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Private health insurance

lionking

In the Peanut Gallery
lionking
Joined
Jan 23, 2007
Messages
57,825
Location
Melbourne
I have been reading with dismay about the problems the NHS is experiencing. This leads me to compare the UK system with Australia’s.

Back in the1970s Australia introduced a universal health system, Medibank (now Medicare). Before too long government realised that it could not cover what heath consumers wanted, like choice of doctors, non-critical specialist treatment and elective surgery. So our system evolved to become a universal safety net health system, with people paying for treatment over and above. Most Australians took out private health insurance, and even now over 50% of the population has this insurance. And it is, to a minor extent, government subsidised.

By comparison 11% of UK citizens have private health insurance. It seems to me that the UK government, where some Tory MPs are advocating abolition of the NHS, should subsidise private health insurance. And this is not a party political post, as I’m certain that when Labour is in power, fully funding NHS will be unaffordable.

For the record my wife and I are covered by BUPA and pay $70 a week. I have looked very closely at whether this is worthwhile for us, and while we draw back only a proportion of this cost, it is after all insurance, and the benefits outweigh the cost.

Comments?
 
lionking said:
I have been reading with dismay about the problems the NHS is experiencing. This leads me to compare the UK system with Australia’s.

Back in the1970s Australia introduced a universal health system, Medibank (now Medicare). Before too long government realised that it could not cover what heath consumers wanted, like choice of doctors, non-critical specialist treatment and elective surgery. So our system evolved to become a universal safety net health system, with people paying for treatment over and above. Most Australians took out private health insurance, and even now over 50% of the population has this insurance. And it is, to a minor extent, government subsidised.

By comparison 11% of UK citizens have private health insurance. It seems to me that the UK government, where some Tory MPs are advocating abolition of the NHS, should subsidise private health insurance. And this is not a party political post, as I’m certain that when Labour is in power, fully funding NHS will be unaffordable.
For the record my wife and I are covered by BUPA and pay $70 a week. I have looked very closely at whether this is worthwhile for us, and while we draw back only a proportion of this cost, it is after all insurance, and the benefits outweigh the cost.

Comments?
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Sorry but it is - we could easily fully fund the various NHSs if we wanted to, it's a political decision to not to do so. In the UK this is entirely a matter of political ideology.

What percentage of taxation goes to Australia's universal healthcare?
 
Darat said:
Sorry but it is - we could easily fully fund the various NHSs if we wanted to, it's a political decision to not to do so. In the UK this is entirely a matter of political ideology.

What percentage of taxation goes to Australia's universal healthcare?
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17%.

The Australian Labor Party has been pretty good at making people who can afford it to help pay for health care and education for ideological reasons. The LNP for fiscal reasons. There seems a consensus here that fully funded health care, including specialist treatment, and even “alternative” treatments, should not be fully funded.
 
Okay, it seems the UK spends 12% on health care. And it was far less under Labour.

So why is this happening? Demand more is spent on health care by government (and Blair didn’t) or get the public to pay more through private health insurance. The current system seems badly broken.
 
Governments choose how to tax and spend for their citizens. The current ideologues in charge in the UK want less of a tax burden on the well off and make spending decisions based on this ideology. Since they have cut their own throats with Brexit, and since they seem to see the UK as still being some sort of great power in the world requiring ridiculous levels of defence spending especially on nuclear weapons. Changing taxation rates and spending priorities would enable the NHS to be better funded and supported without imposing more costs on an already struggling population.
 
a healthcare system needs to be funded.
so either it's run efficiently and effectively, with no more than average profits to the providers, ... or ..., you tax the hell out of price-gauging Big Pharma etc. and finance a wasteful system that way.
 
lionking said:
Okay, it seems the UK spends 12% on health care. And it was far less under Labour.

So why is this happening? Demand more is spent on health care by government (and Blair didn’t) or get the public to pay more through private health insurance. The current system seems badly broken.
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The current system has been deliberately broken by Tory governments all through my adult lifetime (see many posts I have made in the UK politics thread), from Thatcher's implementation of the first Griifiths Report which gave us managerialism and baked in short-term planning linked to the contracts of managers, through things like the purchaser/provider split which forced whole extra layers of administration and management to oversee that split, to the move to external commissioners most of whom knew little about either the clinical or geographic areas (round here the MH commissioners knew nothing about MH and could not comprehend what we did nor why - I spoke to several and also to one of the higher ups in local commissioning), through the deliberate running down of buildings...

I could go on for a long time...The Cameron/Clegg austerity and subsequent decisions around the NHS are just more in a very long line of highly deliberate decisions made to do down the NHS (look at books written by Andrew Lansley and Jeremy Hunt, which make this very clear); the Orange Book Lib Dems, who were the ones keenest on coalition in 2010, also wanted to get shot of the NHS.

Issues around recruitment and retention of staff have been known for donkeys' years but deliberately never addressed - since 2010 nurse and medic training places were cut, which was never going to be consequence free; pay has been frozen, i.e. real world cut; experienced staff were deliberately removed; career progression, certainly in nursing has been curtailed by loss of those jobs and by tinkering with the Agenda for Change system; post-registration training, which is necessary in the increasingly technical and specialised work of healthcare, is not provided.

When you have the designed effects of all this coming to fruition, shifting to an insurance model is not going to improve anything, aside from the profits of those providing insurance.

It is ALL political decisions.

This has been building for decades, with, as I have said before, the best time I knew for service delivery being the 2000-10 decade.
 
Also, per Jimbob's signature, the amount of money the UK spends on the NHS is below what many other developed countries spend - IIRC we usually sit somehere in the middle of WHO tables on proportion of GDP spent.

Not to mention that in recent years our pathetic excuse for a government hass been able to conjure up billions of pounds to spend on various Covid-related schemes, which didn't work, were never used (Nightingale hospitals), or just siphoned money into the pockets of party donors to no benefit to us. Money exists, there are folk around with a clue how to run health services, but the money isn't spent on that and those folk aren't listened to.

Political decisions all the way down.
 
It is political. As an example, the government gave something like 33 BILLION POUNDS to that stupid bitch to organise a test-and-trace system that never worked, plus however much more to Michelle Mone for PPE that had to be destroyed because it was useless, etc, etc. And get this. All this money was counted as spending on the NHS. So they're boasting about how much they spend on the NHS while starving it to death.

It's not about how much is spent, as much as what it's spent on. If a lot of money goes to shareholders, that isn't contributing directly to patient care. If every doctor has to employ four secretaries just to keep track of all the billing and insurance claims, that money isn't going on patient care. If medical insurance companies flourish, with huge numbers of employees and shareholders and enormous marble buildings panelled in mahogany as offices, that money isn't going on patient care.

That's how the USA manages to spend multiples of what everyone else spends on "healthcare", with overall poorer outcomes. We seem to be headed down the same road. Never was the phrase "cut out the middle-man" so desperately needed.
 
The NHS involved setting up a national insurance system, where pretty much everyone earning a wage pays in, the aim being for that to cover everything.

Prior to that, as my father remembers, there were local insurance systems. Where he lived, all the families paid the local doctor a small amount each month and then did not pay for appointments and minor medical treatment. Hospital visits had to be paid for.

Private health insurance works off the same principle as national or local schemes. Only a national scheme guarantees everyone can get free at the point of delivery every time. Private or local schemes mean only a certain cover and then pay. The US is full of former well off old people bankrupted by their illnesses and with no cover.
 
lionking said:
So who here has private insurance to cover the gap? Which will forever be there.
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I have self insured/warrantied for many things, putting money away to cover emergencies, rather than give it to companies.

I looked at private insurance and realised for us, that it made more sense to just occasionally pay to go private, which my wife and I have done three times, purely to skip NHS queues. It was £150 to skip the queue to get my consultation and then I got the meds for free by taking that doctor's prescription to my GP and getting them to prescribe what I needed.
 
I don’t know for certain but it looks like the UK, despite its much vaunted NHS and given the percentage of GDP spent on it, has never been a benchmark health system. Yes, better than the US, but not so great.
 
lionking said:
I don’t know for certain but it looks like the UK, despite its much vaunted NHS and given the percentage of GDP spent on it, has never been a benchmark health system. Yes, better than the US, but not so great.
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The UK NHSs are not the best way to fund and run a universal health care system, unfortunately it's a matter of that old joke "If you want to get to the Three-legged-dog Pub I wouldn't start from here".
 
Darat said:
The UK NHSs are not the best way to fund and run a universal health care system, unfortunately it's a matter of that old joke "If you want to get to the Three-legged-dog Pub I wouldn't start from here".
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All funding methods involve an insurance scheme, or people have to pay or go without. What is the best way?
 
Nessie said:
All funding methods involve an insurance scheme, or people have to pay or go without. What is the best way?
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It's from a few years back - Jimbob may still have the figures but I think it turned out that a combination of public taxation and compulsory (with subsides/low rates for low income) insurance was the most cost effective compared to outcomes.

Where the UK model is undoubtable "the best" was in ensuring true universal healthcare with nothing to pay at the point of delivery. It used to be also an incredibly efficient organisation, much more so than private companies. Sadly that has now also gone since so much of the NHS is now provided by private companies who can slap a NHS logo onto their paperwork.

Our current problems with our NHSs can be directly and easily traced back to 2010 and the decisions of the then and subsequent Tory governments to defund and "break up" the NHS. It is an entirely matter of government policy - there is no fundamental flaw in the NHS - beyond what the Tories over the last 12 years have deliberately introduced.
 
Nessie said:
The NHS involved setting up a national insurance system, where pretty much everyone earning a wage pays in, the aim being for that to cover everything.

Prior to that, as my father remembers, there were local insurance systems. Where he lived, all the families paid the local doctor a small amount each month and then did not pay for appointments and minor medical treatment. Hospital visits had to be paid for.
Private health insurance works off the same principle as national or local schemes. Only a national scheme guarantees everyone can get free at the point of delivery every time. Private or local schemes mean only a certain cover and then pay. The US is full of former well off old people bankrupted by their illnesses and with no cover.
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Rich beggars! For many people it was charity or nothing.
 
Echoing what most posters have said in this thread, that the current crisis in the NHS was sadly predictable and deliberately engineered.

The list of things that the NHS lacks is a long one and whilst money is always good to have, it's less useful when you lack personnel. The number of vacancies in the NHS is at record levels and a combination of Brexit and a long-term failure to train sufficient personnel has ensured that there's no prospect of the situation being reversed not least because working conditions are so bad that qualified people are leaving the NHS to work elsewhere in other industries or to retire.

The other problem is a lack of government funding for local services which means that the NHS ends up dealing with all kinds of problems that it shouldn't have to face. There are thousands of people in hospital who should be at home because the services in the community aren't there to look after them and people are going to A&E because they cannot see their GP.

The Conservative government has no interest in fixing the NHS, they simply want to avoid negative headlines and personal culpability while they continue their programme of privatising the easy and potentially profitable parts of the NHS.
 
lionking said:
Okay, it seems the UK spends 12% on health care. And it was far less under Labour.

So why is this happening? Demand more is spent on health care by government (and Blair didn’t) or get the public to pay more through private health insurance. The current system seems badly broken.
Click to expand...

The last time the UK NHS (as a whole) was in anything like such a state was when Labour got into power last time - because again the Tories for political reasons had underfunded the NHS. Blair and Brown then started to increase the percentage spent on healthcare taking it up and up. Until 2010 the average increase in NHS expenditure was 3.4% a year, from 2011 that was cut to 1.4%. So whilst the Tories crow that they have been increasing NHS funding they know that it wasn't enough to even keep the NHS to where it was in 2010.

And that also excludes the damage done to the education for new healthcare professionals.
 
lionking said:
I don’t know for certain but it looks like the UK, despite its much vaunted NHS and given the percentage of GDP spent on it, has never been a benchmark health system. Yes, better than the US, but not so great.
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Obviously this is now out of date, but I'm only responding to the highlighted word:

FcljchZ.png
 
Some of this is quite simple. First, almost nobody can fund all the healthcare they might conceivably need, although conversely many people will never need much spent on them.

If everyone has to fund their own care, then almost everyone will have to spend nothing at all on non-essentials, salting away every possible spare penny in the event they develop an expensive cancer or have an accident that requires major surgery and rehab. Consequence, most of the country's assets locked up in savings accounts, and all industry and enterprise that supplies non-essentials will disappear. No holidays, no entertainment, no hobbies. (Leading to mass unemployment, which worsens the problem exponentially.)

Most of this money will never be needed, but since you don't know that you won't be the one who needs it, you can't take the chance.

Conversely, if you take the total necessary healthcare spend for the population and divide it by the number of people in the population, it becomes surprisingly affordable. Doubly so if you devise a system where 90% of the money is actually spent on healthcare, not on shareholder dividends or mountains of paperwork. If you tweak things just a little so that those who can't afford even this "surprisingly affordable" sum are covered (by top-loading the contributions of those who won't even notice it), it gets even better.

Consequence, nobody has to salt away six-figure sums just in case they develop an expensive healthcare condition, everyone can go out and spend on holidays and entertainment and hobbies. Everybody's lives just got immeasurably better, and the economy flourished because industries and enterprises supplying non-essential goods and services started employing people again.

But somehow we want to move away from this because some people want to skim off much or even most of the money available for spending on healthcare into their own private pockets.
 
Here in Switzerland private health insurance is compulsory. You can choose from numerous different combinations of policies with numerous providers and choose your level of excess; once the basic legal requirements are met, you do what you like. It’s expensive if you want the most comprehensive coverage, but the quality of medical care is excellent and waiting times are, in my experience at least, very short.
 
I just visited a friend in Texas who found out she has Stage 4 oesophogeal cancer last year. She told me quite a bit about her life since her diagnosis, much of it I'm sure would be very familiar to people with cancer everywhere. But at least half of her tale of woe was taken up by explaining how difficult it was to get treated at all - she was between jobs when she got her diagnosis, and had no health insurance. She's in her thirties, and figured she'd probably be OK for a few months till she got another job.

When she found out how bad it was, the doctor she saw told her to present herself at a local A&E and not leave until they'd admitted her. Oh, and make sure you go on your own, don't let your parents go with you or they'll be made to pay. And don't tell the hospital you've already had a CAT scan revealing the cancer, or they won't admit you. And that was just the first day.

Obviously the whole story is horrible, but there's a whole level of horribleness that would be completely absent in the UK.
 
My insurance is through my wife's job. She's a teacher. It's ultimately funded by the government.

Most of my doctors are under the umbrella of WVU medicine. WVU is a state run university. So effectively owned by the same government.

So it would seem that essentially I am within a government run system. Except this is the US so both of these ends hire private companies to "administrate" their operations.

As it stands now somehow in July my insurance from the state will not be accepted at some hospitals ultimately owned by the state because of a reimbursement dispute between these for profit companies.

This seems... absurd.
 
Matthew Best said:
I just visited a friend in Texas who found out she has Stage 4 oesophogeal cancer last year. She told me quite a bit about her life since her diagnosis, much of it I'm sure would be very familiar to people with cancer everywhere. But at least half of her tale of woe was taken up by explaining how difficult it was to get treated at all - she was between jobs when she got her diagnosis, and had no health insurance. She's in her thirties, and figured she'd probably be OK for a few months till she got another job.

When she found out how bad it was, the doctor she saw told her to present herself at a local A&E and not leave until they'd admitted her. Oh, and make sure you go on your own, don't let your parents go with you or they'll be made to pay. And don't tell the hospital you've already had a CAT scan revealing the cancer, or they won't admit you. And that was just the first day.

Obviously the whole story is horrible, but there's a whole level of horribleness that would be completely absent in the UK.
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Once before, when we were discussing this on the forum, I watched a film about cases that fell between the cracks. One of these was very similar to this. A woman in her thirties decided to leave her job and set up her own estate agency company. She did take out health insurance, a policy that would cover her for a year. She hoped by then to be able to afford more long-term cover.

She was diagnosed with breast cancer.

Initially her insurance covered everything. But breast cancer isn't completely cured in three months - which I think is what remained of her insurance coverage at the time. Once the three months had passed she was on her own, no coverage, and no insurance company would take her on because she had a pre-existing condition. She was managing to get some treatment but she was rationing it. She was probably going to die of something that should not have killed her, and I think she knew it.
 
Going back to the question lionking asked - I do not currently have private health insurance and the only time I had it was when I was Sales Director of a company and it was provided, and paid for, by the company.

I have a problem with well off people like me having private insurance and it's the same issue I have with private education. If you're not affected by failures in public services then you're not going to fight for them.

It tends to be people like me who are the most vocal and so if we don't fight for the NHS it'll wither and die.

Edited to add...

IMO every penny spent on private medicine results in finite resources being directed away from, and denied to, the NHS either directly or indirectly. Shortcutting the process may be good for the individual, but it's bad for the health of the nation as a whole.
 
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The Don said:
Going back to the question lionking asked - I do not currently have private health insurance and the only time I had it was when I was Sales Director of a company and it was provided, and paid for, by the company.
I have a problem with well off people like me having private insurance and it's the same issue I have with private education. If you're not affected by failures in public services then you're not going to fight for them.

It tends to be people like me who are the most vocal and so if we don't fight for the NHS it'll wither and die.

Edited to add...

IMO every penny spent on private medicine results in finite resources being directed away from, and denied to, the NHS either directly or indirectly. Shortcutting the process may be good for the individual, but it's bad for the health of the nation as a whole.
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Same for me - added in for me even when it formed part of my benefit package I've "pre-existing" conditions (diagnosed when I was an early teen) that meant it covered very little.
 
lionking said:
I have been reading with dismay about the problems the NHS is experiencing. This leads me to compare the UK system with Australia’s.
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If you want to feel good about Aussie, compare it to ours, where you need to be at Stage IV cancer to get seen in the same calendar quarter.

I've insisted all my kids get health insurance - we have a perfect two-tier system over here, where those with insurance will live a lot longer than those without.
 
malbui said:
Here in Switzerland private health insurance is compulsory. You can choose from numerous different combinations of policies with numerous providers and choose your level of excess; once the basic legal requirements are met, you do what you like. It’s expensive if you want the most comprehensive coverage, but the quality of medical care is excellent and waiting times are, in my experience at least, very short.
Click to expand...

My friend who lives in Germany describes a similar system, where the employer pays half and he pays half into compulsory insurance, but the care is then excellent and he reports once arriving at an A&E in Berlin, on a Friday night, to find he was the only person there.

He was here last week and said that for the first time he was worried what if something happened, as it is news there how bad it is now here.
 
Rolfe said:
Once before, when we were discussing this on the forum, I watched a film about cases that fell between the cracks. One of these was very similar to this. A woman in her thirties decided to leave her job and set up her own estate agency company. She did take out health insurance, a policy that would cover her for a year. She hoped by then to be able to afford more long-term cover.

She was diagnosed with breast cancer.

Initially her insurance covered everything. But breast cancer isn't completely cured in three months - which I think is what remained of her insurance coverage at the time. Once the three months had passed she was on her own, no coverage, and no insurance company would take her on because she had a pre-existing condition. She was managing to get some treatment but she was rationing it. She was probably going to die of something that should not have killed her, and I think she knew it.
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Which reminds me of a news story a few years back, about a young American lady visiting Scotland. She has asthma, and the cost of the inhalers is so high that even in her well paid job (I think it was as a teacher) she lived in relative poverty to pay for those inhalers. She has a bad attack and the inhaler fails or something like that, she ends up in a chemist and they just give her a new inhaler. The shock of the story was that here she got something for free, which in the US was condemning her to a life of poverty.
 
The Atheist said:
If you want to feel good about Aussie, compare it to ours, where you need to be at Stage IV cancer to get seen in the same calendar quarter.

I've insisted all my kids get health insurance - we have a perfect two-tier system over here, where those with insurance will live a lot longer than those without.
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Thinking about the many years using NHS England and I can recall quite a few NZ bods, have we snagged many of your bods?
 
Nessie said:
Which reminds me of a news story a few years back, about a young American lady visiting Scotland. She has asthma, and the cost of the inhalers is so high that even in her well paid job (I think it was as a teacher) she lived in relative poverty to pay for those inhalers. She has a bad attack and the inhaler fails or something like that, she ends up in a chemist and they just give her a new inhaler. The shock of the story was that here she got something for free, which in the US was condemning her to a life of poverty.
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Probably the most damning thing I can say about my health insurance is that my supermarket pharmacy stopped taking my insurance and it turned out that I paid the same price. To be fair, I am on generics and it comes to about $30/mo.

Similarly, I have a cpap machine for sleep apnea. I had the whole thing stolen out of my car a few years back. I found out that by going straight to the manufacturer I could buy a cpap for less than I paid the insurance for the first one. Also that buying cpap supplies off Amazon is also significantly cheaper than going through the insurance.

US healthcare is wild.
 
Darat said:
The last time the UK NHS (as a whole) was in anything like such a state was when Labour got into power last time - because again the Tories for political reasons had underfunded the NHS. Blair and Brown then started to increase the percentage spent on healthcare taking it up and up. Until 2010 the average increase in NHS expenditure was 3.4% a year, from 2011 that was cut to 1.4%. So whilst the Tories crow that they have been increasing NHS funding they know that it wasn't enough to even keep the NHS to where it was in 2010.

And that also excludes the damage done to the education for new healthcare professionals.
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During the Thatcher period, NHS funding went up in real terms every single year. Unfortunately, it is a consequence of medical advances and our aging population that healthcare costs are rising in real terms by more than any government is funding. I'm all for paying more taxes to fund the NHS because I think we can afford it but, at some point in the not too distant future, we will have to call a halt.

There's also the problem that, in commercial terms, the NHS is inefficiently run. That said, you really don't want to be running your healthcare system like a private business. If you do, you end up with a monstrosity not dissimilar to the US health care system.

I love the NHS and I think it's the best thing my country has done since the end of the Second World War, but the problems are real and fundamental, and a Labour government is likely only to fend off the crunch for a few years.
 
A lot of what is wild about debates over medical spending issues is that it gets framed as waste when spending a ton of money on healthcare should be a good thing in and of itself. It increases quality of life and that is as core an interest as there should be.

There is, of course, efficiency and profiteering that needs to be controlled, but we've let that issue largely obscure the idea that medical care is a good. Which creates hostility towards public healthcare options at the core of this mess.

It also moves the debate away from supply. We, especially in the US, need to be more focused on training more and more doctors in a way more economically sustainable than giving them massive student loan debt requiring massive incomes to pay off. We look almost exclusively at the demand side and that's silly.
 
Nessie said:
Which reminds me of a news story a few years back, about a young American lady visiting Scotland. She has asthma, and the cost of the inhalers is so high that even in her well paid job (I think it was as a teacher) she lived in relative poverty to pay for those inhalers. She has a bad attack and the inhaler fails or something like that, she ends up in a chemist and they just give her a new inhaler. The shock of the story was that here she got something for free, which in the US was condemning her to a life of poverty.
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This story does not ring true. At least, not completely true.

Teachers in the public systems in the US are not relatively well paid generally, but they do benefit from both employer provided , reasonably good health care plans and relatively good pension programs.

It I certainly would not be normal for an employed US teacher to live in poverty as a result of having to pay for inhalers. My daughter is a public school teacher in one of the poorest, lowest paying states and she has (by US standards) good health insurance at reasonable cost that would ca- her out of pocket prescription expenses at under a couple of hundred a month.
 
jeremyp said:
During the Thatcher period, NHS funding went up in real terms every single year. Unfortunately, it is a consequence of medical advances and our aging population that healthcare costs are rising in real terms by more than any government is funding. I'm all for paying more taxes to fund the NHS because I think we can afford it but, at some point in the not too distant future, we will have to call a halt.
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Unfortunately it still meant it was underfunded. (ETA 2) And just using the top line figure often disguises where underfunding often happened i.e. training and education.

jeremyp said:
There's also the problem that, in commercial terms, the NHS is inefficiently run. That said, you really don't want to be running your healthcare system like a private business. If you do, you end up with a monstrosity not dissimilar to the US health care system.
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No it isn't - by all measures it is an incredibly efficient organisation. Granted over the last 10 years the Tories policies have decreased its efficiency by their privatisation by the back door. It's still always rated as one of the most efficent health systems in the world.
jeremyp said:
I love the NHS and I think it's the best thing my country has done since the end of the Second World War, but the problems are real and fundamental, and a Labour government is likely only to fend off the crunch for a few years.
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The problems are indeed real but apart from dental healthcare there isn't any actual fundamental issues, everyone knows what is wrong, everyone knows how the current problem came about and everyone knows how to fix it. It is having the political will to fix it that is the issue. Especially since the fixes will take over a decade it is whether the long term political will is there to fix it.

ETA:
The United Kingdom has the second most efficient health system of 19 economically developed countries, while the US health system ranks 17th, a comparative study has found. The research in the Journal of the Royal Society of Medicine (doi:10.1258/shorts.9 Aug 2011

https://www.bmj.com/content/343/bmj.d5143
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Darat said:
No it isn't - by all measures it is an incredibly efficient organisation.
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I'm not an NHS employee but I have recently come off a two year project contracted to the NHS. Believe me, it is not efficiently run - at least the bits I saw were not efficiently run.

ETA: underpaying your employees and making them work insane hours might look like efficiency, but it isn't really.

The problems are indeed real but apart from dental healthcare there isn't any actual fundamental issues, everyone knows what is wrong, everyone knows how the current problem came about and everyone knows how to fix it. It is having the political will to fix it that is the issue. Especially since the fixes will take over a decade it is whether the long term political will is there to fix it.

ETA:
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There are fundamental problems. The costs are rising faster than the budget, even though, for the most part, the budget is going up in real terms. Somebody quoted to me that costs are rising by 4% year on year. Not sure where that figure came from, but this article says spending needs to rise by 4% in order to get some modest improvements and we certainly need modest improvements. The only way this is sustainable is if the national income rises by at least that amount every year. It's not going to be close to that for a while, if ever.

The NHS has not been served well by the current government, but do not be fooled into believing it is just the current government's fault and that everything will be sweetness and light once it is kicked out of office.
 
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Darat said:
Thinking about the many years using NHS England and I can recall quite a few NZ bods, have we snagged many of your bods?
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I don't know for sure where UK ranks on the list of destinations for Kiwi medical staff, but probably second after Australia.

We've been dealing with a wide range of specialists here lately, and the common factor in all departments is that 90% of nurses and doctors in the pediatric area are foreigners.

You and Aussie take ours, we take them from Indian and Africa, and the people in India and Africa go without.

Capitalism at its purest.
 
sarge said:
This story does not ring true. At least, not completely true.

Teachers in the public systems in the US are not relatively well paid generally, but they do benefit from both employer provided , reasonably good health care plans and relatively good pension programs.

It I certainly would not be normal for an employed US teacher to live in poverty as a result of having to pay for inhalers. My daughter is a public school teacher in one of the poorest, lowest paying states and she has (by US standards) good health insurance at reasonable cost that would ca- her out of pocket prescription expenses at under a couple of hundred a month.
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IIRC, her inhalers were costing around the equivalent of £16,000 a year.
 
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