What should we do with the NHS?

h_m_boro said:
Am I right in thinking in the USA you pay for Health Insurance - hundreds of dollars a month - but don't pay "direct" tax to the government (our income or NI contributions)?
But this country will be looking to move to a similar system......but we will pay both every month? 😬
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Yes. People who advocate for this system seem to think this will result in taxes and national insurance being lowered. I think we know what would happen in reality.
 
h_m_boro said:
Am I right in thinking in the USA you pay for Health Insurance - hundreds of dollars a month - but don't pay "direct" tax to the government (our income or NI contributions)?
But this country will be looking to move to a similar system......but we will pay both every month? 😬
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No, that's not correct. We paid around 28% stoppages at the time and the company provided health insurance. We were able to claim back deductibles, I can't remember exactly what they were but it worked out as a tidy sum.
 
h_m_boro said:
Am I right in thinking in the USA you pay for Health Insurance - hundreds of dollars a month - but don't pay "direct" tax to the government (our income or NI contributions)?
But this country will be looking to move to a similar system......but we will pay both every month? 😬
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92% of all Americans have health insurance.
50% of all Americans have health insurance entirely provided as part of their employment (or their partner's/father's/mother's employment).
Of the 42%, 80% have health insurance but copay or pay deductibles.
Presumably 33% of all Americans pay some, or all of their insurance premiums. Health insurance is $3000 to $8000 pa for most mid age families.

Mean US income is $97k, and median income is $67k.
 
Soutra said:
92% of all Americans have health insurance.
50% of all Americans have health insurance entirely provided as part of their employment (or their partner's/father's/mother's employment).
Of the 42%, 80% have health insurance but copay or pay deductibles.
Presumably 33% of all Americans pay some, or all of their insurance premiums. Health insurance is $3000 to $8000 pa for most mid age families.

Mean US income is $97k, and median income is $67k.
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For that 50% where it's tied to employment, what happens when they retire?
 
Philly-Red said:
Fund it properly. Privatising healthcare is a slippery slope and will only benefit the already wealthy at the detriment of ordinary working people. Just look at America.
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I doubt Britain will ever leave the "treatment free at point of delivery" model.

There are a lot of people working far too hard for too little in the NHS, and a few who aren't productive enough.

Apparently no shows are a big problem right across the NHS from GPs, to hospital appointments, to consultant appointments, to minor procedures, to major procedures. Is it ok to charge someone (say) £25 for an appointment, that you get back when you attend?
 
Soutra said:
I doubt Britain will ever leave the "treatment free at point of delivery" model.

There are a lot of people working far too hard for too little in the NHS, and a few who aren't productive enough.

Apparently no shows are a big problem right across the NHS from GPs, to hospital appointments, to consultant appointments, to minor procedures, to major procedures. Is it ok to charge someone (say) £25 for an appointment, that you get back when you attend?
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No.

What happens if they don't have the £25 up front?
 
sherlock1969 said:
For that 50% where it's tied to employment, what happens when they retire?
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It depends. Some employers carry on insuring ex employees, some do so but with copayments, some stop altogether, but generally only if the ex employee enrols in Medicare. Medicare is pretty good, it covers at least part of the cost of treatment for retirees, and all of the cost for many serious conditions.
 
Soutra said:
I doubt Britain will ever leave the "treatment free at point of delivery" model.

There are a lot of people working far too hard for too little in the NHS, and a few who aren't productive enough.

Apparently no shows are a big problem right across the NHS from GPs, to hospital appointments, to consultant appointments, to minor procedures, to major procedures. Is it ok to charge someone (say) £25 for an appointment, that you get back when you attend?
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Wouldn't work, it would cost more to administer than it would make back in missed appointment fees.

Loads of people won't have the 25 quid, loads of people won't have a way to pay the 25 quid if they do have it. The NHS will not want to be handling a load of cash.

It's a total non-starter.
 
Soutra said:
I doubt Britain will ever leave the "treatment free at point of delivery" model.

There are a lot of people working far too hard for too little in the NHS, and a few who aren't productive enough.

Apparently no shows are a big problem right across the NHS from GPs, to hospital appointments, to consultant appointments, to minor procedures, to major procedures. Is it ok to charge someone (say) £25 for an appointment, that you get back when you attend?
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It's another simple answer to a complicated question.

On of the worst traits in modern Britain.
 
Absolutely not for me. The principle behind the NHS is sound, the strategy to deliver that principal (or to actively erode it) by the current Government is not.

Social care is a big part of this as well, that's knackered currently which is exerting even more pressure on the NHS. Fix that, and you'll go some way to relieving that pressure.

The Government should be doing much more to ensure chronic illness levels reduce in my opinion as well. Obesity, smoking etc - yes improve the supply side but demand should be considered too.
 
Wiseman_Vaughn said:
I'm coming around to thinking that if you can pay for treatment - you should - giving relief to people that need it and can't afford it - elderly, unemployed and low pay should all be exempt.
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we do pay for it through tax lol, pay for it again? say what lol

I wouldnt be against having bit extra tax for it if it sorts it out once and for all and is managed right.
Wiseman_Vaughn said:
As I said earlier. people who are unemployed, on minimum wage or elderly should not pay.
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everyone should be entitled its a public service, if they are not taxing enough to cover it then they need to adjust that and make it work.
in reality its probably more than just tax and bet they some contracts and drugs companys taking advantage of things

also medical insurance is a rip anyways, near enough everything I've had a policy put in front of me it's always been on the provision that you use the NHS first, which makes me think well what is the f'ing point if you dont get private care in the first instance lol, be like having home insurance and you get burgled and they contents insurer says well lets just wait a year or so and see if the police recover your property first before we help lol
 
Soutra said:
Apparently no shows are a big problem right across the NHS from GPs, to hospital appointments, to consultant appointments, to minor procedures, to major procedures. Is it ok to charge someone (say) £25 for an appointment, that you get back when you attend?
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It's actually a whole lot easier these days to just track the appointment via an app.

Make it clear the appointment will be cancelled if a response isn't recieved and then ping a request at 7 days prior, 3 days prior, 1 day prior and on the day itself.

Things come up. People get side-tracked or plain forget (been there myself).

There would be people that need to opt out for a variety of reasons but the vast majority could be serviced with a fairly simple app (I'm assuming some of this is done already).

The only change would be a notification of cancellation if you didn't respond to two consecutive reminders (for example).
 
Soutra said:
Apparently no shows are a big problem right across the NHS from GPs, to hospital appointments, to consultant appointments, to minor procedures, to major procedures. Is it ok to charge someone (say) £25 for an appointment, that you get back when you attend?
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This isn't really a big problem at all. Minor problem if that. Most departments will overbook as they expect some DNAs. If a clinic should has 12 slots, they'll book 13. It's not like there are a load of staff finishing early because their patients didn't turn up. It's even less of an issue in a GP. GPs are full all day and if there are any cancellations someone waiting will be given the slot.

The time it is a big problem is if they don't show for a surgery because you can't just overbook surgeries and there might not be anyone to fill the slot but the DNA rate on surgeries is really low. They do pre-op the day before so they know if there is a reason why someone can't take the slot in time to fill it so there are not many same-day cancellations. A bigger problem is not being able to get staff if someone has to be off sick etc which causes a full list/clinic to be cancelled.

The hospital is almost always at full capacity. The issue is that capacity being reduced because posts/shifts can't be filled or there are too many people turning up at the door when capacity is already full.
 
muniz said:
we do pay for it through tax lol, pay for it again? say what lol

I wouldnt be against having bit extra tax for it if it sorts it out once and for all and is managed right.

everyone should be entitled its a public service, if they are not taxing enough to cover it then they need to adjust that and make it work.
in reality its probably more than just tax and bet they some contracts and drugs companys taking advantage of things

also medical insurance is a rip anyways, near enough everything I've had a policy put in front of me it's always been on the provision that you use the NHS first, which makes me think well what is the f'ing point if you dont get private care in the first instance lol, be like having home insurance and you get burgled and they contents insurer says well lets just wait a year or so and see if the police recover your property first before we help lol
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I’ve had BUPA for years through my job, it’s a bit like vet insurance for the dog, any preconditions or recurrences are excluded, what a joke.
 
Nano said:
This isn't really a big problem at all. Minor problem if that. Most departments will overbook as they expect some DNAs. If a clinic should has 12 slots, they'll book 13. It's not like there are a load of staff finishing early because their patients didn't turn up. It's even less of an issue in a GP. GPs are full all day and if there are any cancellations someone waiting will be given the slot.

The time it is a big problem is if they don't show for a surgery because you can't just overbook surgeries and there might not be anyone to fill the slot but the DNA rate on surgeries is really low. They do pre-op the day before so they know if there is a reason why someone can't take the slot in time to fill it so there are not many same-day cancellations. A bigger problem is not being able to get staff if someone has to be off sick etc which causes a full list/clinic to be cancelled.

The hospital is almost always at full capacity. The issue is that capacity being reduced because posts/shifts can't be filled or there are too many people turning up at the door when capacity is already full.
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10 million missed appointments in Apr 21 - Mar 22.
The value of that is estimated at £300 million in clinical time wasted alone. The value of time spent arranging those appointments, and sending letters and rearranging those appointments is not included.
 
Fund it stop paying private companies and invest that money in NHS services by the NHS
Then cut down on the number of administrators leaching out they system and pay the front line staff what they deserve and make the profession a viable career option again
 
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