Posted by chocolate on Wednesday, 31 January 2007 21:44:42

All your points are valid but you seem to be ignoring two crucial elements.

Firstly, you haven't considered those who would struggle to afford health care. Yes, they could receive benefits to cover health costs, but it strikes me that many of the people most prone to habits which are detrimental to one's health (smoking, unhealthy eating, etc) are those from less affluent backgrounds, and therefore the same problem of lack of incentive to live healthily remains for those very people who are the most prone to live unhealthily. (You'll forgive the Vicky Pollard stereotype, but you get what I mean)

Secondly, Britain already has a high quality private health care sector (or so their adverts have led me to believe), so those who want this higher quality of health care and would be willing to pay for it, already can. If people have a problem with the state of NHS hospitals, they aren't without alternatives.

Posted by Geddes on Wednesday, 31 January 2007 21:53:17

RE: Chocolate

Ah well, there comes the great thing. If you smoke, drink, eat McDonald's for dinner - you will die fast. The Health Service won't be happy dealing with you, and pump up the cost just for you, because it is your own fault you have all these problems. So clearly, you don't want to pay all this money, then you will have to be almost forced to lead a healthy lifestyle. And if you really do not care, well then that, again is your fault.

The New Right is a very brutal theory, but the harder to hit someone, the more determined they will be to get up again. (My opinion anyway!)

Your second point I really cannot argue. But consider that the NHS is in huge debt and crisis, so rather than have two class service - one for the rich, the other for the poor, why not give them one system in which they have to pay, again being ruthless. Those who do look after their health and still struggle to afford the Health Care, they will either have to work harder, try harder or, yes receive a very small benefit.

Posted by chocolate on Wednesday, 31 January 2007 22:07:42

You're right, it's very ruthless.

The NHS in this case then is just a battleground for the more general clash of ideals between the Welfare State and the New Right. Naturally, having grown up in a low-income single parent household, I've experienced first hand the benefit of benefits! I'm afraid I just can't subscribe to a policy of "be rich or you're screwed".

Posted by Geddes on Thursday, 01 February 2007 20:24:30

re: chocolate

"be rich or you're screwed" - I think its more like "be rich or work as hard as you can"... I am currently growing up in a single parent family, with no employment. No benefits, we'd wither be living on the streets OR my parent would get a job much much quicker.

Posted by canvas on Friday, 02 February 2007 11:22:43

Hospitals (Healthcare) in France are very impressive.

"Despite being expensive to maintain and under constant funding pressure, the French healthcare service is still one of the best in the world, offering a wide choice of general practitioners and healthcare specialists. For those who have experience of the health system in France and, for example, the UK, the contrast in standards can be startling.

The French healthcare system is funded by the working population. French employees pay about 20 per cent of their gross salary – the self-employed pay even more - deducted at source, to fund the social security system, known as Sécurité sociale.. A significant proportion of this money goes towards public healthcare, to which every legal resident of France has access under the law of universal coverage called la Couverture maladie universelle.

If a person subscribes to Sécurité sociale, part of the cost of their medical treatment is covered by the state. However, regardless of cover anyone in France can consult a doctor or specialist. Similarly, everyone has the right to emergency hospital treatment, although for those who subscribe to Sécurité sociale, the cost is partly reimbursed.

State healthcare
To compare the NHS and private sector in the UK with the same in France is akin to comparing apples with oranges. There is no great difference in the quality of care between private and public hospitals in France and there is not necessarily any great difference in price. Being treated in private clinics in France does not mean avoiding waiting lists for the simple reason that, with a few specific exceptions, waiting lists such as those in the UK do not exist. And going private does not mean you will have to foot the entire bill.

Unlike the UK in France treatment, whether private or public, is not free at the point of delivery. Even if you subscribe to the Sécurité sociale, on seeing a doctor or specialist (specialiste) you first pay the full bill (tarif) and are then reimbursed at a later date (about 10 days). Generally speaking, Sécurité sociale refunds 70 per cent of the cost of a visit to a médecin traitant (a GP or family doctor) and most specialistes."

Posted by davetheslave on Friday, 02 February 2007 12:16:58

The idea of a private system with state reimbursements is used in several countries throughout europe, and seems to work fine. However, the argument that it would lead to lower costs, or that people would take better care of their health, I believe is false.

Taking the improved health argument to begin with, it is clear that even in countries where health care is completely unsubsidised, or not completely free, there are massive public health issues. Prime examples are the USA which has a massive obesity problem (no pun intended), and France, which has a high rate of alcoholism, and the resultant cirrhosis which comes with it (3 times higher than the UK).
http://www.who.int/substance_abuse/publications/statusreportalcoholeuro/en/index.html

With regards to lower cost, or better value for money, from OECD data it can be seen that both France and Germany spend more per capita on healthcare than the UK. (France: 3048 USD; Germany: 2983 USD; UK: 2317 USD; 2006 figures). The USA spends a whopping 5711 USD per capita on healthcare (more than double the UK spending). This wouldn't really matter if the difference in spending was reflected in life expectancy, but it's not. Of the four countries, the USA has the lowest life expectancy (77.71 years) whilst France has the highest (79.6 years), although the differences aren't massive. Overall, amongst industrialised countries, there is no firm connection between spending and life expectancy.
http://www.kff.org/insurance/snapshot/chcm010307oth.cfm
http://education.yahoo.com/reference/factbook/countrycompare/le/1a.html

So, what is to be done? Cuba is often taken as the textbook example of what a country can achieve with limited resources. The per capita spend on healthcare in Cuba is 186 USD, around 1/25 of what the USA spends, yet life expectancy is similar, at 76.9 years. What are the reasons for this discrepancy? No-one really knows, although there has been much speculation. Possible factors are: the cheaper cost of trained professionals, a healthier diet due to poverty/sanctions/lack of capitalism, an emphasis on preventative medicine, less inequality. Could these be reproducible in the UK, and would they lead to benefits? Well, I assume that not many doctors would be willing to take a massive pay drop, to staff costs are more of less fixed. Quality of diet and greater emphasis on prevention are currently big issues in the UK, and will remain so. Reduced inequality? Possibly under PM Brown, definitely not under the Tories. Will a greater emphasis on public health initiatives and prevention work? A model for this is Finland, which in the 1960s had the highest incidence of heart disease in the world. A public health initiative was launched in the 1970s, with the goal of improving diet and stopping smoking. The incidence of heart attacks has decreased by 75% since the 70s. So, yes, there is evidence that public health initiatives work, and that, in my opinion, should be a focus for whatever government is in power in the UK.
http://www.irishhealth.com/clin/ffl/finland.html

Posted by canvas on Friday, 02 February 2007 20:03:51

Davetheslave - what do you think about this quote?

"Real community care focusing on public health with more health visitors, doctors and nurses would shift health care away from being hospital-centred, and away from just treating illness to actively encouraging well-being.

The public health system in Cuba shows the possibilities. There, the GP-to-patient ratio is three times higher than in Britain. Family doctors are attached to neighbourhood polyclinics (health centres) serving the local community.

These primary care teams provide for most health care needs, including dealing with over 50% of emergencies. This has resulted in hospital admissions declining by 25% over the last 20 years and hospital waiting lists of only one to two weeks.

Cuba is a poor country. It has a planned, publicly owned economy but is administered in a bureaucratic, top-down and undemocratic way. Imagine what would be possible in Britain, the fourth richest country in the world, with a health service that was publicly owned, publicly funded and democratically controlled within a broader, planned economy."

Posted by davetheslave on Friday, 02 February 2007 20:33:50

@Canvas

If the facts about the Cuban health service are correct, then it would sound like a pretty good idea to put in place those structures in the UK, i.e. greater access to GP care, more care in the community and less demand for hospitals. There have been experiments done by individual doctors in Sweden which show that when they promise to see a patient with at most 24 hours notice, the overall demand for the GP goes down after a time. It seems that people get so stressed about the possibility of not being able to see a GP when they're feeling unwell that they book unnecessarily. When they know it'll be no problem to see a GP, they only book when needed. I should emphasise though, this has only been tried on a very small scale.

As for the idea of a planned economy for the UK: I think it's been pretty conclusively proven that they don't work. Social democracy is the way ahead.

May I ask who the quote is from?

Posted by canvas on Friday, 02 February 2007 20:39:50

I think there are valid points in that quote.
By the way - it's from the Socialist Party ;) LoL

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LoL :)