Live data from Hacker News

How Palantir Will Steal the NHS

pluralistic.net

21–30 of 39 posts

Re: How Palantir Will Steal the NHS

#21
post #4

Earlier quoted context omitted.

> I think anyone who knows about the current state of the NHS is under no illusions that it's in any way fit for use. I think a lot of people wouldn't mid an American-style system if it gives them access to healthcare. Anecdata: nah. At least of my friends in the UK, they're fine with the waits if it means they don't have to pay our ludicrous health insurance premiums, deductibles, and other costs. A case comes to mi…

Anecdata: i know of somebody who had a suspected stroke . waiting times to get an MRI scan was weeks long. 8 hour waits in A&E is considered normal and Ambulances often don't show up on time. Getting an appointment with any kind of specialist within a reasonable time frame is flat out impossible in lots of cases. The NHS when it works is wonderful, but at the moment it's in deep crisis. I have no doubt they waste tre…

> I have no doubt they waste tremendous amounts of money.

Do you have any examples?

> If done properly privatisation and deregulation could just save it.

How do you de-regulate healthcare without killing people?

We already have private providers of NHS healthcare, and they usually hand the contracts back because they can't afford to do it for the money. We could experiment by paying private providers more money, but if we're doing that why not just give the money to NHS providers?

Re: How Palantir Will Steal the NHS

#22
post #16

Earlier quoted context omitted.

Come to X, have a medical emergency and see how the local health system deals with it. Substitute UK or US for X and see what people would rather have.

Healthcare extends far beyond medical emergencies. Also, in the UK there is a very real possibility of dying before getting medical attention.

Sure, I think we both know how that would go. Care to provide comparative statistics for other kinds of healthcare?

Re: How Palantir Will Steal the NHS

#23

Among the Europeans I know, the NHS is considered a laughing stock, and they find it absurd how much national pride there is for it. A move towards a European system like Germany’s would likely have significant positive outcomes. In the UK, you can barely see a GP in a week; in Germany you can see a specialist in days. There’s a spending disparity but it’s not big enough to explain the difference in outcomes IMO. Unf…

Germany spends quite a lot more than England. Depends how you measure (per capita there's a big difference; percentage of GDP the difference is smaller).

Another thing that's really affecting the English NHS at the moment is Brexit - it's making it very difficult to recruit and retain staff, which has pushed up staff costs because of the spend on locum doctors and agency nursing staff.

But, really, the main problem is 12 years of a Conservative government that does not believe in tax-funded public services. Cameron and May were bad, but Johnson and Truss have been catastrophic for the NHS.

Re: How Palantir Will Steal the NHS

#24
post #21

Earlier quoted context omitted.

Anecdata: i know of somebody who had a suspected stroke . waiting times to get an MRI scan was weeks long. 8 hour waits in A&E is considered normal and Ambulances often don't show up on time. Getting an appointment with any kind of specialist within a reasonable time frame is flat out impossible in lots of cases. The NHS when it works is wonderful, but at the moment it's in deep crisis. I have no doubt they waste tre…

> I have no doubt they waste tremendous amounts of money. Do you have any examples? > If done properly privatisation and deregulation could just save it. How do you de-regulate healthcare without killing people? We already have private providers of NHS healthcare, and they usually hand the contracts back because they can't afford to do it for the money. We could experiment by paying private providers more money, but…

Their apparent addiction to hiring full time diversity officers on six figure salaries is a neuralgic one, not so much because of the scale of the waste (small) but because it's so obviously waste, so easy to fix and so obviously designed purge the NHS of anyone who isn't ideologically pliant, regardless of the political cost of provoking large numbers of taxpayers and voters.

But the real problem with waste (really, dysfunction) in a Soviet-style system is that it's systemic. There isn't necessarily one big thing you can point at and say "here's a big pile labelled pure waste", if it were that easy it'd be trivially fixed and nobody would care. The problem is waste at every level of the system because nobody is incentivized to get rid of it. It's things like doctors who are supposedly on-call in a hospital but who are actually "working" from home. It's things like GPs deciding en-masse that they'll not bother seeing patients anymore, because their NHS contracts pay them regardless of whether they actually let people into their surgeries or not.

You can't fix this sort of thing with the NHS structure, it's impossible, governments spent most of the 20th century trying and failing.

"How do you de-regulate healthcare without killing people?"

The NHS is not regulation of health care. Most countries have heavily regulated but private healthcare.

Perhaps you mean, how do you privatize healthcare. The answer is you just do it, and then fewer people will die. It's as simple as that. For all the shit Europeans give the USA about healthcare, a lot of it is denial. In the USA if you read an extreme story like this which ends with a 25 year old literally dying because the health system refused to serve him:

https://www.bbc.co.uk/news/health-63057872.amp

... the reason is because the guy deliberately chose not to buy health insurance. It was their decision to take the gamble. Even then, in the USA you can get emergency healthcare even when uninsured. But in the UK, this guy did nothing wrong. He paid his taxes and then when he needed the system it simply wasn't there for him. Not at the GP, not at the emergency room - nowhere. As far as this poor man goes, 100% of the tax he ever paid for the NHS was pure waste, because even as he was dying of cancer the NHS refused to see him in person, told him to take a lemsip and go to bed. Now he is dead.

The sad thing is, cases like that one are increasingly not a mere outlier. The NHS is gone, it's collapsed, it's failed entirely. It cannot provide even the most basic emergency health care reliably. How long will it be until other countries start recommending their citizens avoid the UK due to the inability to get emergency health care? It's probably going to take a shock like that for Brits to wake up to the catastrophic failure that the NHS model represents.

Re: How Palantir Will Steal the NHS

#25
post #12

This is just an opinionated rant masquerading as news. particularly revealing is this line >resistance to its privatisation and the importation of America's grisly omnishambolic health care "system." I think anyone who knows about the current state of the NHS is under no illusions that it's in any way fit for use. I think a lot of people wouldn't mid an American-style system if it gives them access to healthcare. (ed…

Remember that the UK also has a private healthcare system — everyone pays for the public option, but if you have a lot of money you can get expensive care. The thing is that British people pretty much uniformally reject private healthcare, because they don’t think you should pay for something as basic as healthcare. Instead the big popular drive is to make the NHS better (even though the current government is activel…

Back here in reality, about 10% of Brits pay for private health care on top of the NHS, despite that they're forced to pay for the NHS as well, so that is in no way uniformally rejecting it.

"because they don’t think you should pay for something as basic as healthcare."

Everyone pays for the NHS. The idea you don't pay is obviously wrong, you just pay in different ways and at different times.

No, the relatively low proportion (compared to other countries) is not due to some moral superiority of the British, but because the government monopolizes healthcare and forces people to pay for their service via taxes. Given how expensive healthcare is very few people can afford to pay for it twice.

The NHS' supporters are always like this - trying to present support for it as a moral issue. It never was. The NHS isn't a moral issue, it's a bureaucracy for managing resource allocation. People warned for many years that such a system could never be reliable and would eventually collapse. They were ignored and now it's too late, the collapse has happened. Not because of the current government: Labour supported the policies that triggered the collapse even more strongly than the current government did. It's collapsed simply because it was inevitable.

Re: How Palantir Will Steal the NHS

#26
post #4

Earlier quoted context omitted.

> I think anyone who knows about the current state of the NHS is under no illusions that it's in any way fit for use. I think a lot of people wouldn't mid an American-style system if it gives them access to healthcare. Anecdata: nah. At least of my friends in the UK, they're fine with the waits if it means they don't have to pay our ludicrous health insurance premiums, deductibles, and other costs. A case comes to mi…

Anecdata: i know of somebody who had a suspected stroke . waiting times to get an MRI scan was weeks long. 8 hour waits in A&E is considered normal and Ambulances often don't show up on time. Getting an appointment with any kind of specialist within a reasonable time frame is flat out impossible in lots of cases. The NHS when it works is wonderful, but at the moment it's in deep crisis. I have no doubt they waste tre…

I'm not sure whether the "deep crisis" is to blame. I've had occurrences of wait times worth several hours in A&E a year before the pandemic, and this was in the middle of London.

If they can't even provide adequate service in London, I don't want to imagine how bad it must be outside of it.

Re: How Palantir Will Steal the NHS

#27
I think it works this way, every GP or medical specialty has their own computer and record system and these need to be unified into a universal record. In the USA you basically have Epic and Cerner. If you stay in the affiliated hospital system you are basically OK. If you go outside that or to a different system, expect FAXes etc... I think for complex as well as emergency care this can be problematic since you may not patient history.

Re: How Palantir Will Steal the NHS

#28

This is just an opinionated rant masquerading as news. particularly revealing is this line >resistance to its privatisation and the importation of America's grisly omnishambolic health care "system." I think anyone who knows about the current state of the NHS is under no illusions that it's in any way fit for use. I think a lot of people wouldn't mid an American-style system if it gives them access to healthcare. (ed…

Nobody wants an American style health care system except for Americans who have convinced themselves that the absolute buckets of money they feed into that horrific system have given them 'world leading' healthcare The NHS isn't fit for purpose because it's been deliberately undermined by decades of right-wing government. Other nations such as Australia have walked a similar path

I don’t know anybody who likes the American system. I think it’s not the healthcare system we defend, so much as the complete lack of political representation of the median person. We’ve legalized corruption and given up expectations that having an opinion and a vote matters, but we’re happy to complain about the effects of that, such as in the case of healthcare.

Re: How Palantir Will Steal the NHS

#29
An episode of The Office (US). In that episode Pam, who is pregnant and has contractions, would not go to the hospital before midnight because "the healthcare provider will not pay for more then two nights."

That wasn't even the main plot line, just something that was casually brought up and unchallenged by anyone.

UK doesn't need that kind of crap. No one does.

Re: How Palantir Will Steal the NHS

#30
post #21

Earlier quoted context omitted.

> I have no doubt they waste tremendous amounts of money. Do you have any examples? > If done properly privatisation and deregulation could just save it. How do you de-regulate healthcare without killing people? We already have private providers of NHS healthcare, and they usually hand the contracts back because they can't afford to do it for the money. We could experiment by paying private providers more money, but…

Their apparent addiction to hiring full time diversity officers on six figure salaries is a neuralgic one, not so much because of the scale of the waste (small) but because it's so obviously waste, so easy to fix and so obviously designed purge the NHS of anyone who isn't ideologically pliant, regardless of the political cost of provoking large numbers of taxpayers and voters. But the real problem with waste (really,…

> Their apparent addiction to hiring full time diversity officers on six figure salaries is a neuralgic one, not so much because of the scale of the waste (small) but because it's so obviously waste, so easy to fix and so obviously designed purge the NHS of anyone who isn't ideologically pliant, regardless of the political cost of provoking large numbers of taxpayers and voters.

How would you propose managing programs to equalize quality of care across populations when conscious, unconscious, human, and automated biases exist?

Post reply on HN