Oh God, no. NHS hospitals have tons of motive to be efficient - they’re working within a budget and meeting all sorts of targets.
PPFI, anyone?
Part of adopting universal healthcare is the realization that medicine is not an industry.
My old Mum got exemplary care when her bowel ruptured after a really bad fall. A screamingly fast ambulance, a life saving operation, a couple of weeks in high dependency care and another month in a more general ward. Before she got out of the hospital the NHS/ the local Council made things easier for her to go back home (asking my Dad in very kind fashion) handles fitted next to the toilet and around the bath, a commode next to her bed etc. A nurse came to the house several times a day to help with the stoma for the first few months, and the GP turned up every couple of days to make sure that my Dad was coping OK.
My Mum gets a bumper pack of stoma bags and the various unguents and contraptions on a regular basis from her local chemist shop. Costs her nothing out of pocket.
I’m glad that my tax goes to pay for things like that.
NHS is in a definite deficit to me.
According to this, in 2007, the NHS budget was £90 billion, which represents around 17% of tax spending. Extrapolating from that, in the four years I’ve been back earning in the UK, assuming I pay an average of £1,000 per month income tax, at around £170 per month ($273 at today’s exchange rate) I’ve paid roughly £8,000 into it and had maybe £500 of care back.
Expressed that way, it feels like insurance, but it’s cheaper than insurance. I know it’s there for me if I need it, and was there for your mum when she did, and I like it that way.
I actually agree. I’d be much happier if the society would divest itself of the emotional - and irrational - attachment to a social service. That attachment has been encouraged over decades and, in some senses, that hasn’t been a bad thing because it acts as a moat around the general principle. It has, though, been propagandised for decades.
In the context of other developed health care systems around western Europe the NHS is right out there on a limb, possibly an economic folly. It’s a great, bonkers, absurd folly but the point is, could the UK deliver better health care to the entire population by adopting from elsewhere. We’re just not going to have that debtae in the UK becasue of that decades long propaganda.
as a US Citizen, UK resident (and working on changing the first half), I’d say 2 because of the dental situation and mental health care being sometime difficult to obtain. But these are things I wouldn’t be able to afford at all in the US
I’ve gotten prescriptions that would run $300 in the US for £5. I’ve also had surgery on my ladyparts via the NHS, and wouldn’t change a thing about that experience. Good care and aftercare.
Having worked in the NHS, I have personally seen some of the problems and also the strengths.
One big issue is the management. The personnel systems in place mean that most ‘managers’ are actually administrators. When certains changes need to be made there is huge inertia due to these systems and less than stellar management.
The next huge problem with the NHS is that it is used heavily in policitical debate, which means lots of interferance, and that includes uninformed comments by the public, press and politicians - there are votes in the NHS debate so stories get exaggerrated, distorted, or just plain old fashioned lies.
Perhaps the greatest problem is cost, by almost any reckoning, NHS provides performance despite it being underfunded. The costs come out of taxation and of course taxation is another political issue. When you examine the UK GDP that is spent on health services you’ll find it still some way below that of the EU average.
We had pretty ropey healthcare back in the early 1990’s, and much of that can be laid at the feet of the previous administration whose mantra was to cut taxation at all costs, which meant we actually spent just over one third on healthcare compared to the US, and just over one half of the EU average.
Many people only have infrequent contact with our healthcare system, and if that was 7-10 years ago, well you simply cannot directly compare, we now have working time limits on our medical staff which is a very recent change - which will in turn bring better and more accurate diagnoses - instead of having junior doctors working 18-24 hours straight and on a regular basis. This will cost more, but will be an improvement
Since then, spending has increased, and from waiting lists of up to 18 months, we now have waiting times of less than 20 weeks for non-urgent conditions, with a pledge to get this below 17 weeks for non-urgent procedures.
So where are we now ? Our healthcare system has improved, dramatically over the last 10 years, I know this may well be seen as a political comment, but the reality is that the previous administration underfunded our healthcare system for 18 years, and was seriously looking at breaking it up and selling it off part by part, treatment by treatment. It was public concern at the state of our healthcare system that was one of the (many) significant factors in their losing of that election.
Our healthcare system is not perfect, nor will it ever be, but it has certain advantages over the US system. It is not the only way to deliver healthcare - the German and French systems work very well.
One thing that is reported widely in the US is the waiting times. In the US if you have the insurance or the money you wait for nothing, but this ignores the fact that US healtcare is rationed before you even carried into the waiting room.
You get competant but basic care if you do not carry insurance but, for longer term chronic conditions, the uninsured in the US do not do anything like so well as in the UK - the price in the UK is that if your condition is less than urgent you will wait.
The US system works extremely well for those with the coverage and these are the ones with the loudest voice, the money, the activism to shout about the failings of other systems, but for those in the lower echelons of US society, with less voice, less clout then it isn’t so good. The US system entrenches class differances, which seems a shame given what your constitution says about equality
Above all, the US system, whilst only covering two thirds of the population, actually costs very nearly double ours, but few if any people in the UK, or in any socialised healthcare country will ever be bankcrupted merely for being ill.
I would warn our US posters of one thing though, if you do introduce true universal healthcare, you will get a shock, it will cost far more than you expect, because you do not really have any idea of the unmet need, that is, persons with medical conditions who do not present themselves for treatment because of cost.
You may well be overwhelmed by the sheer scale of this unmet need, it happened in the UK, and this unmet need is what changed the view of the anti’s in the UK in 1948 when we brought in universal heathcare, because then the antis were forced to realise just how selfish, and frankly unethical their behaviour had been in the past.
My anecdotal experience has ranged from good to excellent throughout my use of the service. Despite this, obviously option 2 makes the most sense, but that’s because medical practice is always advancing, and any system of healthcare will never be prefect. Expensive and ineffective attempts to integrate private investment through various PFI schemes have, from what I’ve read, probably been a mistake, and there are areas which need, and are now beginning to receive greater priority.
Access to adequate health care should be a fundamental human right, in my opinion, not a privilege. I find there’s something almost inherently sociopathic about those who feel that people who fall through the cracks don’t deserve medical treatment.
Another anecdote of mine; I’ve had problems with acne since I was a young teen, however since it was limited to my back I decided to live with it. Last year while I was at university it got worse (to the point it was painful to wear my backpack). When I returned home for Easter, my parents told me to visit the doctor.
Since I’d been living in halls (and thus the local doctor was no longer my GP) I was worried I’d have to fill in endless amounts of paperwork. However, I got an appointment (for the next day) and when I got there the form I needed to fill in was a single A4 sheet, and took less than 5 minutes to fill in. After speaking with the doctor (after waiting about 15 minutes) I was prescribed some anti-biotics. I then headed to the nearby pharmacy and got my prescription (for free even though I hadn’t yet registered the fact I was a student, since this was in Wales). When I renewed my prescription (twice, as it was a 6 month course of antibiotics) each time I was able to get it for free (because I’m a student) and I was able to talk to a doctor about it at a days (in fact, a few hours at uni) notice.
Also, I found this amusing little quote. It’s not very reliable given the source, but;
It’s a real quote. One of the conservative posters linked to it in support of his/her side in one of the other healthcare threads.
Ah, here it is.
They’ve edited it out. Left all the other inaccuracies and downright lies in, though.
Ha! So they have.
I don’t like that prescription prices vary so much within the UK. Not sure how that can be justified.
I’m sure there are management issues that could be improved and then there’s seemingly endless IT fuck up.
Then there is the length of time it takes to get psychiatric help if you are not at the point of being a danger to yourself or others.
Prescription charges don’t vary. It’s a flat rate of £7.20, as specified on this NHS page.
I agree with you about the delays for psychiatric help. And when you do get it, it can be very hit and miss; though I suspect that that could be because psychiatry is still a young and immature science.
I’d soon sort them out. But I’ve applied for a number of IT positions and they keep appointing others.
Agreed, but I’d add two caveats: if properly managed this initial unmet need will be a hump that will pass, though it may take over 5 years; secondly, this unmet need can also be partially managed by tightly defining what and who can and cannot be covered by UHC.
You are incorrect and alexandra is right: Prescription charges do vary within the UK.
In England, the charge is £7.20; in Wales, there is no charge; in Scotland, the charge is £4, with plans to abolish charges from April 2011. In Northern Ireland, the current charge is £3, with plans to abolish charges in April 2010.
Three.
The NHS cannot cope with the load. It’s as simple as that. It was founded on several assumptions that have since proved to be not merely wildly inaccurate but complete and utter nonsense with no basis at all in fact. These problems were compounded by treating the NHS as a sacred cow that was “the best in the world.” It should have been dismantled and rebuilt in the '60s.
As to what option to follow, I’d suggest an insurance-based system where the patient is expected to contribute to paying up front, rather than the system being funded by general taxation (in which I include so-called “National Insurance” contributions, which is basically a tax on employment.)
In the interests of full disclosure : I have a chronic, lifelong illness and as such I get all prescriptions and eye treatment free. I still think change is necessary.