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Economy of scale works right up until someone says "public ownership" at which point the free market pixies all get scared away and it becomes really bad.
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Nov 3, 2015 17:38
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Phoon posted:The reason the nhs is so cheap for the breadth/quality of coverage is that it's so large it benefits from economies of scale + it gets favourable treatment from government + it has no profit/investors pulling money out of the system - the idea that its too big or should be private makes no sense at all. Unless you're one of the people who will be pulling money out of the system. (Hint: the Tories are among those people, and so are their mates.)
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Nov 3, 2015 17:38
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Guavanaut posted:Obese people and smokers are actually cheaper to care for across their entire lives, and generally cost less in other areas too.
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Nov 3, 2015 17:40
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On that article, I admit I only read the findings but healthy long lived people having a higher lifetime expenditure isn't totally surprising is it? I'd be curious what the spend as a percentage of the income received during the lifetimes of the obese/smokers is compared to the healthy is. Unless I've misunderstood what they meant by expenditure. And I don't know if what I'm thinking would be of any significance. e: Guess I should have read more closely "Alternative values of epidemiologic parameters and cost definitions did not alter these conclusions."
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Nov 3, 2015 17:46
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Jedit posted:Unless you're one of the people who will be pulling money out of the system. (Hint: the Tories are among those people, and so are their mates.) Or anyone who pays in more than they take out, which leads to a death spiral.
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Nov 3, 2015 17:49
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Malcolm XML posted:Or anyone who pays in more than they take out, which leads to a death spiral.
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Nov 3, 2015 17:50
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Yeah, that's how insurance works innit
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Nov 3, 2015 17:51
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Reminds me of... some kind of scheme
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Nov 3, 2015 17:52
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You could probably make the argument that the smoker or obese person is less productive over their working life enough to negate that or something, but a) I can't find any good statistics on that and b) it still falls into the trap of treating humans as a cross between a mineral seam and a draft animal. The argument is almost locked in to having to talk in economic terms with all the talk about 'deficit denial' etc. at the moment, and the reduction of people to statistical groups, but it could probably do with someone standing up and saying "actually, this is about quality of life rather than the bottom line."
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Nov 3, 2015 17:53
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baka kaba posted:Reminds me of... some kind of scheme Does it involve a tetrahedron?
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Nov 3, 2015 18:00
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Jedit posted:Also they plan to widen the A303 into the Stonehenge heritage site. It would be better if either: 1) The A303 was a dual carriageway along its entire length (even better, a motorway) and didn't go near Stonehenge at all, or 2) The A303 was a dual carriageway along its entire length (even better, a motorway) even though it does go past Stonehenge, because while it would be an eyesore at least it would be an eyesore upon which the traffic flows freely and one half of the people who suffer (ie the drivers and local residents) would get some relief. While we're at it we can extend the M5 to Plymouth, St Austell and Truro and re-route the Great Western Railway north of Dartmoor so that Cornwall isn't so cut off from the rest of the UK that it's one of the poorest regions in the entire country. Zephro fucked around with this message at 18:06 on Nov 3, 2015 |
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Nov 3, 2015 18:03
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Prince John posted:Does it involve a tetrahedron? I was hoping for more of a cone
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Nov 3, 2015 18:06
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baka kaba posted:I was hoping for more of a cone Vertical success triangle 
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Nov 3, 2015 18:12
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PlantHead posted:My example of the NHS needing to improve. I also had a lump checked for cancer, it also took 6 weeks for the appointment. This was because my GP had assessed the likelihood of it actually being cancer was extremely low so I wasn't a priority patient, personally I was fine with this. The fact that you say you 'want it checked' rather than 'need it checked' makes me think it likely you are also considered at low risk for cancer which is probably why you're waiting 6 weeks. In any health system without effectively infinite resources patients will be prioritized on some criterion. In a private system that criterion is money, in a public one its need. I know which I prefer.
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Nov 3, 2015 18:14
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Random Integer posted:In a private system that criterion is money, in a public one its need. I know which I prefer. You mean the two aren't the same thing!?? E: Realtalk I would love for the NHS to have say, 0.5% of its service capacity devoted to a pay-for-access model. But only ever 0.5% Ban private hospitals and let the ultra-wealthy outbid each other for access to very limited priority services. Put the money into improving the NHS. OwlFancier fucked around with this message at 18:18 on Nov 3, 2015 |
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Nov 3, 2015 18:16
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^^^ That's exactly how it starts thoughMahmoud Ahmadinejad posted:Vertical success triangle Speaking of success https://www.youtube.com/watch?v=sNQglX_6tSA I'm guessing the tories use similar technology with archive footage of the huddled masses when they're pitching policy
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Nov 3, 2015 18:18
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baka kaba posted:Obviously there are improvements to make, and big changes that need to happen going forward (like a proper IT infrastructure project that isn't poo poo and beholden to private companies' whims again). But when people say "don't change anything" they're talking about the overall structure and operation, and they're saying it in the context of the Tories trying to rip it up and push through sweeping, damaging changes because "we can't go on like this" What's your opinion on the Trust setup, particularly the way we have to engage in this weird pseudo-corporate competition for service contracts? It just seems like a massive waste of time and resources to me, because one Trust is very much like any another and when a site changes hands nothing of substance really changes (unless the line staff get reshuffled). OwlFancier posted:You mean the two aren't the same thing!?? Denied. It's not even about any supposed slippery slope, letting even only a small number of people pay to queue jump or get better service or whatever creates a two tiered system, something which I find entirely unconscionable in a public health service.
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Nov 3, 2015 18:24
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Renaissance Robot posted:Denied. It's not even about any supposed slippery slope, letting even only a small number of people pay to queue jump or get better service or whatever creates a two tiered system, something which I find entirely unconscionable in a public health service. *shrug* it already works that way, the tories wouldn't be fond of scrapping the NHS if they didn't have the option of paying for access to an elite service. I propose removing the pretense and getting that money into the public system instead.
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Nov 3, 2015 18:26
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Alternative: rich people are allowed to pay to fast access services. But it's actually the same service, they just feel like it's probably better since they paid to go private. Second alternative: The wall.
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Nov 3, 2015 18:36
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winegums posted:Second alternative: The wall.
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Nov 3, 2015 18:42
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Yes and, hence, yes.
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Nov 3, 2015 18:43
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There isn't much I like about this country (Hello Theresa May!) But the NHS, especially at ground level, is something to be very proud of, and cherish. 111, on the other hand, is what we get when its jobs for the boys. Its too big? Its the National Health Service. Are we being trolled by Jeremy Hunt?
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Nov 3, 2015 18:48
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111 is fine as a supplementary service but it's not being used properly. It's good as a "hey when I slam my dick in the door while jerking off it stops feeling much after then tenth go and a little bit of blood comes out IS IT CANCER?!>" screening service.
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Nov 3, 2015 18:50
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Not connected to an idiot spouting nonsense about the NHS: According to someone I know who works on one, more and more county councils are devolving responsibilities for things like road repair, tree trimming and the like to parish councils. Except they're not giving them any more money. This means that one of three things will happen. 1. Services will have to go and roads will get worse. or 2. Council land will be sold off to cheap to developers. or 3. Council tax will go up dramatically despite no rise in services performed. Trick question, actually it's all three. Having responsibility for the roads will bankrupt parish councils very quickly - for the councillor I talked to, the amount of money they're getting from the council tax hike will pay for one pothole to be filled annually, and accidents caused by poor road surfaces will not only keep happening but will also increase in number, with the parish council liable for damages. The county council has also given them the opportunity to have the trees trimmed once this year for free by the county council, after that they have to pay for it. Of course they can just cut all the trees down, which the county council has offered to do for free. And she's a parish councillor for one of the richest towns in the UK, in Tory heartland. In short, by the time the Tories are out of power we'll be living in a concrete wasteland with no trees and dirt paths for roads.
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Nov 3, 2015 18:52
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OwlFancier posted:111 is fine as a supplementary service but it's not being used properly. Its really not. They rarely have clinicians make decisions in my area, so your health is in the hands of someone as ill trained and inept as me. Trust me, thats not good, and its killing people.
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Nov 3, 2015 18:55
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Trickjaw posted:Its really not. They rarely have clinicians make decisions in my area, so your health is in the hands of someone as ill trained and inept as me. Trust me, thats not good, and its killing people. Like I said it's not a replacement heath service, but it's good to have a line you can call and ask your stupid questions to, provided that they know to say "dunno, see a doctor" when appropriate. There was something like that available when I was a kid so it's not a new idea.
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Nov 3, 2015 18:57
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MrL_JaKiri posted:According to someone I know who works on one, more and more county councils are devolving responsibilities for things like road repair, tree trimming and the like to parish councils. Except they're not giving them any more money. This means that one of three things will happen. OwlFancier posted:It's good as a "hey when I slam my dick in the door while jerking off it stops feeling much after then tenth go and a little bit of blood comes out IS IT CANCER?!>" screening service.  )e: OwlFancier posted:Like I said it's not a replacement heath service
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Nov 3, 2015 18:59
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Guavanaut posted:It probably is.
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Nov 3, 2015 19:00
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Oberleutnant posted:I'm drawing a blank on this, sorry! I've done it myself, because it works well in some audiences, like defending early-years education on the grounds of the HighScope Perry Preschool Study showing excellent long term return on investment, which it does. But funding early-years education is good for a host of other reasons and funding healthy eating campaigns is good even if it is a lifetime loss.
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Nov 3, 2015 19:07
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Renaissance Robot posted:What's your opinion on the Trust setup, particularly the way we have to engage in this weird pseudo-corporate competition for service contracts? It just seems like a massive waste of time and resources to me, because one Trust is very much like any another and when a site changes hands nothing of substance really changes (unless the line staff get reshuffled). I don't know much about inter-trust competition, but that sounds weird to me. I like them as regional bodies that can handle wider decisions and planning, and specialising in particular types of care, and I don't see the point of breaking up PCTs into lots of redundant CCGs that nobody working in the NHS really has time to be involved in. I guess the competitive tendering thing is some weird side-effect of having to compete with private tenders, and trusts are incentivised to take part and try to take over other trusts' responsibilities? That kind of thing is the whole problem with a market-based approach, it puts ~* competition *~ at the heart of everything as though it inherently produces better outcomes. It's at odds with a unified, coordinated system that organises itself to be as effective as possible. I mean yeah, if another trust is better suited to handle a thing, that's definitely a switch that can be made - but that's an internal NHS decision. Same with commissioning private services - if they're something that's needed and a good fit for the NHS, great. Maybe they're something that the NHS should be providing itself, in which case they should look at developing that internally. Being bound to the rules of glorious free-market competition should never come into it, because the NHS should be making its own rules. Its whole purpose is to be some kind of fortress of health, protecting people from disease and the ravages of inequality. Creating internal battles and forcing it to open its doors and let the enemy shack up inside completely undermines that purpose (which is obviously the point)
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Nov 3, 2015 19:09
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LemonDrizzle posted:How could you run any sort of healthcare insurance scheme that didn't rely on most people paying in more than they take out? You can't, which means if enough young healthy people decided hypothetically to stop enrolling in a private NHS it would enter into a death spiral due to adverse selection Which is why privatizing it without a 100% mandate to have health insurance wouldn't be good, as it would either lead to adverse selection or a pre-PPACA style world where the insurers look for any excuse to deny claims.
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Nov 3, 2015 19:11
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So we replace a publicly-owned organisation that we all have to pay money for with a privately-owned organisation that we all have to pay money for?
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Nov 3, 2015 19:17
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XMNN posted:So we replace a publicly-owned organisation that we all have to pay money for with a privately-owned organisation that we all have to pay money for?
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Nov 3, 2015 19:18
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XMNN posted:So we replace a publicly-owned organisation that we all have to pay money for with a privately-owned organisation that we all have to pay money for?
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Nov 3, 2015 19:18
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XMNN posted:So we replace a publicly-owned organisation that we all have to pay money for with a privately-owned organisation that we all have to pay money for? Erm idiot the new system will be better and more convenient for rich people ergo: it's good.
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Nov 3, 2015 19:19
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OwlFancier posted:Like I said it's not a replacement heath service, but it's good to have a line you can call and ask your stupid questions to, provided that they know to say "dunno, see a doctor" when appropriate. Sorry, I'm biased about this particular 'service'. Its still contracts subbed out to mates.
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Nov 3, 2015 19:20
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Trickjaw posted:Sorry, I'm biased about this particular 'service'. Its still contracts subbed out to mates. It would certainly be better if it was just part of the NHS, yes.
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Nov 3, 2015 19:25
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The NHS is good and has helped me tremendously with my melanoma and any of yoos talkin trash about my NHS and I'll burn you like a poppy.
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Nov 3, 2015 19:25
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Gonzo McFee posted:The NHS is good and has helped me tremendously with my melanoma and any of yoos talkin trash about my NHS and I'll burn you like a poppy. You can bum me like a poppy if'n you want. 
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Nov 3, 2015 19:27
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MrL_JaKiri posted:In short, by the time the Tories are out of power we'll be living in a concrete wasteland with no trees and dirt paths for roads. This is one of the big things that gets me really - so much of Tory policy (and its knock-on effects) involves passing the buck, and it's almost never mentioned. Their flagship 'free childcare' policy is pretty much issuing a decree to childcare providers, "you're going to make this happen, out of your own pocket, work something out". Cuts are called 'efficiency savings' but they're never backed by a set of identified efficiencies, just "you're getting less funding, deal with it". Devolving powers and funding is just going to mean central government absolving itself of yet more responsibility and leave local government to work out which limb to cut off. It would be one thing if they were getting held to account for this, but it seems like they can shift all the responsibility onto someone else and avoid the blame when the consequences are bad. And that means they can pretty much do anything
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Nov 3, 2015 19:27
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