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Is it a good idea to make a cult out of a public service? Credit: Oli Scarff/AFP/Getty
I can’t remember exactly where I was when I first heard the depressing news. I had somehow, in spite of all the rules making it almost more trouble than it was worth, managed to have a drink with another human being. And we may have been celebrating the fact that the vaccine had arrived, faster than anyone had dared to hope, more effective than we’d expected, and was now being put into the arms of vulnerable people, not just hundreds of thousands of volunteers on clinical trials.
But I do remember very clearly that when I heard that Health Person solemnly say that, vaccine or no vaccine, we would still be wearing masks and social distancing and so on for the next 18 months, my response was not fit to print.
Now, I’m no idiot. I know that a vaccine in a vial is as much use as those gym weights gathering dust under the bed. Vaccines don’t work till people are vaccinated with them. Getting them into the people at serious risk from Covid-19 will take a few months. We’re going to be firefighting till Easter, stoically trudging through the grim, dark, post-Christmas months before normal life can be resurrected with the Spring.
Then it will take more months to vaccinate the rest of us, not everyone perhaps, but enough to provide herd immunity. So no, I am not expecting Covid-19 to vanish overnight, just because a vaccine exists. And I do expect that some of the vulnerable population who can’t be vaccinated will still end up in hospital with it. And that, despite improvements in medical treatments, some of them will die.
But I also expect that the risk of death and serious illness from this novel disease will, by next summer, genuinely become comparable to seasonal influenza.
And that’s why I am worried about the way our relationship with the NHS has been reconfigured during this pandemic.
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SubscribeMaybe if the hallowed NHS spent lass cash on administrators, diversity tsars, equality impact assessment officers, pen pushers and paper shufflers fat salaries and fat pensions they’d have a little bit more cash to spend on treating people with illnesses instead of treating people with well paid jobs for life.
…….just a thought…..
You are aware that matching the proportion of GDP spent on healthcare by other Western European countries would require increasing NHS spending by 20% overnight…….. are you?
How about giving us the percentage of tax take per country, rather than GDP?
Most European countries insist that if you can afford to you must pay for some private health insurance, and they seem to work better than here.
This can’t be true, there’s only the sainted NHS model and the nasty US model. Any deviation from the NHS model is truly evil.
A British friend who currently lives in Germany tried explaining their system to people in the UK, he said they seemed unable to handle the idea that the British system might not be best, regardless of outcomes.
Funny really most of the biggest advocate of the NHS would run a mile at the thought of British exceptionalism, yet for this fundemental service they’re convinced we’ve nailed it and pretty much every other country has got it wrong.
The only other country with the NHS model is – drum roll- Cuba.
I would say Canada is a close third…..although….shhhhhh…..don’t dare say that out loud or the pitchforks and cries of “but at least you won’t be bankrupted by a heart attack!” will be hurled your way. Canadians are very smug about the healthcare system and only seem to use the US as a comparison. While it might be true, basic and emergency healthcare won’t cost you the roof over your head, if you require any peripheral treatment (chiropractor, dentist, god forbid orthodontist or long term medication for a chronic condition) and you don’t have employer benefits, it will cost you a fortune. Also, if you need any diagnostic testing or referral to a specialist, you might, without exaggeration, die waiting. We lived in Austria for nearly a decade before moving “back” and knew we would be sorely disappointed in the healthcare system in comparison. The narrative here is also lockdown to keep the healthcare system from being overwhelmed, even though due to staff shortages (most of our “good” doctors and nurses leave to work stateside where they can actually earn enough to pay back their student loans) and never ending federal and provincial budget cuts, the system’s natural state of being is overrun……COVID is just the stick we’re beating the dead horse with.
You’re forgetting that Canada borders the US and Canadians can come to the US for care they would be waiting for in Canada.
They can, if they can afford to…..and some do.
Not all of it is patient paid or even private insurance paid. About 30% of healthcare spending in Canada is through private care. Canadian Medicare will pay for care in the US in some circumstances (patients having to wait too long in Canada, testing and/or care not available in Canada, or better in the US, etc) Also, it allows Canadians who can, as you say pay, or those who purchase private insurance to cover what Canadian Medicare does not cover, to jump the line.
As the UK doesn’t border the US, this option is less frequently available to NHS patients.
“[Crossing the US border] allows Canadians who can, as you say pay, or those who purchase private insurance to cover what Canadian Medicare does not cover, to jump the line. As the UK doesn’t border the US, this option is less frequently available to NHS patients.”
I doubt whether the gold-plated (a US friend of mine had a consultant paid $2million a year), private-profit-obsessed, lawyer-influenced (–> defensive medicine to cover legal backsides rather than help the patient), etc US healthcare system would have much to offer the NHS in terms of cost-effective capacity augmentation. And if people in the UK want to go privately because cost is no object, they already can – and if their condition deteriorates there, the private hospital picks up the phone and calls an ambulance to take them to an NHS hospital.
Don’t confuse private pay care with Canadian Medicare. NHS patients don’t live in a country that shares a border with the US. Most Canadians live in the southern part of Canada, close to the US border. So it’s not hard for them to get here for care.
And while some pay privately, they don’t all pay privately. Canadian Medicare will cover care in the US if it cannot be accessed in a timely way in Canada or if the care needed is not available in Canada.
Oh so true. The Canadian systems (they vary from Province to Province) are nothing like the NHS.
and Brazil? We call it SUS.
The principle of free at the point of use is great, but then there is the reality of outcomes and we are far from world class in the treatment of many illnesses.
With the NHS being put on a saintly pedestal, the full debate we need about whither the NHS is going to be postponed whilst a mediocre level of service continues.
The figures are not comparable nearly so simply. It depends what is included as hospital care, social care, local community care, etc, etc. On that adjusted basis we are big spenders compared with anybody
This is a sensible and informed comment – the NHS is so much more than acute healthcare and outpatients. There is merit in many of the comments on ‘bean counters’ as well and internal market inefficiencies. However there is a much larger debate about the wider purpose and function of the NHS which is much more difficult due to the vast and complex nature of the offer. In terms of outcomes, there is no perfect system in the world surely?
Except we’re fairly mid ranking GDP spending in health care for western European countries. Not as high as some, higher than others. Spending 20% more would put us near the top.
Not quite ,the Uk spends 9.5% on a poor service, in Europe they pay 11% for a far better service. The concept of a state monopoly provider needs to be examined. If you increased NHS spending to 11% would it be as good as Germany’s private insured provision ?
No because the NHS is a financial black hole and any extra will be wasted on more bean counters and managers – and that is before the car crash NHS Wales is in the equation.
Dogma.
But it’s not fully taxpayer funded in those cases.
Mixed funding : private and taxpayer. Won’t happen her ….sadly.
Are you sure that’s true? As there is no equivalent to the NHS in any European country I am not sure on what you base your calculation.
We have fed ever-increasing quantities of cash into the gaping maw of the NHS for ages, and it’s still unfit for purpose. It needs a thorough reform. It won’t get one, of course – that would upset people like whoever painted that vomit-inducing mural above.
…and they would still claim it was not enough. In fact, few other health services are funded in the same way as the NHS, and the political class should look seriously as why this is; and why it is that many of them seem to have better outcomes. To do so is not an attack on NHS staff or on the principle of free at the point of need. Still less is it heresy.
.
Maybe some of the £350 billion could have been spent on the NHS instead of paying for perfectly healthy, low-risk people to stay home and do nothing.
Here in Scotland we don’t even have an internal market. Our Trusts cooperate instead of competing. We don’t employ armies of bean counters as a result.
Ever wonder how we can afford other good things? That’s part of it.
What good things?
All those nice houses covered in beige pebbledash, which are the universal housing stock outside of historic districts.
Huge subsidies, a massive deficit and terrible health outcomes?
Still good to get rid of some bean counters, though I think in Scotland now public sector admin roles are the best paying.
You sir, are a legend. Comment of the Week.
Though you could have added “leaching off of England and giving back nothing substantial”.
Please leave the Union guys, please? I cant wait to see the brain-drain and the constant trickle of Scottish refugees across old Hadrian’s Wall.
Yep, you are definitely over compensating Aaron. Just relax and stop trying so hard, honestly, poor thing.
You can’t afford those other ‘good things’.. free prescriptions, free uni tuition etc – they are paid for with English money by people who have to pay about £9 per item on prescription and 9 grand a year for uni. You get £2000 per capita more than England…get real !
But would you seriously consider living in Scotland, for a free prescription and subjecting your offspring to the torture of a Scotch University?
Off course not. As Dr Johnson observed mote than two centuries ago, the ” finest sight a Scotchman can behold is the A1 to England”
It is still the same!
I believe it was the high road to England, pal.
And the reason the sun never sets on the Empire? Even God wouldn’t trust an Englishman in the dark.
Scotch is whisky, btw. We are Scots or Scottish.
Quite, but check what Johnson actually said.
Good comment ref Johnson (not the chippy English-hating bit). In fact, I think he said it was the “finest prospect”, which makes the original quoter even more inaccurate.
You are correct, but I thought I would bring it up to date for younger readers.
You second point, yes God was correct, not forgetting that many Scotch were great Imperialists.
The Oxford English Dictionary has you as Scotch, as in egg, and Scotch Corner on the A1/A68 Junction. What is the problem?
The problem, as ever, is Scotch/Scots/Scottish chippiness. Always has been always will be.
Fortunately, they “always rise to the bait”.
Mark I’m disappointed, you need to find a new game to play!
My apologies, puerile behaviour and guilty as charged.
My only defence, recurrent attacks of Lockdown Syndrome (LS).
Only joking, I have been known to play the game myself every now and then 😉
I don’t know how the Scots get this reputation for being chippy, they’ll deep fry anything up there, not just potatoes.
Yes its true, did you know we invented Southern fried chicken…
Comes from their knowledge that they always are, have always been, and always will be, the smaller and far less important nation in our little Union, you ken? I know smugness is ugly, but envy is even more so.
Hmmmm, smelling a major whiff of inferiority complex about your posts here Aaron, feeling a wee bit threatened by your Scottish neighbours there are you lol. Love it :0
Smaller yes, but I wouldn’t say less important. I’m of the opinion that all the countries that make up the Union are of equal value and have all contributed to its history and well being. Look at the Scottish Enlightenment, or the scientists, mathematicians and writers from all parts of the UK. True, I get fed-up with all this breaking-up of the Union talk and in the end it’s up to the individual countries, but I for one, will be sad to see what has been a generally successful union of countries, from which all have gained, broken-up.
Well, ackshually….smart boy indeed. Scots, Scottish, Scotch, You are parasites is what you are. I could easily forgive that, its just the damn whining.
Ahh there it is, the male English ego, for all to see. Make your mother proud son 🙂
He has form this guy. Abuse is his thing.
Oh Isla! Just as xenophobic as Aaron and sexism added for bad measure.
This is satire, right? Or simple trolling?
Please – go and do your homework. Scotland has terrible performance on health, healthcare, education, fiscal responsibility – and manages all that uselessness despite free cash from England.
Free cash almost always leads to failure. If you can’t earn it well, you won’t spend it well.
Pity that no longer enables you to afford Scotland’s once world class education system.
I suggest you read “Scotland’s drug problem is a national scandal” in The Spectator.
I’ve not worked in NHS England but trust me NHS Scotland still has a ton of excessive admin. Folk work hard to make it work but the sheer fact it’s the only employer in town for most medical careers causes it to tend towards bureaucracy.
I would have thought that part of the answer to you affording good things is that under the obsolete Barnet formulae you are still paid a large subsidy per capita out of public funds
Yyyyyyyyyyyyyyup!
Possibly, but please remember that many of these admin people were brought in under the privatisation and internal market measures which were supposed to make the NHS so much more efficient. There seems to be approximately zero evidence that they have done so.
Alas, the internal market was taken out to the back of the NHS and quietly strangled. Then thing went on as before except in very nice new hospitals
Privatisation is and always has been a grift.
The Grenville fire was an outcome of privatisation.
What is an ‘internal market’ when its at home? Nothing about the NHS is even vaguely like the private sector, and never will be.
instead of everybody being secluded until we can get the vaccine into the vulnerable people – why don’t we just seclude the vulnerable people until we can get vaccines into them.
How do you seclude the 70 year old heart patient with a younger partner who works in a supermarket? And a 30 year old son who lives with them because he’s employed in the gig economy?
They could do as I mentioned above or they could all seclude together. Leaving the 28 and 35 and 42 year olds not living with vulnerable people to get on with life. Lots of people with elderly parents living with them secluded along with them.
This kind of argument really amounts to a technicality when compared to the upheaval of the solution we used instead – the closing of the economy and the mass incarceration of huge sectors of the poulation.
A functioning costs and benefits process would have realised the cost of the chosen approach and re-allocated resources accordingly to Local authorities and their partnerships to provide community based support to those who wished to isolate.
Also, note the word ‘wish’; the elderly have been denied their agency with this whilst, at the same time, being isolated and put at greater risk of other neurological deterioration and neglect issues – giving lie to the claim that it’s ‘for their own good’.
Would “wish” is something we tend to forget about when considering the elderly. There are all kinds of elderly, some are in vigorous health and might hope for an extra decade or two. They would likely think a year of social distancing a worthwhile price. But if you’re really frail you probably think each day is a bonus, you may think this year will be be your last, do you really want to sacrifice your last good year for a few more months in a nursing home?
The 70 year old with a heart condition has been more or less secluded for the last nine months. You’re actually arguing for 90% seclusion, which is seclusion on the cheap, only offers partial protection, which likely just increases the chance of catching Covid-19 over the next year.
I suspect one of the reasons why no country has adopted a Barrington approach is that it would require actual planning and organisation. You would need to arrange food drops to those who are vulnerable. You’d need to isolate not just care home residents but also care home workers too. And so on. Our current approach is so much easier, just get Boris in front of a camera to tell us what the rules are, allow the police to enforce petty tyranny, “track and trace”, job done.
You don’t, you make sure Granny has taken her Vitamin D, Zinc, and vitamin C, and hey presto, no covid bug, and no problem..
I’m sure you’re being sardonic at the expense of the ‘natural health’ fantasists.
Or just move her to a room in the west wing.
I’d settle for a nice bit of hydroxychloroquine myself, but then I wouldn’t want to ignore the advice of the “experts”. Trump supported it, so it must be bad.
You can’t. You might as well ask, how can I stop myself from dying, like, ever? We you are 70 with a heart condition, you mut accept that you treasure every day. It’s not callous, it is speaking the truth in love.
This is the essence of The Great Barrington Declaration – despite the clinical expertise of its founders, considerable effort has been invested in trashing it – I wonder why?
Because it makes too much sense. Why should two 28 year olds be stopped from working? Even families with one vulnerable person can easily protect that person. My sister is married to a doctor who went to the hospital every day. She has some breathing issues so he stayed in another bedroom, they shared no meals or bathrooms. He used another door in and out of the house. Not pleasant but doable. But some folks would rather inconvenience everyone.
So they had two bedrooms and two bathrooms and two doors from the house to the outside.
Annette, you are American, this is often not the case in the UK. Flats above the ground floor (US: first floor) do not have two doors to the outside. The majority of British homes have one bathroom irrespective of the number of bedrooms. And the whole point of the Bedroom Tax, introduced by our cuddly Conservatives, was to penalise those people receiving Housing Benefit who had a spare bedroom – in other words, couples who had more than one bedroom, and couples with 1-2 children who had more than two bedrooms.
Isolating vulnerable people was considered by the Government. It was rejected because it’s not workable.
Of course it’s workable. Just because one 30 year old has to isolate with an elderly parent or grandparent doesn’t mean that all 30 year olds have to stay home from work. It makes no difference how many bathrooms a 30 year old couple have. Families with vulnerable members simply have to follow isolation procedures.
Chris C – you’re right about the bedroom tax, it’s a shameful policy. But isolating everyone is no more effective than isolating the vulnerable. “”Oh but it is, it would have been so much worse if we hadn’t!!!” Sure, maybe, no. We’ll never really know.
Leaving aside the fact that most people don’t have two bathrooms – this is a virus we are talking about. If it could find its way from China to all parts of the world in record time, you are really going to struggle containing it in a small house.
It’s not about bathrooms. Two healthy 28 year olds should not be locked up even if they only have one bathroom.
Who is suggesting containing a virus in a small house? Who even mentioned people with a virus in a small house? If you have the virus you HAVE to be isolated, no question about it.
My elderly parents live in an assisted living apartment with one bathroom. They are vulnerable and so, appropriately are isolated. It can be done.
Vulnerable people and those who live with them should surely be protected. But that isn’t everyone. The damage done to young, healthy people has been criminal.
We were discussing the possibility of isolating individuals within households.
Yes we were. And it’s possible to isolate vulnerable people without locking up non vulnerable younger people.
My better half caught covid, positive test, I had to laugh at track and trace telling him to use a separate bathroom, cutlery, cook his own food, load his own dishes into dishwasher, wash his own clothes etc as he could barely get out of bed. Myself and kids waited with baited breath till end of our isolation period, I was sure I must get it, there was no way I wasn’t exposed… Not one other person in the house caught it…. Go figure
“My better half caught covid, positive test, I…… I was sure I must get it, there was no way I wasn’t exposed… Not one other person in the house caught it…. Go figure”
What is your actual suggestion? Please could you make it explicit for the benefit of the rest of us? Are you suggesting that this disease is not infectious, and is not spread by proximity? Seriously?
And BTW, how can you exclude the possibilities that (a) you and your children were not already immune due to previous symptomless infection which your partner did not catch (maybe you are one of the minority who had low infectiousness towards him at the time) (b) you and your children did catch it from your partner when he was ill with it recently, but like many younger people showed negligible symptoms, unlike him ?
Calm down. I’m sorry that what actually happened to her trashes an opportunity to get all self righteous. Oh, hang on, it didn’t.
The fact that nobody listens to you in real life is NOT because they are not serious enough. It is that you lack the imagination to imagine someone with less righteous certainty than yourself.
Calm down, stop hating the world, stop hating yourself.
Simply an observation, take from it what you will, as you most certainly have 🙂
It would be an interesting observation – if you could exclude possibilities (a) and (b) which I’ve listed.
But you can’t.
You forgot c) we just didn’t catch it lol….
I’ve heard stories like this before. It does seem pretty random who gets it and who doesn’t.
Sunk cost fallacy. Having invested so much going down one path (both in expenditure and the cost to the economy) it is too painful for them to admit other options were available.
That’s a fancy phrase for ‘evil sociopath’.
Actually I really do wonder why. No one stands to benefit from this current course of action. The only explanation that makes any sense to me is sunk costs fallacy.
I hope you are right. Which is worse: outright stupidity or outright malice?
It could be both just at different times. At the beginning when no one knew anything about the virus including who was most vulnerable, it might have made sense to isolate huge numbers of people. So let’s say ignorance rather than stupidity at that point. But now? There’s no excuse. Now it’s sheer bullheaded malice.
knowing full well that many many on this thread are ideologically adverse to all things science here is the latest development in scientific research on the ability of SARS-CoV-2 to breach the brain-blood barrier.
Nature Neuroscience
Published: 16 December 2020
The S1 protein of SARS-CoV-2 crosses the blood”“brain barrier in mice.
Mechanistic studies indicated that I-S1 crosses the blood”“brain barrier by adsorptive transcytosis and that murine angiotensin-converting enzyme 2 is involved in brain and lung uptake, but not in kidney, liver or spleen uptake.
The zombie apocalypse can’t be far behind.
Bad luck NY, looks like you’ve had it!
Sad really, because that was far more coherent than usual.
Could you please expand on your last sentence, as I know nothing of this?
Eh?
Could we have that again in plain English, please?
ad hominem is the hall mark in intellectual bankruptcy…no need for you to fear the zombie apocalypse as your brain has already been eaten away by your consertvative ideology…Happy Christmas!
The private sector has administrators and diversity tsars as well.
And CEOs paid millions or tens of millions.
And shareholders taking large amounts out of the system.
And corporate lawyers, and merchants banks, to advise the Board.
And fatter salaries than a nurse or a healthcare assistant.
And private healthcare systems may, and often do, pay doctors more highly than the NHS.
Just a few inconvenient facts.
I was rather astounded , as I don’t know why I hadn’t thought about it , to learn that a lot of our Council Tax is also spent on fat salaries( one Council chief apparently get £550,000 a year) and of course on council pensions. i suppose same in NHS, but what proportion of Council Tax and what proportion of National insurance is spent on staff salaries and pensions? does anyone know?
Almost all of it, in both cases.
Yes, but you sometimes get your bins emptied and when your house is burgled or your car broken into, you can get a crime reference number conveniently over the phone – without further charge.
Or a policeman like Andrew Harper leaves behind his wife of 4 weeks and goes out in the dark to tackle an unknown threat from low-life youths, and ends up being dragged along the road by a strap tangled round his leg and loses his life.
Just one of those public sector people with bloated pay who are sitting on their backsides, while the brave and productive people on this thread are sitting at their computers and putting the world to rights with their reflex cynicism and their conspiracy theories?
Chris C – you shock me sometimes, in a good way 😉
The public sector does need a kick up the arse frankly, and too many people do think that whining about things on the internet will fix a problem. That said, your local council is like a shadow-state, or a swamp. You can’t just get rid of it or those wallowing below the surface.
So for your purposes, a policeman is ‘public sector good’, not ‘oppressor of black people bad’? So hard to keep track with you lefties.
Yes, a policeman is ‘public sector good’. And a Tory Government cut their numbers by 23,000. It’s so hard to reconcile the conflicting narratives of you right-wingers.
I was being a little cynical about the police. They attend your crime scene with great alacrity, provided you let them know that you believe the crime you have suffered was motivated by hate.
Slightly off topic, but same applies to the BBC and how your TV licence poll tax (assuming you still pay it) funds the inflated remuneration of hundreds of on and off-screen corporate apparatchiks.
It’s a market (you know, the thing you rightwingers revere). If the BBC doesn’t pay people enough to retain them, they will go elsewhere. But maybe destroying the BBC is the real objective?
The same is true of physicians. Healthcare is a market. Don’t pay doctors enough to retain them and guess what they do? Viola, physician shortage. But hey, you’re keeping costs down, right?
And in the private sector the Chief Executive would get twice as much.
No, he would not. How on earth do they actually derive these figures for
salaries – do they just pick the biggest number they can think of on the
spot… and then double it? I say to these piggies fattening at the trough, go forth, and show us your ‘talents’ in other spheres….
Check out the bios/CVs of some of these people, absolute parasites.
Broadly agree, except your third point. Shareholders own “the system” (company, in fact) and are therefore entitled to enjoy the profits produced from their capital. If this were not the case, they wouldn’t put up the cash and the system would disappear.
…along with the corporate and income taxes that pay for all public services.
When they don’t evade tax by routing the profits via the Cayman Islands.
Oh, but so many of them do, don’t they? And David Cameron’s family shopped around between the Cayman Islands and the Virgin Islands to pay negligible tax on their investments.
Where they just might find “the Guardian” Scott Trust based as well.
The cash is mostly invested in speculative hege funds and other financial instruments gambling on outcomes. The days of the genteel capitalist investing in real things are long gone.
Tulips, South Sea trading, Mississippi Company. The good old days
In many companies, the original shareholder investment has long ago been replaced many times over by the profits created by the workers and management over the decades. Yes, the shareholders have a legal right to the profits, but the reality is that the shares in those companies are just chips in a casino.
So shareholders can also lose it all. That’s your point, right?
Ever occur to you that one of the largest groups “taking large amounts out of the system” are thd pension funds who use said funds to pay the pensions of private and even many public sector retirees?
Actually they do not-only ~20% of the LSE is “owned” by pension funds (2.6%), insurance funds (4.1%), and privately (11%)=less than 20% of the LSE. The majority is overseas owners (55%), so the mythology that companies need pay dividends so pensioners will not starve is simply NOT true. Suprising I know as I was shocked to see how little is owned by private or pension funds.
Further inconvenient facts for you:
The private sector is Wealth Creating, the NHS is not.
Private Healthcare is not paid for from taxation (exception when NHS sub contracts to private sector) but by corporations or individuals often from post tax earnings.
“The private sector has administrators and diversity tsars as well.”
And in spite of this (perhaps even because of this) companies manage to thrive in highly competitive markets.
The managerial problem in the NHS is that managers do not have the capability to manage. They are outgunned by powerful professional interests.
I suspect you right – the managers are outgunned by powerful professional interests. Consultants seem to call the shots in hospitals. I never understood why there are cosy private wards attached to NHS hospitals until someone told me that it is so that consultants private work is nice and handy for them (as if NHS work isn’t sufficiently lucrative) – and is arrangement that dates back to when the NHS was founded and was their price for playing ball with the NHS.
” In 1948 Bevan boasted that he was able to accomplish his goal “by stuffing the doctors’ mouths with gold.” What he meant by his famous and oft quoted statement is that he allowed some British doctors or consultants as they were called, to continue seeing private paying patients if they accepted NHS patients.”
A more concerning aspect to this is that Consultants draw their private patients either from the waiting lists, or from those who have taken out private insurance in order to avoid the waiting list.
It is therefore in their interests to maintain the waiting lists. No waiting lists, no lucrative private work.
Mind…blown. That’s dark man, really dark.
NHS doctors are poorly paid actually, relative to physicians in other countries. Waiting lists exist because there are doctor shortages in the NHS and there is also not enough hospital or operating room capacity. Doctors don’t maintain waiting lists, the system maintains them. If you paid doctors better and hired more doctors, your shortage would disappear. But that would take significant additional expenditure.
I know, the world is such a simple place isn’t it.
Only if you believe it’s never about money, Dave.
“But that would take significant additional expenditure.”
So no chance of that under Boris and his tax-evading chums, then.
Or anyone else apparently. It’s hardly a new problem that the NHS has been starved for funds for decades, is it?
It was well-funded under Labour, which increased National Insurance contributions (effectively, a form of income tax) by 1% of income in order to spend the money on the NHS.
Under Labour, targets for speed of being seen in A+E, and speed of being treated after cancer was detected, were introduced and kept.
In 2019, both of those targets started to be missed, as the afterglow of Labour spending was faded out by years of Conservative underspending. Another effect of Tory rule was to reduce the value of the NHS stockpile of PPE by 40% between 2014 and 2019. When the pandemic came along, the cost of buying those items was 15x as high as their pre-pandemic level. That’s the Tory version of “efficiency”.
Even under labor, there were waiting lines, physician shortages and every year the flu strained capacity. The very fact that you had to have targets to get people seen adequately is proof that there were issues.
Cancer has been a particular problem in the NHS with detection as well as treatment. Late detection leads to worse outcomes as does waiting months for care. UK cancer survival stats are not good.
One of the reasons, I believe, for a shortage of physicians in the UK is the gatekeeping that accompanies access to medical schools. It is, after all, only undergrad level life sciences with a large vocational element. The gatekeeping behaviour is necessary to preserve the elitism of professional medicine and perpetuate this state-funded cartel, which is no better illustrated than in the case of general practitioners.
Maybe but not all UK doctors go to medical school in the UK. Quite a few are foreign trained.
That is true: why are they then induced to uproot from their own countries and practice in the UK? Surely this would seldom happen if UK GPs are relatively poorly paid.
Not everyone can get to the US.
A recent Cambridge University study showed the NHS managerial expenditure (1.6%) was lower than most other European health care systems.
Diversity is usually just window dressing to evade parastic and puritanical journalists. My employer has outsmarted them though; we made 20%(!) of our staff female and BAME… the cleaning and office staff have never looked so vibrant and feminine. There is no dedcated on-site HR department – thank merciful Christ.
Because we have to actually make money and don’t have a cash pump from HM Treasury, all the actual decision-makers, technicians, IT staff, R&D and Management remain firmly in the hands of the competent and meritorious. Race, sex and perversion do not factor into hiring in these areas – no prizes for guessing how these departments look.
> they’d have a little bit more cash to spend on treating people with illnesses instead of treating people with well paid jobs for life.
There are queues of ambulances in Northern Ireland under the NHS, there are queues in Los Angeles under the American system. Rapid exponential growth will overwhelm any system. Unless you can make hospitals, nurses and doctors which reproduce like viruses, you can’t keep up, so you have slow down the virus. Otherwise, those cancer patients and car crash victims won’t be getting treated either.
The “Protect the NHS” slogan in this country does use the public’s affection for the NHS to motivate people to behave sensibly, but why not?
Agreed BUT it should spend money on Operational managers. Medics can’t manage at this mass level. NHS is a mass production service enterprise and needs to be managed well.
Or we could keep our money and chose our healthcare………
The NHS costing £2000 per person (£8000 for the average family) per year buys a lot of healthcare. Or indeed, other things like better food, gym membership, more time with the kids, a bigger house….
Choice. Such a scary thought, if you are a liberal elite.
And when someone needs a £30,000 operation, once in their life?
How does that work? We need more details.
Choice does seem to be the sticking point. Yet something like 16% of Brits carry private health insurance. Which should not be necessary if the NHS is sufficient.
“if the hallowed NHS spent lass cash on administrators”
This is always the gut reaction, as if the only people needed in an organisation are the frontline staff. The real problem (or one of them) is that the NHS is not effectively managed, that some of those working within the NHS are highly resistant to being managed, and relative power is such that managers are not actually able to manage them.
The NHS is not an organisation that is over managed, it is one that is ineffectively managed. Arguably it is impossible to manage, and more fundamental structural change is needed.
Maybe the NHS could be properly funded rather than quietly dismantled by this government?
It actually needs to be dismantled, rebuilt and better funded. No other country is trying to operate a system from 1948, basically without update or change. And there are very good reasons that is the case. Medical care is nothing at all today like it was in 1948.
That’s not the problem. The structure of the NHS as a huge state bureaucracy means that reform is a pipe dream. Not even worth bothering with. Take off and nuke it from space. Take the pieces, put them on the market and let capitalism do its thing.
Would you like the US capitalist system?
This is the top rated comment. A generic moan about NHS bureaucracy. No insights, nothing new, nothing added to the conversation. Just “blah blah…down with this sort of thing”. I’m not having a go at Andrew, but as for the rest of you… Give me strength.
This sums up a worry I have had for a while now – almost since we all first started applauding the NHS like trained sea lions in the spring.
The NHS is the closest we have in this country to an ultimate moral authority – and in the name of an ultimate moral authority, you can justify the ultimate inhumanity. To regulate human contact and human activity in such a manner as has been done during this event is an inhumanity, and has been engaged in with virtue signalling glee by the masses in the belief they are ‘protecting our NHS.’
What should be happening (in normal times you would have expected it to happen by now), would be that people would instead start to question whether a free-at-the-point-of service health system is worth it if it allows your ruling classes to violate your liberties; encourage you to think of yourself and your fellow man as contaminated (in violation of normal social mammalian needs) and possibly even violate your bodily autonomy.
It seems that it only takes a bit of cheap manipulation (constantly referring to ‘our’ NHS, for instance; and the daily reporting of non-contextualised death statistics) to undo all that we have learned.
I think the answer lies in teaching people to separate what is admirable about the NHS (the nurses, doctors, orderlies etc. and their sense of service), from what is contemptible (the bureaucracy, the mismanagement). There were conceivably better ways of easing the burden on NHS staff – especially given the amount it has cost us to close the economy and the army of volunteers we had from the public at the beginning – surely, a convergence of those two things could have produced a practical solution.
We need to restore some critical thinking – so people realise there are better ways of helping the NHS rather than this pitiful sacrificing of basic liberties, then hopefully they will be a bit more critical of those who continually demand our dehumanisation to ‘protect our NHS’.
‘We need to restore some critical thinking…’
No chance of that. The West is now entirely incapable of critical thinking, as has been obvious for many years now.
Sadly, you’re right. We can always hope though.
There are exceptions though, surely. Yourself. for example.
The people never could think critically, but thought Nationally, Patriotically, which meant they voted for the good of the nation. Liberalism with its divide and conquer has taught the unthinking to vote selfishly and cliquishly as they killed patriotism, so not putting country first, but dispirit groupings first, is the modern voter priority.
We just need to be sensible.
We need to be rid of a socialistic centralised NHS. It’s perfectly possible to have a system that is not monolithic, offers choice, yet is free at the point of need. Look around Europe and there are plenty of examples, Germany for example.
However, this elevation of the NHS to godlike status thats happened in UK prevents any discussion about alternatives. I never expected Labour to welcome such a discussion, but now we get Boris referring to ‘our fantastic NHS’ and its clear the tories won’t go there either.
So the bottomless money sink will continue until it bankrupts us.
I don’t think we’ll get a cheaper health service with restructuring – but we could get a better one.
I do not care about the structure of the organisation that provides healthcare when I need it, only that it works well. We could experiment, same with schools – private vs public, same money in – compare the outcomes. It seems cold, but it’s better than just presuming one works. Of course to some degree this is what a genuine free market does for you anyway..
Agree Luke, except that the howling, screaming socialist mob within the NHS and Education would rather destroy the entire set up than allow us to experiment with any private provision of services.
Every few years we get a campaign whipped up by the Labour party and education unions to abolish private education in the UK. ‘It’s unfair’ they cry, ‘strip private schools of tax relief’ they scream. Why? Because private education produces hugely better results than state education and cannot be controlled by the unions.
“Every few years we get a campaign whipped up by the Labour party and education unions to abolish private education in the UK. ‘It’s unfair’ they cry, ‘strip private schools of tax relief’ they scream. Why?”
Cost of VAT exemption on Eton’s £43,000 fees = £8600 per year.
Average cost of state education: £5000 at primary level, £6200 at secondary level.
So the VAT exemption alone costs more than giving Old Etonians a free state education. Is there a good reason for subsidising the ultra-rich?
“private education produces hugely better results than state education”
Private education overwhelmingly takes the kids of higher-paid parents, and spends much more on them per capita (school fees are several times the £6200 spent on secondary school pupils in the state sector). Of course they will get better examination results. But it also produces people like David Cameron and Boris Johnson. Go figure.
The IEA have produced a very good analysis of the various ways, other than a pure taxation basis, in which other countries deliver universal health care https://iea.org.uk/publicat…
The “bottomless money sink” which consumes 9.5% of GDP, compared with 11% of (larger per capita) GDP spent on healthcare in Germany, and 19.5% of (even larger per capita) GDP spent on healthcare in the US.
If you want to see a country whose economy is strained by the runaway cost of its healthcare, it’s not the UK, it’s the US. The capitalist US healthcare system is a massive burden on individuals, the biggest cause of personal bankruptcy, AND a major economic strain on US employers who pay for employees’ health plans.
Well said – except we didn’t “all” applaud the NHS earlier this year… Quite a few of us didn’t.
I certainly didn’t!
It was all key workers we were applauding – that included the police, the firefighters, the bin men, the people teaching the children of the key workers, transport workers, cleaners etc etc. All those who risked their health to keep society going.
Mark, I guess some people would rather applaud CEOs who give themselves 50% pay rises while cutting staff pay, or bankers, or corporate lawyers charging £1000 an hour. It’s all about values.
The martyr generator – thank you for your service but I am not going to bang pots in the streets or support laws that give privilege to key workers above the average citizen.
For critical thinking read Commonsense and Logic
You call the nurses, doctors… admirable, and management contemptible, you are one of the Sheep baaaing out the correct conditioned response. NHS is first a Social Engineering organization, second a health provider, just as BBC is first a Social Engineering organization, and entertainment and information second.
The NHS was the tool the system plan used, which to alter UK for ever by making the British not want to work in the Health industry, shut the school places, reduced health care worker status and pay till the best will not do it, and the others have not enough slots in schools to train to do it; and thereby open the borders to hero foreigners by the millions. NHS is something like the third largest employer in the world! And it hires the world ahead of the British.
NHS is not what it seems, it is Orwellian in its actual purpose. I left London in the 1970s and moved to USA, I return regularly to visit family, London is a foreign land in my old parts. The place has been social engineered till it is something entirely different, and not for the better. NHS has been the main tool in this. NO ONE can explain why this change was done, and if it was pure demographic shortfall, then WHY the ones who were brought in and not others? Preti is going to bring up to 2 million Hong Kong successful people to leaven out the other millions.
So your right-wing hostility to the NHS is based on a mixture of paranoia, and hostility to ethnic minorities.
Currently what really is the burden on the NHS ? In March and April we had as low as 60% bed occupancy in our hospitals which is virtually unheard of. The winter months normally have every hospital on black alert. Not this year . And it would have been even better if 17-25% of Covid infections had not been hospital acquired due to managerial incompetence. In most primary care surgeries business is largely conducted over the phone rather than face to face even if it is offering substandard care.
So after working for the last 35 years in the NHS i can safely say that it is the ‘contemptible’ part of the NHS which feels it needs protection. Are we overwhelmed? If anything less than in previous winters as this year we seem to have suitably scared our ‘clients’ to such an extent that they have preferred to sit at home with cancers growing and heart disease progressing!
Currently what really is the burden on the NHS ? In March and April we had as low as 60% bed occupancy in our hospitals which is virtually unheard of. The winter months normally have every hospital on black alert. Not this year . And it would have been even better if 17-25% of Covid infections had not been hospital acquired due to managerial incompetence. In most primary care surgeries business is largely conducted over the phone rather than face to face even if it is offering substandard care.
So after working for the last 35 years in the NHS i can safely say that it is the ‘contemptible’ part of the NHS which feels it needs protection. Are we overwhelmed? If anything less than in previous winters as this year we seem to have suitably scared our ‘clients’ to such an extent that they have preferred to sit at home with cancers growing and heart disease progressing!
That’s a bit out of date, Shalal. Area of London I’m in has over 95% bed occupancy, is cancelling electives due to increased pressure on beds, ITU and staff due to Covid-19 and has got cancer activity and referrals up to pre-Covid levels.
‘Masks aren’t that big a deal.’ Yes they are. They are the ultimate sign of compliance with government diktat, and they also serve the purpose of keeping firmly in people’s minds, the fear they are supposed to be feeling at the very thought of the mighty, intelligent, all-powerful virus.
I agree – wearing a mask is no small thing; especially given the lack of evidence for its efficacy in addressing the one ill it’s being mandated for.
The masks are dehumanising; demoralising and – frankly – disgusting (a bacteria soaked rag covering your natural air passages – and this is something being advised by ‘doctors’?).
As objects that obstruct your access to the air you breath (surely the only thing that all living creatures can universally claim as a ‘birth-right), they are no small imposition and all mask mandates should be instantly rescinded.
In the context of the article, however, I think the author was merely trying to state that they are not opposed to making sacrifices – I just think those sacrifices would be fairer (and more useful) if they were just the same ones we make every flu season (don’t visit elderly relatives if your ill, cover your mouth when you cough, sanitise your hands etc).
Do you include the mandates on surgeons wearing masks while carrying out operations (to offer a degree of protection to themselves and patients)? Or the masks that might offer some protection to health care workers treating known infected patients?
There’s nothing more disgusting about masks than there is about underpants or swimming trunks.
I’m not in the habit of wearing my underpants over my mouth amd nose.
I know of a secret club where it is de rigeur. I have not been there myself, I hasten to add.
Those are some pretty apparent false equivalencies, if you don’t mind me saying.
If the surgeon had been walking around town all day doing his shopping and then turned up to do a heart operation using the same mask, would you think that was appropriate?
Surgeons wear masks for two reasons: so they don’t accidentally inhale or otherwise consume bodily fluids from the patient, and so that they don’t accidentally drip saliva on the patient. It has nothing to do with prevention of virus transmission.
Exactly, they don’t typically walk around wearing masks.
To an airborne virus the typical ‘mask’ is off less consequence than a chain link fence is to a mosquito – So many new studies are concluding the pointlessness of the ‘mask’ – Countries like Spain with stringent mask mandates have the same deaths as everybody else – For months our own government said masks are pointless – They are by far the most iconic symbol of authoritarianism and massage the ego of authoritarians imposing them to such an extent that hose wielding the power or influence will never want to lose the thrill of something so literally in the face of those they command.
Deaths are a useless metric to use when looking at an intervention which is designed to reduce transmission (along with washing your hands more frequently and not meeting anyone) because whether you die or not depends on a huge number of other confounders – age; co-morbidities; social circumstances; the nurse / patient ratio in the hospital you ended up in; the weather; what your immune sytem was like the day you breathed in your bolus of virions; the competency of the care you received; the availability of suitable treatments and the timing of those treatments etc. etc.
This is epidemiology 101.
You want to reduce your risk of ending up in hospital or transmitting to someone else who could end up in hospital ? Then don’t let the buggers up your nose or in your eyes in the first place.
I could list 8 systematic reviews and 20 + other studies showing that masks of various types do have the capacity to reduce transmission of droplets carrying viable virions but UnHinged doesn’t allow links.
Do masks prevent transmission totally ? No of course they don’t but they don’t need to. Every bit helps. Masks provide some protection, social distancing provides some protection, washing your hands provides some protection and a vaccine that mitigates disease and maybe reduces viral load provides some protection. Together as a group they provide more protection than any single method (or none at all).
Wearing aviator goggles would protect the eyes from being a place of transmission, and as we know “If IT Saves One Life’.
And I could list you 8 systemic reviews and 20+ other studies that show precisely the opposite.
Problem is, no-one is wearing masks. They are wearing ‘face-coverings’. And if you read the papers on mask effectiveness they headline “masks work” and bury “but face coverings may worsen the situation” deep in the middle where no-one looks. I know, I’ve looked.
This isn’t a conspiracy, merely sanity. Why be pilloried by the scientifically illiterate mob?
If you are wondering how that works imagine virus floating around on a loose cotton fibre.
Do you wear a condom when out shopping? They protect in the right situation, like the surgeons mask, but are not really helpful outside those situations.
Yes, fair enough re. the context of the author’s remark. I physically cringe when a I see the dirty bits of rag being dragged out of bags and pockets, time after time, and slapped onto faces. The ones who fiddle with the front of their masks then touch items in shops, items which I may need to buy, are the real argument against the mask mandate. One shelf stacker in my local supermarket did a massive sneeze into his mask, pulled it away from his face to make it comfortable then carried on stacking the shelf with his germy, damp hand. Lovely.
This is, sadly, how we have been reduced to regard our fellow man. With disgust. Actually, I find the shelf stackers and delivery boys far more admirable at this time than those who are paid to work from home and still faint with fright at the thought of some virus that kills a small percentage, but leaves most people “unsymptomatic” i.e. they don’t get sick from it.
BBC News at six o’clock today showed an interesting study being done with the help of volunteers from religious faiths to investigate the effect of singing on aerosol droplet generation (relevant to Christmas services, at least for Christians). They sing in a laboratory in darkness, with laser imaging of the emitted droplets.
Singing without mask: large cloud of droplets, moving fast.
SInging with a mask: virtually no droplets, and those few which are formed are much slower moving and thus less likely to hit the next person.
That’s incorrect. The study, by Laurence Lovat has released no results. The BBC story does say though that current research indicates that singing does not produce substantially more respiratory particles than speaking at a similar volume. That study was done by the Univ of Bristol.
Coming from NZ and now living in the UK I’ve been amazed at how the NHS is treated as some sort of sacred cow. In NZ it is just another govt. institution. Right from the start of ‘Covid’ I thought the adulation piled on the NHS, outside of the ICU staff was way over done. As a cop of 22 years I faced real risk everyday, we even went looking for it as we sought to combat gang crime. None of us thought we should shelter away when things got sticky. We just took extra precautions and manged the risk as best we could.
“Our NHS” is in essence a socialist project which the British Left are desperate to hang on to ““ like shipwreck survivors clinging to a lifeboat. Your socialist credentials can be measured by how much devotion you show to the NHS and its angelic staff.
The only criticism NHS devotees will accept is that of its administrative sector (those pesky overpaid managers!). Comparison with more successful healthcare systems in other countries is not encouraged. As any diehard socialist will tell you ““ Our NHS is the envy of the world.
I’ve now lived and worked in 8 different countries. All of them have dedicated hard-working caring doctors and nurses. My wife and I have received good treatment in all of them – but nowhere have they said they envied the UK for the NHS. When we were in Canada we did not have to pay privately for some high-tech treatments which are not available on the NHS.- they were covered by the Provincial Health Authority from the mandatory government health premiums from salary.
“I’ve now lived and worked in 8 different countries. All of them have dedicated hard-working caring doctors and nurses. My wife and I have received good treatment in all of them – but nowhere have they said they envied the UK for the NHS.”
And equally, the British don’t say they envy the healthcare in other countries.
“When we were in Canada we did not have to pay privately for some high-tech treatments which are not available on the NHS- they were covered by the Provincial Health Authority from the mandatory government health premiums from salary.”
In other words, they were provided by a Government body and paid for through taxation.
Actually some British do say they envy the healthcare systems of other countries. In fact, some say so on this site.
About 30% of Canadian healthcare is privately funded so it’s not all provided by the government or funded through taxes.
“Actually some British do say they envy the healthcare systems of other countries. In fact, some say so on this site.”
Few British people do. This site is run as clickbait for the kind of people who believe that Trump is a good thing, so of course there’s disproportionate criticism. I’ve met Americans who envy us the NHS, and I didn’t have to go onto a fringe website to do it.
And since you’ve popped up again to comment about our health system from 3000+ miles away, let me ask for the ***FIFTH*** time – how much does your own healthcare insurance cost you each month? You know, the one you were so keen to tell us about on another Unherd NHS thread, and to tell us that you had both your knees replaced the week you decided you wanted that done, and how much better that is than anything we British get under the NHS, but resolutely refuse to tell us the cost of – because of course it would give the game away about how much the bloated profit-making US private medicine charges its victims, sorry, patients. Come on, you can tell us if you are brave.
Just looking at the comments on here much less in liberal publications such as the Guardian, there seems to be more unhappiness with the NHS than you recognize.
I don’t give out personal financial information on internet sites and would hope you’d be smart enough not to as well. You’ve also badgered other posters in addition to me (asking five times does constitute badgering, it also makes you appear to be slightly unable to catch on) to provide personal financial information.
But you are correct, I didn’t wait 18 months for knee replacements. Once I decided, it was 8 days. That seems to bother you tremendously but I cannot think why it should. I’ve said repeatedly that healthcare is a quality of life issue, at least for me, and that I wouldn’t be happy with every expense being spared on it. I’ve also said that if others don’t mind waiting, that’s their business.
You seem to think you can persuade people who are clearly willing to pay a greater price for better access to care that they shouldn’t be willing to do so. But you’d have a tough time making that case even with many Brits who are willing to pay for better access, much less Americans.
Annette, you attempted to suggest that the ultra-capitalist US health system which fails so many of your fellow citizens (but from your various postings, you don’t care about them, you only care about yourself) is superior to our NHS because you got your knees replaced 8 days after you took the decision, and the NHS would not do that for us.
It’s therefore highly-relevant how much it costs you per month for that level of healthcare, because if you quoted the amount, it would show that it’s fantasy to imagine that that level of healthcare could be offered on the basis of need. And that’s why you refuse to disclose the amount, not some specious excuse about “personal financial information”.
You gloss the denial of a good (NHS type) level of healthcare to a significant proportion of US citizens as “healthcare is a quality of life issue, at least for me, and that I wouldn’t be happy with every expense being spared on it. I’ve also said that if others don’t mind waiting, that’s their business“. [emphasis added by myself] Annette, US citizens on low incomes (but above the Medicaid limit in their State – a limit which I understand is kept particularly low in most Republican-governed States) are not waiting in pain and disablement for THEIR knees to be replaced because they “don’t mind waiting“. They are waiting because they don’t have the money, and never will. You know that’s true, but you don’t want to admit it. In the UK they would wait too long, especially when the Conservatives are in power and have run down NHS spending, but they would eventually get the operation because the NHS operates on the basis of need.
Wow, my knees are a real problem for you aren’t they? You could just say that you’re happy I didn’t have to wait in pain. I’d be happy if someone in the UK didn’t have to wait months, sometimes as long as 18 months, for the same surgery because I know exactly how damaging to quality of life it is. If you need surgery, 18 months of agony is not reasonable, in my view. As I’ve said, some people may not mind waiting, yourself for example. You seem to have some unpublished information as to waiting times for surgery in the US. Care to share the stats? Then we could compare waiting times in the UK vs the US.
“This site is run as clickbait for the kind of people who believe that Trump is a good thing…”
I take exception to that comment. This site is run as a forum on which people interested in current affairs can have a civilized discussion. Some commentators, including myself, think that some of Trump’s policies were good, including his efforts to get drug pricing under control. Some of us also believe that the NHS is no longer fit for purpose and that discussing alternative models is worthwhile. How is any of that “clickbait”?
Of course it’s clickbait. Despite Unherd’s centrist claim, 80pc plus of the commenters here are right wing. They respond well to any articles involving immigrants, race, Islam, Brexit and Trump. The headlines are often changed during the day, usually to ‘bait’ them with trigger words such as liberal, BLM or elites. I’m surprised that you can’t see that and bemused that it’s something you’d take exception to.
I my country, South Africa, we’ve always had a system of private medicine for the rich and free health care for the poor. The poor got exactly the same service, ironically, actually better – at university hospitals, but they can’t book an appointment and have long waiting times in the waiting room. Always. Since I can remember. I was born in 1955. My mother was a nurse. All nurses were trained at government expense at government colleges and government hospitals. And they received the best of training, so they got head-hunted by the NHS, and other European countries. Since the 1990s hospital administration has deteriorated, I’m told, but still, I’m told, pretty world class medicine. I made a recent comment somewhere else that if I were American I would vote democrat because I think it is dreadful for hospitals and doctors to refuse to care for someone who can’t pay. An American immediately set me to rights and said there is provision for indigent care.
;… if I were American I would vote democrat because I think it is dreadful for hospitals and doctors to refuse to care for someone who can’t pay.’
The corporate Democrat establishment – Clintons, Biden’s, Pelosis – is implacably opposed to Medicare for All. Trump has actually been to the left of them on some issues of healthcare. particularly in terms of reducing the cost of drugs.
Now, since 1988, back in the country of my birth and youth, and missing the medical aid care we received in South Africa. Husband’s % of salary payment to the SA medical aid far less than whatever the NIC part went to the NHS, and treatment WAS better. Surgery I had with a world class specialist doctor in Johannesburg impossible in the UK. .
But I hear things are not so good now.
But (a) the quality of the “indigent care” isn’t clear and (b) to keep the cost of indigent care down, the income threshold for receiving it is kept low (particularly in Republican-controlled States) and you can be pretty poor and yet ineligible for it. So since you are pretty poor, you may die without proper healthcare. When I was working in the US, I was told by a storekeeper of a young man he knew personally who had an untreated tumour the size of a grapefruit on his hip. He eventually died of it. In the UK NHS, he would have been treated and probably survived. That’s US medicine for you.
Indigent care has no income threshold. It’s care for people with no money and no insurance. It provides payment to hospitals for such care. You’re confusing indigent care with Medicaid.
There is also uncompensated care which is sometimes confused with indigent care but differs in that there is no compensation at all for it.
Yes indigent care addresses care for those with no insurance and no money. There is also uncompensated care which is simply care provided by hospitals with no compensation from the patient or any insurer. Uncompensated care is a budget line item in any US hospital.
A mandatory govt health premium from salary…..you mean some kind of national insurance premium , paying for a national health service?
Some of the idiots stood out in the rain clapping thin air ,I didn,t I stood on one leg in the living room and kept dry I,M NOT STUPID
No, you’re just ungrateful.
And you are sanctimonious
Spot on, and well done and thank you for those people and their property that you protected.
As a cop and thus a public sector worker, you should be aware that many people on this site would regard you as a parasite with a bloated salary and a ridiculous pension. But if the police were privatised and replaced by private sector guards from an agency charging the taxpayer silly amounts per hour, you would instantly become part of the wealth-creating private sector! – such is the confusion created by dogma
You should be aware that some of those people may be rather more discriminating in their judgment of the value of different types of public sector worker. I should add that I use the word ‘discriminating’ in a positive context here: I know that this word can trigger a certain type of individual.
I left the police by taking early retirement because I was disenchanted with police practice. I don’t get a pension. Instead of a silly ad hominem you could have engaged with my comment. I’m not sure if you are serious about privatisation but it has not worked well with regard to prison reform and I’m not sure the profit motive is a great way to maintain the rule of law. Mind you the legal profession are living off the pigs back, having gained monopoly control of justice….
This speaks to the question of, when does this end? No one knows. On occasion, you get mumbling about “when it’s safe,” but no one can define that, and at this point, that looks more intentional than not. Masks have become a totem and officials continue to regard this virus as a threat to the entirety of society rather than one that is worst on specific populations.
Two thirds of Britons surveyed in November 2020 said they’d support a third national lockdown after Christmas if cases remained high.
How many would support a lockdown if it meant consequences for themselves? Because it seems people support a great many things so long as they are not impacted by those things. The people issuing the decrees and mandates haven’t missed a paycheck. They’re not worried about business loss, foreclosure, depression, and the other fallout.
It seems about half British work for government with paychecks com