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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

#221

Post by rleigh »

Teever wrote: post #206
rleigh wrote: post #182

Earlier quoted context omitted.

> You’ve also misrepresented the nature of private healthcare in the UK I mentioned that we don't have the right to opt out of paying for the NHS. It's not possible go entirely private. If you could opt out, you could pay that money to a private provider instead and entirely forego the use of the NHS. That isn't an option today. But it should be.

Why do you think this should be an option?

Why should it be an option? Because we live in a free country, and should be free to spend our money as we see fit. Even if others don't agree with it. Why should we all be compelled by the force of law to divert a huge fraction of our income to an organisation which is so ineffective and inaccessible?

We are forced to spend a significant fraction of our salaries on the NHS whether or not we want to. If we feel that this is not good value for money, or of poor quality, we don't have any real option of choosing to pay an alternative provider. Like all nationalised industries, it's inefficiently run because top-down administration of huge organisations blunts initiative and freedom of action. It's run by Whitehall and politicians, with little input from those actually doing the real work. And the result is that it's in perpetual crisis, with COVID having pushed it right over the edge. Is it really fit for purpose? I don't personally think so, and haven't for many years.

Competition is good for many reasons. It improves the quality and value of goods and services. The NHS has no real competition. There's no direct cost of failure, no direct cost to poor purchasing decisions, no direct cost for poor quality of service, and no real driving reason for improvement in the quality and efficiency of its services. They get the money anyway.

Other healthcare systems in Europe have fully private provision--you have the choice of where to take your money, even if you paid into a public system. If a particular hospital or clinic is providing poor or expensive service, you can take your money elsewhere which is better quality and better value for money. That's a very real incentive to drive improvement and efficiency. That is not the case for the NHS system. There is no choice, and the incentives to improve are minimal.

If there is to ever be any improvement in the NHS, there needs to be competition. The NHS should be somewhere you choose to have treatment because it's the best option, not because it's the only option.

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

#222

Post by paganel »

Inu wrote: post #85

According to Eurostat Portugal "recorded an excess mortality rate of 23.9 %" in June 2022. "Other countries with rates over 15 % were Spain (16.7 %) and Estonia (16.2 %)." Overall: "Following a peak of 26.5 % in November 2021, in June 2022 excess mortality in the EU decreased slightly compared to the previous month, to 6.2 %." Bulgaria, Czechia, Italy, Hungary, and Slovakia recorded little or no excess deaths. https:…

Romania (from where I’m from) recorded the least number of monthly deaths in June 2022 since at least 4 or 5 years (I’m on my phone, I have the Excel file with the stats themselves on my computer at home), and, comparing June 2022 to the average of June months for the 5 years before the pandemic, we had 15% less deaths (so you could say we had 15% “less” excess deaths, if that’s even a term).

The explanation is simple, most of our excess deaths happened during the pandemic itself, October 2021 had close to 100% more excess deaths compared to previous pre-pandemic October months, and while that was the worst month for us in terms of extra deaths there were still others with 30-40-50% excess deaths.

In other words it looks like, to put it bluntly, many of the people who would have died in June 2022 out of non-Covid causes had the pandemic not existed actually died in 2020 or 2021 because of said pandemic. In countries like Spain or Portugal not that many people died during the pandemic, hence those countries are now getting “out of it” with a weakened populace, a populace who dies “more” because of that “weakness” generated by the societal effects of the pandemic (less access to face-to-face doctor consultations, for example).

A true science-based society will try to look at all these numbers in 5 years’ time with a neutral mind, so that when the next pandemic comes we will be better prepared to make decisions about lockdowns (“is it really worth it to close everything down if people will die nevertheless when the pandemic ends?”), but I have a feeling that won’t happen.

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

#223

Post by aceazzameen »

Aerroon wrote: post #212
Folcon wrote: post #122

Earlier quoted context omitted.

I don't wish to be snarky, but you are aware that the NHS as an institution has existed since the late 1940's and has been working reasonably well for a long time? An institution does not become beloved by the public for failing to provide a good standard of care for a long enough time that people become used to it doing so. So when you say: > It never had a great track record to begin with. Are you talking about gov…

> An institution does not become beloved by the public for failing to provide a good standard of care for a long enough time that people become used to it doing so. Here's how you do it: you pump unsustainable amounts of money into the service over time. This allows you to offer a great service until in the future you can't pump enough money into it anymore. But that's a problem for the future generations. Those futu…

What's a better system then? Because it certainly isn't privatization. And correct me if I'm wrong, but I'm assuming that's what you're arguing for.

>you pump unsustainable amounts of money into the service over time. This allows you to offer a great service until in the future you can't pump enough money into it anymore.

This is how every growth based juggernaut business works as well. Quality of service always goes down to continue growth of profits, especially after you've crushed the competition.

IMO, healthcare of the public should not be a profitable business. Or the business will always find ways to squeeze their customers who simply need care for the health.

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

#224

Post by ZeroGravitas »

odiroot wrote: post #215
ZeroGravitas wrote: post #71

Earlier quoted context omitted.

Maybe I'm just a nerd, but this bit: > Getting a GP to see you in person is now quite difficult (they want to do everything via phone) Doesn't really strike me as a bad thing in itself. Once you get past the front line, things get pretty specialist and a general move to Telemedicine is probably a good thing, and is presumably happening all around the world for all sorts of reasons. People even do telesurgery now. And…

Preventive care is absolutely the most important to keep the society healthy and moving forward. Currently people just give up on contacting their surgeries, letting their symptoms develop into something potentially more dangerous. Then they end up at A&E, overloading the hospitals. Maybe it's not so bad in the 3 biggest cities (possibly due competing private services), but at smaller cities and towns, it's impossibl…

The NHS spends a lot of money trying to get people to use the right level of care, like pharmacists, info on the web https://111.nhs.uk/ and by phone.

I don't particularly see a face-to-face visit to a GP when you think you have an issue as preventitive, but if it was, I still don't see how telemedecine wouldn't be a partial solution to that problem, not make it worse.

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

#225

Post by MattPalmer1086 »

lotsofpulp wrote: post #96
heisenbit wrote: post #87

Earlier quoted context omitted.

Here in Germany the health care system is severely stressed particular nurses are hard to come by. Nurses and young doctors were often coming from other EU countries but Covid slowed this migration. I could imagine the situation in Britain much worse due to Brexit and quite possibly and even higher reliance on foreign skilled health care labour.

> reliance on foreign skilled health care labour. I think it is more accurate to say cheap labor.

No, we really did import a lot of skilled labour and did not train enough of our own people.

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

#226

Post by simonh »

rleigh wrote: post #182
matthewmacleod wrote: post #176

Earlier quoted context omitted.

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…

> You’ve also misrepresented the nature of private healthcare in the UK I mentioned that we don't have the right to opt out of paying for the NHS. It's not possible go entirely private. If you could opt out, you could pay that money to a private provider instead and entirely forego the use of the NHS. That isn't an option today. But it should be.

I have private health care through my employer, I've only used it once but it was very handy. I don't agree with your take at all, there's no way a private health care outfit could efficiently provide an effective emergency service across the entire UK for all possible injuries and illnesses, completely replacing or duplicating the NHS. The USA has tried this and it's an incredibly expensive disaster.

Employed middle aged workers in the USA pay about the same as we do for the NHS to support Medicare, Medicaid and CHIP through taxes, and then have to pay about the same again to actually get health care for themselves. Plus the system that costs twice as much as ours per citizen still leaves tens of millions of Americans without health insurance. It's utterly godawful. Our current system where everyone supports the NHS, and if you want top up services you pay for it, ensures solid funding for everyone's health care. The fact that my private care actually subsidises the NHS by reducing demand on it is a feature, not a bug. There's also the fact that private health care increases overall investment in health care, so in emergencies the NHS can call on private medical facilities which otherwise wouldn't be available. I know there's a fairness argument, but in practical terms our system benefits everyone.

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

#227

Post by pclmulqdq »

creato wrote: post #217
pclmulqdq wrote: post #163

Earlier quoted context omitted.

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.

> In contrast, the care that people get from Medicare is substantially worse than what you get from private insurance in the US. I don’t think they are comparable. Medicare exists because private insurers refuse to cover old people at a reasonable price. It’s a good scam the private insurers have going: take peoples money when they are generally healthy and productive, drop them like a sack of shit onto the governmen…

The price of elder care in the US is not due to insurance companies, but due to the amount of attention someone demands before them die in a US hospital. Many socialized healthcare systems do not allow doctors to waste nearly as many resources this way.

That is why the life expectancy of the average obese, unhealthy American is about the same as the life expectancy of the average (much healthier) Japanese or European person. Americans are allowed to eat their way to an early grave and then have medical resources thrown at them to desperately keep them alive a few days longer.

EDIT: Also, I should point out that doctors generally demand a lot less end-of-life care than members of the general US population. They seem to understand that it is merely prolonging the inevitable rather than helping.

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

#228

Post by etc-hosts »

pharmakom wrote: post #214
jeromegv wrote: post #121

Earlier quoted context omitted.

They have actively worked at crippling it. Now that it’s crippled they tell you.. oh but surely the government can’t fix it, we need private enterprises to fix it! You walked right into it. What makes you think private business are capable of delivering something cheaper than what the government can do? The most expensive health care in the world is private.

This makes me wonder… if Conservative strategy is to run it into the ground and then privatise, which is an unpopular plan with the public, then how are they able to consistently win elections?

Probably because the opposition party has poor leadership and most UK newspapers are aligned with the Tories.

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

#229

Post by ricardobayes »

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 just don't know why that is, every piece of that puzzle I have met, was really efficient and generally doing a good job. Spain is now trying to fix this and pensions by doubling self-employed tax. UK should probably follow suit, UK self-employed tax is ridiculously low. 20% on profits until 50k pounds won't cover a functioning healthcare system (or pensions for that matter).

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

#230

Post by moistly »

Silverback_VII wrote: post #102

Excess death is higher in Europe in general. you can see the stats here: https://www.euromomo.eu/graphs-and-maps#excess-mortality What I find strange is the increase in excess death among children since April 2021.

I don’t find that strange at all: vaccination/deaths of the elderly meant the virus needed t9 find a new susceptible population. Spanish Flu did the same: started out hurting adults, ended up killing kids.
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