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Old 19-06-2018, 12:26 PM   #221
bidderman1969
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I reckon we could make up a pretty decent government from a lot of members of this forum,

I’d be PM mind………
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Old 19-06-2018, 12:35 PM   #222
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Originally Posted by bidderman1969 View Post
I reckon we could make up a pretty decent government from a lot of members of this forum,

I’d be PM mind………
Which of the admin would be speaker?

ORDER, ORDER WILL THE HONOURABLE MEMBER PLEASE KEEP IT ON TOPIC 🤣😂😂😂
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Old 19-06-2018, 12:42 PM   #223
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America's healthcare system is an absolute farce. I've no idea why people always refer to it as an example of how private healthcare works - They're forced to subsidise other's healthcare with premiums which have increased by an average of $6k (family premium) since the wonderful Obamacare came into force. Couple that with restrictions on competition and you've got average family insurance premiums of $18k.

Conversely, a friend of mine had major surgery in South Korea at a cost of £400.00. The hospital was state of the art; recovery ward was like a five star hotel.

The example given re. Boots is exactly what I'm talking about - Also a prescription of paracetamol will cost the NHS £10 when you can pick up supermarket own brand for 30p!

I don't believe it's much of an argument to state that many people owe their lives to the NHS. Of course they do when it's the primary provider of healthcare... If the NHS didn't exist, then they'd owe their lives to whatever system provided healthcare; be that private or aid based if they couldn't afford it.

There is nothing the government provides which the free market couldn't be better at.
In a market of supply and demand do you think you're going to get a skilled doctors willing to offer their services for £400 for major surgery when there's not enough of them as it is?

My private health care physio charged £100 per hour.

We're not going to get surgeons working for mechanics hourly costs. Don't many NHS doctors also work in private hospitals as they get far more money?
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Old 19-06-2018, 12:48 PM   #224
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In a market of supply and demand do you think you're going to get a skilled doctors willing to offer their services for £400 for major surgery when there's not enough of them as it is?

My private health care physio charged £100 per hour.

We're not going to get surgeons working for mechanics hourly costs. Don't many NHS doctors also work in private hospitals as they get far more money?
Question is, if they can elsewhere then why not here? What sort of premiums would we be looking at rather than direct access cost?

Supply and demand isn't the only factor to consider. Competition would drive prices down like it does in every other industry/profession.
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Old 19-06-2018, 01:23 PM   #225
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Whether supplied by public or private sectors, health will have to be paid for - arguing about where is like pushing water around a bath. You will pay for health care out of your taxes or your income, but either way you will pay. The questions are how much and what do you get for it?
So the issues the country should be grappling with are efficiency and effectiveness as much as economy.

I'm not much fussed who provides the services provided they work but, as has been pointed out repeatedly, they need to take account of social care at the same time.

For those who think that the NHS simply needs more money, the US highlights the problem of simply hosing down the medical world with cash. We need to be thinking more about models that reward health care providers based on their patient population’s health outcomes.

For lovers of the free market, such accountability could create a business case for health care providers to invest in certain social services or other non-clinical interventions, if doing so would be a cost-effective way to improve patients’ health. Over the long term, such a strategy could potentially alter the current balance between health and social services spending to ensure better outcomes.

The US experience is instructive and does highlight some key issues. (Most of the figures below are data collected by the OECD for 2013.)

The first thing to point out is that high health care spending has far-reaching consequences in the US economy, contributing to wage stagnation, personal bankruptcy, and budget deficits, and creating a competitive disadvantage relative to other nations. Another consequence of high health spending in the US is that it crowds out other forms of social spending that arguably support health more cost-effectively.

Even before Obamacare came in, health care spending in the US far exceeded that in other countries. At 17.1 percent of GDP (2013), the US deployed at least 50 percent more of its economy to health care than did other countries. Even public spending on health care, on a per capita basis, was higher in the US than in most other countries with universal public coverage.

How can we explain the higher U.S. spending? It is likely that the additional expenditure is likely driven by greater use of medical technology and higher prices, rather than use of routine services, such as more frequent visits to doctors and hospitals. In other words, work with higher margins or with machines which costs need amortising...

In the US, health care spending substantially outweighs spending on social services. I suspect that this imbalance may contribute to the country’s absurdly poor health outcomes.

Despite all the spending on health, in terms of outcomes, the US has a poor story to tell: On several major measures of population health, Americans had worse outcomes than their international peers.

The US had the lowest life expectancy at birth of the countries studied, at 78.8 years in 2013, compared with the OECD median of 81.2 years.

Furthermore, the U.S. had the highest infant mortality rate among the countries studied, at 6.1 deaths per 1,000 live births in 2011; the rate in the OECD median country was 3.5 deaths. That mortality rate is higher than in some developing nations...

The prevalence of chronic diseases also appeared to be higher in the U.S. The 2014 Commonwealth Fund International Health Policy Survey found that 68 percent of U.S. adults aged 65 or older had at least two chronic conditions. In other countries, this figure ranged from 33 percent (UK) to 56 percent (Canada).

A 2013 report from the Institute of Medicine found the US performed poorly on several important determinants of health. More than a third of adults in the US were obese in 2012, a rate that was about 15 percent higher than the next-highest country, New Zealand.

Other potential causes of the United States’ poor health outcomes include the large number of uninsured, as well as differences in lifestyle, environment, and rates of accidents and violence. But, crucially, the Institute of Medicine found that poorer health in the U.S. was not simply the result of economic, social, or racial and ethnic disadvantages—even well-off, non-smoking, non-obese Americans appear in worse health than their counterparts abroad.

We might moan about the NHS but with better outcomes, far less expenditure (i.e. rationing), we have a much better starting point for reform than the US.
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Old 19-06-2018, 01:30 PM   #226
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Question is, if they can elsewhere then why not here? What sort of premiums would we be looking at rather than direct access cost?

Supply and demand isn't the only factor to consider. Competition would drive prices down like it does in every other industry/profession.

We've already for public and private medical options and neither is currently cheap. There's already plenty of established companies and services in place that would be difficult to displace. We already know we've a huge shortage of skilled UK doctors and nurses. Where are we going to generate competition from especially whe the NHS and private care already overlap?

Use dogs for example. There is plenty of vets locally that should be healthy for competition. They are all busy and they all charge a fortune. Someone I know was hit with a £6000 bill the other week after their new dog instantly took ill. They didn't even find the root cause why the dog was ill. I've read of simple leg breaks running into thousands of pounds.

Even in a free market with choice and competition costs are very high for animals.

As we see often with our beloved 4 legged friends there often comes a time where money is more important than life.
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Old 19-06-2018, 01:44 PM   #227
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I feel sorry for a lot of the nhs workers. My mum works in the nhs and says there over worked and under staffed. She can work a 12 hour shift and have no lunch break or any break at all. Happens daily. Lots of staff leaving, agency staff coming in at a cost of 3 times as much. She used to love her job, now she hates it. Many a time she says she's rather work in lidl on a checkout and be a lot less stressed.
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Old 19-06-2018, 01:49 PM   #228
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I feel sorry for a lot of the nhs workers. My mum works in the nhs and says there over worked and under staffed. She can work a 12 hour shift and have no lunch break or any break at all. Happens daily. Lots of staff leaving, agency staff coming in at a cost of 3 times as much. She used to love her job, now she hates it. Many a time she says she's rather work in lidl on a checkout and be a lot less stressed.
I have heard similar and it's a shame. They need more stability and more consideration for their staff.

But get her to look up Lidl and their employment practices if she's in any danger of seriously applying to work there..

Best

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Old 19-06-2018, 01:54 PM   #229
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Which of the admin would be speaker?

ORDER, ORDER WILL THE HONOURABLE MEMBER PLEASE KEEP IT ON TOPIC 🤣😂😂😂
I'll put whizzers name forward for that job
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Old 19-06-2018, 02:03 PM   #230
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I have heard similar and it's a shame. They need more stability and more consideration for their staff.

But get her to look up Lidl and their employment practices if she's in any danger of seriously applying to work there..

Best

Peter
I view this slightly differently. Working as a chef for years, 80-90 hour weeks were common. If I got 2 days off in one week it was for something special that I'd booked months previous! I was paid a salary with no lieu time or overtime even thought of. Have a few friends now who worked part time in pubs/restaurants while studying who are now in the NHS every one of them says while it is hard work they prefer it to the hospitality industry. They love the overtime they get, the extra weeks of holidays earned in lieu and a couple of them are raking it in doing private work, I'd say on their days off but they admit to doing some of this while at NHS so getting paid twice!!!
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