Collapse of emergency healthcare in England may be costing 500 lives every week • Hacker News Board

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

#271

Post by Jensson » Tue, Aug 23, 2022, 10:10 PM UTC

asdff wrote: post #219

Jensson wrote: post #201

Earlier quoted context omitted.

Problem: Politicians are corrupt! Solution: Give more power to politicians! Lack of power corrupts, need to give them more until they stop being corrupt! Not sure why anyone thinks that would work.

I really don't understand how people can simultaneously believe that governments are corrupt and the private sector would support the public's interests. Guess who is corrupting government: the private sector who only support their own interests.

The politicians you vote for can regulate those companies, that is how the system is intended to work. If those politicians takes bribes to not regulate those companies, then the problem is corrupt politicians taking bribes, you don't fix that by giving those politicians more power you fix it by voting them out and voting in politicians who does what you want.

> Guess who is corrupting government

How are they corrupting the government? Is the private sector deciding who gets power in the government somehow? Sounds like your democracy doesn't work then. Giving all the power to politicians when the democracy doesn't work just leads to the same scenario as in Soviet.

Bribing the government isn't "corrupting" them, a politician who accepts bribes or tit for tat deals is already corrupt.

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

#272

Post by simonh » Tue, Aug 23, 2022, 10:10 PM UTC

rdl wrote: post #249

mattlondon wrote: post #234

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…

The best thing about NHS (from my perspective as a US person, although I lived in the UK for a while) is the use of QALYS to allocate budget, rather than spending huge sums on a small number of interventions at extreme cost and limited benefit. Has that focus shifted? (My personal belief is there should be a level of universal medical care funded by some public entity, probably the nation state currently, but it shou…

We still use QALYS. The problem is you don’t get to choose how much a given level of health care costs, and I think 1% of GDP is woefully inadequate. You spend about 4% of GDP just on Medicare alone.

As a US tax payer you pay about as much for Medicare, Medicaid and CHIP as tax payers in most developed countries do on health care in total. But then to actually get health care yourself you have to pay about the same again fir private health insurance.

I get private health care here in the UK through my employer. I pay for the NHS through taxes, and that’s actually how I and my family get most of our health care in practice. The private cover is basically a top up. If I use it I can get treatment more quickly, but at no cost to the NHS.

I think this is the best of both worlds. As a nation we get health care comparable to the US at half the cost, it’s truly universal so millions of people don’t fall out of the system. So I fully support the NHS, as a beneficiary of private health care I still think I and my family have got excellent value for money from it throughout my life. Private health care expands health care capacity, and reduces demand in NHS services, so everyone benefits. It may not see, ideal, but in practice I think it works very well, and frankly it’s how well it works that actually matters.

Currently the NHS is in rough shape, but this is mostly down to the flat economy since the financial crisis and the pandemic. Spending levels at the peak of the boom in 2008 were unsustainable whoever was in power.

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

#273

Post by oliwarner » Tue, Aug 23, 2022, 10:12 PM UTC

mattlondon wrote: post #234

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…

It's because they're acting as an emergency care home.

My local 450-bed DGH has over 150 medically fit patients waiting to be discharged into community care that isn't available.

And this happened secondary to central government funding being withdrawn from social care.

So hospitals like this one are actually running at 120% in summer. They do need "MOAR MOAR MOAR" but that more is a place to look after the patients that don't need to be in hospitals.

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

#274

Post by trs8080 » Tue, Aug 23, 2022, 10:12 PM UTC

WalterBright wrote: post #242

MichaelCollins wrote: post #230

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.

Actually they remain mired in poverty largely because the US keeps meddling in their affairs: https://en.wikipedia.org/wiki/United_States_involvement_in_r...

So it's more like "they remain mired in poverty because of the United States' predilection for predatory capitalism."

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

#275

Post by gambiting » Tue, Aug 23, 2022, 10:14 PM UTC

baobob wrote: post #172

gadders wrote: post #110

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

No post body was provided.

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

#276

Post by Scoundreller » Tue, Aug 23, 2022, 10:15 PM UTC

rdl wrote: post #249

mattlondon wrote: post #234

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…

The best thing about NHS (from my perspective as a US person, although I lived in the UK for a while) is the use of QALYS to allocate budget, rather than spending huge sums on a small number of interventions at extreme cost and limited benefit. Has that focus shifted? (My personal belief is there should be a level of universal medical care funded by some public entity, probably the nation state currently, but it shou…

Is the NHS using QALYs beyond drug treatments?

Is there a list somewhere of the QALYs for every intervention?

It becomes enough of a hot potato to say "drug X works, but not enough so we're not paying for it" because it lets you complain that the drug companies are charging too much.

But when you say "surgery X works, or 1:1 therapy works, but not enough so we're not paying for it", criticism now comes from both sides: the workers doing their job and the public.

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

#277

Post by MichaelCollins » Tue, Aug 23, 2022, 10:15 PM UTC

pessimizer wrote: post #269

MichaelCollins wrote: post #236

Earlier quoted context omitted.

This is hard to believe. Just wheel the patient through the front door and let the hospital do the babysitting. There is no sense in using an ambulance as a waiting room.

The patients are waiting in the ambulance because the waiting room is full, but I see your point. Why not just tip the patient onto the pavement outside the waiting room? I'm sure a full hospital with a full waiting room won't be to busy to sort that out.

> Why not just tip the patient onto the pavement outside the waiting room? I'm sure a full hospital with a full waiting room won't be to busy to sort that out.

Literally yes. Keeping them in an ambulance instead of the sidewalk won't get them into the ER any faster. And keeping the ambulance tied up at the hospital won't do any good for the next guy who has an emergency and is sitting on the sidewalk at the site of the accident either. At least if you move the injured people to the sidewalk at the hospital, the nurses can look outside and prioritize the worst. And the problem will be highly visible to the public, instead of papered over by using ambulances as waiting rooms.

What they're doing now is obviously prioritizing for appearances, not patient outcome.

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

#278

Post by s1artibartfast » Tue, Aug 23, 2022, 10:16 PM UTC

simonh wrote: post #272

rdl wrote: post #249

Earlier quoted context omitted.

The best thing about NHS (from my perspective as a US person, although I lived in the UK for a while) is the use of QALYS to allocate budget, rather than spending huge sums on a small number of interventions at extreme cost and limited benefit. Has that focus shifted? (My personal belief is there should be a level of universal medical care funded by some public entity, probably the nation state currently, but it shou…

We still use QALYS. The problem is you don’t get to choose how much a given level of health care costs, and I think 1% of GDP is woefully inadequate. You spend about 4% of GDP just on Medicare alone. As a US tax payer you pay about as much for Medicare, Medicaid and CHIP as tax payers in most developed countries do on health care in total. But then to actually get health care yourself you have to pay about the same a…

>and I think 1% of GDP is woefully inadequate. You spend about 4% of GDP just on Medicare alone.

That all depends on the spending ROI. If the first 1% of GDP gets you 90% of the benefit and is universal, it may be just fine.

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

#279

Post by captainredbeard » Tue, Aug 23, 2022, 10:17 PM UTC

MichaelCollins wrote: post #236

dia80 wrote: post #231

Earlier quoted context omitted.

Yes, The ambulances are waiting outside the hospitals with the last patient so they can't go to get the next one. Source: Family members have recently waited some hours outside A&E in an ambulance.

This is hard to believe. Just wheel the patient through the front door and let the hospital do the babysitting. There is no sense in using an ambulance as a waiting room.

An ambulance is a portable "mini" ER room...

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

#280

Post by twic » Tue, Aug 23, 2022, 10:18 PM UTC

mattlondon wrote: post #234

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…

Other countries spend more (10 - 20 % more) and get better outcomes, so it seems like the solution is indeed to spend more. The fact that it has been climbing slowly and we haven't seen radical improvement doesn't contradict that. Sorry.