[francis-io]

The problem with the idea (for me) of letting people live with the consequences is that in the UK, I'm forced to pay a good chunk of tax (I think it's about 1/5th) on a failing health system.

Rough "napkin" math on this is massively over simplified but the NHS spent roughly £134 billion in 2019/20 (before covid). We have around 67 million people in the UK. That works out at roughly £2000 (~$2500) a year. I ended up spending 4 hours in A&E a few weeks ago trying to get some some antibiotics for a suspected infection because my GP just wouldn't call me back to prescribe them.

I would love to go private (and likely still will), but since I'm forced to pay into our NHS system, I feel like I have already paid for healthcare. I was quoted around £45 a month for private healthcare, which doesn't include the first stage GP visit, but some companies are adding on a handful of video call GP visits as part of the private plan. Bupa charge something like £80 for a 30 min GP visit.

Obviously I'm young and that cost will increase, but at this point I feel like the NHS is just enforced social healthcare thats no better than what can clearly be provided by the private sector. I've only started looking into this recently after my awful experience here in the UK and I'm sure I've missed a ton of factors.

My point is, if I'm forced to pay for healthcare from my tax then I expect healthcare for any issue I have in a reasonable time and to a reasonable quality. Opting out is not really a realistic option.

https://fullfact.org/health/spending-english-nhs/ https://www.ons.gov.uk/peoplepopulationandcommunity/populati...

[pjc50]

The GP system is failing, but the Americans will tell you that a £2k bill for an A&E visit is quite cheap. Mind you, the American system has three sets of numbers which are mostly fictional and completely different: the hospital bill, the amount paid by the insurer, and the out-of-pocket "excess" that you actually have to pay.

Don't forget that in both countries public healthcare has to do a lot for the over-65s who don't have spare money for spiralling costs.

[looseyesterday]

But the choices are not the American system vs NHS. The dutch do a good job of an insurance based system, Singapore is totally different still (though obviously not applicable as its a fairly small country.

A great counter example is Signapore where each individual has a mandatory savings account which can only be used for healthcare. However, catastrophic illnesses and insufficient funds are covered by the gov. Another element of the scheme is that the savings accounts can be used for family members. This incentives people to seek the cheapest care, and keep family members healthy. While the poor, retired etc are still taken care of.

The problem I have with the NHS is that I dont see what my care costs at any point. I dont think that leads to good decision making.

[pjc50]

> I dont see what my care costs at any point. I dont think that leads to good decision making.

How much extra do you want them to spend on computing this? To what extent do you actually want cost factored into your care?

[looseyesterday]

In the context of a Singaporean system what you spend matters, as it reduces your ability to gain benefits in the future. It will discourage people from getting scans and tests that are only of marginal benefit.