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by pjc50 634 days ago
The NHS manages demand by rationing with queues rather than prices. That seems not to be accounted for. You get great care once they get round to you, but people routinely wait months or years in pain for fairly routine treatments.

I don't really know what the answer is because eroding "free at the point of use" will also push a load of people out of healthcare.
2 comments
JeremyNT 633 days ago
> The NHS manages demand by rationing with queues rather than prices. That seems not to be accounted for. You get great care once they get round to you, but people routinely wait months or years in pain for fairly routine treatments.

For what it's worth (don't let the politicians tell you otherwise) the US is the exact same way.

Here, because it's all about profit and margins are so thin, there's no slack in the system. It takes literally months to book an appointment with my primary care doctor. If you aren't already "established" it might take even longer.

Tests for not-immediately-life-threatening things are the same way. You get the next available slot which could be weeks or months out.

There aren't free slots floating around because they want all the staff busy all the time.

And you might think "well can't you pay extra to get to the front of the line?" The answer is well... I can't. Maybe there's some income level that this is possible or secret handshake, but it's not accessible to middle class people.

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mytailorisrich 634 days ago
The issue with the debate over "free at the point of use" is that it is often framed as two extremes: It's either free or we'll have the same as the US where people are pushed out of healthcare on price (ignoring the counter-examples of most other developed countries).

But in reality there is a vast continuum between "free" and prohibitively expensive. There is also of course the option that some categories get "free" care in any case (like prescriptions now, which in England are £9.90 in general but 0 for children and people on specific benefits).

"Free at the point of use" is totemic of the NHS and any suggestions of change are rejected as a matter of quasi-religion (which can be seen in a few comments here to some extent)

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