Is the NHS useless?

[unbeliever]

But everyone has lots of experience of really poor service from successful private business, who continue to trade and turn a profit despite being crap. The courier market is crowded and yet Yodel still exist. Look at what VW did with diesel and then apply that ethos to healthcare. Hmmm.

 

So buy a Toyota and use DHL.

[I1L2T3]

I'm considering a model where all the healthcare provision is in the private sector. All doctors, nurses, therapists etc are either self employed or employed by a private sector organisation.

Everybody working full time at a good rate buys health insurance. Said insurance is taxed and the taxes used to fund a state scheme to cover the poor.

This introduces competition for value and quality between healthcare providers, as a replacement for targets. I'm generally of the view that competition is better at driving up standards than top-down targets which tend to create perverse incentives.

 

How would this help you in your present case?

 

You seem to have switched from niche provision to overall value and quality. In a private system there is no guarantee that anything will be provided, the only guarantee is that profitable services will be provided. For this reason there are very few totally private health systems.

 

Looking at the USA as an example which I guess is closest to what you argue for there are categories of health provision that the private sector hardly provides. Burns units for example, which have an unpredictable rate of usage but are extremely expensive to maintain as a standing service when idle. Not profitable enough!

 

Taking another system is an example in Switzerland there is compulsory insurance but it does not cover every treatment category. To get the treatments you describe you would have to top up the basic premium above the approx £200-250 per month per adult basic insurance cost.

[Cyclone]

I'm considering a model where all the healthcare provision is in the private sector. All doctors, nurses, therapists etc are either self employed or employed by a private sector organisation.

Everybody working full time at a good rate buys health insurance. Said insurance is taxed and the taxes used to fund a state scheme to cover the poor.

This introduces competition for value and quality between healthcare providers, as a replacement for targets. I'm generally of the view that competition is better at driving up standards than top-down targets which tend to create perverse incentives.

 

It also introduces higher costs for anyone with an existing condition or a reason that they might have one (family history maybe).

[exxon]

 

But everyone has lots of experience of really poor service from successful private business, who continue to trade and turn a profit despite being crap. The courier market is crowded and yet Yodel still exist. Look at what VW did with diesel and then apply that ethos to healthcare. Hmmm.

 

I was going to mention the wonderful example of British Leyland with the strikes, shoddy workmanship and diabolical cars like Allegros and Marinas. Then I remembered that they were nationalised.

[I1L2T3]

It also introduces higher costs for anyone with an existing condition or a reason that they might have one (family history maybe).

 

The Swiss system doesn't discriminate based on previous history. Everybody pays the same compulsory premium and everybody gets access to the same basic services with no restrictions.

 

Problem with doing that in this country is the point where a couple gets asked to stump up £500 a month plus premiums for children over 3 months old on top of that. Anything other than basic care costs even more!!

[spilldig]

I appreciate the concession. Shows me that I'm dealing with somebody who allows facts to overrule ideas when they disagree.

Their motto is "Affordable, quality health care. For everyone.".

That's the motto of a lobbying group, not a bunch of academics interested only in facts.

 

---------- Post added 01-11-2015 at 09:13 ----------

 

 

How is it that no matter how much extra money the NHS gets each year, they manage to be in financial crisis anyway and making cuts?

 

I think one reason is that it's top heavy with management. I reckon a lot of the pen pushers should go. I also think bringing back real hospital cleaning staff with good working conditions, instead of agency staff would be a good thing.

[unbeliever]

France has universal healthcare, largely funded by the state, but they haven't nationalised the whole system.

I not suggesting we just blindly copy the French model, but it's much closer to what I was thinking of than the US system.

[I1L2T3]

Whilst the NHS should be the provider of most services, in some instances the voluntary sector may be an alternative. I doubt the NHS alone could have developed the services available to people with heart problems, that's why we (our family) support the British Heart Foundation, whose R&D has meant great strides in causes and treatment, and saved many lives.

 

If I needed help with mental health issues, I'd also look at the services offered by Mind, who are a specialist charity: http://www.sheffieldmind.co.uk. Just an option.

 

Very good point.

 

It's not just the voluntary sector that should be participating but the best of the private sector as well. The challenge is how to bring those services in in the best way. There's room for all.

[onewheeldave]

How is it that no matter how much extra money the NHS gets each year, they manage to be in financial crisis anyway and making cuts?

 

A large part of the problem is the admin system which is dire and financially extremely wastefull.

 

Another, is the medical systems focus on symptom management and the consequent lack of focus on prevention.

 

I no longer believe that pumping more money into the NHS in it's current state, will do anything other than create a bigger system crippled by it's own admin system, and it's misguided lack of emphasis on prevention.

[tinfoilhat]

A large part of the problem is the admin system which is dire and financially extremely wastefull.

 

Another, is the medical systems focus on symptom management and the consequent lack of focus on prevention.

 

I no longer believe that pumping more money into the NHS in it's current state, will do anything other than create a bigger system crippled by it's own admin system, and it's misguided lack of emphasis on prevention.

 

Prevention is down to individual in the main though isn't it? Think how much the NHS would save if people ate better, excercised more and didn't get hammered every Saturday night. Obviously our social care costs would go through the roof but you get my point.