Today, I’m going to do something a little different. Normally I use This Week in Mentalists to do a round-up of weekly thoughts and musings from mental health bloggers. However, this week there seems to be a particular issue that’s popping a lot on the blogosphere, and that’s the way US right-wingers have been attacking the NHS as part of their own debate on healthcare reform. So, I’m doing a TWIM special on that very issue. Regular TWIM will be done tomorrow instead.
To us Brits, the NHS is like a son who is basically decent but you just wish would apply himself a bit more and try to live up to his proper potential, and you grounded him last week for coming home drunk and throwing up on the stairs. Naturally you call him every name under the sun, but if one of your neighbours lays a finger on him you’ll kick your neighbour’s ass.
Aethelred the Unread loves America, but doesn’t understand the opposition to healthcare reform.
We are told that support for reform has slipped as low as 50%. I understand that there are powerful vested interests ranged against reform, and that these are conducting an expensive advertising campaign. I might, in fact, describe this as a campaign of deliberate misinformation, given that Americans have apparently been told that UK patients over the age of 59 can’t get treatment for heart problems. This is a lie – there is no upper or lower age limit for receiving treatment on the NHS, neither is treatment withheld because a person is terminally ill.
My own mother (who was 75, and terminally ill) received expensive treatment at the hands of dedicated and caring professionals right up to the moment of her death, and did not have to pay a penny for it (beyond the money she had paid in tax earlier in her life, of course). Ultimately she did die – there was no way back at any price from what eventually killed her, sadly – but she was never refused treatment. In fact, in the final months of her life she benefited from a treatment so new it was being reported in the current issue of the British Medical Journal at the time she received it. I wonder if a private health insurer would have paid out for a new treatment so rapidly?
Other lies and distortions are being peddled also. One of the more amusing was the (hastily retracted) claim that Stephen Hawking would not receive treatment on the NHS. The paper making this claim (and the many anonymous internet commenters who have repeated it) seem to be unaware of the fact that Professor Hawking is a UK resident, and has received all of his medical care free at the point of delivery on the NHS.
Just to add my own footnote to Aethelred’s comment on the claim that ” UK patients over the age of 59 can’t get treatment for heart problems” – My mother is over 59 and continues to receive ongoing and complex treatment for congenital heart disease from the NHS.
Social work blogger Fighting Monsters also rises to the defence of the NHS.
I may be biased and so be it. I have to say that although I have been fortunate to enjoy good health, I can reach out for many family members and friends who, in through some of the most troublesome times, have received beyond exceptional and in one case, ground-breaking care with no charge incurred whatsoever, no worry about premiums or employment status, no question that the procedures that need to happen would happen when they needed it and at the hospital of choice.
The British hold the NHS dear for a very good reason – we all have a constant interaction and even the healthiest of us have had some kind of contact with it. Knowing that when a patient is discharged from the hospital which I work in, never has to pay or worrying about paying for a prescription or at the very least, when a prescription charge is incurred, there is a capped charge that is nowhere near the cost of the medication.
Knowing that I will never be in the position of having to make a decision about health care based on cost alone is most resolutely a place I want to be and a service I am proud to work in and with.
Frontier Psychiatrst takes Sarah Palin to task.
Former Vice-Presidential candidate Sarah Palin – whom, for what it’s worth, I entirely loathe – is not shy of this imagery. She wrote on her blog, in a gross characterisation of the Obama proposals:
…the America I know and love is not one in which my parents or my baby with Down’s syndrome will have to stand in front of Obama’s ‘death panel’ so his bureaucrats can decide, based on a subjective judgment of their ‘level of productivity in society’, whether they are worthy of healthcare. Such a system is downright evil.
Here and elsewhere the NHS has been getting caught in the crossfire. Palin is presumably referring to NICE’s attempts to decide whether expensive drugs provide value for money. Republican senator Chuck Grassley has also confidently said that, under the NHS, Senator Edward Kennedy would be left to die untreated for his brain tumour.
If I was the NHS I’d sue for libel.
Moving into the non-mentalist blogosphere, Liberal Conspiracy calls Tory Euro-MEP Daniel Hannan (who has been touring the US news channels slagging off the NHS) a national disgrace.
So to see a British politician roaming the USA, frequenting the most biased, unreasonable and willfully ignorant news outlets in existence, spouting misinformed drivel to screeching hate puffed lummoxes like Glenn Beck about the imaginary horrors of ’socialized’ health care is almost obscene.
Watching Daniel Hannan speaking as a supposed representative for Britain on Fox News, bleating about how our country has been rendered feral and crippled by the NHS is enough to raise a sudden, unexpected swell of patriotism normally reserved for the success of a British icon on the global stage or spectacular sporting defeats.
Unfortunately, his eloquence alone is enough to elevate Hannan to the position of grand visiting statesman in the miopic yellowed eyes of Fox and friends. That he only speaks half-truths, lies, and distortions, while grossly misrepresenting 99% of the population of Britain is not enough to stop the increasingly rabid American right-wing to beg him to ‘run for congress!’ or ‘run for Prime Minister!’ or ‘for God’s sake, run for something!’
Ministry of Truth also lays into Daniel Hannan.
So, in the last couple of days I think we’ve safely established that Daniel Hannan is a complete and utter twat. That said, the full extent of Hannan’s outright twattery only becomes fully apparent when you examine the background to his assertion that the NHS should be replaced with a Singapore-style system of personal health accounts because…
The Singapore system produces better outcomes than ours for half the price.
Taken at face value on a comparison of key health indicators and taking into account the relative proportion of GDP spent on healthcare in the UK and Singapore that’s perfectly true but it rather ignores a very important and somewhat unusual feature of the Singaporean system, one that makes it very different from healthcare systems in both Britain and the US.
When it comes to providing healthcare to its citizens, both the supply and the price of healthcare in Singapore is actively regulation by the Singaporean government, in both the public and the private sector in order to control costs and avoid the kind of significant inflationary pressures that pretty much every other healthcare system in the world has had to deal with.
Now that’s a great trick if you can pull it off but not one that I’d suspect forms part of Hannan’s grand plan for doing away with the NHS given his fondness for anti-state rhetoric and free markets in just about everything else. Indeed, for someone who is so vehemently opposed to state involvement in just about anything, Singapore is a rather curious exemplar to hit upon.
Go to the blog post for more number-crunching from Ministry of Truth.
Penny Red reports on her partner’s ongoing treatment under the NHS for a chronic bone disorder.
Whenever he needs an operation, my partner receives top-quality care from our local hospital – eventually. Because his debilitating, agonising condition is not life-threatening, he normally has to wait many months for the free operations, and the process of consultation and aftercare varies on a sliding scale from risible to non-existent.
On the other hand, his disability makes him unfit for most work, and were we US citizens my meagre half-salary would doubtless put us amongst the 43 million Americans with no healthcare cover at all. We can and do complain about the NHS – being British, it’s one of our favourite hobbies – but the specialist painkillers he needs to get through his worst days are free, and they will remain free for the rest of his life.
It isn’t easy for my partner, being 25 years old and facing a lifetime of pain and limited mobility. He worries about his future; I worry, among other things, that any children we decide to have will inherit his condition. But one thing we never have to worry about is being able to afford those vital operations, or the medication that keeps him stable.
Moreover, if I were to fall pregnant tomorrow, even on my low-income I would be treated to regular check-ups, help to quit smoking with free NHS classes, ante-and-post natal care, and food vouchers so that I could afford to drink milk, eat vegetables and take supplements to safeguard my health and the health of the fetus. By contrast, staggering inequalities in the US healthcare system mean that the United States has the highest infant mortality rate in the developed world.
I’m proud to live in a country with ‘socialised’ healthcare. For all its faults, its shoddy waiting lists and its dreadful dental care, the NHS system erases health inequalities and relieves millions of people, rich and poor, from the burden of constant anxiety about medical bills and sudden sickness. Even more importantly, it creates the progressive impression that the physical and mental health of the nation is the collective responsibility of all its citizens. In the process, without making a fuss about it, the British NHS truly upholds the principles of life, liberty and the pursuit of happiness for all. If that’s socialism, then sign me up.
NHS Blog Doctor compares the British and US systems.
God knows, all is not well in the NHS.
If I were a multi-millionaire and/or insured up to the eye balls, I would be delighted to have any acute, serious medical condition treated in the USA. Acute medical care does not get better than the best of American medical care. If, that is, you can access it. If, on the other hand, you have a chronic medical condition, like rheumatoid arthritis, don’t got near the USA.
Obama is tackling the festering sore, the national disgrace, of those millions of Americans who have no health care at all. They would love to wait a few weeks for a hip-replacement. Beats not getting one at all because you have no money. The uninsured Americans are from no definable constituency. They are poor, they are black, they are Latino. Few will speak up for them. This President is trying and he might, he just might, for the first time, get something done.
There is nothing like health care reform to get the fly-over zone, Ku Klux Klan supporting facist-hyena, boonie-bred American to sit up and take interest. The American right-wing, the insurance companies, big business, and all the racist red-necks are mobilising. They are misrepresenting the NHS, they are tarring it with the word “socialized”. We have seen nothing like it since the “better dead than red” paranoia of the 1960s. And they are mobilizing rent-a-quote malevolent shits like Professor “please don’t mention Imperial Collge” Sikora and Daniel Hannan to buttress their cause.
There is much good in both health care systems. But, if you are poor, unemployed and seriously ill, you are better off in the UK. We may not have got it right, but we do not have diabetics dying because they cannot afford insulin; we do not have teenagers dying prematurely of leukaemia because they cannot access treatment.
Just to quickly state my own views: I work in the NHS. I’m not blind to its faults – the waiting lists, the postcode lotteries, the infuriating bureaucracy, the political meddling. Even so, while it’s true that Michael Moore’s Sicko did to a certain extent gloss over the failings of the NHS, it’s also true that the likes of Glenn Beck, Sarah Palin and Daniel Hannan are ignoring or distorting its successes. There are no ‘death panels’ that decide who lives or dies. We do not refuse treatment for heart conditions or brain tumours if you’re over 60. Professor Stephen Hawking would not have died if he lived in the UK – Oh wait, he does live in the UK!
I’m in my early 30s and in good health, so my use of the NHS has always been for relatively minor interventions – the odd hernia operation here, a sprained ankle there, my annual helping of hayfever medication. However, my family have received a great deal of help for complex and serious conditions, including strokes, heart conditions and cancer, and I remain profoundly grateful to the NHS for the help and the life it has given us.
Like any good or service, state provision is more costly than that provided by genuinely competing (healthcare) companies. People who defend the NHS are attacking the ability to best meet the demands of patients, which is certainly a curious move for anyone who professes to value health.
Sadly, many are duped into believing that without total control by the state, poor people would be left to die.
“I’m not blind to its faults – the waiting lists, the postcode lotteries, the infuriating bureaucracy, the political meddling.”
These faults (and others) are *necessary* components of state-provided services. To be sure, there would be similar issues to be resolved in a non-state system. However, the difference is that competing firms have an incentive to please customers. With 1.4 million employees and no serious competition, the NHS has to answer to no one.
“However, my family have received a great deal of help for complex and serious conditions, including strokes, heart conditions and cancer, and I remain profoundly grateful to the NHS for the help and the life it has given us.”
I am lucky to have had few medical ailments, but others in my family have been less fortunate. I am grateful to the staff who treated them, but I will never be grateful that the state created a de-facto monopoly on healthcare and introduced enough legislation to make the private provision of such services far too expensive for the average person. It is a shame that whenever the subject of healthcare is discussed, some people (not necessarily you, I mean generally) prefer to hang on to the absurd proposition that an NHS is the best way to ensure a healthy populace.
The We-Love-The-NHS movement makes me ashamed to be British.
With 1.4 million employees and no serious competition, the NHS has to answer to no one.
No serious competition? You’ve never heard of BUPA?
I totally hang on to the absurd proposition that an NHS is the best way to a healthy populace.
The *only* beneficiaries of a predominately private competitive health care system would be shareholders. Then possibly some cheap patients.
The beneficiaries of free markets are overwhelmingly the customer. The regular, poor, average customer. Standards of living have, in the past few centuries, improved beyond all expectations. Division of labour and genuine competition ensure that the customer gets what they want, at the lowest price and the highest quality. This holds true for all goods and services, and so is true also for healthcare.
Sure enough, shareholders of successful medical firms will do well. But only when the companies they invested in please their customers.
Sadly, we are brought up to believe that private industry is an evil that is must be tamed by our friend the state. How wrong this is.
“This holds true for all goods and services, and so is true also for healthcare.”
No, it holds true for those good and services which are amenable to competition. Like shoes. There should be a free market in shoes. Markets are the best way of making shoes. But no-one really cares about shoes. Would you want the military to be privatized? Do you think we would have put men on the moon if space exploration was privatized? Do you think we would have eradicated smallpox if public health were privatized?
“There should be a free market in shoes. Markets are the best way of making shoes. But no-one really cares about shoes.”
Oh dear. So the critical difference between shoes and healthcare is that people only care about healthcare? To such an extent that the basic laws of economics are broken? No.
“Would you want the military to be privatized?”
I’ll assume you are not completely ill-informed here. What is your definition of ‘private’?
“Do you think we would have put men on the moon if space exploration was privatized?”
How on earth is this relevant?! I fully “concede” that some things the state throws money at will not have occurred without the state throwing money at it. This is undeniable. Space travel is a peculiar example to use for whatever point you were trying to make though — many people on all sides find NASA and related govt agencies a complete and utter joke.
“Do you think we would have eradicated smallpox if public health were privatized?”
Let us break down your (unstated) argument here. You are saying that because the state can throw money at a particular project, therefore the state should have a monopoly on healthcare provision. Well, it simply does not stand. By pointing out that the state can direct massive amounts of resources at something and occasionally achieve a goal, you are completely blind to the costs of doing so. The question is: can we achieve the same or better results by using better methods. And the answer is: obviously yes.
I can’t afford private healthcare, and private health insurance usually does not cover pre-existing conditions. That’s not because I’m heavily taxed, it’s because I don’t have that much money to start with. (It turns out depression and poverty tend to go together. Poverty is depressing, and the mentally ill rarely have the spare energy to bust their asses getting out of poverty. Who knew?)
My choices are free healthcare or no healthcare. Without the NHS, my depression and eating disorder would have killed me. I have very little patience for people talking in theoretical terms how wonderful it would be, when my actual real life would be over.
Most people cannot dream of paying for private. Why? Because people have already paid tax to fund the NHS, and b) massive regulation bumps up costs above where they would be without the beloved state “overseeing” matters. So no, BUPA are not serious competition.
BUPA and other private companies are all well and good, and indeed I received excellent treatment in a private psychiatric hospital courtesy of them, but you are completely screwed if you have a pre-existing condition and want private insurance. I unfortunately lost my private health insurance (long story) but I would be more than willing to pay for it again IF it would cover my mental health problems. But since it won’t, unless I am free of medication, therapy, and symptoms for 2 years, and even then maybe not if that is what they decide, it just isn’t worth it. So yeah, insurance is great and lots of things are better private, but many people either can’t afford to do this, or have pre-existing conditions etc etc, and for all of those (the majority) the NHS is absolutely invaluable. The mental health treatment I get on the NHS may be poor (although I know in some areas it is very good), but if I had to rely on private treatment via an insurance company I would get nothing. Nobody is telling the Americans that if they have a free health system that *have* to use it, and nobody can go private, but at least there would be a choice. I have heard some Americans slagging off the NHS saying ‘Have you seen their teeth?’ Well I wonder if they have seen the teeth of the millions of Americans who can’t afford expensive insurance or treatment, for their teeth or anything else, and so just have to suffer with whatever problems they have. No, the NHS isn’t perfect, but I certainly wouldn’t want to be without it.
you are completely screwed if you have a pre-existing condition and want private insurance. I unfortunately lost my private health insurance (long story) but I would be more than willing to pay for it again IF it would cover my mental health problems. But since it won’t, unless I am free of medication, therapy, and symptoms for 2 years, and even then maybe not if that is what they decide, it just isn’t worth it.
Yes. Because this is how insurance companies make their money – they sell policies to the people least likely to claim on them. In this case, it means you can only have healthcare if you probably won’t need it.
BUPA can not really be considered serious competition to the NHS. That would be like saying that a privately owned Deli in the centre of town is “competition” for Sainsburys. Sure they are both in the food retail sector but that is as far as it goes.
“But no-one really cares about shoes”
Oh dear Neuroskeptic you obviously have not met my wife.
I generally agree with Ted that a free market is the best way to provide goods and services such as shoes, cars and haircuts, but I also agree with Neuroskeptic that certain services such as health, defence, and law enforcement do not. It would be nice if we could “shop” for health care in the same way we “shop” for food but an average sized town while it can sustain two or three supermarkets could not support two or three hospitals.
The bit I don’t get is why an insurance based sytem works so badly in America but works so well in France and Germany?
I agree! Markets must be better and more efficient than state provisions, that’s just a truth. I mean there are loads of really convincing arguments for that.
The fact that Americans spend twice as much on healthcare as a % of GDP and die sooner doesn’t change that at all. Who needs numbers?
It’s just like police, military, and legal services. They work better when they’re privatized. Now I’m off to Somalia to live the no-state dream.
Strip away the hype and it appears that the average life expectancy of a Brit is virtually identical to the average life expectancy of an American.
The real question is not what do we currently have but where do we go from here ? There was an interesting little anecdotal piece in the Mail today about an American lady shocked at the lack of aspiration in British young people. Young Americans know, damn well, that they will have to achieve something in life to have any hope of decent care. I`m actually rather fond of the NHS . However, if we continue as we are the welfare state, with the NHS rather closer to its heart than I would like, will drag this country to it`s knees whilst the USA will remain comparitively prosperous.
Where are Beakie and Mr Ian ? Have they got their slothful arses out of the computer chair and taken a peek at the real world ?
Why are you so sure that the country will end of its knees, given that 50 years of the NHS doesn’t seem to have done that so far?
Neuroskeptic,
Are you really not aware of the reasons why markets allocate resources better than elected officials?
First, you neglect to mention how much the US Government spends on healthcare. Second, you imply that US citizens are spending money on healthcare provided in a free market (this is clearly not true). Third, your references to private police, military and legal services are empty and thus pointless.
I’ve read plenty of economics theory if that’s what you mean. I could explain in some detail why markets are more efficient than planned economies at making shoes, if you’d like, but we both agree on that.
I am saying that healthcare is, in an important sense, like the military, which no-one seriously wants to be privatized. You said that “Division of labour and genuine competition ensure that the customer gets what they want, at the lowest price and the highest quality. This holds true for all goods and services” – I am saying that unless you think that police, defence and legal services should be privatized, you are clearly not talking about all goods and services. That’s the point, it is hardly pointless.
“I am saying that healthcare is, in an important sense, like the military, which no-one seriously wants to be privatized”
Some people do, but most want a socialist system. This is just majority opinion though, and does not make something right or wrong.
“I am saying that unless you think that police, defence and legal services should be privatized, you are clearly not talking about all goods and services. That’s the point, it is hardly pointless.”
As it happens, my position is consistent — all goods and services can be provided better by the market. I am pleased that you brought it up, but it does not bear closely on the matter at hand. Clearly, there are massive structural problems with state provided healthcare that even a moderate liberal could agree need removing.
So you believe that military and police services would be better provided by markets – although we don’t know whether this is true because no state has ever tried to privatize those services.
Now I see why you think medical services are better provided by markets, although as I said above, the American model costs twice as much and gives worse outcomes than the “socialist” British model.
You just think that markets are the answer to everything, and as I sarcastically said, who needs numbers when you have a belief like that?
The smallpox example was not a matter of “pointing out that the state can direct massive amounts of resources at something and occasionally achieve a goal, you are completely blind to the costs of doing so.” of course eradicating smallpox cost a lot of money. And it saved millions of lives, as do other vaccination programs.
Vaccination programs are a great example of something that can only be done by states. If you tried to sell people vaccines like you were selling them a pair of socks, some of them wouldn’t be able to afford it, or would choose not to be vaccinated, and you can only eradicate a disease by vaccinating (almost) everyone. By its nature public health is not something you can leave to markets.
Environmental protection is another one (although you might be able to harness the power of markets by introducing artificial costs such as carbon taxes).
“no state has ever tried to privatize those services.”
If those services were to be truly private, the state would disappear. But anyhow, this is getting away from the point of the article.
“Now I see why you think medical services are better provided by markets, although as I said above, the American model costs twice as much and gives worse outcomes than the “socialist” British model.”
The American model is awful and should be abolished. It is not, by any stretch of the imagination, a private system of healthcare provision. That said, you can receive good healthcare in the US relatively easily.
“You just think that markets are the answer to everything, and as I sarcastically said, who needs numbers when you have a belief like that?”
But the numbers are not comparing free vs state provided healthcare, as I said. The numerical comparison in entirely invalid. You never answered my question asking how much the US Govt spends on healthcare (per person, as a % of GDP, whatever).
“The smallpox example was not a matter of “pointing out that the state can direct massive amounts of resources at something and occasionally achieve a goal, you are completely blind to the costs of doing so.” of course eradicating smallpox cost a lot of money. And it saved millions of lives, as do other vaccination programs.”
What is your point here? I said that the state can sometimes achieve goals that may or may not have taken place in the free market, and that the costs of these achievements are usually dismissed as irrelevant. Obviously it saved lives. But so would spending twice, three times as much as much GDP on healthcare. The question is who can provide it better according to the needs of the public. Markets are more efficient than elected officials at allocating resources. This is undeniable.
“By its nature public health is not something you can leave to markets.”
I’m not clear what you mean by public health. It used to refer to things like dealing with contagious diseases, but now refers to whatever the state wants to be involved in. Are we talking about only contagious diseases, or all diseases, etc etc etc. The differences are very important.
“Environmental protection is another one”
With the state having a monopoly on law enforcement, it is *slightly* unfair to suggest that no one other than the state has provided a system for dealing with environmental protection.
“The American model is awful and should be abolished. It is not, by any stretch of the imagination, a private system of healthcare provision.”
OK, but it is, you must surely admit, more private than the British system.
“You never answered my question asking how much the US Govt spends on healthcare (per person, as a % of GDP, whatever).”
The US government spends more on healthcare than the British government – according to this anti-NHS blog. Then Americans spend as much as that again on private healthcare, so they spend twice as much overall.
“I said that the state can sometimes achieve goals that may or may not have taken place in the free market, and that the costs of these achievements are usually dismissed as irrelevant. Obviously it saved lives. But so would spending twice, three times as much as much GDP on healthcare. The question is who can provide it better according to the needs of the public. Markets are more efficient than elected officials at allocating resources. This is undeniable.”
Well, if you want to define “allocating resources” in such a way that, by definition, markets are the best way of doing it, then yes, you’re right. Of course, states do not spend resources on exactly the same things that markets do. And if you regard any deviation from market equilibrium as “inefficiency” then by definition states are bad.
I personally think that eradicating smallpox is a very important thing to allocate resources to, and I don’t think it would have happened by now (if ever) without state action.
“I’m not clear what you mean by public health. It used to refer to things like dealing with contagious diseases, but now refers to whatever the state wants to be involved in.”
Not really, but even on a strict definition of preventing infectious diseases, you need state action.
Ted, good to see you again it was getting rather dull around here without you to liven things up a bit.
As an example of how unfettered free markets do not always give you the best results what do think of this report in the BMJ (British Medical Journal 323:126 21jul01)
“Smokers are doing their country a huge favour by boosting tax revenue, dying early, and not drawing a pension, according to a report by the tobacco giant Philip Morris.
Officials in the Czech Republic have been given an analysis, commissioned by the cigarette manufacturer, which suggests that the economic benefits of smoking to the country far outweigh the harmful effects. Rather than being a drain on healthcare resources, smoking actually saves the country more than £100m ($140m) a year because of the premature death of smokers, concluded the Massachusetts based consulting firm Arthur D Little International, which carried out the analysis.
It worked out that the early death of smokers saved the government up to £21.5m on health care, pensions, and housing for elderly people in 1999. The auditors also calculated how much the country spent on caring for people with smoking related diseases and the income tax lost when smokers die. Overall the net profit made by the government, including the revenues from tobacco tax, in 1999 came to £102.3m.
Philip Morris moved into the Czech Republic almost a decade ago and now owns nearly 80% of the former state tobacco company, Tabak, selling its flagship Marlboro cigarettes alongside local brands. The company said that it received the report at the end of last year and made it available to officials in the Czech Republic after they complained about the enormous burden that smoking was placing on their healthcare resources.”
I generally agree with you that a free market is the best way to provide goods and services such as shoes, cars and haircuts, but I also agree with Neuroskeptic that certain services such as health, defense, and law enforcement do not. It would be nice if we could “shop” for health care in the same way we “shop” for food but an average sized town while it can sustain two or three supermarkets could not support two or three hospitals. Some services fall into what I would describe as a natural monopoly (health, transport& defence) while others do not
The bit I don’t get is why insurance based health systems work so badly in America but so well in France and Germany?
Neuroskeptic,
1. Please explain how you can reconcile the following two statements (both of them yours).
“OK, but it [the US system] is, you must surely admit, more private than the British system.”
“The US government spends more on healthcare than the British government.”
2. Here is another error you make.
You said: “Well, if you want to define “allocating resources” in such a way that, by definition, markets are the best way of doing it, then yes, you’re right.”
But you clearly misread me. I said that markets are the most *efficient* way to allocate resources. It so happens that I also think they are the *best* (ie fairest) way, but that is a different step of the argument. I didn’t simply define markets as best and then happen to find they are best. You say yourself that markets allocate more efficiently than officials. Efficiency as a concept is not political. Preferring one set of rules for transfer of property over another set is political. Please be more careful when you attempt to characterise others’ arguments.
3. Lastly…
You said: “Not really, but even on a strict definition of preventing infectious diseases, you need state action.”
Not only do you not know this to be the case, but you fail to address my point that public health now means something very different to what is used to. Unless you are clear on what it means, debate is pointless.
There are so many counters to the but-it-needs-to-be-state-run position that it would take too long to list them all. One immediate response is to ask, if so many people really want a state monopoly on healthcare, why don’t all the supporters put their money where their mouths are and let anyone who wants out to enjoy the obvious benefits of health services provided under competition? I read somewhere that the NHS costs each person in the UK £1,500 per year. Doesn’t it strike anyone with some amount of imagination that this figure is far higher than the average person would need to spend on healthcare in an average year?
“1. Please explain how you can reconcile the following two statements (both of them yours).
“OK, but it [the US system] is, you must surely admit, more private than the British system.”
“The US government spends more on healthcare than the British government.””
The American system is more private and it’s so inefficient that the government has to spend more than we do to clean up the mess.
Easy – come on, try harder please.
“Please be more careful when you attempt to characterise others’ arguments.”
I stand by my characterization of your argument. I said that state action achieves important things that markets cannot do – and provided several examples – you didn’t dispute my examples but claimed that markets are, nevertheless, more efficient.
Neuroskeptic,
So your evidence for the US being a private system (in the face of the US Govt spending double the UK Govt) is that private provisions are inefficient and therefore require a helping hand?!
Are you serious?!!!! You have either misinformed yourself about the meaning of ‘private’ or are attempting to overlook your clear mistake by focusing on some alleged reason for US Govt involvement, rather than the point of debate (ie, the *fact* that US healthcare is largely state-provided and regulated).
“I stand by my characterization of your argument.”
I already made the point that saying markets are more efficient (true) and saying they are morally best (up for debate) are not the same thing, but you gloss over my point and simply re-assert your preference for statism. If you cannot read and respond to what I write, then there is no point me bothering.
Laughing at the Stephen Hawking issue, cos I work at the hospital where he is treated – and have even walked past him ! (shock horror !)
The NHS has a lot of faults, most of which is down to poor management and government crackpot schemes. But I have to say where else in the world is there provision of free treatment for all ? (yes, yes I know it is funded through our taxes etc ). That said I am concerned that the way the NHS is currently funded/ run is not sustainable, particularly with regard to the sheer numbers of people being treated.Then we have the expectations of the government and their target setting and paperwork generated – complete pains in in the bleedin arse .Don’t even get me started on the attitude of a great deal of the public towards the poor bloody staff who work in the hospitals. I do wonder though at times if the Great British Public do really have a grip on what goes on in hopitals and the real reason for failings in hospital care. Finally I just wish they’d understand that hospitals are not hotels and trying to piss the staff off with unrealistic demands is just going to get them nowhere.
Markets – would those be the markets that mean that our fuel costs keep rising? You know, the ones where no one can prove a cartel, but, surprise surprise, all the prices locally seem remarkably similar and allow shareholders to make a massive profit increasing retail prices whilst wholesale prices go down?
Would those be the markets that mean that prices to farmers go down whilst prices in supermarkets go up?
Would those be the markets that mean that we have three bus companies operating the same route, but they all charge the same (high) fares and come in convoys so as to try and pick up one another’s passengers, which means that we don’t benefit from a more frequent service?
Nutty, if you are genuinely concerned about a lack of genuine competition in the provision of good and services, then you might want to reconsider that removing all competition from the provision of healthcare is perhaps not the answer to be looking for.
My understanding of economics, slim as it is, is that a capitalist system (free market with competition between groups/companies/whatever) is better than a state run system because it allows new ideas and theories the chance to test themselves against the established (in this example, state controlled) theories. A good point of reference is the fact that not many people brought Russian state produced cars, because they were crap. The free market however, innovated and produced better, more reliable vehicles, through what’s basically a darwinian system. And it’s still happening to this day (American car companies are relying far too much on the “Buy American” market, which is why they have so few exports. I’m talking of course about private ownership “leisure” cars, actual work vehicles are probably very different.).
This is a theory I will defend to the hilt (and personally, I’m pretty left wing. Not enough to join a group or anything), simply because it evidently works in line with the theory. However, medicine has it’s own set of judgements that defines how well it works, and cash-paying uptake is not it (if so, we should be prescribing internet “Viogra” for every condition, cos a load of people pay for it after getting those emails…). It is called Science, and the defining factor is how effective it is for patient care. And so in that, a single large group, with all the differing ideas and theories on a problem (obviously, working outside political influence and entirely for the good of said science) is the way to get results. Such as NICE. Frankly, I wish there were similar groups controlling for example, ward staffing ratios etc…
However, that’s just my opinion, and you’re free to tear it to shreds.
Just reading back through that, I realise I’d focused more on the science of healthcare itself, rather than the economics of it (which is of course what the real argument’s about, the whole “Barak Obma’s a Nazi Muslim who was born in Kenya” crap notwithstanding). Anyway, like I said, I feel a single large conglomerate of differing ideas that are tested scientifically is the best method.
And so how do we fund this conglomerate, you may ask? (fair question).
Well, you do it the same way that you fund the other vitally important things to the nation. Such as the police, military, and Nuclear arsenal.
Admittedly, garunteeing absolutely no political influence on results or decisions may be tricky (God knows we struggle enough with it over here…), but I’m sure you can handle it.
And if you disagree, then privatise Nuclear missile control. Else you are a hypocrite.
Again, only my opinion, tear it apart, etc…
“However, medicine has it’s own set of judgements that defines how well it works, and cash-paying uptake is not it”
Medical insurance is one way to get around some of the difficulties of up front payment. However, when the state gets involved to the extent that is basically runs the whole show (eg USA), the results are a disaster.
Another thing which your left-wing sentiments might appreciate is that the decriminalisation of all drugs would make it easier for all people to access medication (especially pain medication). The control of medication by state-licensed doctors is a particularly cruel joke to play on the public, who unfortunately don’t seem to realise the harm it does.
My understanding of economics, slim as it is, is that a capitalist system (free market with competition between groups/companies/whatever) is better than a state run system because it allows new ideas and theories the chance to test themselves against the established (in this example, state controlled) theories. A good point of reference is the fact that not many people brought Russian state produced cars, because they were crap. The free market however, innovated and produced better, more reliable vehicles, through what’s basically a darwinian system.
In theory. Unfortunately, you also get fun examples like Microsoft and the British train system.
The NHS, as Z has already pointed-out, has a deeper symbolic meaning than just a state-controlled health provider, it has a place in many people’s sentiment which cannot be captured by a mechanical economic model.
To understand this, try standing in a blood donar queue and listening to the competative banter as to who has given the most blood. But everywhere volunteers are donating tissue, time and services freely. NHS staff work many unpaid hours (personally, every week I work two and a half hours unpaid because I do not take a lunch-break) We do this because it is a ‘not for profit’ organization. Many volunteers do it because it is an altruistic act of true citizenship. But of course, the unintended consequence of this is enourmous economic savings.
I do hope that the free-market supporters on this forum have factored this into their very rational balance sheets.
“I do hope that the free-market supporters on this forum have factored this into their very rational balance sheets.”
You are joking, right?
You are joking, right? – of course I am
Just checking!
sideshowjim, I am quite confused about your stance on the free-market, you say you are a leftie and then you appear to agree with the notion that private is more innovative than public organizations. Is being a leftie congruent with supporting laissez-faire?
With regard to this claim (which is one of many liberal dogmas), I will continue with your American/Russian example:-
In 1917, the population of Imperial Russian consisted of 95% peasantry, most were illiterate, of those quite a few were serfs (yes serfs in the 20th century) By the 1970s, the Soviet Union had the highest proportion of scientific and technical staff in the world. In a century where the symbolic pinacle of scientific acheivement was space exploration and travel, the Soviet Union put the first man into space. How more innovative can you get?
Ah, I can see where I wasn’t totally clear there (sorry, 1 am messages never tends to come out as well as we’d like!).
My point of view is that the free-market works very well in some areas, areas where there’s space for multiple competitors. This way, better products or what have you thrive, and so on. However, many systems I feel are better run by the state, particularly those where the nature of the system/product/whatever would create natural monopolies (e.g., trains, healthcare, water supply, major projects, and so on). Ideally in as non-partisan a manner as possible as well (although arguing for more QUANGOs is probably not a winning strategy for most politicians!).
That was the basis for what I meant, although I may have blurred it a little in the text (desperately trying to prevent people replying with “FILTHY LEFTY LIBERAL!!/MAIL-READING NAZI!!!” and the like!)
And also, I’m definately not denigrating Russia’s achievements! The rapid pace of industrialisation and growth into high technology can’t be denied. I’m just saying that few brought a state-produced stereo or car if they had the choice! But like I said, the production of stereos and cars is different to that of healthcare!
Hope that clears up my views, although it’s probably still not as unambiuous as I’d like…
Oh, and for the record, I’m definately not in favour of laissez-faire capitalism! Regulation is vital in my opinion!
“And also, I’m definately not denigrating Russia’s achievements! The rapid pace of industrialisation and growth into high technology can’t be denied.”
Except by someone with some sense of the costs of those “achievements”.
sideshowjim, Thank you for clarifying that.
I can`t believe there are still halfwits, probably from the People`s Republic of South Yorkshire, still willing to fly the flag for the Soviet system. Perhaps the many millions who were sent to the Siberian re – education camps or those who tramped through the frozen wastes, with pockets stuffed with lard, trying to escape across the Finnish border may not agree with you. As for their space programme, they got a man into space by the skin of their teeth in the most basic and dangerous manner.
Whether lefties will concede it or not the NHS is poorly managed. inefficient, wasteful in the extreme, fawns to too many patients who have been the authors of their own woe and tolerates far too many lazy bastard staff who view their employment as a sinecure. I don`t care where the solutions to these problems comes from – BUPA, big business, America, Germany, France or elsewhere – but if we don`t find answers quickly Ted`s arguments look more and more attractive.
“the NHS is poorly managed. inefficient, wasteful in the extreme, fawns to too many patients who have been the authors of their own woe and tolerates far too many lazy bastard staff who view their employment as a sinecure”
In other words, the NHS is not perfect. OK, but is it measurably worse than the system in, say, France, or Canada, or Japan? If so, we might be able to improve it. If not, pointing out that the NHS is “bad” serves only to drive up Daily Mail sales, not improve things. Nothing is “bad” in politics, only better or worse than the possible alternatives. So until someone points out a better alternative to the NHS, I’ll defend the ineffiency, waste and lazy bastards to the hilt.
My brother lives in Germany and I can honestly say that he receives a level of health care that we can only dream of here in the UK. Also the WHO, in 2000 ranked the US 37th, Canada 30th, UK 18th and France 1st in terms of it’s health provision ( http://www.who.int/whr/2000/en/whr00_en.pdf page 152 for the rankings table).
I think I am right in thinking that France still has more hospital consultants per head of population that the UK so yes I think we can say that the NHS is measurably worse than the system they have in France and probably the rest of Europe. Also the survival rates for cancer are measurably better in the US which would indicate that if you are able to access it health care in the US is better too.
“if you are able to access it health care in the US is better too.” – fine, although this is probably only true for cancer, but that’s not really the point.
I think, if you can access it, the American health care system is better for for most things including cancer if that is not the point then what is?
Because many people can’t access it and I care about the people who can’t as well the as people who can.
I have a solution to the world’s food problems – a massive six-course meal cooked by Gordon Ramsey three times a day, every day. Great idea, eh!
I have already acknowledged that many people in the US cannot access the American health care system and that is a major failing with it. But there may be other things we can learn from our American cousins, if you really cared about improving our own failing health care system you might want to find out what that thing was. The Germans and the French appear to have done so.
Gordon Ramsey might not be able to feed the world three times a day with a giant personally cooked meal but he might have some other insight into how the worlds hungry might be fed.
“In other words, the NHS is not perfect. OK, but is it measurably worse than the system in, say, France, or Canada, or Japan?”
So you are asking if the NHS is much worse than other socialist healthcare systems. Why?
“If so, we might be able to improve it.”
The problem is structural, not aesthetic.
“So until someone points out a better alternative to the NHS, I’ll defend the ineffiency, waste and lazy bastards to the hilt.”
Where have you been for this entire debate?
Winning it. You?
Still generating more heat than light OSB?, it’s a shame that you do not understand the contextual issues of most debates on this forum. No country has been immune from committing atrocities, including our own. Read the posts again, it is about state capitalism, private capitalism and innovation.
You’ve already spread your vitriol about NHS staff on another thread, it’s about time you innovated and created something new, perhaps you can expand on Ted’s arguments and state exactly why they are so attractive.
BTW, after you do this perhaps you can furnish us with your words of wisdom about how the NHS could learn a lesson from the private financial sector.
The only good thing I can think off to come from the Soviet Era are the A. V. Alexandrov Soviet Army Twice Red-Bannered and Red-Starred Song and Dance Ensemble (and they are fucking awesome), and strapping great muscley women chucking lead balls around.
Sing With Me! The Cossacks Ride Over the Duna River”.
tolerates far too many lazy bastard staff who view their employment as a sinecure
Well, that’s very, very true. They wouldn’t know a hard day’s work if it crept up behind them and slipped them a quicky. They need to be exposed to the market.
It’s already happening here. The Trust lost the drug and alcohol contract for the county – it’s now being done better by Addaction. Although it’d be better still if the PD-con-artist, performance-junkie, sub-group were just locked up and left to go cold-turkey. Perhaps the householders they robbed will be invited to watch them convulse.
… I’m just going for a nice cup of tea and I’ll be back once I’ve got in a proper lather…
8.57 p.m and you`re still at your keyboard, jbarber. You need to start walking to work for tomorrows day shift. Or are you relying on your hugely “innovative”, “developed by technicians immersed in science, pinnacle” of automotive engineering Lada to get you there.
The stupidity of your argument is quite staggering, Neuroskeptic. I could fire off anecdotal and first hand evidence `til my fingers bleed but I can`t be arsed. I`ll confine myself to the story I`ve used before about a colleague of mine, who works nights consistently, who is almost universally perceived to be weird for, perhaps obsessively, switching off unwanted lights. Waste is waste. Leaving unnecessary lighting on isn`t good for the environment nor is it good for the taxpayer. Why the fuck would you need to make comparisons with Japan, France or Canada to identify it as a problem. Staff don`t see the electricity bill, think about the electricity bill and end up not caring about the electricity bill. Addressing the problem is hardly putting Sputnik up but if one of the hordes of Soviet trained innovators develops a clever gadget for doing the job then we should embrace it.
“Defending waste” and “to the hilt”. You are a pillock.
“Why the fuck would you need to make comparisons with Japan, France or Canada to identify it as a problem.” – Because there’s a difference between a problem and a problem that can be solved by actually changing something.
The NHS is “wasteful”. Compared to what? The French system? The Japanese system? Your dream of a perfect health service where everyone gets cured by sexy nurses waving a magic wand?
Even you, Neuroskeptic, should have the capacity to turn off a light switch. I have no idea what the figures are but if I could show you the electric bill of your local hospital and then take you on a tour at night to switch off unnecessary lights, you would have an industrial amount of egg to wipe off your face.
The problem with state monliths is that people quickly develop the impression that they are funded out of some bottomless pit. A problem which is strangely compounded in this country by a general laissez faire attitude with regard to what the government do with our tax pound. If there were two tills in bars and petrol stations, one to pay for the product and one to pay the tax due, there would likely be civil unrest. Brown knows this hence his fondness for stealth taxes.
The problem with blogs like this, habituated by bovine lefties, is the pathetic response every time a socialist sacred cow is questioned. The immediate Mandelsonian, unfounded accusations that the cow is to be slaughtered. The NHS is NOT above criticism and it should NOT be immune from reform. Most pathetic of all though is the attitude of numpties like you with your preference for a lame, overweight cow over giving it a dose of much needed medicine.
‘The problem with state monoliths is that people quickly develop the impression that they are funded out of some bottomless pit.’
Seems that our private financiers also thought that too, at the moment £1.450bn of taxpayers money has been spent to bail them out – that’s a whole load of lights left on. To put this into perspective, the NHS costs about £95bn per year.
The problem with you OSB is that you recognize that there is a problem but all you do is rant when anyone makes any suggestions as to how they could be addressed. You did this to Beakie when he wrote a post stating that certain services within the NHS needed to be cut back (incidently, where is Beakie and Mr. Ian?)
All of Europe is suffering from the same problems caused by rapid demographic and economic change over the past 50years. We cannot carry on producing and consuming as we have done over the last 20years or so – not least because our environment cannot take it. It will take time to adjust, but the argument that private is better than public is quite limp at the moment, especially bearing in mind the number of industrialists being jailed for massive fraud in the USA and our troubled finance system
I rest my case.
about 50% of the workers pay all the tax to fund the 50% that makes up the public sector. that’s a lot of grommet polishing on minimum wage, to hear people complain that £27,000, is fuck all, and wont even pay for rudimentary nut-waxing.
There’s a very good Indian Psychiatrist to be found in a dark corner of the Interwebs, who’s on about £126 week. and seldom complains about anything…
I think you’ll find that 100% of the population pay the taxes which fund the public sector.
As someone who has to get the train to work, I’m deeply suspicious of privatisation.
Lorna,
Genuine privatisation in healthcare would be nothing like the so-called privatisation of the rail industry, which amounts to not much more than some people at the top of government handing their friends a big lot of cash alongside other privileges such as monopoly rights (eg Manchester-London mainline) and bailouts when they fail. The general public pay for it through taxes, while customers pay again through ticket prices which are far higher than would be the case under competition.
Having said that, any “privatisation” the healthcare sector would probably go down the same route. I too would be deeply suspicious of anything – eg Tory plans to get some private sector involvement – that is sold to the public this way. Whatever way you look at it, the problem is government, and the only solution is to remove all government intervention.
‘Genuine privatisation in healthcare would be nothing like the so-called privatisation of the rail industry’
Nope – it would be like the private finance sector after that had been deregulated.
“it would be like the private finance sector after that had been deregulated”
Which regulations are you referring to?
Whatever way you look at it, the problem is government, and the only solution is to remove all government intervention.
You’re never gonna sell me on a plan that leads to me dying of untreated chronic health problems. Seriously. Give up.
Btw, Neuroskeptic, if you still need an idea of how to solve the problems of state provided healthcare, here is one answer..
http://mises.org/story/3643
Having a look now at the recommendations on that website:
Well, that sounds like news that “Doctor” Gillian McKeith would welcome…
There are many industries operating very well without statutory licensing. Only if you a) ignore all this evidence, and/or b) presume that people are too stupid to pay attention to the qualifications of medical professionals, does the argument for statutory licensing have any merits. In any case, it is still undeniable that eliminating these licensing requirements would increase supply, force down prices, and create a wider variety of healthcare available to poor, average and rich people alike. If customers didn’t want the new services, they would be under no obligation to a) pay for them, or b) use them.
I’m sure people do pay attention to the qualifications of medical professions, but what they may not have is the time, expertise or inclination to do is sift through those qualifications and work out which ones are genuine and which ones are plausible-sounding but actually baseless.
That, after all, is why Gillian McKeith was stopped from calling herself “Dr” – because she had a set of qualifications that initially looked impressive – PhD from the Clayton College of Natural Health, member of the American Association of Nutritional Consultants – until the mighty Ben Goldacre cast a thorough look over these qualifications and found them not to be worth the paper they’re printed on.
Your proposal sounds like an immediate way to give instant and bogus kudos to every snake-oil salesman, pyramid-muncher and urine-bibber out there. Directly followed – once they’ve defrauded a load of patients and killed a few of them – by a catastrophic loss of public confidence in *real* doctors.
zarathustra,
Your points are all clearly ones that people offering services without statutory licenses might wish to address. But, as I already said, many sectors get along just fine without such measures forced on them.
But there is nothing fundamentally special about healthcare which makes it an exception to this. Unless you want to argue that there is. Think about it for a minute. Your disaster scenario just isn’t at all likely. Why? There are more professional associations in the medicine sector than in most industries. They already provide best practice guidelines, regulation, etc etc. The notion that they wouldn’t seek to provide service providers with a seal of approval guaranteeing reputation to customers is absurd. Beyond this, insurance companies would provide insurance for anyone failed by medical contracts they enter into. Rather than a public crisis of confidence in doctors, people would have more options at less cost than they otherwise would.
Even so, and irrespective of the merits of the arguments for state control of health, anyone who wishes to weigh up the pros and cons will have to figure in that absence of licence requirements will create a wider supply at lower prices. For anyone without a massive amount of money, this is a blessing. If unsure, customers can seeks alternate services without having to pay for the former.
I prefer evidence to speculation, so no thanks. And the evidence is the healthiest countries in the world don’t do any of the things recommended there, quite the opposite in fact.
The Mises Institute – always good for a laugh, until you remember that some powerful people take that kind of stuff seriously.
Neuroskeptic, your professed love of evidence doesn’t stand up to even the slightest independent thought. For one, all the powerful and relatively healthy nations have massive state involvement in healthcare, so there is no counter example to compare your “evidence” to. You offer literally no argument of any kind against the ideas, but are happy to dismiss it out of hand.
“some powerful people take that kind of stuff seriously.”
Like who?
“For one, all the powerful and relatively healthy nations have massive state involvement in healthcare, so there is no counter example to compare your “evidence” to.”
Exactly. You have no idea whether privatizing healthcare would work. As I said right at the start, there are no doubt arguments that make it sound good in theory. But Communism sounded good in theory, too.
If you were clear that what you are proposing is an entirely untried new idea that might or might not work and should be done carefully in a step-wise fashion, I would not be so opposed to it, but you (and the Mises Institute) seem to think that privatization is something that will *obviously* work, if only someone tried it.
There is nothing obvious about it.
“You have no idea whether privatizing healthcare would work.”
What do you mean by “work”? Private provision means there are incentives for providers to offer services that people want. Competition benefits everyone – poor and rich alike. Asserting I have “no idea” is to assume your conclusion, namely, that state healthcare is the way to go. Even worse, it is to take a very extreme position re: the usefulness of theory.
“But Communism sounded good in theory, too.”
It clearly didn’t to anyone who spend any time thinking seriously about it. Ludwig von Mises was one of those people, but there are plenty of others.
So now your argument is that is hasn’t been tried? Why should the onus be on me to present a full policy plan to break up the NHS? I am presenting arguments – moral, economic, practical – against the existence of state provided healthcare. That it “hasn’t been tried” is a very very weak response. If you were serious about what would “work”, you would engage with the arguments presented.
Ted – “For one, all the powerful and relatively healthy nations have massive state involvement in healthcare”
So why change it?
Ted ‘What regulations are your referring to?’ I said deregulation BTW
The most far-reaching and IMO the most disastrous was the ammendments to The Building Societies Act in the 1980s -
1. The ability to demutualise
2. The right to floatation
3. The receiving of bank status
We once had a mortgage with The Northern Rock, when it was still a mutual society, it had a reputation second-to-none for professionalism and it deserved it. What a pity this great organisation ended up the way it did.
“I said deregulation BTW”
Yes, deregulation implies that particular regulations were removed.
“The most far-reaching and IMO the most disastrous was the ammendments to The Building Societies Act in the 1980s”
I don’t know much about your example, but we must be clear if you mean deregulation, or simply amendments to old ones replaced by new ones. The value of regulations in the finance and banking sectors cannot be viewed without recognising that the state controls the money supply, creating money from thin air as a “solution” to unpopular economic corrections. I agree that it is a shame that people find it difficult or even impossible to obtain honest mortgages, but the sector from which they originate is one of the most regulated out there. If this doesn’t suggest that statutory regulation fails, then I don’t know what would. Northern Rock (pre-nationalisation), like any bank, had access to state bailouts in the form of lender of last resort funds. With measures in place incentivising high-risk ventures, it is no wonder so many did so.
The Old Testament recognised greed as a problem. Jesus railed against it. Mrs Thatcher began the process of banking deregulation and a wave of unpalatable greed was unleashed. Brown never tires of telling us he went to Church. He witnessed what went on under Mrs Thatcher. He virtually changed his name by deed poll to “Prudent”. However he dregulated the banks further. He fiddled while people took out 125 % mortgages and juggled 12 credit cards in a blatantly, obviously unsustainable way. Now if Fred Godwin gets kicked to death in the street I will walk by with a clear conscience but make no mistake the person primarily responsible for the banking crisis in this country is Brown.
Not, jbarber, that that is the point. Two wrongs don`t make a right and despite your ridiculous, Scargillite propoganda they never will. Waste in the NHS is wrong. The fact that the NHS replicates your beloved, wholly disgusting Soviet regime doesn`t change the fact. Nor does the unrelated assertion that the government may have wasted greater sums bailing out the banks. What is wrong is wrong. Simple as.
You come out with your witless drivel and wonder why people rant.
OSB – If you want a debate about the Soviet regime why don’t you write a header post or at least let the rest of us know what point you are making and perhaps we can all get involved. And what has Scargill got to do with this debate?
I really do not know what your position is, perhaps you or someone on this forum could let me know. You criticize the NHS and you also criticize the private sector, however, in another thread you waxed lyrical about how efficient the private sector was. Incidently, I wasn’t suggesting that two wrongs make a right but it was a nice try at building a straw man
I did not vote for Thatcher, but I believe she betrayed her audience with her seemingly benign neoliberal promises. And the difference between Thatcher and Blair parallels the difference betwee coca-cola and pepsi-cola.
BTW, have you considered anger-management?
Incidentally, a British friend of mine is currently studying in America, and has mental health problems. She even has health insurance, but still regards the US system as pretty much the worst thing ever, and saves up her appointments for when she’s visiting home.
E – your comments about American survival rates for cancer are a little simplistic (leaving aside the fact cancers account for over 200 different diseases) – take a look at this;
http://scienceblog.cancerresea.....ncer-care/
I don’t know about light bulbs but according to Price-Waterhouse-Coopers “wasteful spending in the health system has been calculated at up to $1.2 trillion of the $2.2 trillion spent in the United States, more than half of all health spending”.
http://www.pwc.com/us/en/healt.....cess.jhtml
And if the French are so great why do they consume more antibiotics, painkillers and antidepressants than the rest of Europe put together?
http://lornakismet.wordpress.c.....alth-care/
http://www.guardian.co.uk/worl......jonhenley
Sideshowjim
” A good point of reference is the fact that not many people bought Russian state produced cars, because they were crap.”
People didn’t buy the Russian cars manufactured by Russian state owned companies because they were really quite rubbish .
You cannot compare the NHS to the state owned Eastern European car companies, because unlike them the NHS is not rubbish.
In fact, there have now been a few generations born in NHS
hospitals, who have utilised the NHS their whole life and who are now enjoying long life spans as a result – and all without having to be able to afford private care.
I bet very few of them drive Ladas – But I bet most continue to utilise the NHS.
I think you would find it hard to find even a small minority of UK nationals who would like to see the NHS replaces by a U.S style system.
Privatisation is already happening. Deal with it and move on…
Private firms could run hospital
The Cambridgeshire hospital owes the NHS £40m
Private and public sector organisations are being encouraged to apply to run an NHS hospital in Cambridgeshire.
In October, NHS East of England (EoE)will be inviting partners interested in running Hinchingbrooke Hospital from April 2011 to put in applications.
Andrew MacPherson, director of strategic projects for EoE, said the scheme was unique in the NHS.
He said he hoped private firms, charities and in-house NHS teams would put forward bids to run the hospital.
Mr MacPherson said it was hoped that the winning organisation would find a way to deal with Hinchingbrooke Hospital’s historic £40m debt to the NHS.
‘Exciting opportunity’
He said staff at the hospital were doing a great job, but NHS EoE wanted to find more creative ways to improve services.
“This is an exciting opportunity and it also means providing a sustainable future for Hinchingbrooke,” said Mr MacPherson.
He said the plans also secure the hospital’s maternity and accident and emergency departments.
In October NHS East of England, together with the Hinchingbrooke Health Care NHS Trust, will be inviting expressions of interest from in bidding for a “franchise” to run Hinchingbrooke Hospital from April 2011.
Mr MacPherson said: “We are fully committed to a transparent and inclusive process for the benefit of all stakeholders.”
Before the process starts, an independently-chaired Stakeholder Panel is being set up to represent the interests of local people and Hinchingbrooke Hospital staff at every stage.
A preliminary business meeting of the Stakeholder Panel will take place on 2 September 2009 from 1400 until 1700 BST at the Assembly Rooms at Hinchingbrooke House in Huntingdon.
A spokeswoman for NHS Cambridgeshire said all staff would continue to be employed by the NHS, which will still own the hospital and its assets.
As long as I can hang onto my final salary pension bring it on it can hardly be any worse than the way my current Trust is being run. Personally I quite like the idea of having Richard Branson as a boss I could be one of his community virgins!! (Perhaps not
)
There we are then, Socrates is usually very well informed, if it`s happening under a Labour government it`s looking quite likely. Hugely sad but I still maintain that an organisation that is criminally wasteful and seemingly has 45, 000 of its employees on the sick every day needs to suck it up or immediately strengthen its resolve to do better when it`s attacked.
I had concluded that Beakie and Mr Ian had run off together to fat camp in the outback. Why is Posey using Beakie`s little rabbit ?
Mr Ian wen’t off to play with his digery doo after receiving a good twatting over at Dr C’s place and hasn’t been seen since. As for Beakie aka “Vicky Pollard” who knows and frankly who cares.
It`s o,k, we have jbarber, who is effectively beakie lite. Probably in every sense.
[...] between time perception and anger. The debate about the NHS discussed above is covered by Mental Nurse and also Frontier Psychiatrist with lots of discussion in the comments section of both posts. There [...]