see a GP. Not a huge amount, perhaps £5-£10 a time, with people eligible for low income free care being exempt. We are charged for prescriptions and for dental treatment at set rates, why should a trip to the GP be any different?

I must also say how much I value and frankly owe my life to the NHS, having being diagnosed with an incurable condition from birth, that I have received expensive continuous treatment for all my life. Without the NHS, my parents, and subsequently myself as an adult, would have been unlikely to afford much of the care costs, despite having fairly average salaries. The thought of losing the NHS and it being replaced with an US style system genuinely terrifies me - I have no idea what it would mean for me and my care, and whether or not I'd be able to afford or even be approved for insurance with a pre-existing condition. I think the system needs a big overhaul to protect it, but losing it altogether is just unthinkable.

dealer_wins

Small charges say £30, £10 for those in receipt of benefits for seeing a GP or attending A&E would take a lot of pressure off these often misused services.

My mum worked in a hospital for 25 years and she said way over 3/4 of the people attending A&E didnt need to be there and knew it.

paparossco

There are those that would rather wait 4 hours in the ED than wait days to see a GP. Solve that problem and you are well on your way to solving the problem.
Charging is not the solution IMO as it is a slippery slope, think prescriptions.

Carl31

Caitykinss wrote: »

I think there's something to be said about being charged to see a GP. Not a huge amount, perhaps £5-£10 a time, with people eligible for low income free care being exempt. We are charged for prescriptions and for dental treatment at set rates, why should a trip to the GP be any different?

i think an easy solution here is just bring the prescription charge forward. Most people, if truly ill, must have an expectation they will come away with a prescription which they will have to pay for, so know they will be paying later that day

Make that charge the fee. Those who expect to pay it are no worse off, those that dont expect to pay anything may think twice about whether they do need that appointment

Of course, not all GP trips result in a prescription, so its not perfect, but might relieve some pressure on doctors