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

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

#171

Post by mgerdts »

jajahusjsna wrote: post #8

Covid is one aspect of this. Another is the massive. underfunding of the NHS over the last decade. This has become much more evident post-covid thanks to the backlogs. - Getting a GP to see you in person is now quite difficult (they want to do everything via phone). - Seeing your GP (depending on your area) can involve a 2-3 week wait and waiting in an hours long phone queue. - When you are referred to hospital for t…

I live in a US city with a metropolitan population of about 600,000. The largest provider in town is a university hospital with a sprawling set of clinics that employs 1850 physicians and 21,000 staff. I have pay for insurance that provides the best coverage in my area.

Last September I asked for an appointment with my GP before the end of the year. The first appointment was on January 3. I took the appointment. In October they called to reschedule that appointment. I could take a video appointment another time in early January or an in person visit in June. I took the virtual appointment. Rather than charging a $200 facility fee, they charged a $70 for the telecommunications that were pretty much the same as a zoom call. My insurance would have covered the room charge as required by law. They refused to pay the telecom charge.

Last December my GP ordered a routine screening procedure at my request. I was hoping to have that complete before my January visit so we could discuss any interesting results. In July the clinic that performs that procedure called to schedule the procedure which is scheduled to happen this week.

For this procedure, the clinic is requiring a negative Covid test. They scheduled this test at the one place that they provide these proactive tests. This is a drive through test site that is a 25 minute drive each way from my home. They provided an estimate of the costs for this test. That is $399, which (before taxes) would be earned in 23 hours by someone making the median wage in my city. My insurance company doesn’t think the Covid test is medically necessary so will not cover it. I canceled that Covid test appointment and got a free test at a more convenient location from public health.

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

#172

Post by naasking »

kurthr wrote: post #49
neverrroot wrote: post #29

The Great Barrington Declaration, unfortunately cancelled by mass media and the people in power.

So, if they don't die in the first wave of COVID, they need to die of underfunding? I mean sterilizing immunity through infection is now known (through many thousands of documented re-infections and likely hundreds of millions) to be both irresponsible and a failure. However, if the goal was to reduce the long term cost of the British medical system through the death of it's oldest and most expensive, then perhaps th…

> I mean sterilizing immunity through infection is now known (through many thousands of documented re-infections and likely hundreds of millions) to be both irresponsible and a failure.

Infection is documented at being more effective at protecting you from reinfection and from having serious complications from a subsequent infection. Let's not pretend that the Great Barrington Declaration was necessarily wrong, given the suffering supply chain disruptions are now causing, not to mention the excess deaths from untreated conditions and increases in substance abuse. Only hindsight will give us a proper understanding of which choices were better.

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

#173

Post by neilwilson »

rleigh wrote: post #165
solar-ice wrote: post #40

Earlier quoted context omitted.

Indeed; the reason people exonerate it is that the Tories have been threatening the population with a dismantling and privatisation of the NHS for over a decade now, and that's not what anyone wants. People want the NHS to work, to be funded and managed appropriately. A primary reason it doesn't is the Tories crippling it.

> 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 b…

"I pay privately through my employer's plan, and then again for the NHS."

And yet it is the private system in the UK that is taking away scarce supply from the NHS making it more vulnerable.

There is a supply side limit on doctors and nurses, which means private healthcare works like the Fast Track queue at Alton Towers. All it does is allow people with money to jump the queue at the expense of everybody else.

And remember that since the inception of the NHS Primary Care, ie the GPs, have always been private businesses. Yet that is the bit that is completely on its knees at the moment.

This isn't a private vs public argument. It's far more fundamental than that. It how do we share out increasingly scarce resources in a country that is getting poorer.

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

#174

Post by rtpg »

eastbound wrote: post #34
rtpg wrote: post #4

Are there still major pandemic restrictions in Britain? Lots of quotes in this piece seem to imply there’s ongoing issues here but everything I see in Europe or the US from abroad seems to heavily imply that people are “back to normal” (at least in terms of movement). The idea here (treatment delays lead to excess deaths) seems ok, but is it really the restrictions? Isn’t it more that hospitals are still extremely fu…

> much simpler explanation: Covid infections increase risk of other health issues. Or even a simpler one: The discouragement from doing sports that was lockdowns and curfews, encouraged asthma, obesity, breathing interior paints too much, couch potating, mental breakdowns, social isolation, lack of parties, lack of pleasure in life, looping on negative thoughts, eating butter and sugars by buttloads, and not being ab…

I do not believe your explanation is simpler. At least not without more evidence.

The main reason is that all of the lockdown and curfew stuff was 2 years back now! Most people have just signed out of the covid discussion and are not doing any mitigation. The "psychotic episode" (your words) ended in like... mid-2021. Why is it all falling apart now?

We are mid-2022. Hospitals are still a mess worldwide, because _they are all still getting a sickness that knocks people on their feet for a couple of days to a week_. People whose bodies get hit by this end up being weaker and more susceptible to other issues. Seems pretty simple!

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

#175

Post by throwawayacc2 »

SamoyedFurFluff wrote: post #97
throwawayacc2 wrote: post #66

Earlier quoted context omitted.

>> decimate the health system and waste money on sending Refugees to Rwanda. It’s idiotic to prioritise that over the NHS. It all depends how you view the world. For many people, preserving the historical character and demographic of their country is an important issue. It might not be to you, you might consider it stupid, but it is a concern many people have. So much so, they would see illegal arrivals of non histor…

Wait, I’m seriously confused by this. If preserving the character of one’s country is an important issue, is the NHS not part of the character of the UK? My understanding is the NHS is one of the defining symbols of the UK, a showing of communal strength and compassion, the Western sensibility in the face of the devastation of war. It touches everyone who lives there, is born there, and often when they die there. It’…

>> Genuinely, why are refugees something to be prioritized over a cultural touchstone institution if the goal is preserving historical character?

I wish I could answer you unfortunately censorship measures currently in place prevent open discussion.

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

#176

Post by matthewmacleod »

rleigh wrote: post #165
solar-ice wrote: post #40

Earlier quoted context omitted.

Indeed; the reason people exonerate it is that the Tories have been threatening the population with a dismantling and privatisation of the NHS for over a decade now, and that's not what anyone wants. People want the NHS to work, to be funded and managed appropriately. A primary reason it doesn't is the Tories crippling it.

> 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 b…

I find this is a common and totally unjustified take. The NHS is fairly frequently subject to alteration and reform in various ways, and there is no real truth to the “piles of bureaucracy and waste” stories - it remains broadly pretty efficient as a healthcare system when compared with other developed countries.

You’ve also misrepresented the nature of private healthcare in the UK - this is almost universally not a replacement for NHS services. It will offer you things like faster GP appointments, consultants, and routine operations. It will not replace many of the specialist or emergency services offered by the NHS, leaving you dependent on it anyway.

A bigger “problem with the debate” is that we so frequently find people like yourself who are insistent on having some kind of “debate” without really knowing about what, or why.

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

#177

Post by neilwilson »

refurb wrote: post #63
verytrivial wrote: post #9

The word "funding" does not appear in this article. The NHS has been systematically underfunded since the Conservative entered power more than a decade ago. The crisis is real, but it is a political choice.

What does "underfunded" mean? The UK has a similar system to Canada. Costs are controlled by controlling the funding. You set a cap to what you'll spend and let the system figure out how best to allocate those funds. It's a big reason why the cost per capita for healthcare is quite low - you simply choose not to spend more. The demand for healthcare spending is almost infinite. You can set it up so everyone get an MR…

Generally it has nothing to do with money. What you actually need to decide as a nation is how many people will work in the healthcare service, rather than in the private sector producing stuff others consume.

Healthcare is an insurance service itself. It's designed to keep people going so they can continue to contribute to society.

The more productive the producing sector, the more of society you can have working in healthcare.

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

#178

Post by hotpotamus »

mgerdts wrote: post #171
jajahusjsna wrote: post #8

Covid is one aspect of this. Another is the massive. underfunding of the NHS over the last decade. This has become much more evident post-covid thanks to the backlogs. - Getting a GP to see you in person is now quite difficult (they want to do everything via phone). - Seeing your GP (depending on your area) can involve a 2-3 week wait and waiting in an hours long phone queue. - When you are referred to hospital for t…

I live in a US city with a metropolitan population of about 600,000. The largest provider in town is a university hospital with a sprawling set of clinics that employs 1850 physicians and 21,000 staff. I have pay for insurance that provides the best coverage in my area. Last September I asked for an appointment with my GP before the end of the year. The first appointment was on January 3. I took the appointment. In O…

This doesn't seem all that realistic - that's pretty surprising that they were willing to quote a price for the test ahead of time.

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

#179

Post by Mordisquitos »

origin_path wrote: post #146
Mordisquitos wrote: post #127

Earlier quoted context omitted.

In fact, I would argue that for all its possible faults (which all systems have) the fundamental problem with the NHS is not in how it is structured or in its processes. Rather, it boils down to funding. Nothing else. Just that. The one feature that the NHS has proven time and time again is that it is one of the most cost-efficient healthcare systems in the World, and given that it is working suboptimally that is a c…

NHS funding increases constantly over time, often by massive amounts. The NHS is currently not merely suboptimal. You could have argued that before Team Expert came along in 2020 but not now. It's totally collapsed. There are now people routinely dying whilst waiting to be seen in A&E let alone the massive backlog for cancer. By any metric the NHS in 2022 has completely ceased to function properly. There seem to be a…

Still, merely "more vs. less" privatisation is not the determinant factor. Case in point, I currently live in Spain where universal healthcare is fully public as is the NHS(*), and over time decentralised and became fully devolved to each of the 17 autonomous communities (almost federal states in all but technicalities).

In general, from a user's perspective, Spanish healthcare tends to work better than the NHS in many regards, albeit with less flexibility at the GP level and more of a hassle when moving between regions. Anecdotally, from the experience of Spanish friends having lived in countries with a more or less public-private model (Belgium, Germany, Ireland) have expressed that the systems there are generally worse, and miss the Spanish healthcare system.

However, different regional governmens have made a greater or lesser move towards covert privatisation via externalisation, and while the two that have done it the most (Catalonia and Madrid) are generally the worst performers, there is little correlation otherwise. The Basque Country, Navarre, Asturias and Aragon are all top performers, yet the first two have privatised significantly while the latter two have kept the system more fully public. On the other hand, Andalusia with very little privatisation is together with Madrid and Catalonia as one of the worse.

And yet, when compared by investment, the pattern becomes much more clear. Madrid, Catalonia and Andalusia have some of the lowest healthcare investment per capita. The Basque Country, Navarre, Asturias are some of the greatest investers—Aragon not so much, but still on the top end of the scale.

(*) As a digression, due to historical differences in how each system evolved, they are not quite the same. Spanish healthcare evolved from Social Security, and thus used to require being either employed, officially on unemployment, or being a dependant of someone in either circumstance (now it's more lenient). Also, all doctors involved are state employees. The NHS on the other hand evolved as a right of all legal residents of the UK, and GPs surgeries are almost always private businesses that are adscribed to the NHS.

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

#180

Post by rleigh »

neilwilson wrote: post #173
rleigh wrote: post #165

Earlier quoted context omitted.

> 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 b…

"I pay privately through my employer's plan, and then again for the NHS." And yet it is the private system in the UK that is taking away scarce supply from the NHS making it more vulnerable. There is a supply side limit on doctors and nurses, which means private healthcare works like the Fast Track queue at Alton Towers. All it does is allow people with money to jump the queue at the expense of everybody else. And re…

> how do we share out increasingly scarce resources

We make people pay for them. Like we do with every other resource on the planet.

Healthcare is something which should be accessible for all, and we can of course subsidise the less well off. But it still ultimately needs paying for.

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