Silent crisis of soaring excess deaths in Britain is only tip of the iceberg

Isn't it possible that demographics have changed enough that funding requirements have changed enough that the 1940s-2000 or so system is no longer viable?

I know the demographics in the US has vastly changed some cost models over that time, making some earlier social program hit major funding problems through no evil from govt actors.

This is the first time I have ever heard of Medicare being held up as efficient. Medicare is 13% of the US government budget. More federal money goes to Medicare than to the Department of Defense. In contrast, the care that people get from Medicare is substantially worse than what you get from private insurance in the US.

> that's not what anyone wants

The NHS has been turned into what is effectively a state religion in some quarters. It's untouchable. It can't be criticised. It's immune to meaningful improvement and reform at this point. Yet everyone I know who works for the NHS has a litany of stories about the inefficiency and waste. And it consumes an increasing proportion of the GDP. Eventually, something will have to give.

Its been on an unsustainable path since its inception. It's always been in crisis and needed increasing amounts of cash. Cash that we taxpayers have no choice but to pay up. The NHS isn't optional, it's mandatory.

If we have the option to opt out of paying for the NHS and go private, many will do so. I already have to pay twice over. I pay privately through my employer's plan, and then again for the NHS. I suspect if there is the possibility of opting out and going entirely private, many would do so. At this point it's the only way to ever get a GP appointment for many of us.

The problem with the debate here is that it's always framed in terms of UK vs US funding models, both of which are horribly broken in different ways, and never looks at other European countries or other systems around the world, some of which have systems which work better and provide better health outcomes for less money. If we were to privatise it along French lines, for example, it might be a massive improvement all around. But that debate has never happened.

I agree with almost everything you've written. The NHS is indeed treated like a sacred cow, and it is absolutely not world beating. I live in Switzerland, but am British, and I would infinitely prefer to get my medical care here and to pay for it. The French medical system has a better reputation than ours also.

Swiss medical insurance is actually quite strongly regulated and not like the US system at all. Extras are generally where insurance make money, like having a private room in a hospital instead of a ward.

Where I disagree is that a change of government will improve things, because I don't think 'more money' will magically solve all of the problems. As an example, GPs should be doing face to face appointments again as you say, and they should be on call for out of hours. Not for extra money, they're already highly paid. This is just part of the job - people aren't ill conveniently between 9-5 Mon-Fri. Before anyone says this is unfair, UK software engineer salaries look nothing like US ones most of the time, whereas doctors are 'raking it in'. Yes, being a doctor is a tough profession, undoubtedly, but getting into medical school is highly competitive and sought after. So you either want the status and money in exchange for unsocial hours and dealing with the sick and dying or you choose a different career.

I don't find it a convincing argument that 'this is all the fault of the tories' because I also had a problem with panic attacks when I lived in the UK under a labour government, and was also outright refused treatment because our local area had only adult facilities and I was 17.5 when it started. I've plenty of other stories, but this is mine.

Generally UK politics is polarised like the US and people who believe the conservatives' sole motive in life is to dance on the graves of the poor while watching a food bank burn are likely to be overrepresented online. Remember that austerity came on the heels of Gordon Brown trying to spend his way out of a recession, the same PM who as chancellor sold off the UK gold reserves at the bottom of gold value and tax raided a bunch of pensions. Labour are by no means perfect either, and unfortunately even governments have to budget.

Don't get me wrong, the tories have been the government for quite a while now. They've had time to improve things and they definitely haven't. I'm just saying the idea Labour will magically resolve NHS issues is a fallacy. I'd argue that the real issue is the short term/electoral driven policymaking with regards to the NHS - it is a sacred cow, and even the slightest mention of change could potentially be political suicide.

> We're not trying to stoke fear, we're trying to see what's really happening.

Thanks for your hard work. Politics have entirely abducted reason on this topic. We all so clearly fear that the same certain thing may be true, so we are left doing nothing that matters.