British NHS May Soon No Longer Offer Free Care 634
An anonymous reader writes "Coinciding with challenges in the rollout of the U.S. Affordable Care Act are challenges for NHS. The Independent reports, 'A National Health Service free at the point of use will soon be "unsustainable," if the political parties do not come forward with radical plans for change before the 2015 election, top health officials have warned. Stagnant health spending combined with ever rising costs and demand mean the NHS is facing "the most challenging period in its 65-year existence," the NHS Confederation said ... In a frank assessment of the dangers faced by the health service, senior officials at the confederation say that the two years following the next general election will be pivotal in deciding whether the NHS can continue to provide free health care for all patients. "Treasury funding for the service will be at best level in real terms," they write. "Given that demand continues to rise, drugs cost more, and NHS inflation is higher than general inflation, the NHS is facing a funding gap estimated at up to £30bn by 2020."' From The Guardian: 'Our rose-tinted view of the NHS has to change.' More at the Independent, Mirror, and Telegraph."
My spider sense in tingling.... (Score:4, Insightful)
I sense controversy in the air, a lot of it.
Re:My spider sense in tingling.... (Score:5, Insightful)
Nah, that's just your allergies kicking in.
No surprise, really. Medical care is something hard to avoid - everyone will get sick / aged / infirm sooner or later and few will opt not to try and at least feel better, if not lengthen or improve their lives. Western medicine is simultaneously very powerful and pretty pathetic. We've gone after much of the low hanging fruit - the newer interventions are going to center on complex molecular biology and that stuff doesn't come cheap. On top of that the population is simultaneously increasing and aging. Not good for controlling medical costs.
We could limit costs. Remember the 80 / 20 rule (actually closer to 90 / 10) - a few patients consume most of the resources. Limit those folks and you've saved quite a bit of money. Of course, that's rather a large change in our social contract and I expect one that would not be palatable to the vast majority of people.
Barring that, there are still some options to reduce costs. Carefully evaluate the cost / benefit ratios of expensive therapies (bye bye dialysis). Basically freeze drug research (it's not like they have come up with any great new therapies) and essentially force generics. Get rid of Big Pharma's advertising budget (bigger than their research budget). Get rid of insurance companies and simplify the byzantine American medical system (one time savings, but a big one, basically kicks the can down the road). Limit reimbursement. Shoot the lawyers. Ration. Ration. Ration.
But people really want good health care which means somebody has to pay for it (preferably someone else). Now, IMHO, in the US at least, we could come up with all the money we needed if we restrained our military from trying to outspend the rest of the world by orders of magnitude. We don't need 11 carrier battle groups. We don't need the F-35. And so on - the money is there, we just have to figure out what our priorities are.
Unfortunately, given the partisan nature of US politics nothing substantive will happen. The ACA was likely the best political compromise available and it sucks big time (basically doesn't change the issues noted above). In the UK, obviously they have fewer levers to pull so they may, again, have to have that difficult 'social contract' conversation.
Just exactly what do you want society and government to do? (And don't give me any free market drivel, even the highly modified 'free market' in the US hasn't worked out so well in terms of patient safety. Just what do you think would happen if the government regulators went on permanent holiday. Do you think any consumer can rationally evaluate treatments? Who has the club in that scenario?)
Re:My spider sense in tingling.... (Score:5, Informative)
There's nothing even approaching a free market in the US. You can't negotiate a price (possibly on some elective things, but not much), you can't bring your own aspirin, hell, they can't/won't even tell you what they're charging for their aspirin until you get your bill.
Re:My spider sense in tingling.... (Score:5, Insightful)
"And don't give me any free market drivel, even the highly modified 'free market' in the US hasn't worked out so well in terms of patient safety."
There's nothing even approaching a free market in the US. You can't negotiate a price (possibly on some elective things, but not much), you can't bring your own aspirin, hell, they can't/won't even tell you what they're charging for their aspirin until you get your bill.
You can't negotiate a price when you need an ambulance or emergency care. The mystical, magical, almighty free market that you worship won't work there.
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The government doesn't grow food. It gives people money to buy food but relies on the market to respond to the increased demand and provide it.
The government doesn't provide housing. It give people subsidies to buy housing and relies on the market to provide housing.
The government doesn't provide medical care (except at the VA). It gives people subsides and
Re:My spider sense in tingling.... (Score:4, Insightful)
Perhaps the government should provide subsidies to private fire brigades, or private police forces, or private armies.
Oh, wait, they already do that last one.
Re:My spider sense in tingling.... (Score:4, Informative)
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"unsterilized" new money is purely inflationary, and thus takes money/value from the citizenry at large.
Re:My spider sense in tingling.... (Score:5, Informative)
This.
You want first hand expirience? Go and break/twist something whilst skiing in Austria, I had to ski off a glacier with a broken rib due to certain circumstance but if you have the option of forking out for a ski-do lift off you will, or worse if you need a helicopter out of there you can forget "choices". Obviously it's "choices" that got you there in the first place to an extent but as an illustration of how quickly a fit individual can instantly lose all freedom of choice via nothing but bad luck and random accidents you get the point.
The care afterwards was epic BTW, I obviously had insurance so walked into one of the private medical clinics, in one hour I'd had a technician do three x-rays, a doctor check me over and then handed over to a nurse for a quick bandage up. Back out to reception and they'd almost instantly burnt my x-rays to a CD complete with program for viewing them, written up my prescription and compiled the bill. Everyone spoke at least passable English as well.
I've had the flashing blue-light treatment back home via an NHS ambulance as well and whilst it was good and everyone was nice, competent and helpful they were no where near as efficient as the Austrians but there again they were free at the point of need and a general treatment A&E.
On balance I'll pay my (considerable) taxes all day long to have the NHS there thank you very much.
Re:My spider sense in tingling.... (Score:4, Interesting)
I imagine that there's some limit, like maybe only emergency room visits are covered for visitors or something like that. Still, the process was simple, the staff were helpful, and my daughter got what she needed and she was fine as soon as the antibiotics kicked in.
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The discussion is almost exclusively how to make everyone have health insurance. It should be all about how to have as inexpensive healthcare as possible.
The cheapest possible healthcare is your doctor, her staff and you. Every insurance lamprey, bureaucrat and government added cost, e.g. endless taxes and unneeded regulation added to that list, drives up the
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I am caught between moderating this down or providing the real answer. Basically any one who thinks that National Insurance has anything to do with the NHS is a uninformed idiot.
Of course if you had read the link you provided you would actually understand that...
Re:My spider sense in tingling.... (Score:5, Informative)
The NHS is free at the point of delivery, or in different words, free in at the time of need - which is what the care in healthcare is all about.
No-one said the NHS is free. Someone has to pay for it in the end. The beautiful thing about the NHS is that is you don't have to worry. You don't have to worry money when you are sick, or when you loved ones are sick. You don't have to worry about co-pays, or what this insurance covers and what it doesn't. You don't have to worry about dealing with insurance companies or with your company on healthcare coverage. And on top of that, if you want 'luxuries' like jumping the queue, or private en-suites, you can have that as well, by buying additional private cover.
What you said about NI funding the NHS is not entirely true. Only a very small amount of NI actually ends up in the NHS. The NHS is funded by and large by general taxation. It is budgeted according to need and is relatively efficient - around 8% of GDP is spent on healthcare in the UK, half of what is spent in the US, while covering 100% of the population.
Re:My spider sense in tingling.... (Score:5, Informative)
The NHS is funded by general taxation. If the government is insolvent, then it's not just the NHS that has a problem.
On the other hand, it's unlikely the the UK will default on its debt any time soon. First of all, Parliament is actually functional, you can't have a group of legislators holding to population to ransom by refusing to fund government. This is because the government is formed by a majority in the House of Commons, any time a budgetary vote is lost, confidence in the government is lost, Parliament is dissolved, and new elections called.
In any case, what you said doesn't make any sense whatsoever? What's going to go up? Your insurance premiums? There isn't any? Taxes? Well it funds a lot more than the NHS. You don't seem to have any concept of the political atmosphere in the UK do you? People in the UK are, by and large, happy to pay taxes to keep their health service public - even the conservative here tread very carefully, any government giving any indication that the NHS might be harmed will get kicked of office instantly.
Re:My spider sense in tingling.... (Score:5, Informative)
Do you have to worry when your currency is collapsing because of out of control costs? Or when the death panel decides that you aren't worth treating?
There's a fine line between satire and actually being crazy... I want to give you the benefit of the doubt and assume you're being facetious, but given the rhetoric going back and forth in the US lately, I just can't let it go....
In response to your first question -- Canada has had a publicly funded single-payer health care system for nearly 70 years. If it was going to make our economy collapse, it would have done so by now. More than that, in 2008 when *your* economy fell into the shitter, we didn't have *any* banks collapse, and for several years, our dollar was worth more than yours. Your dollar *still* isn't anywhere near recovering to where it was before the 2008 collapse -- 10 years ago, $1 CAD was worth about $0.65 USD. Today it's $0.98. Clearly, a publicly funded health care system will *not* make the currency collapse....
In response to your first question -- "death panels" don't exist. Never have, and never will. The decision on what kind of treatment options to pursue is made by both the patient and the doctor together, and nobody is refused care under any circumstances. Whether that care is palliative or therapeutic will depend on the individual case: just like in the US, sometimes it's better for your quality of life to give you meds so you can breathe easily and not suffer pain than it is to put you through another round of chemotherapy. The sad reality is that medicine *can't* cure everything, and any doctor worth his salt will tell you when the chances are slim/non-existant and give you the choice in how to proceed.
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"Free" doesn't mean "costs nothing" - in this instance it means "Free at the point of access", meaning that your treatment is already paid for from your NICs.
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Did you just figure that out. Newsflash!!!! Government never provides anything for free. Someone, now or in the future, will pay for it.
That wasn't his point. He said that NI pays for the NHS, in the sense that it's money taken for a specific service - not a service that's paid for out general state funds. I don't see how you could read the AC comment as meaning that the NHS is magically funded by magic money that magically appears on a desk in HM Treasury.
AC is wrong here. NI doesn't pay for the NHS. It may contribute to some of the costs, but it isn't accurate to consider NI to be the bill that covers bandages.
To my knowledge, the only wa
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Over here in the Continental US, I've heard of the NHS, but those who talk about it have never, that I've noticed, been specific about exactly where HMG gets the money to run it, so I'd never heard of National Insurance Contributions before.
So the AC made an informative and worthwhile contribution to the thread.
Comment removed (Score:5, Informative)
Re:My spider sense in tingling.... (Score:5, Interesting)
The free market works for elective surgery because you *can* shop around and take advantage of competition. That isn't where the problems lie. The problems occur in situations where you *cannot* shop around and for which there is no competition, sometimes not even consent (you can't make a deal when you're unconscious). How do you propose to 'let' the free market work in these cases? Why is the care in the US 2.5x as expensive as the "too expensive" NHS (per person per PPP normalized GDP/capita) if the free market system works so well?
Insurance helps, but it comes with a host of its own problems. Very few people are qualified to evaluate a plan (those that are work for insurance companies) which translates into a clueless consumer: if only 1% of people only ever get cancer and require their plan to pay out more than they payed in, then only 1% of people know if they were being ripped off or not. The bandwagon effect and lack of law-of-large-numbers make things worse (risk grows with sqrt(N), risk is cheaper per person for larger plans). And then there is the problem of buying perscription drugs, where even the largest of insurance companies have virtually 0 bargaining power as compared to single payer systems, forcing them to pay 2x for drugs.
We have been 'letting' the market work for the past decade. As a result, our care is 2.5x as expensive. You're nuts if you think that eye surgeries are anything but an outlier.
Re:My spider sense in tingling.... (Score:4, Interesting)
The second point is why socialised health care and insurance companies have advantages over individuals in negotiating for care. An individual probably won't need to go to hospital in any given year, and very few of the ones that will need to can predict what treatment they will need in advance. In contrast, you can statistically work out roughly how many people in a country will need what kinds of treatment, with quite high accuracy. Negotiating to pay for them all together puts you in a much stronger bargaining position.
The big problem with this debate is that it conflates a whole range of choices in a single socialised medicine vs private medicine debate. In reality, there are a lot of points on the spectrum, depending on:
The question of what role the free market plays is complex. Obviously, you can't have people who have just suffered a heart attack shopping around for the best value ambulance to take them to the best value hospital. But you can have, for example, a central government buying medical services for all citizens (which typically counts as socialised medicine in these debates), but having different medical centres competing for the business, especially if they're allowed to take private patients as well so that they can stay in business when they don't have the majority of the government contract.
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You can't negotiate a price
You most certainly can. My father-in-law is not a US citizen. He came to New York for a surgery, balked at the initial price estimate, and negotiated it down significantly.
I have health insurance, so have never needed to do this, but you certainly can negotiate price - they key is to do it BEFORE you receive care.
I used to go to a dentist that suggested that I pay him a lower fee than I was currently paying in dental insurance premiums. I didn't take him up on it, but it was tempting.
Re:My spider sense in tingling.... (Score:5, Insightful)
You clearly haven't been lying on an emergency ward bed on the verge of dying of respitory failure before. Trust me, at that point the negotiating powers are rather poor and frankly one isn't feeling much like a "rational agent".
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And you have never heard of anyone needing essential but non-emergency medical attention?
Re:My spider sense in tingling.... (Score:5, Insightful)
OK. Bullshit. I am dying of a heart attack, they are wheeling me into surgery and I shout stop, let's first negotiate how much this is going to cost me or even fucking better, a child is being wheeled into emergency surgery and the parent shouts stop, how much is this going to cost me, hmm, that's to much, sorry sweety you are just going to have to die. See, obvious blatant in your face 'BULLSHIT'.
Re:My spider sense in tingling.... (Score:4, Insightful)
Ahh, yes. As a building estimator contract administrator I was to base all my future medical procedures on the lowest tender, are you absolutely fucking nuts. You got any idea about how often that lowest tender turned out to be a disaster, poor job execution, demands of extra payment, incomplete job et al. Let's reiterate, your in the operating theatre, the surgeon makes his first cut, you scream, surgeon says, oh by the way, aesthetic, that's extra and it ain't cheap.
Or we could (Score:5, Interesting)
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There is much truth in what you say - in my opinion the biggest, single factor in the spiraling health care costs is the pharmaceutical industry; and they are also in a perverse way on of the biggest hindrances to the development of real cures to some of the diseases that cost society so much.
To understand this, one just have to look at the fact that companies exist primarily to make money. If you find a way to cure, say, cancer, the company that produces the medicine can make money once per patient; but if
Re: My spider sense in tingling.... (Score:3)
And that doesn't influence what they decided to work on/research?
Re:My spider sense in tingling.... (Score:4, Insightful)
"In the UK, obviously they have fewer levers to pull so they may, again, have to have that difficult 'social contract' conversation."
I don't think we do. There are plenty of places we could cut first and save a fortune. For example, in the UK if you have a kid and earn less than £50k a year you get a few grand a year for free.
I imagine we'll stop giving free money to people for no other reason than the fact they chose to have kids long before we start denying people healthcare.
Our government wants to spend £50bn (assuming it's even on budget) on a new train line too which seems to have no financial case judging from impartial and non-partisan scrutiny.
Then there's our nuclear submarines we want to replace.
That's before you consider other benefits:
http://www.theguardian.com/news/datablog/2013/jan/08/uk-benefit-welfare-spending [theguardian.com]
We can even stop giving free TV licenses, free bus passes, free money for fuel bills and a state pension to wealthy retired baby boomers also if necessary - yes, that's right, even if you're a millionaire you get money to help pay your fuel bill and a free bus pass past a certain age all paid for by the state.
Really, there's an awful lot that can go before we need to start considering restricting access to healthcare with literally no negative impact on society. As much as they'll still bitch and moan anyway because that's what they do does anyone really think that denying the thousands with even only half a million in assets and a pension access to a free bus pass would have any negative effect on society whatsoever given that they could trivially afford to just pay for the bus with their existing money like anyone else?
Couple that with getting competent people rather than the typical lifelong public sector jobsworths they normally get to pretend to improve the situation (and who inevitable fail) of efficiency in the NHS and I'd wager not only can we deal with that £30bn gap, but we can still have change left over for another carrier group or nuclear submarine or whatever else we fancy.
Free care in the NHS isn't going anywhere at all in at least the next few decades, if ever.
Or if Labour are in at the time (not that I'm a fan of the Tories FWIW) we'll probably just stick it on the national credit card and grow the deficit to pay for it instead, because that's far easier than dealing with the actual problems like free handouts to those who neither need nor deserve them, and major problems of inefficiency largely due to lack of accountability.
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Right, and those that call it "fair and non-discriminatory" are the air-heads to fail to realise there isn't a finite pool of cash and would rather give money to those who don't need it and condemn those to death for whom we can't afford the treatments they require.
You are claiming to be an advocate of fairness but ultimately condemning suffering on the poor whilst giving handouts to those who simply don't require them, some of whom have even said they'd gladly forego them. Given that the discussion is abou
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PS:
I did the math a few years ago - it would actually be cheaper for the US government to mail a check to every single household for the maximum welfare amount/year than it currently costs to administer the program.
Re:My spider sense in tingling.... (Score:5, Insightful)
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always cracks me up when people whine about the ACA and "rationing" health care and "death panels" - look around, we already have them and have had them for decades - controlled by corporations out to maximize profit.
Re:My spider sense in tingling.... (Score:5, Insightful)
In case you didn't notice, corporations ARE already deciding what we eat.
And no, not even growing your own will avoid that, unless you somehow manage to find some kind of seeds that aren't patented yet.
Re:My spider sense in tingling.... (Score:5, Insightful)
At least in a private system, if an insurance company won't cover you, they don't charge you either.
No, they charge you for years and then either deny your claim or cancel your coverage over discrepancies in your medical records.
Re:My spider sense in tingling.... (Score:5, Informative)
Re: My spider sense in tingling.... (Score:5, Insightful)
To put it another way, the military is an entitlement programme.
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You also get citizens with PTSD and higher suicide rates. At least the latter won't be a drain on Social Security.
Re: My spider sense in tingling.... (Score:4, Insightful)
And what do you think if those "entitlement systems" as you call it get shut down? Enjoy your life? I sure don't hope you do if you really think that's a good idea.
What do you expect people to do if their services are stopped and they're without a job, without a home, without food, without money, without medical services without ... you name it and they don't have it? You think they'll just go "oh well, what a pity", sit down and die peacefully?
You're living in the country where owning firearms is legal, buddy. You might want to rethink taking people away everything so they end up with nothing to lose.
Re:My spider sense in tingling.... (Score:5, Insightful)
I salute you. You have quoted an article from a source less reputable than even the Daily Mail. Well trolled.
In any case the NHS 'crisis' is mostly manufactured. The NHS is constantly fighting for budget (as with all other parts of government), while the private sector wants a piece of the action. Everybody's got an agenda, but by and large, the British are very happy with the NHS.
So from 10% to 12% of GDP? (Score:5, Informative)
http://www.theguardian.com/news/datablog/2012/may/02/uk-healthcare-spending-gdp
http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS
http://shr.sagepub.com/content/2/7/60.long
No comparison to ACA (Score:5, Informative)
It's privatisation in the back door, under fund it, make it under perform, all of a sudden privatisation becomes an easy argument to make.
More signs of strain on NHS (Score:5, Informative)
NHS has clearly been under pressure for quite some time. Strange that it rarely comes up in discussion.
Complaints about doctors 'double in five years' [bbc.co.uk]
Crackdown on migrants rights to NHS and council homes [telegraph.co.uk]
Patients facing eight-hour waits in ambulances outside A&E departments [telegraph.co.uk]
Watchdog issues NHS with financial health warning [scotsman.com]
Why do the UK's cancer survival rates still lag behind the rest of Europe? [theguardian.com]
Thousands of NHS operations cancelled because of blunders as complaints about standard of treatment rise [telegraph.co.uk]
The frightening truth: NHS-managers are incentivized to ignore problems [telegraph.co.uk]
Hungry, thirsty, unwashed: NHS treatment of the elderly condemned [independent.co.uk]
Dying for a drink: Over 12,000 killed by dehydration in hospitals every year [mirror.co.uk]
Labour must bear the blame for the shameful decline of the NHS [telegraph.co.uk]
So what? (Score:5, Interesting)
At present, the NHS is still one of the more efficient healthcare systems out there - way more so than the US system, for example.
Healthcare is getting more expensive, and I would imagine that in the next few decades technologies such as synthetic organs will make it even more so. What if every elderly patient wanted a new synthetic heart, lungs, kidneys at a cost of £5,000,000 each? At some point it becomes a logical impossibility to pay for everything that can be done, for everyone. Even now it's not uncommon to find individual patients who've had £2,000,000 spent on their care (small kid with leukaemia) or who needs arthritis drugs at £30,000 pa.
The basic NHS model of prividing medical care is a good one. As a doctor I always ask 'what needs to be done' for my patient. Not 'what can they afford'? I'm frrequently appalled by the unnecessary extra scans etc I see booked in the private system here, or the insurance 'gotchas' (e.g. patient breaks ankle; sent to NHS hospital. Insurance pays for operation in a private hospital but not for the ambulance transfer to it).
The problem with the NHS system isn't that it doesn't work. It's that at present it's being attacked for ideological reasons and that presently we're being forced to do too much with too little. An injection of money would help - and as we spend less than many comparable nations on healthcare it's odd to suggest that this is unaffordable. However at some point we're going to have to accept that we can't do everything for everyone at all times.
Combining subjects (Score:3)
For the people on the bottom that physically work and produce nothing really changes. All that people really need is food and shelter and in the western world we can afford to eat a lot less. The people at the bottom already live paycheck to paycheck and they know how to do physical work and how to fix things themselves. The people that will be hurt are the infirm that our modern society supports which includes the elderly, chronically sick and cripples. Most of us will someday at some point join the infirm.
This is the scenario after a "worldwide bankruptcy" All the land with all the houses and apartments will still exist. All the farmland that produces all the food that overfeeds our country and the rest for the world will still exist. All the fertilizers, chemicals, and natural resources will still exist. At least two thirds of the people, working to produce and distribute the above, will continue doing what they already do. Many of the poorest people of today live in luxury compared to a hundred and two hundred years ago. What will change is the "rich" will be out on the street sort to speak with their bank accounts decimated. There will be a memorable backlash against lawyers, investment bankers, and politicians that support their rackets and games.
Medical patents will be vacated and health care will go back to being affordable. Doctors will be better protected legally and not need insurance like the do now but will be subject to more public records, reviews and audits. Medicine will go back to being affordable comparable to the 1960. There will be no million dollar procedures unless you have a million dollars. People will die at 85 instead of 90. Doctors pay checks will no longer be quite so big but they will no longer need to support the insurance industry and lawyers. They will become more respectable and esteemed members of society back when children wanted to grow up to be a doctor not because of the paycheck but rather to be a hero of society.
Higher education will become affordable again but no longer be government subsidized.
Political will (Score:5, Insightful)
comparisons (Score:5, Interesting)
I've lived in three countries, the UK with a full free health service, New Zealand with a partially free health service, and the US, and I've had contact with all of those health services for myself or my family.
The NHS in the UK is the best all round. You see your doctor, you feel that they care about you, they have the backing of a good hospital system to do anything they need to do. It can be slow to get treatment, but you can always go private if you can afford to do so, but when I had problems they were fast enough.
The system in NZ is the second best. The doctors care, and there is a smaller population so it feels more intimate. However, that smaller population means less in the way of economy of scale, so treatment might not be available or you have to travel further. Pharmac negotiates drugs on a national level so that is good for the tax payer, but maybe not for the individual that requires an esoteric cancer treatment. As with the UK you can always go private if the public system is too slow, and I've had an occasion where that was the case.
I don't really know where to begin with the US system. On the positive side its nice and shiny. Individual people do care and help you out, but it doesn't feel like the system as a whole gives a shit. There is a lot of paperwork (absent from the previous examples). There is an abundance of choice and options. When you are sick (or your kid is sick) you don't want choice or options. I was shocked that the health coverage from my company was only subsidised and I still had to pay on top, and I'm utterly confused by the insurance options and savings whatnots (you put money into an account for health stuff?). It is a complex and scary system, but at least if it turns out I have the wrong coverage I can flee home to sanity.
I hope they keep the NHS free. Adding fees will ruin feel of it. I know what they'll do if they charge fees is they'll create a health card for low income people who can't afford the cost. But it is a needless barrier to treatment, if they do that why not just raise tax?
Introducing Admin Costs Killed the NHS (Score:5, Insightful)
The UK's NHS has, for most of its life, been neither a single-payer nor an insurance based system ... instead its costs came out of general taxation with no treatment-accounting. By that I mean there was no financial record-keeping related to individual treatments or doctor consultations ..... Family doctors (GP) receive a flat annual sum for each patient they have registered, regardless of how many or how few times the patient visits them. Likewise Hospitals were funded based on the medical needs of the area, with no financial records kept of individual's treatment episodes.
this approach resulted in admin costs of about 5% of expenditure only
Tony Blair started the rot when his Labour government introduced the "internal market", forcing every medical episode to be recorded and costed.. The excuse being that hospitals would compete for patient-referals from family doctors ... as the NHS had gone through a phase when it relocated most district's hospital services onto single sites, most areas of the country have only a single hospital competing against itself. There was no medical advantage to this change BUT it introduced the financial recording system needed for future privatisation
The result was an explosion of admin and financial staff ..... and admin costs that reached 11% of expenditure..
the current government's reforms are predicted to push admin costs over 20% of expenditure.
The other aspect that the Tories hate is that it is paid for out of general taxation not through an insurance premium ... so the rich contribute more than the poor and the unemployed and the less affluent pensioners still receive health-care. with the original funding method, most people paid far less in their taxes for healthcare than in insurance systems such as the US.
In general there are no medical co-pays as in the US ... Drugs are free BUT, unless are exempt (over 60, under 16, etc) you pay $10 for the prescription ... there are small co-pays for a few services such as dentistry and glasses .... things like hearing aids, breathing equipment etc, are provided free .... the NHS used to be the worlds biggest manufacturer of hearing-aids, false-teeth, glasses and artificial limbs ...
Hope they know what they're in for (Score:3)
Wow, I knew the UK was becoming more like the US every year, but I had no idea how much. Maybe this is Margaret Thatcher reaching out from beyond the grave to dismantle the remaining state institutions?
Nobody seems to understand that healthcare (a) has to be treated like a public good (in the economic sense) to be fairly available to everyone, and (b) that requires rationing of care to keep costs reasonable. The ACA we have now does neither of these -- it was a compromise to keep the "free market" insurance companies in on the game while giving them millions more customers.
If I were king, I would just declare Medicare to be the default universal insurance plan for everyone. That's a good compromise, since it doesn't cover everything and the insurance companies could fight over that market. It does cover catastrophic things, which is the primary failing of our system now. No one thinks the insurance companies would ever deny their claims, but they should try getting very sick sometime and see how fast the friendly relationship changes. People's taxes would go up, but they would be getting a valuable benefit for it.
The other thing single-payer care could eliminate is the tying of insurance coverage to employment. I personally know a few people whose families have serious health problems and they're literally trapped at their current employer because of the insurance plan they offer.
I think the ACA will reduce cost by a little bit, but it has flaws:
- You're still dealing with for-profit insurance companies who are looking for every reason to not cover a claim -- I doubt customer service will improve.
- The uninsured population that qualifies for subsidies isn't necessarily going to know or care about their ability to get cheap or free health insurance. It's not nice to say that people are stupid, but they are...
- Same goes for the policies themselves. Even educated people are confused by the language in health insurance policies and it's only gotten more complex with high-deductible plans, MSAs, etc.
- People who have insurance through work are just going to grumble about their rates going up and get no immediate benefit. Almost everyone vilifying single-payer healthcare has steady, well paying jobs and has never had to worry about going bankrupt if they land in the hospital. Because they don't understand the target population (low income workers with crappy or no insurance from their low-level service job) they think there's no benefit.
- The current political climate in the US labels anything beneficial that the government provides as socialism and therefore evil.
I think we should ditch the whole thing and just go single-payer. Doctors would get paid fee-for-service and not have to deal with insurance companies, individuals would be able to use healthcare without worrying about the cost, and things would be better. There's no reason a country like ours with so much wealth can't provide universal healthcare. People complain about government inefficiency, but what's efficient about tons of for profit insurance companies nickel and diming their policyholders and healthcare providers in order to make a buck? I think government would be very efficient at this task (and the NHS is -- the UK has a higher life expectancy than we do and spends less.)
Obvious End-Game (Score:3)
Something that can't go on forever, won't.
You cannot possibly tax enough to pay for offering something for free to everyone where a significant percentage of people will abuse the privilege.
Some free heath care systems work because of cultural insularity, but that will not last forever either without sacrifices...
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"You cannot possibly tax enough to pay for offering something for free to everyone where a significant percentage of people will abuse the privilege."
It's not free, it's paid as tax.
If it can't work then neither can insurance (health, or any kind) because it's exactly the same - you just have to make sure you charge enough such that your average payment is higher than the average cost of treatment.
I don't really see how people can "abuse" the NHS, you're either ill or your not, and you're going to be ill or
The Tories have been angling for this for years (Score:4, Insightful)
Publicly they've claimed to want to maintain the NHS, but every single policy has been towards further privatisation, with the ultimate goal being that people "pay their own dues". They are the closest thing you'll find in Britain to the Republicans, but they know they wouldn't get elected if they publicly admitted to this, so they lied and a lot of people have been fooled.
That said. Norway's national health service (and I've just moved back here) is not free at the point of service. Everyone pays approximately $30 per GP consultation and something like $50-100 for a specialist appointment. Unless you're a child (in which case everything is free) or get a "free card" or if it is an emergency (in which case I've never heard anyone get charged).
A free card you get either for being unemployed, on benefits, or if you simply have alread spent more than about $300 on medical bills that year. So a few hundred dollars is the most anyone will spend on health care appointments in a year.
I find this to be a reasonable compromise and it does stop a lot of people from going to their GP "frivolously" and will thus save the health service a considerable amount of money. My only concern is that patients aren't necessarily the greatest judge of what is "frivolous". Men, in particularly, can take a long time going to the GP because they're sure "it's nothing". I'd hate for genuinely ill people to not turn up to the GP because they don't want to waste $30.
NHS has been plundered by government (Score:5, Insightful)
The right-wing party hate the NHS because it represents a large slice of the economic pie that their buddies in industry want to get their fork into. They don't care that it's one of the most efficient healthcare systems in the world with excellent outcomes.
The left-wing party just fucked things up by being corrupt and not having the balls to bring the contracts started by the right-wing party to an end.
The biggest crisis facing the NHS is the Public Private Partnership scheme - in which big private companies get the contract to build hospitals and other medical facilities AND a sweetheart contract to run them for 30 years, which typically runs the total cost of ownership up to around 300% of what it actually would have cost.
That was probably the killer blow - you now have hospital trusts struggling to make their buildings payments and keep their clinical services functioning at the same time, which enables the politicians to step in and say "Look, this hospital is struggling! The only thing that can save it is the Invisible Hand of the Market!" ... with no actual coherent explanation of how a private company which by definition will take their cut off the top, can provide a better service than a public institution that has had years of practice at running an operation on a shoestring budget, having had their income cut to the bone so many times that their bones are now rather thin.
The Invisible Hand of the Market of course just wants to reach up the patient's backside and pull the gold fillings out of their back teeth. They don't care about the risky, expensive, uncommon, and difficult procedures, they care about the assembly-line procedures and services that have predictable consumption rates and costs, like hip replacements, haemorrhoids, etc, which they can monetize nicely, ignoring the fact that that surplus on these procedures is what paid for the difficult stuff, like open heart surgery that saves the lives of babies with congenital defects.
The destruction of the NHS is just outright evil, because it will result in less healthcare (because doing less and charging more makes more money), at a greater cost (when the NHS struggles, the private company is brought in. When the private company struggles, it will be bailed out), for less of the people that need it (the lower social demographics require NHS services disproportionately more and are less likely to be able to stump up the co-pay), all to line the pockets of a few Conservative party donors. Doing bad unto others for your own benefit or amusement being the definition of evil.
Incorrect Title is Incorrect (Score:5, Interesting)
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>And this is the system Democrats want the United States to emulate?
No. Where did you get that idea?
The ACA simply makes it easier to get insurance and requires people to purchase it.
There is nothing free about it.
Re:Rose-tinted view indeed (Score:4, Insightful)
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Oh no, no, no. ACA was passed on a party line vote. It was what the Democrats would support that was the limiting factor. As it was they passed it by hook or by crook, with plenty of pork bribes to key holdouts.
House Passes Historic Health Bill [wsj.com]
The House gave final passage to the Senate's health legislation on a climactic 219-to-212 vote, as Democrats muscled the measure through on the strength of the party's big majority. In the final roll call, no House Republican voted for the bill, and 34 Democrats voted no, many of them representing Republican-leaning districts.
A short while later, the House, voting 220 to 211, approved a companion bill making changes to the Senate bill, a measure necessary to attract support in the House. Those changes now head to the Senate, where action is expected this week. All Republicans voted against the companion bill, as did 33 Democrats.
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Sorry, but you are confused. Progressive lobbyists helped the Democrats write that bill. Republicans had nothing to do with it.
Center For American Progress* President Shares Part In Obamacare: "I Helped Write The Bill" [realclearpolitics.com]
* Not at all a Republican think tank.
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Sorry, but you are confused. Progressive lobbyists helped the Democrats write that bill. Republicans had nothing to do with it. (Are you going to call the President of the Center For American Progress* (a fellow "progressive") a liar when she claims credit for her work?
Center For American Progress* President Shares Part In Obamacare: "I Helped Write The Bill" [realclearpolitics.com]
In any event there were substantial practical differences between the two plans. The policy from Heritage was never an unqualified mandate.
For the b
Re:Rose-tinted view indeed (Score:4, Informative)
Keep some perspective. It still costs half as much per person (normalized to GDP/capita). Our medical industry increases its costs faster than inflation too, but when the free market raises prices and another 50k people lose coverage, it isn't news, it's business as usual.
Re:Rose-tinted view indeed (Score:5, Insightful)
Re: (Score:2, Interesting)
By "strong Conservative/Tory assault", you mean the horrors of a competitive tender process to try and find the cheapest provider, so you can offer the most efficient service? Or do you mean they've cut funding? Why ever could that be? [google.com] I know, I know, conservatives just hate poor people, and the fact that the UK's debt is now 90% of it's GDP is irrelevant - they should just keep pouring money into the NHS and hope the problem just goes away.
Margaret Thatcher still applies - the problem with socialism is, ev
Re:Rose-tinted view indeed (Score:5, Insightful)
Why ever could that be?
What do you think that graph shows?
Here's what it seems to show. Between 1997 and 2008- the entire Labour term in office before the financial crash- debt dropped to 40% of GDP. This coincides with the highest increase in NHS spending in recent history. Now I'm not trying to argue a causal link- but it clearly wasn't NHS spending which caused our government debt. It spiked in 2008, which correlates with the huge government spending to nationalise and otherwise prop up financial service providers- not spending on a single other thing.
The chart goes on to show that since 2010, the debt to GDP ratio has continued to go up at a faster rate than at any time before the financial crisis. This coincides with the harshest cuts to NHS spending in recent history. So clearly cutting NHS funding hasn't made much of a difference to our government debt either.
Arguing that cutting spending on the NHS or welfare is going to make the blindest bit of difference either way is disingenuous. The only reason the Tories are cutting spending on the NHS is because they always want to cut spending on the NHS, in all circumstances. It's just their basic political modus operandi.
Re:Rose-tinted view indeed (Score:5, Interesting)
FWIW I work for the NHS. The Labour governement indeed poured billions into the health service during their term but it was almost totally squandered on failed IT projects, an army of midde-managers, non-jobs and grossly overpaid execs.Very little of it was invested in actual patient care.
I do believe the Tories are genuinely trying to fix it, my problem with them is that they're doing their usual carpet-bombing approach instead of carefully targetting the gross inefficiencies that are blighting the NHS.
Re:Rose-tinted view indeed (Score:5, Insightful)
The lowest bidder is propably not what you want.
This outsourcing nonesense has had none of the predicted benefits. Overall costs have not gone down and professionalism has not gone up. It's more of the same with a larger overhead since the outsourcing agency has a beureaucratic overhead as well as the public agency and their respective law departments. To keep the cost roughly the same the people who actually do the work get pathetic wages that in no way shape or form echo their value in the whole system.
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Privatisation probably works reasonably well for discrete procedures such as hip replacements or cataract surgery, but holistic healthcare is another issue.
It depends on what you mean by "privatization". From the articles the GP linked, the changes the Tories have been making don't create what you'd consider a "private health sytem" - that is, one where the end-user pays. Instead, they're restructuring the NHS model so that instead of the government running the program directly, they hire private medical contractors to perform the same task. This means they can hire multiple providers (generally in different regions), evaluate them against each other, encourag
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Re:Rose-tinted view indeed (Score:4, Interesting)
Actually, if you follow international news at all, there has been a strong Conservative/Tory assault on the NHS for several years now.
If you follow the news you realize that Labour might have some involvement since they ran the government for so long.
Labour must bear the blame for the shameful decline of the NHS [telegraph.co.uk]
Up to 1,200 needless deaths, patients abused, staff bullied to meet targets... yet a secret inquiry into failing hospital says no one's to blame [dailymail.co.uk]
- Up to 1,200 patients died unnecessarily because of appalling care
- Labour's obsession with targets and box ticking blamed for scandal
- Patients were 'routinely neglected' at hospital
- Report calls for FOURTH investigation into scandal
I'm sure there is plenty more to find.
Daily Fail (Score:5, Informative)
Up to 1,200 needless deaths, patients abused, staff bullied to meet targets... yet a secret inquiry into failing hospital says no one's to blame [dailymail.co.uk]
Yeah, I'm not saying that there's no some truth in there, but I'd want to get the story from a more trustworthy source than the blatantly partisan, fact-skewing, lying-by-omission, wouldn't-trust-them-as-far-as-I-could-throw-them Daily Mail.
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It's still way cheaper that *public* healthcare in the US alone (medicare and medicaid), let alone the full costs of US healthcare, which are astronomical in comparison, but funding has been massively cut the last few years in real terms.
The conservatives have strangled funding for the NHS deliberately for ideological reasons, while funding several expensive wars abroad, because they want to undermine it and then get rid of it piecemeal, as they did with dentistry in the 80s. This sort of story is the precu
Re:Rose-tinted view indeed (Score:4, Insightful)
I am sure that some are very good. I also know that others are not. Which one do you bet our government will put out? You know... The government that gave us the TSA...
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As a person who has lived in those countries, and in the US, the stories are greatly exaggerated by the republican side of the argument. In general, I would say I have been treated more promptly, and with less hassle in countries with socialised health care than in the US. The UK if anything has been best of all in this regard, as it involves absolutely no payment when you are treated, which takes a large chunk of stress out of the situation.
Re:Rose-tinted view indeed (Score:4, Informative)
The direct quote in the summary talks about doubts over
The title says
The person who transformed the first into the second has serious problems with either English or logic. "We may have to charge some patients" isn't the same as "We may have to charge all patients".
Your reference to "discontinuing free care" is ambiguous, but without qualifiers is easier to interpret along the lines of the title rather than of reality.
Re:Rose-tinted view indeed (Score:4, Insightful)
Long waits? When was the last time you went to visit your doctor in the US? I'm lucky if I can see him this week.
Same with the emergency room - unless you are bleeding all over the place chances are you'll be waiting for a couple hours.
My one scrape with socialized medicine was in Canada where they fixed a broken arm - put it in a cast. I don't remember waiting at all in the emergency room and to this day I haven't been billed.
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Long waits? When was the last time you went to visit your doctor in the US? I'm lucky if I can see him this week.
Same with the emergency room - unless you are bleeding all over the place chances are you'll be waiting for a couple hours.
My one scrape with socialized medicine was in Canada where they fixed a broken arm - put it in a cast. I don't remember waiting at all in the emergency room and to this day I haven't been billed.
Well let me reply since I'm from Canada, the last time I needed a doctor visit, it was a 3 week wait. My sister in Alberta has to wait for a doctor to come to her town. Once per month, from another city 6 hours away. When I goto see my neurologist, I get appointments for either 1 month or 3 months depending. If I have to cancel, it's a min. of 35 days for the next. I have to travel 1.4 hours to see her, there's no one closer. My sister drives 7 hours to go see her diabetic specialist. Once every 3 mo
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I can see my (NHS) doctor within 24 hours too, in usual circumstances. And on the off chance that's not possible, or I need to see a doctor today (even though it isn't emergency- let's say it's the day before I go on holiday or something) there's a walk-in GP surgery which takes people on a first-come-first serve basis and is usually available within a couple of hours without an appointment.
Last time I had a medical emergency, an ambulance picked me up within 10 minutes, whisked me through A&E without s
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One patient on one day, did you take time to read the whole article?
Not particularly great but not as terrible as the headline would like to suggest.
And just for a little context, UK NHS A&E now handles around 21.7 million cases a year.
Re:Rose-tinted view indeed (Score:4, Interesting)
Yes... Just fine. Those stories of long waits, or unavailable diagnostic care are just rumors, I am sure...
Yes, they are.
Believe me,I lived for 7 years in UK and now I'm in my 6th year in USA and it is incomparable. US system is just massively inferior - and I work for a big national lab and hold the most expensive insurance option.
So yes, I'd go back to NHS any moment.
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I had to resort to US health care only once so far. Compared to other medical services I had to use (though I should admit that so far at least I only needed medical services in parts of the "western world"), the US service is by some margin the worst, and generally just something I'd have considered possible in some third world country. Sure, the whole thing looks nice, building those houses sure must have been expensive, but when you look at the inside and see people who drop blood on the floor sitting ne
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Yes... Just fine. Those stories of long waits, or unavailable diagnostic care are just rumors, I am sure...
Yes, they are.
Well, actually they aren't. Looking at both Britain and Canada, both the media and government have reported problems with waiting times. It isn't a new problem, and it both can and does impact patient care. Perhaps you haven't experienced it as a problem, or maybe you have and are accustomed to it, or maybe even pride in the system won't allow you to admit it, but it exists.
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Actually, no, the stories are absolutely correct. They just fail to mention that this is the story when you have essentially unlimited amount of money to spend on healthcare. Then you get top notch care with no waits etc in US, and compared to that, regular NHS service might not look so good. But, of course, this is comparing apples to oranges - people can get private insurance with better service in UK, as well, and most Brits who can't afford it and stick to NHS are served much better than most Americans
Re:Rose-tinted view indeed (Score:5, Interesting)
I woke up with a hard pain in my right side. It got worse and worse, until it was clear it wasn't cramp, but something badly wrong.
I called an ambulance. I live in a rural area, so an hour away from the nearest hospital. Ambulance was there in 10 minutes. They assessed me, took me to hospital.
After blood tests, they put me on high dose antibiotics and painkillers, and onto the ward. They suspected a gallstone. A few hours later, I had an ultrasound; no sign of a gallstone, but the gallbladder was clearly inflamed and I had an infection. They decided to see if the antibiotics would tackle the infection, so I could have elective surgery more safely in a couple of weeks to remove the gallbladder.
I got worse over night, with a worsening fever. They booked me in for emergency surgery to investigate, and I was going under anaesthetic inside an hour. Turns out, my gallbladder had turned necrotic and had started to fall apart, and needed removing in a hurry - they had to switch from keyhole to open surgery, took it out on the spot.
I then spent a week in the hospital, recovering from the 6" abdominal hole from the surgery. When I was discharged, my total bill was... £0.
I was treated with huge professionalism and care, survived what could easily have been a fatal infection with rapid treatment, and I didn't spend a second worrying about what it would cost me. Ok, the food was airline quality, but I wasn't exactly hungry anyway.
The NHS is running out of money because there's more people, living longer, wanting the latest, best drugs that cost more, while funding levels are being cut in real terms by the Tory government. That's something that will have to be dealt with, but it's certainly not a reason to kill the NHS. It's one the best things about Britain, and if we have to up our contributions a few percent to pay for it, I for one am glad to do so.
Re:Rose-tinted view indeed (Score:4, Informative)
Yes, they are. By and large, all of those stories ARE just rumours.
Canadians aren't exactly clamouring to emulate the US system. The Canadian woman that appeared in Republican commercials trying to smear our system had a non-threatening disorder that she felt was more serious than it actually was. She wasn't being refused care because we didn't have the capacity, she was being put on a waiting list because she could afford to wait while other people that had more threatening problems were triaged up the chain first.
We have waiting lists, yes. There are times where the system fails, yes. These are problems that every system tries to work out. But people here get care, and they get it without going bankrupt. The best case scenario in the Canadian system is that you get timely care with minimal cost. The average case is probably that you got reasonably timely care with a bit of wait, but still at minimum cost. Putting aside the worst case scenarios of death or misdiagnosis which are endemic in any system that involves humans--including the American system--you may have to wait a long time for care, but you're STILL not on the hook for any costs.
Many of the best case scenarios in the USA seem to leave middle class people with great care but crippling bills. The rich get off scott free, the poor simply don't get any care at all (or emergency room care, which is too little, too late, for too much).
I can understand not necessarily wanting the Canadian system. There are actually plenty of examples of even better systems in the world. But the fact remains that Canadian outcomes and costs are, objectively, better at lower cost. Life expectancy is higher here, infant mortality is lower.
But the current American system? A failed experiment. Try something else.
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"Like Canada where the government is laying off doctors and nurses and people are starting to get private insurance because the government isn't covering everything?"
Cite your sources for this FUD.
Signed, a Canadian who has not seen any of this.
Re:Rose-tinted view indeed (Score:5, Informative)
Do you jerk off while spreading fud?
Iceland isn't bankrupt, they unlike everyone else, took the healthy choice of defaulting on their loans, restructured and recovered. They are actually fairing better than pretty much anyone else right now.
Why would France want to cover (illegal)immigrants (guess you left that out for your fud)? No-one else are doing so.
Greece is going bankrupt for wholly different things, it's not their public health care that are destroying them.
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I like how to just take all the bullshit and swallow like a cum hungry crack whore.
Non of those statements is actually true, but it fits you bias so you spew it out.
The NHS Confederation is not part of the NHS. They are a group that seems to get a boner thinking poor people with go without medical aid.
Can't afford it and US health tourism (Score:3)
With respect to the UK (not England, England is not the UK, just as the USA is not America): "Can't afford it" is an interesting question.
Is it rather a case of "what the government chooses to spend its money on"?
I am reminded of the quality of life in Costa Rica opposed to its neighbours: Costa Rica decided to abolish its army in 1949 and spends the money on education and health instead; it has a high level of literacy and has 'health tourists' who visit from the USA [wikipedia.org]. Perhaps the issue of cost is a
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France arguing over immigrants suggests that not restricting immigrants could lead to a failure. Guess what? The US system allows non-legal immigrants unrestricted access even for non-life-threatening treatment.
Back during the initial "debate" on Obamacare, Wisconsin Public Radio had the minister responsible for Finland's health care system on as a guest to explain how it would solve all of our problems. You could hear the host (an ardent liberal) gasp when the minister suggested that the Finnish system wou
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That's bull shit. What they want is a system like Canada and Mexico where it is a single player system. And free government health care ends up not covering many expensive treatments, so only the rich get care.
In the United States, federal law requires hospitals to provide everyone life saving care whether or not you can afford it.
So what Democrats are pushing for would lead to only the rich getting care. Our current system is fucked up and can use reform, but worst case scenario is a bankruptcy, but your l
Re:Rose-tinted view indeed (Score:5, Informative)
Ah, the chutzpa of the American winger. Call bullshit, then spout off a bunch of nonsense that's nothing but bullshit.
Bullshit. If that were the case, you'd be rattling off how this single payer country doesn't cover cancer treatments, and that one doesn't cover organ transplants. You don't because you can't.
Bullshit. They only have to get you healthy long enough to get out the door. And their bill collectors will hound you as long as they are legally allowed to and quite possibly past that as well.
Which Democrats are those? Certainly not the ones in the White House or in Congress, since they are the right wingers who first killed the possibility of single payer, then traded away the public option to the hospital lobby, and finally passed the Heritage Foundation plan/Romneycare.
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Uhmm... where do you live?
The only native people I know who don't pay taxes live on a native reserve.
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The usually tame UK press started to find out about the Liverpool Care Pathway. So the term Liverpool Care Pathway is no longer used.
http://www.theguardian.com/society/2013/jul/15/liverpool-care-pathway-independent-review [theguardian.com]
The UK will have to work with what it has: a cheap pharmaceutical list, citizens only care, hospice early and often.
Redefine old age health care back to the point of handing out free canes for knees/hips or dark glasses for cataracts?
Blood transfusions
Bullshit!!! (Score:5, Interesting)
UK has been getting a flood of immigrants who want nothing more than to live on the UK's generous welfare system.
Sensible arguments are can be made from the right - about NHS, immigration and other stuff, but you wrote flaming nonsense.
No economic migrant anywhere in the world is a leech on the host. They are the most hardworking - generally doing the low wage work the locals are not really keen to do. They pay taxes - may be not income tax - but every other tax when they consume products and services.
Who's the famous immigrant bogeyman in UK? The Polish Plumber. Who's he? A plumber. Someone who unclogs the stupid shit you guys excrete.
This is the same all over the world. Mexicans and Central Americans in US, Bangladeshi's in India (before partition - 60 years back - Bangladesh and India was the same country, calling Bangladeshi's illegal immigrants is stretching matters, still India has 1 billion plus population - so at least in the short term the argument 'we do not need extra heads' may make sense), Sub Saharan Africans in Italy who perish in large numbers when their boats capsize and so on.
The countries taking immigrants - willingly or otherwise - have a brighter future. You need headcount. The native population is not going to procreate in the numbers needed to keep your economy growing and humming. US is a prime example. Japan is on a long term decline for precisely the same reason - they are so insular they have a great derogatory word for non Japanese - GAICHIN. Ask yourself - do you want to live in a Japanese society full of inbred Japanese who all look the same? Parsi's in India - otherwise a very sensible community - is in decline for the same reason. They are so insular if a Parsi marries a non Parsi they are kicked out.
What you - and the type like you - also forget is the cultural and social contribution of the immigrants. Diversity and mixing of gene pool is a good idea. It makes your country stronger.
The new slogan should be "make love to someone of your opposite in gene pool, not war."
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From what I have heard, UK has been getting a flood of immigrants who want nothing more than to live on the UK's generous welfare system.
The non-productive immigrants are totally draining the system.
I challenge you to find a source for that, I dare you. No, wait, I double dare you! Ironically, immigrants subsides benefits for the rest of the rest of the UK. http://niesr.ac.uk/blog/migrants-benefits-and-public-services-what-does-new-research-evidence-tell-us [niesr.ac.uk]
Re:Could root cause be the UK's immigration system (Score:5, Insightful)
You hear wrongly.
http://euobserver.com/social/121778 [euobserver.com]
http://www.telegraph.co.uk/news/worldnews/europe/eu/10361971/Britain-admits-it-has-no-figures-on-EU-welfare-tourist-numbers.html [telegraph.co.uk]
Unproductive immigrants are largely a myth. People who can work themselves up enough to emigrate are not usually the sort of people to shy away from work. Statistically, an immigrant is more likely to be in work than a UK native, and is likely to make greater net payments to the state (paying taxes versus using government services) than a native.
Immigration is a knee-jerk right-wing bugbear. You can argue, if you like, that they're taking our jobs. But you can't also argue that they're all work-shy scroungers. Can't both be true.
Re:NHS hospital death rates 45% HIGHER than USA. (Score:5, Insightful)
That's pretty misleading. More people die in hospitals in the UK because they can go to the hospitals for free. In the US, they're more likely to die at home, because they can't afford to go to the hospital.
But dead is dead, and the UK's life expectancy is better than America's, while spending less per capita on health care. No amount of spin can change that.
Re:If wishes were horses we'd all ride (Score:5, Insightful)
Shorter version: they should pay more money for worse care. Other options, like hiking taxes on the rich or slashing military spending to create more revenue, would just be hippie nonsense.
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Shorter version: if you can't afford to pay, go die quietly in the street like the good little serf that you are. It's your fucking fault your last name isn't Walton, or that you
If Britain is like the U.S., and their advertized war budget is half [motherjones.com] of what it actually is, the U.K. could slash their own war spending [wikipedia.org], pay for the entire UHS budget and still be one of the more heavily armed countries on the planet.