Do you think you would have been able to afford to buy your house if you were paying £600-£900 pcm for health insurance ?
One third of our entire tax deductions goes to fund the bloated, inefficient ****ing mess. Given the choice of paying full up for health insurance (which I do anyway) and keeping the 30% of my tax bill, I'll take it thanks all the same Everytime I have the misfortune to visit one our NHS health facilities I'm aghast at the obvious fundamental process flaws and the obvious resource inefficencies. it's a mess and it needs shaking up from top to bottom.
Yeah, sat with an ill relative for 2 ****ing hours in the patient discharge lounge, while they waited for their medcation to arrive from the pharmacy, which was 15 yards away. Listening to a nurse describe the signing off process for a controlled drug with a piece of ****ing paper winging it's way up down and around a 13 floor building for 'sign off' in the age of the computer ffs. I could give you thousands, my daughters both work in the NHS btw.
Healthcare is a basic right. By all means I think our NHS needs improvments but privatising it is just plain wrong.
In my experience the NHS has become less efficient because it has become fragmented. So that now you have different 'businesses' working separately within the same overall organisation. Different parts of the same service are run and operated by different managers with different budgets and increasingly it's being farmed out to the private sector, at extra cost to the taxpayer. Like myself, my grandad worked for the NHS, but not as a health professional, he was a carpenter. If a job needed doing they would get him to do it. Sometime later that day, the job would be finished. Nowadays it is contracted out to tender, so the process takes longer, the administration is more convoluted and ultimately the price is more expensive. More and more of the NHS is going this way and eventually it will become a fragmented organisation that has been carved up by the private sector, to make profit. My solution would be to centralise the whole system again and run it for healthcare rather than as a cash cow for private business.
What's equally wrong is people not having the choice to opt out of it and make their own provision in full, with the tax burden removed.
I agree with some of your points there, but there's plenty of front line procedural and resource inefficiencies that a blind man could see. The issues within the NHS are not merely down to resource level, which is the mantra that's constantly spouted. It's vastly inefficient and needs some non NHS input from the real World, to help it both improve and cater for it's clients in a much more suitable manner. As at the minute they're processed like cattle.
The problem with bureaucrats is that once in place they immediately start inventing rules, regs, etc to make themselves indispensable. It becomes self perpetuating, more regs, more pen pushers, and so it goes on until the whole thing becomes a massive, bloated waste of money. This doesn't just apply to the NHS, it's also true of other regulatory bodies. I well remember the SFA (or whatever they call themselves this week) being formed in the 1980's. It started with around 20 people on one floor of the old Stock Exchange building, there are now over 2500 of them in their own building in Canary Wharf. Is the investment business any safer for the general public? Are there any less scam merchants about? IMO, No!
I agree that there are resource and procedural inefficiencies. But I would argue that they have been made worse, not better by private sector involvement. As I've mentioned, you now have a fragmented system which doesn't communicate properly with other parts of the service, different contractors delivering different parts of the service and a much slower and more admin heavy system which takes longer and costs more. I was involved in some of the tendering processes within my trust in the NHS. The reality is that the private sector only want to bid for the profitable parts that are easy to deliver and have good outcomes, because that's were the profit is. There's only one pot of money, so the result is that an underfunded NHS is left to deal with the difficult to deliver and 'unprofitable' parts that the private sector can't milk. This is one of the reasons why you had to wait 2 hours for medication discharge for your relative. Because staffing is stretched and resources have ever increasing pressures due to lack of funding.
The issue is not the private sector involvement, it's how it's been integrated into an archaic system. The basic operational processes are fundamentally flawed and do not maximise the resource level at their disposal. That's where the private sector could assist, a tender for providing some outsourced resource is not what I'm referring to, it's basic efficiencies. The problem is that they don't want to change and wouldn't want the procedural review process to even touch the clincial process. Look at the average days on the sick, nearly 16 ffs, compared to a national average of 4.4, and this is dragged down by management and doctors. Ambulance staff averaged 25 days last year and nurses 17. They've practically got a sick rosta at that. The reason I was sat waiting for 2 hrs was nothing to do with resource. There was 3 staff stood about yarning in the patient lounge and they stood and waited for the pharmacist to walk across the corridor, as it wasn't protocol for them to go over and collect it themselves.
Maybe 30% of your taxes go to the NHS... And that is a lot; However you're still paying less than half what you would pay in the US total with its Insurance based model. Imagine if you paid 30% fewer taxes... But then double that 30% and give it to an insurance company instead so that you're paying as much each month to insurance companies as you are to the taxman. Insurance driven medical care is a lot more expensive (double) what a national health care system costs.
Only the wealthiest X% (say 20) could probably afford to do that and not be financially disadvantaged. That would make the costs go up tremendously for the other 80%.
Maybe you as an individual, no; however "you" as a nation, I do infact know. I do know that per capita the UK citizen pays LESS than half what the US citizen pays in total medical care... ... And that doesn't take medications into account where costs are way more than double in the US. I also know that tax brackets being structured like they are 20% of people pay over half the taxes. So 80% of people are in that lower half that would end up having to double their medical expenditures. You may be in the top 20% earners... Unless you're in the top 10% you'll probably still pay more under an insurance model anyway. Maybe you're in the top 10%. If so. Good for you, but if you are you're in less critical need of saving money than the rest. You already have a leg up so I'm not too sympathetic. Also insurance is great until, say you have a heart attack. The costs for recovery for one of those can be in excess of £100k. Sure... Insurance may pay 70% but then you're stuck with paying £30k yourself. Again... Fine if you're rich. 30k probably isn't too bad. For the majority of people that's going to really sting. For some people a 30k Bill means homelessness.
That's not true. The processes that the private sector have introduced have made the system less efficient not more efficient. The archaic system that you mention was efficient because it was joined up and communicated properly. The fragmented system is more resource heavy and admin based rather than clinically led. Sickness is high in the NHS due to less workers being asked to do more and more and increasing stress and burnout. In my trust (mental health) I had psychiatric nurses carrying caseloads of 80 people when NICE guidelines state that 20-30 is a safe level. That has arisen due to cuts in the workforce because of CIPS (cost improvement procedures) or cuts in layman terms. It's no wonder people go off sick. And it's ironic that a health service can't even look after its own workforce.
It's based on pooling the risk - like Insurance. Where next, do you have your own lighting in the streets, employ your own police? NHS is what it is (and not perfect by any means) because we all contribute to a National Service that anyone, regardless of resources has the same access to. If you took out the people that would prefer to make their own provision, then it would collapse completely. It is your duty as a Citizen (sorry Subject) to contribute to all these things through your tax.
