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Ill in England? Your Location Can Determine If You Live or Die

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Re: Ill in England? Your Location Can Determine If You Live or Die

#81

Post by gruez »

rcxdude wrote: post #74
gruez wrote: post #22

Earlier quoted context omitted.

>I think it’s amazing that a solid system can be defunded like that until it just sorta crumbles under it’s own weight "defunded"? Maybe if you're comparing post pandemic budgets to pandemic budgets, but spending is still way up compared to pre-pandemic levels. [1] https://flo.uri.sh/visualisation/12020081/embed?auto=1

The increases over the time period in that graph are still less than inflation, making it a real-terms funding cut, especially relative to the growth in population.

Here's a chart that adjusts for inflation:

https://www.economist.com/img/b/400/436/90/media-assets/imag...

As you can see, it's below pandemic levels (as I previously said), but still way above pre-pandemic trends.

Re: Ill in England? Your Location Can Determine If You Live or Die

#82

Post by ghusto »

moribvndvs wrote: post #63
ghusto wrote: post #61

Counterpoint to all the "it's because it's underfunded" arguments: The money's there, it's just misspent, as with all government lead bureaucracies, resulting in service that could and does kill. There are multiple unnecessary levels of bureaucracy being paid, leaving little room for people who do actual work. This also results in those people being stifled by busy work. Source: Doctors I'm friends with, and personal…

Am I supposed to feel better or worse, considering private healthcare also has bureaucracies that could and does kill, on top of destroying people financially? Source: work in practice management and billing software, and personal experience

I was lucky enough to have private healthcare paid for me, and I the only bureaucracy I experienced was having to go to the NHS G.P. first to get a "referral". Basically this is a(n NHS side) tick-boxing exercise where you have to be "referred" to a private doctor before you're allowed to see them, even if you pay.

In practice what happens is you go to your G.P. and literally say; "can you write a referral so I can go and see my private doctor", and they do so on the spot without batting an eyelid.

> on top of destroying people financially?

I'm not sure where that's coming from either? Mine was paid for, but it wasn't exactly extortionate. I could have afforded it myself at the time.

I don't understand why it's such an emotionally charged issue for some people. If it's a poor/class thing, does it help that I grew up in a piss poor council estate, and thank god I don't have to rely on the NHS ever again.

Re: Ill in England? Your Location Can Determine If You Live or Die

#83

Post by nradov »

computator wrote: post #49

It's intriguing that medical care is always the worst kind of service, by far, in every country in the developed world, compared to every other kind of product or service we depend on. Compare it to food, electricity, gasoline, clothing, water, cell service, haircuts, transportation, movies. If you're not in a rural location, you can buy food or a restaurant meal 24-hours a day in less than an hour. There's complex i…

The economics of healthcare in most developed countries are highly distorted through government intervention. This causes shortages and queues, but it also helps to hold costs down and provide access for poor people who might otherwise not be able to afford it at all.

For comparison look at cosmetic surgery in the USA. It isn't covered by insurance so patients pay out of pocket. Only the affluent can afford it but the business is highly competitive and most procedures are available with little or no waiting and high quality.

Liability is only a minor factor. Some US states have severely limited non-economic damages in medical malpractice cases but that only brought costs down slightly.

Re: Ill in England? Your Location Can Determine If You Live or Die

#84

Post by ghusto »

MattPalmer1086 wrote: post #80
nvm0n1 wrote: post #77

Earlier quoted context omitted.

Maybe. There's a lot of noise in these measurements. A lack of error bars doesn't mean a lack of errors. For many years activist orgs and newspapers liked to claim the UK was at the rock bottom of EU healthcare spending, that it spent far below other nations. When new accounting standards came in that tried to unify the way healthcare spending was measured between nations, overnight the UK went up to be about the mid…

The NHS is pretty much like a religion in the UK, it is true. Most of us are very wedded to the idea that health care that is free at the point of use for all is a very good thing. We are also used to people who would rather we had a more US-like health system pretending that they care about it while actually trying to make it fail, effectively to privatise health care by the back door. So it's a hard subject to deba…

It's crazy how weird people get about it, but I think it's a class-shame thing. I grew up in a poor council block, and have _no_ qualms calling it out for what it is.

Also, completely-free or U.S.A.-style-nightmare are not the only two options. There's a whole rainbow in between, those are extremes! I'm now in a country that's got the balance right; everyone has healthcare, and everyone who can afford it (most) pay affordable insurance for it. The standard of care is _amazing_!

Re: Ill in England? Your Location Can Determine If You Live or Die

#85

Post by nradov »

chaostheory wrote: post #52
computator wrote: post #49

It's intriguing that medical care is always the worst kind of service, by far, in every country in the developed world, compared to every other kind of product or service we depend on. Compare it to food, electricity, gasoline, clothing, water, cell service, haircuts, transportation, movies. If you're not in a rural location, you can buy food or a restaurant meal 24-hours a day in less than an hour. There's complex i…

> Compare it to food, electricity, gasoline, clothing, water, cell service, haircuts, transportation, movies Compared to other essential professions, doctors need 8 years of schooling and another 4 years for apprenticeship. As for nurses, they are both abused and underpaid. Maybe AI and subsidizing medical schooling can help? Raising the retirement age should also help. A large portion of the population does not pay…

Physician education is already highly subsidized. AI can potentially improve productivity a little in areas like charting and clinical decision support but don't expect miracles.

The full Social Security retirement age is already 67. There isn't much room to push it higher. By that age many workers, especially those who have done manual labor, are disabled to an extent. It's just not realistic to expect them to continue working.

Re: Ill in England? Your Location Can Determine If You Live or Die

#86

Post by ghusto »

rootusrootus wrote: post #10

Which country has the best health care in Europe? And what makes it the best solution? I ask from the perspective of an American, with access to great health care but it’s expensive. If we were going to reinvent health care here, who should we copy?

The Netherlands! Well okay, I don't know what it's like elsewhere, but I know it's good here :)

Here's the lowdown:

- If you can't afford it, the government pays for your insurance

- If you can, you pay for it (nearly everyone can)

- Prices are regulated by the government

- You can not be turned away, and can not be charged more than the regulated amount for your insurance, no matter what

That last one is the killer feature. You could have cancer, and the insurance company still has to take you, and for a monthly price not higher than the maximum the government's put in place.

The Netherlands had a free system like the NHS, but once the quality started going downhill, they looked at reality in the face and built a better system. The standard of healthcare here is amazing!

This isn't a popular narrative in the UK, because it shows how there are more choices than just "completely free" or "U.S.A. style dystopia", which is the argument used there to promote the idea that the NHS can work.

Re: Ill in England? Your Location Can Determine If You Live or Die

#87

Post by nvm0n1 »

MattPalmer1086 wrote: post #80
nvm0n1 wrote: post #77

Earlier quoted context omitted.

Maybe. There's a lot of noise in these measurements. A lack of error bars doesn't mean a lack of errors. For many years activist orgs and newspapers liked to claim the UK was at the rock bottom of EU healthcare spending, that it spent far below other nations. When new accounting standards came in that tried to unify the way healthcare spending was measured between nations, overnight the UK went up to be about the mid…

The NHS is pretty much like a religion in the UK, it is true. Most of us are very wedded to the idea that health care that is free at the point of use for all is a very good thing. We are also used to people who would rather we had a more US-like health system pretending that they care about it while actually trying to make it fail, effectively to privatise health care by the back door. So it's a hard subject to deba…

I don't think the UK has ever had a government that actually wanted the NHS to fail. Even the most right wing conservatives realize they're stuck with it and that voters will be happier if it works better. They have very few levers to achieve that. Private sector involvement is one but not a very powerful one given that the NHS killed off the private health sector in the UK and ensures it can't regrow to any kind of meaningful capacity. To the extent it grew in the last few years that's only because the NHS is now in the stages of advanced collapse, failing to provide even the most basic services you'd expect and therefore for some paying twice is the only way to get healthcare at all.

I also really doubt there are many in government or politics who want a US style system. The US has a strange system replicated nowhere else (much like the UK). The way healthcare is tied to the employer there is a legacy of socialist economics during WW2. To try and stop inflation wage controls were implemented so companies started to compete via non-wage benefits, like bundled health insurance. Then for reasons I don't know it was made tax-exempt, so the tax system incentivized workers to demand healthcare through their employer instead of paying it themselves. And then legal changes and union campaigns cemented that system. Part of why US healthcare is so expensive is the sheer number of layers between the people who use it and the act of paying for it. It's very much an accident of history born in the war, and not a model to obviously replicate.

The UK system is likewise rather dysfunctional thanks to WW2. Years of wartime propaganda followed by a victory convinced Brits that the government must be very good at things, and of course this was an era in which socialist economics was taken seriously across society. So on victory the UK immediately voted in a Labor government that nationalized many industries including the entire healthcare system, with Bevan famously dividing and buying off doctors who realized it'd be a bad idea by "stuffing their mouths with gold". Governments have attempted to use the same strategy to solve its problems ever since, yet have never been able to predict or control costs in the way a business would need to. Even in its very first year, costs were double what was predicted. This is very far from the original belief that GDP improvements from the NHS would be so great it would effectively pay for itself.

Re: Ill in England? Your Location Can Determine If You Live or Die

#88

Post by themitigating »

thri737 wrote: post #44
bruce511 wrote: post #39

Earlier quoted context omitted.

Yep. It's political suicide to bring up fairly obvious age/prognosis limits, but ultimately we all die of something. Assuming most disease based hospital stays (heart attacks strokes, cancers) are biased towards older folk it makes sense that resources to younger folk be prioritised. It makes -sense-, but asking a decent human to turf an "old person" out of bed because a "young person" has arrived (with a survivable,…

There is no need to kick anyone out of bed. You can adjust policy. For example no lockdowns, that sacrificed young people over old. I still have bad health from that. My daughter has developmental issues. And overweight people should not have publicly founded insurance. We should respect their wish to die! And no publicly founded health insurance for non-citizens. That even has strong political support!

Second reply here because I finally understood your comment and what you meant.

I suggested selective care based on cost and quality of life. That's the logical way to do it even if you think it's immoral. You believe non-citizens shouldn't be helped? Why? "Because they don't contribute with taxes". There are many people who are citizens who don't contribute. Illegal aliens also provide a workforce for vital food production and other jobs that help the economy (regardless of if you think it's wrong).

You also had a issue with fat people because it's their fault. What about people who speed and crash? Skiers who fall, horse riders, any optional activity that carries risk falls into the same category.

---

"For example no lockdowns, that sacrificed young people over old"

Young people were thankfully much more resilient to Covid but was this wasn't known initially when the strictest lockdowns were put in place. Health officials were being cautious. What were to happen if there were no lockdowns? Certainly more deaths of old people but also adults in their 40s, 50s, 60s to a lesser extent.

As for the mental toll on young children- the total lockdowns didn't last long, you could go out and meet in small groups even during the initial phase. Many people didn't even care or follow the advice after the first few weeks. However, kids were remote learning for much longer but if that causes development issues what about home schooling? What about kids in remote areas?

What is the specific situation and time frame that cause your child's development issues?

I'm admitting there was a not insignificant mental toll on children, as this study shows[1]. You need to weigh this against the alternative of less or even not having any lockdowns and lack of information when these decisions were made. This means that using data you have now about the affect on children and how Covid 19 affected different age groups as a criticism, which I don't think is valid

Re: Ill in England? Your Location Can Determine If You Live or Die

#89

Post by DanBC »

nvm0n1 wrote: post #87
MattPalmer1086 wrote: post #80

Earlier quoted context omitted.

The NHS is pretty much like a religion in the UK, it is true. Most of us are very wedded to the idea that health care that is free at the point of use for all is a very good thing. We are also used to people who would rather we had a more US-like health system pretending that they care about it while actually trying to make it fail, effectively to privatise health care by the back door. So it's a hard subject to deba…

I don't think the UK has ever had a government that actually wanted the NHS to fail. Even the most right wing conservatives realize they're stuck with it and that voters will be happier if it works better. They have very few levers to achieve that. Private sector involvement is one but not a very powerful one given that the NHS killed off the private health sector in the UK and ensures it can't regrow to any kind of…

> I don't think the UK has ever had a government that actually wanted the NHS to fail.

> I also really doubt there are many in government or politics who want a US style system.

You might want to read "Britania Unchained" which very much says that they want to dismantle the NHS. There's a bunch of current Conservative politicians who want to effectively dismantle the NHS and implement a US style system. They're very clear about this.

Re: Ill in England? Your Location Can Determine If You Live or Die

#90

Post by DanBC »

HarryHirsch wrote: post #19
nradov wrote: post #18

Earlier quoted context omitted.

Ultimately the only viable plan is going to be severe care rationing. In most developed countries we have an aging population with an increasing incidence of chronic diseases and a shortage of physicians. Regardless of whether payments come from governments, employers, or individuals the reality is that we simply won't have the resources to care for everyone.

In Britain, citizens have a hard time getting basic dental care that they can afford: https://www.bloomberg.com/news/articles/2023-07-13/uk-dentis... The demographic explanation simply does not hold water when routine healthcare is not available.

Important to point out that dentistry in England does not follow the NHS model of "free at the point of delivery, available to all regardless of ability to pay" but follows an insurance model, with a bit of state provision for those who can't afford insurance.

And dentistry is why people in England are scared of changing the model for NHS healthcare, because we see that dentistry is fucking awful for huge numbers of people.

The problem with the NHS is not the model, it's the funding.

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