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Collapse of emergency healthcare in England may be costing 500 lives every week

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Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#331
post #172

Earlier quoted context omitted.

>> The Conservative Party have been in power for 12 years. When they gained power they pursued a policy of "austerity" to reduce the size of the govt and local govt, reduce the funding of nationally funded things, and to replace such govt owned things with "public private partnerships". You seem to be missing a bit of context here - this was after the Global Financial Crisis when even the outgoing Labour Chancellor o…

Folk talking about austerity as a tory thing are going to be in for a monster shock if energy prices persist through the next elections, and when they realize the size of the Covid bill vs the GFC bill. It may very well be Labour sitting as the final nails are driven into the NHS, just by sheer luck of timing

Much of the Covid expense was paid for with newly created money through Quantitative Easing.

Even the unlikeliest of Conservatives seem to be waking up to Modern Monetary Theory [1]

[1] https://twitter.com/SkyNews/status/1554361779857362945

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#332

This isn't a collapse of emergency healthcare, it's a very predicted collapse of community social care: hospitals can't discharge if they need a care home place that doesn't exist. Without inpatient bed availability, ERs and AMUs can't admit to specialties and everything gums up at the front door. Let's be clear: we do need many more doctors and nurses, but the existing ones can't do their jobs because their wards ha…

> This isn't a collapse of emergency healthcare, it's a very predicted collapse of community social care: hospitals can't discharge if they need a care home place that doesn't exist. Without inpatient bed availability, ERs and AMUs can't admit to specialties and everything gums up at the front door. How does that manifest as ambulance wait times? Do you think ambulance drivers are sitting around for an hour before re…

> Do you think ambulance drivers are sitting around for an hour before responding to calls for help because... the hospital is full?

Yes, this happens - my grandfather attended with a head injury, and we were stuck in a side room with the ambulance crew (along with another patient and a second ambulance crew) waiting to do a handover.

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#333

Earlier quoted context omitted.

You can both blame people and society. Modern living makes it easy to be fat, but plenty of us don’t succumb to the temptation of easy meals and overeating. I’m not sure how you’d even change modern life to get around this, save maybe for incredibly large sin taxes on everything from soda to every restaurant. I’m sure we’ll just end up with a pill sometime soon. Semaglutide comes close.

> Semaglutide comes close Until we can mass manufacture that, can we all start taking metformin?

We are mass manufacturing it and you can get it in the UK. It does cause GI side effects though which puts some of people off.

However it's fairly new and fairly unknown yet. I suspect it will become a lot more popular over the next few years.

Interestingly, like Metformin, it's also a diabetes drug.

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#334
post #221

The thread reminds me of the Guardian's podcast "Sewage Sleuths" which uncovered catastrophic sewage being dumped into England and Wales's rivers and streams. Very informative and enlightening how bad some government infrastructure can be (hint: in the podcast they also enlightened HOW the failure got bad). https://www.theguardian.com/news/audio/2022/aug/15/sewage-sl...

It's a failure of privitisation 30 years in the making since water and waste management was privatised in 1989 here in the UK. Of course you can lay some blame at the door of the regulator but let's not forget the tens of billions that have been siphoned off to shareholders and fatcat CEOs, some of whom are arguably criminally negligent and should be put on trial for the catastrophes that have become apparent in rece…

I really don't like this kind of knee-jerk "privatisation bad, fatcat CEOs bad" reaction sadly prevalent in the UK. Let's talk about the underlying argument, shall we?

Firstly, you're talking about a failure of a regulator to regulate an industry and prosecute alleged perpetrators, and the implied solution is to… nationalise the industry, somehow assuming the nationalised entity will be managed better by the very same regulator? I don't think it's a good argument really

Secondly, if we go even deeper, what pressures would such an entity have to provide good service and not be wasteful with their resources? Right now there's at least market pressure, the companies trying to outcompete their peers, cut costs, and ensure future profitability by investment. What pressures do you think exist for a nationalised entity that don't exist for a regulator?

Thirdly, do you actually have any evidence to prove that those companies are uniquely profitable? Because unless they are, it's only fair that people investing their own money into infrastructure (remember, that was one of the goals of privatisation, tapping private budgets in addition to tax money) get some return on it, otherwise they'd just invest it elsewhere, e.g. into Apple stock, which would benefit British people much less.

Privatisation per se is not the problem, political failures are.

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#335

Earlier quoted context omitted.

It is too bad that corrupt government officials keep systemically defunding Social Health programs with the objective of pushing private for-profit healthcare (which just doesn't make sense). Then they point to the deficient healthcare and blame the "socialized" aspect of it for the issues. Here in Mexico we've seen it all play out: We had an amazing social healthcare system (in the form of the IMSS) in the 70s and 8…

>with the objective of pushing private for-profit healthcare (which just doesn't make sense) Maybe it doesn't make sense for you, but it makes their buddies in the private sector a lot of money. And that's the game in capitalism, making a lot of money. The government competing with affordable options for everyone against the private sector is "bad for business".

Well the comment did say it was corrupt government officials conspiring against the people and causing the problems with the healthcare system.

Not sure if giving the corrupt government more money and power is a good idea in that case.

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#336

Earlier quoted context omitted.

> Semaglutide comes close Until we can mass manufacture that, can we all start taking metformin?

We are mass manufacturing it and you can get it in the UK. It does cause GI side effects though which puts some of people off. However it's fairly new and fairly unknown yet. I suspect it will become a lot more popular over the next few years. Interestingly, like Metformin, it's also a diabetes drug.

My guess is that it's now approved for obesity, a lot of drug plans in USA approve of it and that's led to a supply issue: https://www.novonordisk-us.com/products/product-supply-updat...

I wonder if metformin does the same thing, but the patent fell off too soon, so there just wasn't much marketing for its benefits to decision-makers.

metformin for 26 weeks lead to a net 6.6kg weight loss in non-diabetic obese patients (I would've preferred BMI reduction as the outcome measure, and a placebo-control arm, but can't have it all):

https://pubmed.ncbi.nlm.nih.gov/23147210/

Semaglutide yielded net 12kg weight loss in 68 weeks

https://www.cfp.ca/content/67/11/842

Obviously it's diminishing returns over time, but shows how much a drug that's been on the market for decades has still been under-utilized.

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#337
post #322

Earlier quoted context omitted.

It may not be conclusive on the subject of whether the 16% additional deaths were specifically influenced by the additional wait, but in light of that data point, you're going to need a whole lot more evidence to justify your original claim that the cohort that dies 16% more than the baseline population in the days that follow were, without exception, not in any urgent need of medical care...

All I said was: if you can wait 12 hours, it's not an emergency. The emergency room is for things where a person couldn't wait 1 hour without dying. People dying 30 days later: not an ER problem.

Nope, the emergency department of an NHS hospital is absolutely not reserved for things where people couldn't wait one hour without dying (or people who are in danger of death period).

And since we're talking specifically about the subset of NHS emergency department attendees who are more likely to be dead within 30 days if it takes longer than the NHS' target of four hours for them to receive an inpatient bed, I'm pretty unconvinced that the alternative route of booking a doctor's appointment in the next few days to see if he'll refer in a week or two is the more appropriate one...

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#338

Earlier quoted context omitted.

The Soviet Union accrued massive debt due to internal production inefficiencies caused by corruption and mismanagement. Russia has extraordinary natural resources, by all rights they should be one of the most wealthy countries on earth.

The same goes for South America. Yet they remain mired in poverty thanks to their predilection for socialism.

No post body was provided.

Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#339

This twitter thread is excellent. Here are selected tweets to highlight the crisis from hospital and ambulance waiting times. --- "England & Wales as the only part of Europe that has recorded sustained and rising excess mortality over the last few months with no obvious natural explanation." "Patients who waited 8-12 hours had a 16% higher chance of dying in the subsequent 30 days than average." "This was after adjus…

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Re: Collapse of emergency healthcare in England may be costing 500 lives every week

#340

As a UK tax payer, and as a UK tax payer that winces every time they see how much they lose to taxation in their P60 each year (six figures in tax), what are people's solutions to this? It seems like the NHS budget keeps on going up and up and up [1], as does the number of doctors and nurses (while "managers" has either declined or stayed relatively static) [2]. So NHS is getting more funding, and there are more doct…

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