NHS In The Corridor

[R. Richard]

Except dentistry. We have to pay a contribution for dental work.

Our teeth are a national scandal because the politicians still haven't managed to make their minds up between remedial and preventative dentistry. They pay reasonably for remedial work but prevention of dental problems is overfunded.

As a result it is still difficult to find a local dentist who will take on NHS patients. When my daughter moved house she enquired through the NHS website for the nearest dentist taking NHS patients. The "nearest" was 25 miles away.

That might have been OK, but it was 25 miles as a crow flies. The Thames Estuary is in the way. By car it would be over 100 miles.

She is now with an NHS dentist less than a mile from her home. She finally thought to ask Dad.

Og

I presume that you meant underfunded.

The problem you cite with dentists refusing to take on NHS patients is a symptom of a system. It's easy to keep health care costs low, just pay less. However, you get either refusal of service or delay of service, where the delay is tantamount to refusal.

How many of the lower classes have a dad sufficiently familiar with the system to find an NHS provider conveniently close?

 

[R. Richard]

Are you kidding? In the US, taxpayers can go where their insurance providers say they can go, when their insurance providers says they can go there. Only the independently wealthy can choose where they go. The 45 million taxpayers who don't have insurance are in the scraped off the pavement category.

Not true! Many insurance plans allow a decent choice of providers.

As to the 45 million who don't have health insurance, they have nearly unlimited choice. All they have to do is to get to an emergency room and the hospital IS REQUIRED BY LAW to provide medical care, even if the patient can't pay for it. Where does the payment come from? Why, from the paying patients who pay for their own care and also for the non-paying patients care.

 

[Guest]

. . . . .

 

[penandpaper]

They are not 45 million taxpayers. Almost half of them are illegal aliens who do not pay taxes but use public services anyhow. Many of the others are people, possibly self-employed, who could buy insurance but decide not to, and gamble that they will not have any major medical expenses.

In all honestly, the odds tend to favor them, although sometimes things do not work out in their favor.

There are, on a high estimate, 15 million illegal immigrants. (Most census reports put it at 8-12 million.) It is estimated one quarter, yes one quarter of those use health services. 3 to 4 million is hardly going bankrupt a nation.

 

[R. Richard]

In 2006, the State of Massachussets enacted health insurance reform with the goal of universal coverage.

97% of Massachussets citizens are now covered.

The time for a new patient to find a primary care physician is now 30 to 36 days. [Instead of medical care, the new citizen in Massachussets gets a place in a waiting line.]

Visits to emergency rooms in Massachusetts increased 7% in two years. [ER visits are expensive for the provider, up to 10 times more expensive than an office visit. The goal of universal coverage was to lower health costs, not increase them.]

Half of all internal medicine physicians have closed their doors to new patients. [Instead of medical care, the new citizen in Massachussets gets a place in a waiting line.]

What has occurred in Massachussets is rationing of health care. [Massachusetts also has the highest concentration of doctors in the country.]

If you want to see what universal coverage would be like in the USA, talk to someone in Massachussets.

 

[TheEarl]

I currently have very little in the way of spare cash. This is due to problems with moving house and suddenly having to find two months of rent and a £1,000 deposit out of nowhere. Luckily, I have understanding inlaws who loaned me the money, but even with that, I currently don't have the reserves to deal with unexpected expenses.

Even if I were being taxed less, the extra money would go towards servicing my debt, not towards insuring for something that may not happen. That's not me being imprudent, that's me trying to maximise my limited resources.

I then broke my foot a few weeks ago. I thought it was a strained muscle from rugby and ignored it until bullied into going to get it checked out. It's not life threatening, but the NHS meant that I could go to the hospital, get it x-rayed and get advice. If I'd had to pay for medical treatment, then I couldn't've afforded it and would've likely ended up with a more serious problem as I damaged the foot further from not getting proper medical advice.

Just an example.

And yes, I did have to wait in the waiting room for a good few hours. Still grateful.

The Earl


ETA. And I do have private dental insurance, because I'm more antsy about having to wait when I have toothache. It's a choice of medical coverage thing, rather than a "I don't have the money, so I don't get medical coverage" thing.

 

[Liar]

If you want to see what universal coverage would be like in the USA, talk to someone in Massachussets.

You mean someone who can now afford it as opposed to before? I'm sure they're positively furious.

 

[oggbashan]

I presume that you meant underfunded.

The problem you cite with dentists refusing to take on NHS patients is a symptom of a system. It's easy to keep health care costs low, just pay less. However, you get either refusal of service or delay of service, where the delay is tantamount to refusal.

How many of the lower classes have a dad sufficiently familiar with the system to find an NHS provider conveniently close?

You're right. I meant underfunded.

Anyone other than my daughter might have walked into the nearest dentist, NHS or not, and got the answer straight away. She believes that the internet is the best and ONLY way to get information. As far as the NHS is concerned, their internet services are a cluster-fuck because they always use the lowest bidder and then change their mind several times a week about what they want on the system.

Og

 

[trysail]

Two items have infinite demand: money and healthcare.

The supply of these two items is not infinite.

Since the supply is limited and the demand infinite; supply must be rationed— the only question is: how?

There are currently at least three separate markets for healthcare in the U.S.:
I) Private pay,
II) Insured and
III) Indigent.


Market I
I am aware of several physicians who no longer accept reimbursement by health insurers AT ALL. These physicians require payment directly from their patients. For the most part, they provide excellent service. They are not willing to put up with the hassles and paperwork involved with reimbursement by insurers or government. Whether these physicians are competent is anybody's guess— though they are unlikely to be butchers. Some of them do, in fact, specialize in treating "diseases of the rich." These physicians are highly sought after by hospitals and are accorded special admitting privileges. In the parlance of professional services, these physicians are considered "rainmakers." This market segment is rationed and cleared by price.

Market II
The insured patient market represents the vast majority of consumers. Conditioned by decades of no apparent cost, the demand for healthcare soared until recently when prices rose high enough to begin to retard demand.

Market III
With no cost to the consumer, the demand for mandated care by indigents has no constraint. Its cost is, of course, borne by Markets I and II. Since there is no rationing by price, it is reasonable to assume that demand will never moderate.

 

[Pure]

note to try,

not suprisingly, you ignore the working poor, whose employers cannot or do not provide healthcare.

they are not 'indigent', i.e. welfare cases.

in most of the civilized world, england, france, germany, holland, norway--virtually all those with high standard of living-- they would have some sort of access to a national health insurance plan. in the US, the "market" has decided to ration their care, to substandard.

you also ignore that MANY of the insured are underinsured, and stll face bankruptcy. so to say, the 'market' has rationed what's available to them, as minimal: i.e. broken arm is ok, but heart surgery, sell your house.

the 'market' you worship, does not yield rational outomes, not to say, just ones. (hence the number of users of inferior products such as Windows Vista).

 

[JAMESBJOHNSON]

Pure conveniently ignores the fact that hospital corporations own the hospitals; when the insurance companies resist the high costs of hospital care the hospitals toss them out on their butts.

Within a few years the hospital chains will absorb all the small fry and give ObamaCare the finger when he tries to cut payments. Then Obama will return, hat in hand, wanting a trillion dollars to build guvmint hospitals.

 

[R. Richard]

Anyone other than my daughter might have walked into the nearest dentist, NHS or not, and got the answer straight away. She believes that the internet is the best and ONLY way to get information. As far as the NHS is concerned, their internet services are a cluster-fuck because they always use the lowest bidder and then change their mind several times a week about what they want on the system.

Og

Interesting. What you're telling me is that individual practitioners are competent, but the NHS isn't.

 

[Liar]

Interesting. What you're telling me is that individual practitioners are competent, but the NHS isn't.

Ah yes. One thing most government run organisations world wide is lacking, is communication skills. It stems from the tradition of being an insitsution, and the symptoms are endemic obfuscation and complete lack of didactics.

I don't think the problem is that the websites are built by the lowest bidder. Any clown with a template can make a navigational site. The problem is that it's filled with content-by-committee that is not fully thought through. Too many cooks, no clear strategy.

 

[curvy_kitty83]

I'd like someone somewhere in the world to tell me that their country has the most perfect health system.

It wont happen. Because there is no such thing. As with absoloutely everything you will get people who have nothing but praise and then you'll get people who have nothing but abuse to dish out.

C'est la vie.

But for all the Americans slagging off the NHS, what makes your country so perfect? Get your own house in order first.

 

[R. Richard]

Ah yes. One thing most government run organisations world wide is lacking, is communication skills. It stems from the tradition of being an insitsution, and the symptoms are endemic obfuscation and complete lack of didactics.

I don't think the problem is that the websites are built by the lowest bidder. Any clown with a template can make a navigational site. The problem is that it's filled with content-by-committee that is not fully thought through. Too many cooks, no clear strategy.

That is what has me against government run healthcare systems. Any system is run by committee. However, a private system either overcomes the stupidity or goes under. A government survives, despite the stupidity. I want to make sure I survive, despite the system.

 

[Teloz]

Don't believe everything you read in the papers, or anything you read in the Daily Mail!

 

[R. Richard]

Don't believe everything you read in the papers, or anything you read in the Daily Mail!

Of course not! For intellectual stimulation, I read the Sun. The Page 3 girls always have a couple of good points to offer.

 

[SimonBrooke]

You know, if you could find one person - just one person - on this forum who currently has socialised medicine and would prefer to have that scrapped and go back to private medicine, you might find your argument was more persuasive. But you will not find that person.

Yes, the NHS is not perfect. It's like democracy - it's the worst system you can imagine, except for all of the others. But compared to private medicine it's a complete no brainer. It's way cheaper - there's a huge amount less bureaucracy and accounting to do, when everyone gets paid for in exactly the same way. Everyone is covered. You don't lose your cover if you lose your job. You don't lose your cover if your business goes down the pan.

Yes, the NHS is paid for out of taxation. So, guess how much more tax people in Britain pay than in the US? Well, the marginal rate of income tax for people in the US with average earnings is a very modest 25%. And the rate of tax in Britain for the same people? It's a whopping 25%, but in that extra 0% they get all their health care paid for.

Yes, you read that right. In high tax Britain, with our health care paid for out of taxation, average people pay... no more tax than you do.

 

[Teloz]

Why didn't I say that Simon? PMSL

 

[Boxlicker101]

You know, if you could find one person - just one person - on this forum who currently has socialised medicine and would prefer to have that scrapped and go back to private medicine, you might find your argument was more persuasive. But you will not find that person.

Yes, the NHS is not perfect. It's like democracy - it's the worst system you can imagine, except for all of the others. But compared to private medicine it's a complete no brainer. It's way cheaper - there's a huge amount less bureaucracy and accounting to do, when everyone gets paid for in exactly the same way. Everyone is covered. You don't lose your cover if you lose your job. You don't lose your cover if your business goes down the pan.

Yes, the NHS is paid for out of taxation. So, guess how much more tax people in Britain pay than in the US? Well, the marginal rate of income tax for people in the US with average earnings is a very modest 25%. And the rate of tax in Britain for the same people? It's a whopping 25%, but in that extra 0% they get all their health care paid for.

Yes, you read that right. In high tax Britain, with our health care paid for out of taxation, average people pay... no more tax than you do.

You are probably right in that people would rather continue with the NHS than pay all their own medical bills. That's pretty much a no-brainer. However, it's not even close to being that simple. Most persons in the US have medical insurance, either paid by employers or paid by the insured. There are some persons who have no health insurance because they figure they are healthy and not accident prone and it's cheaper to pay for what they need rather than paying premiums to an insurance company. There are also illegal aliens, estimated by the census bureau to be between twelve and twenty million, and they frequently have no insurance.

Do you realize what an unbelievable statement this is?:
But compared to private medicine it's a complete no brainer. It's way cheaper - there's a huge amount less bureaucracy and accounting to do, when everyone gets paid for in exactly the same way.

I seriously doubt you will ever convince anybody that there are institutions more bureaucratic than big governments.

A statement about marginal tax rates is meaningless without context. You refer to a marginal tax rate of 25%, but what does that mean? Is that a flat rate on all income from any source, with no deductions or exemptions? If so, that's much higher than in the US. The 25% federal tax rate you mention is assessed on TAXABLE income in excess of $65,100 and less than $131,450. Taxable income is gross income from some sources, less personal exemptions and deductions and whatever else the taxpayer can find or lie about. A person or family who is paying a 25% marginal rate is usually quite well off.

If you are wondering about those figures, I just looked them up in the 1040 work book for 2008.

I don't know about now, since the 1990's, but the federal government used to pay out, through the states, huge sums of money to pay for the health care, etc. of millions of persons who were deemed too poor to pay for it themselves. I worked for the state of CA, processing the claims by medical providers and authorizing certain procedures and purchases to be done at gov. expense. We were a huge bureaucracy and, I suppose, the feds had a similar one. Some of the things the gov. paid for seemed ridiculous then, and still do, at least to me, such as trimming toenails and transportation by special vehicles to medical appointments, etc. I'm quite sure no private insurance co would have paid for many of these things, considering them to be unnecessary, and the individuals would have passed them if they would have had to pay for them themselves.

My opposition to the fed gov. being the insurer is that I have seen how badly it works.

 

[oggbashan]

Comparing tax systems in the UK and the US would be a real minefield.

Tony Blair and Gordon Brown have introduced or raised a whole set of "stealth" taxes that don't add a penny on the income tax but still raise revenue e.g. fuel duty increased recently, insurance taxation, taxation on investment profits, inheritance, stamp duty, National Insurance, Value Added Tax due to go back up again in the New Year.

The US tax system is different but the US's tax laws and regulations are just as complex as the UK's.

What is certain is that the UK pays far less of its Gross Domestic Product for health care in total (including insurance schemes, private provision and the NHS) than the US does but the UK provides universal coverage.

Og

 

[Liar]

I seriously doubt you will ever convince anybody that there are institutions more bureaucratic than big governments.

Your fly is open and your prejudice is hanging out.

 

[3113]

Your fly is open and your prejudice is hanging out.

Oh, you Europeans! You're just so...European! http://bestsmileys.com/angry1/9.gif

 

[amicus]

R.Richard...not that it is my place to say so, but thank you for fighting the good fight.

Nor is it my place, necessarily, to welcome new posters to the forum, but I noticed a few and do extend the hospitality often lacking here.

SweetSubsarahh, near the top of this page, perhaps said it best for those of a communal mindset, "Free to everyone would be a good thing...." Post #28...

Free medical care, affordable housing, living wages, free education, guaranteed insurance and tenure in employment forever...that is easy to translate: Socialism.

SSS and most of the communal advocates here, will never accept that they advocate socialism or communism or fascism; but they do...time and time again on issue after issue.

I am far from being the only one to conclude that, women, dependent on men for their existence and protection, naturally evolve towards a father figure to tell them how to live their lives.

I am also not alone in concluding that the feminist movement, the independence of women from men transferred via welfare, to government; has also emasculated the male population to where they too, lacking cojones, turn to mama for sustenance.

The, 'elete' intellectual crowd, one can understand easily, they are already totally dependent on a 'money cow', be it government research grants, University tenure or, God forbid, an industrial source of income. They are the worst of the lot of those who are willing to sacrifice the freedom they never understood and never practiced, for a guaranteed 'nanny state' existence.

There are a couple of things most fail to understand. As in all Communist take-overs, the intellectuals, teachers, artists. homosexuals and other deviants, are the first sent to the fields with a hoe in hand or worse.

Second and third combined: once begun, the increased governmental decisions and power, never returns the power to the people without a revolution and not one, not ever, has been successful in providing,'cradle to grave' security for those incarcerated in such 'grave yards', as the former Soviet Union.

This paltry progressive liberal mantra about caring for the poor, is merely a social imperative to take power in hopes they can keep most for themselves.

The best thing you can do for the 'poor', is to create a vibrant, 'free', society and provide the opportunity for all to improve their status. Anything else is a cruel pipe dream corrupt with the desire for the power to tell others how to live their lives.

Amicus

 

[R. Richard]

You know, if you could find one person - just one person - on this forum who currently has socialised medicine and would prefer to have that scrapped and go back to private medicine, you might find your argument was more persuasive. But you will not find that person.

If a person lives in a socialized medcine system, chances are that's the only system with which they have any experience. Why would they want to change to a system that they have no experience with?

As to 'going back to private medicine,' there are any number of people in Canada who do just that. If the Canadian system can't treat a patient, they will and do cover the care from a USA provider. If you want to do a search, there are USA clinics that advertise for Canadian patients. if the Canadian system were as great as many say, then there would be a lot of sick USA people who would 'vacation' in Canada and then find that they suddenly needed free emergency care in the Canadian system. AFAIK, there are few or no USA patients who try to game the Canadian system. Also any number of Canadians come to the USA and pay for drugs, where they could get 'equivalent' drugs for free/cheap in Canada. However, the 'equivalent' drugs don't work for everybody. [There are USA people who do buy the cheaper Canadian drugs.]

Yes, the NHS is paid for out of taxation. So, guess how much more tax people in Britain pay than in the US? Well, the marginal rate of income tax for people in the US with average earnings is a very modest 25%. And the rate of tax in Britain for the same people? It's a whopping 25%, but in that extra 0% they get all their health care paid for.

Yes, you read that right. In high tax Britain, with our health care paid for out of taxation, average people pay... no more tax than you do.

As Og has pointed out, the tax systems of the USA and the UK are quite different. The UK has a Value Added Tax, the USA doesn't. If you have a VAT, you have no idea how much you pay in taxes. [Yes, it possible to calculate how much 'er Majesty's government collects in VAT, but there are markups along the way that pass more cost along to the consumer.]