next »

[Wooster]

No doubt many will have had the mail shot through on the independent report (paid for and commissioned by 38 Degrees members) on the future of the NHS in England.

For those that didn't, you can read it here: http://www.38degrees.org.uk/page/content/NHS-legal-advice/


...it looks like you could be getting screwed by those lazy twats who don't want to take responsibility for running the NHS, and probably more worryingly, by those same twats who are likely to make a fair bit of cash through the new proposals.

It reminds me of the Ehrlichman/Nixon discussion on HMO's

John D. Ehrlichman: “On the … on the health business …”

President Nixon: “Yeah.”

Ehrlichman: “… we have now narrowed down the vice president’s problems on this thing to one issue and that is whether we should include these health maintenance organizations like Edgar Kaiser’s Permanente thing. The vice president just cannot see it. We tried 15 ways from Friday to explain it to him and then help him to understand it. He finally says, ‘Well, I don’t think they’ll work, but if the President thinks it’s a good idea, I’ll support him a hundred percent.’”

President Nixon: “Well, what’s … what’s the judgment?”

Ehrlichman: “Well, everybody else’s judgment very strongly is that we go with it.”

President Nixon: “All right.”

Ehrlichman: “And, uh, uh, he’s the one holdout that we have in the whole office.”

President Nixon: “Say that I … I … I’d tell him I have doubts about it, but I think that it’s, uh, now let me ask you, now you give me your judgment. You know I’m not too keen on any of these damn medical programs.”

Ehrlichman: “This, uh, let me, let me tell you how I am …”

President Nixon: [Unclear.]

Ehrlichman: “This … this is a …”

President Nixon: “I don’t [unclear] …”

Ehrlichman: “… private enterprise one.”

President Nixon: “Well, that appeals to me.”

Ehrlichman: “Edgar Kaiser is running his Permanente deal for profit. And the reason that he can … the reason he can do it … I had Edgar Kaiser come in … talk to me about this and I went into it in some depth. All the incentives are toward less medical care, because …”

President Nixon: [Unclear.]

Ehrlichman: “… the less care they give them, the more money they make.”

President Nixon: “Fine.” [Unclear.]

Ehrlichman: [Unclear] “… and the incentives run the right way.”

President Nixon: “Not bad.”

[BarrieB]

...it looks like you could be getting screwed by those lazy twats who don't want to take responsibility for running the NHS, and probably more worryingly, by those same twats who are likely to make a fair bit of cash through the new proposals.

Do you mean that what everyone said would happen under this government is about to?

[Wooster]

Unfortunately, yes. 

[keasy]

I can never understand why ordinary working class to middle class people in England vote those bandits in. Seriously, why ? They're only out to feather their own nests.

[Hijpo]

What can you do and where do you go to stop these gangsters?

[Kryten]

All political systems have their pluses and minuses, all systems have commonalities and differences. There is an awful lot of space to occupy between "communism" on the one hand and unadulterated "capitalism" at the other. There are also "features" of all modern real systems that remain much the same whatever the system is (the existence of power elites of one form or another, some mechanisms for redressing at least certain types of inequity or achieving broad aims of the community rather than the individual, and so forth).

If the current UK government is seriously looking at privatising the NHS they need look no further than the US. The US has chosen to go a different way from the rest of the modern western economies when it comes to health care. The result seems to be that the very affluent can access the very best of service. The price you pay is that the system is very expensive to run by world standards (based on GDP percentages etc) and that a large proportion of the population either don't have access to all of its features or suffer a lot of financial pain in doing so. It surprises me that the "suffering majority" haven't been able to get their representatives to do more about it.

I honestly cannot get my head round the American attitude to Health. Especially the idea that universal health care is so abhorrent to so many people and the rather ludicrous ideas about the menace of perceived "socialism" in regard to it.

Now, I and my family are on BUPA. We are on it because I am in a good financial position and can afford it.

Prior to being with BUPA (and had I not been with BUPA - and even regardless that I'm with BUPA), if I get sick, I could go straight to my GP or the NHS without having to worry about insurance or how astronomical the final bill will be etc etc.

I still firmly believe that health care for all is one of the basic goals of a civilised developed country and what we should be paying our taxes to support, rich and poor alike.

One thing colouring the debate is that we in the UK do so much loud bitching about the NHS -- the stories of the "they took my grandmother out back and shot her dead rather than give her a hip replacement" variety make government run health care sound beyond horrible. Happier stories don't get told. And "better" systems (like, I'm told, the one in France) are so quietly efficient, one never hears about them.

Its an interesting industry, health. One, in fact, where it is pretty clear that the "private enterprise" model is significantly less efficient than "public service" ones. This is actually more common than many "capitalists" would have you believe.

[Thermalsig]

Not all Americans are against govt run health care. The biggest problem you have to defeat is a perception that any involvement by the govt in considered to be trouncing on the rights of the people. This country was built on the idea that the people can do anything and that govt should stay in the corner and remain as unobtrusive as possible. As a nation we tend to distrust govt and believe in business. The one greatest thing I can say about Obama is that he forced America to put healthcare on the table. He created a huge uproar with the his healthcare legislation. I afraid that it probably won't stand as it is. There will a repeal or compromises forced on it, and he may have forked his reelection chances; but he had the balls to put healthcare front and center and he forced every American to talk about it and think about it. Getting that done may make him mighty in the history books, because a few before him whimpered out in the face of the daunting effect it would have on any political future. I think, as a whole, the nation moved to the left on healthcare and that many more people are becoming vocal about healthcare rights. The problem that is being faced is the bible thumping rabble rousing tea party. They are such a minority, but they squawk the loudest and small parts what they say rings oh so small in so many with less conservatives heads, that they tend to follow the loudest. I think the next election here will be all about healthcare and big govt. When it shakes out, we'll know better where we stand on the future of healthcare. Good luck with NHS and it's future, it seems to be an honest and well done attempt at healthcare for all. The only problem is what happens when the govt. runs out of money and some dick heads start spitting shit about how it might be privatized to save money for the govt and for the citizens. That might work, only with close govt oversight, and that generally won't happen. 

[Wooster]

Maybe he can skip the next one, let the spangles run things for a while, and by the time the election after that comes up they'll be desperate to get a sensible President back in office.

Re: France

I'm pretty sure that you have to pay the doctor when he arrives at your house, if you have to call one out of hours.

[Kryten]

Therm,

Feel free to correct me if I am wrong.

As I understand it, in the US, the main failure point of the health care system can be seen everywhere there is an HMO. Their physical presence is in the expensive office buildings they occupy and large number of staff they employ, all driving cars (sometimes very, very expensive cars). The less physical presence is in the value of their stocks and in the decisions made in their boardrooms. Not that there is anything wrong with expensive offices, large staff levels, cars, the trappings of profitability and management driven by a board of directors with more than a passing eye on the stock value. But it's the patients in the healthcare system who are paying for every bit of that - and yet none of those offices, people, profit or the trappings of business are actively doing anything to cure the sick.

The US system is flawed in that it is driven by profit, not need, and the profit to be made comes from the US citizens - money that otherwise would go directly to health providers... but does not.

Health should not be a commodity that can be bought and sold, but in the US (and by what I've read, soon coming to the UK), that's exactly what it is. People tell me over and over again that it's better that way than to allow government to run it. My response is.... Why? We trust government (usually anyway) to provide us with police, with an armed force to defend us, with any number of programmes to cater for social need, so the argument that socialised medicine isn't the answer is badly flawed.

The reason the US doesn't have a socialised health care system is that there is too much money to be made from it remaining in private hands. Too much lobbying by influential people. Too much self interest among the HMOs and the politicians who own shares in them. Too much belief in free markets to be able to see the value in creating mechanisms of public control and public funding to supplant the greed that exists right now.

When one considers how much money the average family pays every month into their health care policies, set against how much it would cost for a socialised solution instead, it's impossible to see how any nation would not be financially better off. After all, US citizens actually DO already pay for socialised medicine for those who can't pay for themselves - or a large number of them anyway - through medicare and medicaid, and no small amount via the Veterans' Administration, so a significant proportion of those who don't have health care at present, or have such little cover that it doesn't help them, would be just as viable as contributors into the socialised system as the rest.

Or.... something like that.

[Wooster]

There are a few things that shouldn't be profit driven, basically anything that's an essential service.
i.e. Health, Water, Gas and Electricity are the immediate ones that spring to mind.

Luckily Scotland has managed to hold onto two of those so far (Health and Water), but it looks like England is about to lose it's last.


Look at the utility companies.
Privatisation was meant to drive down prices through competition, but instead they are all in cahoots to keep churning out mega profits for their stakeholders.
If you use less, you get charged more per unit.

When BT was privatised we were told that the money accrued would be ploughed into improving the infrastructure and bring in competition.
Instead the money was pissed away and they had to dip back into the public purse (twice I think).
The competition is there, but it's either Virgin's cable service or the multitude of others who are running off of BT's 'barely improved in 50 years' infrastructure.

There's even a new word in the lexicon for it: http://www.broadband-notspot.org.uk/coverage-map.html#5,54.470037612805754,-3.18603515625,all,2

[Kryten]

<SNIP

There are a few things that shouldn't be profit driven, basically anything that's an essential service.

Ha! Well, putting my satirical hat on, why don't we privatise the army also and let the market decide if it is

a) needed

and

b) how it is used.

The oil companies could pay them to invade oil producing countries...

Oh... that happens already!

[Wooster]

And defence procurement is practically a private enterprise as well.


You really missed the ball on that one. 

[Centurion]

I can never understand why ordinary working class to middle class people in England vote those bandits in. Seriously, why ? They're only out to feather their own nests.

Because we had no choice Sad but true