>We have to invest more in identifying and tackling disease earlier if we want to “stop the hospitals from falling over and the GPs from being overwhelmed,” he said.
Demographics and shrinking labor forces alone will bring the system to its knees regardless of money. It's absolutely baffling in the face of this trend that preventative, systemic policies are practically never discussed and everything centers around individual care.
Countries like Singapore show how you can tackle this, strong interventions to prevent entire populations from being obese, a regulated medical sector to bring costs down and private savings funds to encourage personal responsibilty.
> It's absolutely baffling in the face of this trend that preventative, systemic policies are practically never discussed and everything centers around individual care.
I’m surprised that countries with socialized health care doesn’t already enforce preventive care. Yes, it’s draconian but otherwise the entire system will fall apart faster. Maybe they will with the advent of CBDCs?
If we invested more money I think the problem would get fixed. You need to be smart but you don't need to be a genius for most specialties. Some of those people that flood into big tech could instead go into becoming a doctor if the money and working conditions were there.
I think it’s amazing that a solid system can be defunded like that until it just sorta crumbles under it’s own weight. There’s no immediate solution either.
If you build more hospitals, you need more staff, if you need more staff, you need to make it more attractive, but even if you do you need several years before the first doctors/nurses from the wave with renewed interest in the position finishes university.
And that’s only if there is any political will to do so.
Ultimately the only viable plan is going to be severe care rationing. In most developed countries we have an aging population with an increasing incidence of chronic diseases and a shortage of physicians. Regardless of whether payments come from governments, employers, or individuals the reality is that we simply won't have the resources to care for everyone.
Important to point out that dentistry in England does not follow the NHS model of "free at the point of delivery, available to all regardless of ability to pay" but follows an insurance model, with a bit of state provision for those who can't afford insurance.
And dentistry is why people in England are scared of changing the model for NHS healthcare, because we see that dentistry is fucking awful for huge numbers of people.
The problem with the NHS is not the model, it's the funding.
But that's routine healthcare for one particular part of the body. Meaning it could be true for general health.
In the US dental is considered a seperate insurance for most. So there's a separation for whatever reason meaning using it to disprove the demographic theory for "regular" healthcare might be valid
The number of residency slots isn't restricted. The problem is that almost all residency program funding comes from Medicare and hasn't increased much for many years.
Strong planning and hard decisions. Japan over produces doctors. Japan forces a strict 30minute cap on doctor visits when billed by that insurance. Japan limits hospitals to be only owned by doctors, not corporations. Japan has no medical malpractice lawsuits. Japan makes everyone pay 30% of medical costs, UpTo a cap of about 1k dollars per month. There is no such thing as the "nice" health care insurance nearly every American programmer working at a FAANG gets. Japan makes seniors also pay a large deductable.
Japan put in place many strategic constraints on their system to achieve this result. Hard decisions most countries would revolt at, doctors unions would strict at, and westerns would call broken.
But at least the system does it's job and is not projected to collapse. You can win votes, or you can design a functional system. You cannot do both.
Almost everything you mentioned is basically a legislative signature away from being a reality in Western countries.
That’s why I questioned the idea that demographic issues are going to prevent the West from solving this problem. A little bit of political will and some signatures is all it takes.
I don’t like “exceptionalism” arguments in general, and I think “muh homogeneity” is bunk as well, but Japan has a very strong and unique culture that results in outcomes that the rest of the world would not see in the same conditions.
See for example Japan having very few public trash cans but also very low amounts of litter, or even very low wage workers taking pride in their jobs, or Japan having both extremely low unemployment and also low/no wage inflation for very long periods of time. Japanese business culture is one of seeing a duty to the public/consumer in a way that most other capitalist countries do not. They have a cultural aversion to screwing people over and ripping them off, and in working very many extra unbilled hours because it’s expected of them - they’d never have the same healthcare failure modes as in other countries
This. You see this effect to some extent in Switzerland as well. Switzerland, many seem to feel, is "similar enough" to the United States that the existence of its universal healthcare system "seems" like a goal should be similarly within our reach. But this is to discount cultural differences, among other things, and the mindset of the average Swiss is I think quite different than that of the average American.
Some time ago I read 2 different books on healthcare systems, both very detailed, the authors having compared in-depth the many styles of healthcare systems in existence in addition to having relocated for some time to some of the locations to get a personal look. And despite all the complexities involved in such comparisons, both came to the same very basic conclusion: Healthcare systems are a reflection of the mindset of the country's citizens; Americans won't get universal healthcare until the average American believes that other Americans deserve it.
The Swiss are big into responsibility: you must buy health insurance because we don’t want to pay for your healthcare when you need it (and lots of other mandatory insurance, eg bike and gun insurance, things that hardly exist in the USA ). They will give subsidies to those that can’t afford premiums, but otherwise you must buy it or else you are being a burden to your neighbors. It isn’t about people “deserving” healthcare than it is forcing people to take responsibility. The market is made even by disallowing group plans; you aren’t allowed to get it as a benefit at work and must pay for your premiums with post tax money.
The USA is weird in comparison: you get immediate healthcare even if you can’t afford it, with everyone else just paying for those who can’t or don’t want insurance. If Americans don’t want universal healthcare because they don’t think some Americans don’t deserve healthcare, they are doing that really wrong.
These examples heavily downplay the public health, safety, and behavior progress the West has made. In the US, litter, graffiti[1], and smoking were all greatly reduced over the past half century. The male smoking rate in America is half of the male smoking rate in Japan.
I think the idea that the Japanese form of capitalism is more benevolent than the rest is also a bit rosy-eyed. Statistics on hours worked aren’t great for Japan. It’s arguably not a good thing that low wage workers are prioritizing work. You say that there’s an aversion to screwing people over but in the same sentence you’re saying that low wage workers are being exploited and convinced to work unbilled hours.
[1] Jusr do an image search for “New York Subway 80s”
The main problem is that senior retirees are beginning to out number working adults who fund the system. Only skilled legal immigration can stem the tide, but that is not politically popular even amongst liberals. The end result is an entitlement system that is no longer sustainable.
> And that’s only if there is any political will to do so.
More taxes can only do so much if that was what you were implying. Middle class families can barely support themselves now let alone subsidize the little income they have left. Case in point, in the US for a family to have the same economic power as families in the past; they must make $240,000 - $300,000 depending on the metro
The people doing the defunding say that it's defunding. They're proud of it. They wrote a manifesto saying they were going to do it, and then they did it.
It's pretty blatant dishonesty to say that healthcare hasn't been defunded, and then only focus on NHS provision of healthcare while ignoring public health, social care, nursing care, etc.
> The people doing the defunding say that it's defunding. They're proud of it. They wrote a manifesto saying they were going to do it, and then they did it.
Oh? Do what, fund the health system at almost record levels?
> It's pretty blatant dishonesty to say that healthcare hasn't been defunded, and then only focus on NHS provision of healthcare while ignoring public health, social care, nursing care, etc.
It would be if someone had done that. Incidentally, are you saying that NHS has not been defunded? You wouldn't be very popular with said ideologues either then.
The NHS has been underfunded for about 40 years, but especially under Conservative government.
Blair’s Labour—for all their faults—at least stopped the bleeding, but there wasn’t enough political & popular support for significantly increased spending.
Then Cameron & his bs “austerity measures” cropped it
> Blair’s Labour—for all their faults—at least stopped the bleeding,
Stopped the figurative bleeding and started the literal...
But by stopped the bleeding, do you mean kept at levels comparable to those set by the previous conservative government? I.e., agreeing with the level of funding set by the conservative government.
I find it weird how governments are given a pass in that way. Setting funding from X to Y is a horrific crime, but leaving it at Y when you have the power to change it to X is somehow okay.
Looks like there has been no slashing going on, even adjusted for inflation and demographics. And the conservative governments after 2010 kept funding at about the same levels as the Labour governments set it at. Fancy that.
I wonder what governments have had to show for this massive 2x increase in adjusted healthcare spending. Vast improvements to the system, surely.
The increases over the time period in that graph are still less than inflation, making it a real-terms funding cut, especially relative to the growth in population.
This has major implications for many social safety net programs and entitlements ie there aren’t enough working adults paying into the system, which is also exacerbated by recent anti immigration movements which was a major cause for the UK leaving the EU.
This story is now common in many developed countries that offer socialized healthcare.
There's also the issue where people believe that everyone, regardless of age, should be treated to the maximum level possible (or what they can afford in the case of the US).
If you publicity suggested that someone who is 99 years old and in poor health shouldn't receive some treatment that costs a massive amount of money/resources you would be looked at in disgust. No politican would even dare. Combine that with the selfish nature of most people (of course to be fair the instinctual desire to avoid death) and an aging population (as you mentioned) and it seems like a few generations are going to be weighed down to extended the lives of the least productive members of society.
Yep. It's political suicide to bring up fairly obvious age/prognosis limits, but ultimately we all die of something.
Assuming most disease based hospital stays (heart attacks strokes, cancers) are biased towards older folk it makes sense that resources to younger folk be prioritised.
It makes -sense-, but asking a decent human to turf an "old person" out of bed because a "young person" has arrived (with a survivable, but urgent condition) is tough.
In war triage is a thing. Save the ones who can be saved, more-or-less ignore the ones you can't. We cannot, and should not, expect civilian medical staff to triage ambulances, A&E, ward beds. But health services are being drowned in the meantime.
There were lockdowns in the US but the pressure about them from businesses and a decent amount of the population made it difficult to continue to implement.
"And overweight people should not have publicly founded insurance. We should respect their wish to die!"
Overweight people don't want to die. Obviously you know this but were trying to make some point, one I don't understand.
So no overweight people. Hmm. I'm not sure what the cut-off for overweight is...
I guess, if we're going to police lifestyles from a health point of view, we should exclude smokers, vapers and drinkers from the list as well? Apparently no amount if alcohol is good for you...so....?
While we're at it what about red meat consumption? Thats not great in excess.
Oh, and motor-bikes. There's no good reason for those, and they're like accident magnets.
I guess what I'm saying is that once you start down the path of determining non-qualifying behaviors, it's hard to stop. Surely all of us would be disqualified sooner or later.
Second reply here because I finally understood your comment and what you meant.
I suggested selective care based on cost and quality of life. That's the logical way to do it even if you think it's immoral. You believe non-citizens shouldn't be helped? Why? "Because they don't contribute with taxes". There are many people who are citizens who don't contribute. Illegal aliens also provide a workforce for vital food production and other jobs that help the economy (regardless of if you think it's wrong).
You also had a issue with fat people because it's their fault. What about people who speed and crash? Skiers who fall, horse riders, any optional activity that carries risk falls into the same category.
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"For example no lockdowns, that sacrificed young people over old"
Young people were thankfully much more resilient to Covid
but was this wasn't known initially when the strictest lockdowns were put in place. Health officials were being cautious. What were to happen if there were no lockdowns? Certainly more deaths of old people but also adults in their 40s, 50s, 60s to a lesser extent.
As for the mental toll on young children- the total lockdowns didn't last long, you could go out and meet in small groups even during the initial phase. Many people didn't even care or follow the advice after the first few weeks. However, kids were remote learning for much longer but if that causes development issues what about home schooling? What about kids in remote areas?
What is the specific situation and time frame that cause your child's development issues?
I'm admitting there was a not insignificant mental toll on children, as this study shows[1]. You need to weigh this against the alternative of less or even not having any lockdowns and lack of information when these decisions were made. This means that using data you have now about the affect on children and how Covid 19 affected different age groups as a criticism, which I don't think is valid
It's intriguing that medical care is always the worst kind of service, by far, in every country in the developed world, compared to every other kind of product or service we depend on. Compare it to food, electricity, gasoline, clothing, water, cell service, haircuts, transportation, movies. If you're not in a rural location, you can buy food or a restaurant meal 24-hours a day in less than an hour. There's complex infrastructure and supply chains around food production, but it works, and works fast. But you can't start most medical treatment without waiting days, weeks, or even months. In lots of places you can't even see a family physician or primary care doctor without waiting days.
Why is it? It is because medical care is more "personalized" and less of a commodity? Because it's heavily controlled by government? Is it the liability (medical people can get sued for a lot more than a bad haircut)? Due to much higher expectations of what is acceptable medical care compared to, say, food?
It doesn't seem obvious to me why the economics of medical care should be so different than everything else we use and depend on.
The economics of healthcare in most developed countries are highly distorted through government intervention. This causes shortages and queues, but it also helps to hold costs down and provide access for poor people who might otherwise not be able to afford it at all.
For comparison look at cosmetic surgery in the USA. It isn't covered by insurance so patients pay out of pocket. Only the affluent can afford it but the business is highly competitive and most procedures are available with little or no waiting and high quality.
Liability is only a minor factor. Some US states have severely limited non-economic damages in medical malpractice cases but that only brought costs down slightly.
> Compare it to food, electricity, gasoline, clothing, water, cell service, haircuts, transportation, movies
Compared to other essential professions, doctors need 8 years of schooling and another 4 years for apprenticeship. As for nurses, they are both abused and underpaid. Maybe AI and subsidizing medical schooling can help? Raising the retirement age should also help. A large portion of the population does not pay into the healthcare system.
Do all doctors need that much or is it just the homogenizing effect of licensing? You could argue that programmers need many years of schooling and apprenticeship to become useful if you set the bar of utility at the same place Google used to, but in reality most people can be useful way before that. Also self-learning makes a big difference but isn't recognized by the medical licensing system.
You need X doctors per 100000 people. Point. That means the budget for training physicians needs to expand with population, 8 years ahead of time. Instead it’s been dropping and dropping, while the government also made the job of physician much less attractive. And there’s still a Numerus clausus. The idea that remote communities have a local physician is already a romantic idea from the past.
And don’t worry. Student physicians these days are working as a nurse before even the second year in many places. Of course, this is effectively used as a way to save money, not to have sufficient personnel, and that means these students are often standing there alone, not learning much, making mistakes.
The government’s idea seems to be to just allow more immigrant doctors… except immigrant doctors largely go to 2 countries, and even there it’s not enough. And, as per usual, policy fails, government doubles down on failed policy. Meanwhile, professors in medical faculties are keenly aware that they can’t let more people in and failing a student is more 72h shifts for everyone… so the quality of doctors, or at least the bottom level, is going downhill fast too.
The scary bit is that if the system fails beyond a certain point, it’ll require large investment for a decade before you even see the first improvements. And, of course, it will make a lot of victims. We don’t even really know how far that point is.
Physician education is already highly subsidized. AI can potentially improve productivity a little in areas like charting and clinical decision support but don't expect miracles.
The full Social Security retirement age is already 67. There isn't much room to push it higher. By that age many workers, especially those who have done manual labor, are disabled to an extent. It's just not realistic to expect them to continue working.
Isn't this true just about everywhere? Someone who lives in a major urban area is going to have more prompt access to advanced emergency healthcare than someone who lives in a remote rural area, simply due to factors such as travel time, and the clinical need to physically concentrate specialist medical resources (specialist clinical teams need a certain minimum case volume to properly maintain their skills, and if you try to spread them too thinly, you can actually worsen patient outcomes)–but that inevitably means that some people in remote rural areas will die before they get the treatment they need, whereas they may well have survived if they'd lived in a major urban area instead. Inefficiencies and inequities in healthcare systems can no doubt worsen this phenomena, but even if you could have the most efficient and equitable healthcare system possible, it would still inevitably happen, even if to a somewhat reduced degree.
The only countries which can totally avoid this problem, are those that are so small that the whole country is a single major urban area, and "remote rural areas" either don't exist at all, or are such a minuscule percentage of the population as to be a statistical rounding error – so basically city-states such as Singapore, Monaco or Vatican City
This addresses the title but not the content. The NHS is failing to meet its own goals in a pretty bad way, pretty much everywhere. Whether this is true in every country I don't know, but it's certainly not an inevitability.
> The analysis assessed how quickly patients can access health care in each of England’s 533 constituencies — the British term for electoral districts — and found that nearly every single area is failing to meet even half of eight key indicators tracked by the government, from hospital bed availability to ambulance waiting times. A fifth are meeting none.
> Whether this is true in every country I don't know, but it's certainly not an inevitability.
Australia has pretty terrible health care in many of its rural areas, and Australia's governments (both state/territory and federal) are clearly guilty of major policy failures in rural/remote healthcare provision.
But even supposing they did a much better job, even supposing they did the best job humanly possible – you are still going to get higher mortality and morbidity somewhere like Ivanhoe [0] – a town of less than 300 people, 800 km by road west of Sydney – than in the Sydney metro area. It is just the inevitable tyranny of distance. Far Western NSW simply doesn't have the necessary population to sustain the most advanced health care facilities (tertiary/quaternary), and the inescapable physical delays in getting to them (even using air evacuation) is going to cause deaths and clinically inferior outcomes.
Now of course, England is geographically a much smaller country than Australia – England has over twice Australia's population in less than 2% of the area. However, even in England, I would be surprised if the impact of geography on mortality and morbidity completely disappeared – inevitably, even if the NHS were the best health system humanly possible (and it obviously isn't), someone who lives in central London is going to have faster access to the most advanced healthcare than someone who lives in Penzance, [1] – and there are going to be times when that difference makes a real impact to mortality and morbidity.
For reference on just how much smaller England is—your example of Sydney to Ivanhoe would get you nearly all the way from North to South—it's about the distance from London to Aberdeen.
And again, most of the metrics here (bed availability, for example) should not be geographically bound at all.
> And again, most of the metrics here (bed availability, for example) should not be geographically bound at all.
Is that true though? A less densely populated area would have a lower baseline number of hospital beds, which I'd expect would make it more sensitive to unexpected volatility in demand. Major hospitals often have empty wards which are kept available as contingencies for unexpected events such as terrorist attacks or natural disasters – I've seen one in person before, all these beds and medical equipment with the lights turned off gives me goosebumps for some reason – less major hospitals are less likely to have such facilities – but obviously they give hospital management greater leeway (at least in theory) to manage unexpected bursts in demand. And of course, less densely populated areas are likely to have fewer major hospitals and a greater number of minor ones. Similarly, larger hospitals have larger staffs, so greater likelihood they can ask extra staff to come in to meet unexpected demand bursts.
So, in the abstract, I would not be surprised if less densely populated areas of England had worse bed availability than more densely populated areas. And indeed, the least dense area of England, the South West, scored the worst in hospital bed availability in their analysis–as I would have expected.
I think that is a flaw in the methodology of this article, they display no evidence of having considered factors like that, or having attempted to control for them.
I live in a mid sized urban area, a few blocks from a large hospital. My location was certainly beneficial when I needed emergency treatment. But for anything non-emergency, the waiting lists and "pre approval" battle are appalling.
My spouse, who lives in the same house, but has a different employer, gets much quicker treatment from the same clinics.
I’ve personally experienced insurers having different “levels” of plans, and some employers pay for a higher level of cover than others. Once, I switched employers, my new employer perchance used the same health insurer as my old employer-but at a lower level of coverage.
I've seen and experienced this as well, but not to the point where calling the same doctor for an appointment would get me in earlier or later. More typically I have access to different doctors altogether, or need approval for certain doctors, or have different out-of-pocket costs.
In the UK it’s much worse than normal for rural areas due to chronic underfunding of social services and healthcare.
There’s too many factors to go into but the most pressing issue is that there aren’t enough care home beds available to discharge elderly patients so there’s not enough beds available in hospitals. Ambulances often have to wait long times before they can unload a patient at the hospital which ties them up - at one point ambulances had to wait over an hour on one out of ten trips nationally (thats just the stat the NHS keeps, they often wait for much longer than an hour).
Combined with population growth significantly outpacing growth in NHS budget and staffing, it’s created a perfect storm of shite.
You mentioned the population growth but what about aging population? Because of that wouldn't funding need to be exponentially increased each year. At the same time a smaller working population and who are against tax increases would make that difficult.
Integrated healthcare systems in other countries like Kaiser can balance patient flows between hospitals and care homes. This is something that in theory the UK should be good at given it's also an integrated system, but the dysfunction caused by trying to have the government centrally plan everything means it doesn't work in practice. The issue isn't under-funding, the UK social/healthcare system has plenty of money relative to peers.
Beyond general disorganization the UK system shoots itself in the foot regularly. Care homes are bottlenecked by labor cost, so their solution was:
1. Raise the minimum wage, thus increasing care prices and ensuring more people can't afford to pay for it even though there's lots of available labor.
2. Fire huge numbers of carers because they didn't want to get vaccinated, even though the vaccines weren't reducing transmission and their elderly tenants were multiple-vaccinated anyway.
(2) was especially damaging because care homes were one of the few sectors that had vaccine mandates in the UK, so people have now learned that if they go to work at care homes then they will be forced to take experimental medical things even if they don't want to or if it doesn't seem to make sense. That's a big downside to a job that already had few upsides.
Which country has the best health care in Europe? And what makes it the best solution?
I ask from the perspective of an American, with access to great health care but it’s expensive. If we were going to reinvent health care here, who should we copy?
The Netherlands! Well okay, I don't know what it's like elsewhere, but I know it's good here :)
Here's the lowdown:
- If you can't afford it, the government pays for your insurance
- If you can, you pay for it (nearly everyone can)
- Prices are regulated by the government
- You can not be turned away, and can not be charged more than the regulated amount for your insurance, no matter what
That last one is the killer feature. You could have cancer, and the insurance company still has to take you, and for a monthly price not higher than the maximum the government's put in place.
The Netherlands had a free system like the NHS, but once the quality started going downhill, they looked at reality in the face and built a better system. The standard of healthcare here is amazing!
This isn't a popular narrative in the UK, because it shows how there are more choices than just "completely free" or "U.S.A. style dystopia", which is the argument used there to promote the idea that the NHS can work.
I wish there were a quick/easy answer here (we all prefer would to read those) but the truth is that it's not that simple. Even among the nations with excellent universal healthcare systems, most differ from each other in pretty significant ways. This is in part because no two countries are the same, and every detail can have a big effect on what system would work best for them. There are certainly stats-friendly ones about population, economics, and politics. But there are also equally-important ones that are cultural and harder to quantify--for instance, in some countries the people have a distrust of doctors, or a cultural aversion to visiting the doctor unless absolutely necessary, and that factors into the best design for that country, based on how it would be used.
What I can recommend is a great book that compares all the systems, through the lens of an American with the same question you have, called The Healing of America by T.R. Reid. Highly recommended.
In my view, a big part of problem the here is how individuals view the costs/quality relative only to themselves and not to those of a different socioeconomic status.
Counterpoint to all the "it's because it's underfunded" arguments: The money's there, it's just misspent, as with all government lead bureaucracies, resulting in service that could and does kill.
There are multiple unnecessary levels of bureaucracy being paid, leaving little room for people who do actual work. This also results in those people being stifled by busy work.
Source: Doctors I'm friends with, and personal experience (with family members dying or permanently and seriously damaged).
Your study doesn't actually say that. You'd expect their comparison to be with other developed countries given how it's worded, but in reality:
The UK had the lowest healthcare expenditure per capita relative to our comparator countries (UK, $3825 (£2972; €3392); study average, $5700), although this was roughly in line with the average healthcare expenditure of the OECD member states ($3854) and the EU member states
So the UK spends about the same as other EU and OECD countries. It only spends less compared to a set of hand-picked "comparator countries" which are: Australia, Canada, Denmark, France, Germany, the Netherlands, Sweden, Switzerland, and the USA.
That's a remarkably cherry-picked list. If you average such a small list then
the mean will be dominated by healthcare spending in the USA. To get better and less cherry-picked data you can turn to the ONS. See Figure 1 (2017) here:
The UK is around the same level as Finland, New Zealand and other developed countries.
This chart really makes it obvious how they picked their "comparator countries": all the countries that spend the most on healthcare. That isn't surprising. It's hard to get a more biased source on British medical spending than the British Medical Journal. Of course academics specializing in healthcare will claim the UK doesn't spend enough on healthcare.
Maybe. There's a lot of noise in these measurements. A lack of error bars doesn't mean a lack of errors. For many years activist orgs and newspapers liked to claim the UK was at the rock bottom of EU healthcare spending, that it spent far below other nations. When new accounting standards came in that tried to unify the way healthcare spending was measured between nations, overnight the UK went up to be about the middle of healthcare spending. The reason was, social care spending hadn't previously been reported as healthcare spending in the UK whereas in other places it was. Standardizing that fixed the disparity.
There are still big sources of error in these numbers. It's not obvious, but spending on IT systems and hospitals (capital investment) isn't included in these numbers, yet these have sucked up a lot of NHS spending over time especially in the form of large failed IT projects, and capital expenditure on hospital buildings has often been done "off the books" in the UK using PFI schemes.
Unfortunately the ideological basis of the NHS means that many people feel a nearly moral obligation to argue its failings are always about money, especially Brits who work in the healthcare world themselves. It's a risk free strategy. To criticize the way the NHS is actually structured or operates would come dangerously close to wrongthink.
The NHS is pretty much like a religion in the UK, it is true. Most of us are very wedded to the idea that health care that is free at the point of use for all is a very good thing.
We are also used to people who would rather we had a more US-like health system pretending that they care about it while actually trying to make it fail, effectively to privatise health care by the back door.
So it's a hard subject to debate rationally here for sure.
Am I supposed to feel better or worse, considering private healthcare also has bureaucracies that could and does kill, on top of destroying people financially?
Source: work in practice management and billing software, and personal experience
I was lucky enough to have private healthcare paid for me, and I the only bureaucracy I experienced was having to go to the NHS G.P. first to get a "referral". Basically this is a(n NHS side) tick-boxing exercise where you have to be "referred" to a private doctor before you're allowed to see them, even if you pay.
In practice what happens is you go to your G.P. and literally say; "can you write a referral so I can go and see my private doctor", and they do so on the spot without batting an eyelid.
> on top of destroying people financially?
I'm not sure where that's coming from either? Mine was paid for, but it wasn't exactly extortionate. I could have afforded it myself at the time.
I don't understand why it's such an emotionally charged issue for some people. If it's a poor/class thing, does it help that I grew up in a piss poor council estate, and thank god I don't have to rely on the NHS ever again.
Canada doesnt have these kinds of issues with its universal healthcare. We have pioneered new processes to reduce the burden to our medical system [1].
I know you are joking, but the problem is potentially worse in Canada. Private healthcare is illegal in Canada [1]. At least in the UK you can get private health care [2]. You could argue that this is only an option for the wealthy, but my point of comparison is the US, which is similar minus the public option.
Demographics and shrinking labor forces alone will bring the system to its knees regardless of money. It's absolutely baffling in the face of this trend that preventative, systemic policies are practically never discussed and everything centers around individual care.
Countries like Singapore show how you can tackle this, strong interventions to prevent entire populations from being obese, a regulated medical sector to bring costs down and private savings funds to encourage personal responsibilty.