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The Value of the NHS

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  • It makes me wonder who wrote it. Is still rather be trashed in the us system then the health care systems of Syria, North Korea, India. Iran, Iraq, Argentina, Cuba, Somalia, Venezuela or Afghanistan.

    The article states that the review only covered 11 'developed' countries .. so even 'the worst' are probably gonna be far better than the healthcare systems in the countries that you mention
  • And a private hospital would be telling us it's all about the patient when, in reality, it's all about making the investors a profit.

    Just caught up with this thread. Interesting discussion.

    Let's take BUPA as an example of a private health organisation. The clue is in its full name: British United Provident Association. It's a private company limited by guarantee; it has no shareholders, and any profits (after tax) are reinvested in the business. I don't think it still runs its own hospitals but nonetheless it goes some way towards blowing the "private health care only in it for the money" argument out of the water.
    iaitch said:


    Also consultants should either work for the NHS or private not both. Again you're offered an appointment for six months time to see a consultant but if you want to pay then he's free tomorrow.

    This is an over-simplification of the issues. Take my plastic surgeon for example. His main job is working with kids for the NHS, he specialises in cleft palates and does a lot of work on burns. He also spends a fair bit of the year working in places like Sri Lanka and Bangladesh undertaking cleft lip and palate surgery that would not otherwise get done. But he still cuts out the odd bit of skin cancer for me at a private hospital. The hours he works are very scary indeed but he still prefers to take out stitches himself.

    He doesn't do so much private stuff these days but I wonder if people of his ilk would be forced to go totally to the dark side (which funds much of his philanthropic work) if that was the stark choice being offered. They'd then be lost to the NHS for good.
  • Good points CAFC fan. Now instead of Bupa, which has to "compete" with the NHS tell me about the private health companies in the USA?
  • Interesting read.

    The National Health Action Party are standing in my local constituency (probably because Harriet Harman is the local MP).

    Their manifesto says "The National Health Action Party is a political party formed by doctors, nurses, paramedics and ordinary people who've come together to defend and improve the NHS" - sounds good right ? Anyone know any reason why I shouldn't vote for them ? All I've got to go on so far is their website.
  • Good points CAFC fan. Now instead of Bupa, which has to "compete" with the NHS tell me about the private health companies in the USA?

    Okay. 58% of US community hospitals are non-profit, 21% are government owned, and 21% are for-profit.

    The US solely developed or contributed significantly to 9 of the top 10 most important medical innovations since 1975.

    In 2012, per capita health spend in the USA (public and private) was $8,895. In the UK it was $3,647. GOVERNMENT spending on healthcare in the States as a portion of the $8,895 was around $4,400. A figure in isolation that's only beaten by Luxembourg, Monaco and Norway. By comparison the UK figure was $2,919.
    But we have 27 doctors per 10,000 population while the States only has 24. Portugal BTW has 39 doctors per 10,000 population. Meanwhile, that well known impoverished nation, Greece, has 61!
    It seems that in theory US doctors are either more efficient or work longer hours maybe? In researching this, I was staggered to find out the UK has 613,000 nurses and midwives. That seems like a huge number to me and works out as 101 nurses per 10,000 people.

    In 2012 around 60% of the American workforce had their healthcare insurance paid for by their employers. That cost around $13,375 for family cover, so the actual number of people covered factoring in partners and children would have been much more and that would have included dental cover. (But that very high cost might go some way towards explaining why US salaries aren't that great?)
    Nonetheless, if a UK politician asks if you want the sort of health service they have in America the answer is well, maybe I do, as long as you are NOT the UK equivalent of an illegal immigrant from Mexico or someone living in the dirt poor regions of the South or the Rust Belt.
  • cafcfan said:

    Good points CAFC fan. Now instead of Bupa, which has to "compete" with the NHS tell me about the private health companies in the USA?

    Okay. 58% of US community hospitals are non-profit, 21% are government owned, and 21% are for-profit.

    The US solely developed or contributed significantly to 9 of the top 10 most important medical innovations since 1975.

    In 2012, per capita health spend in the USA (public and private) was $8,895. In the UK it was $3,647. GOVERNMENT spending on healthcare in the States as a portion of the $8,895 was around $4,400. A figure in isolation that's only beaten by Luxembourg, Monaco and Norway. By comparison the UK figure was $2,919.
    But we have 27 doctors per 10,000 population while the States only has 24. Portugal BTW has 39 doctors per 10,000 population. Meanwhile, that well known impoverished nation, Greece, has 61!
    It seems that in theory US doctors are either more efficient or work longer hours maybe? In researching this, I was staggered to find out the UK has 613,000 nurses and midwives. That seems like a huge number to me and works out as 101 nurses per 10,000 people.

    In 2012 around 60% of the American workforce had their healthcare insurance paid for by their employers. That cost around $13,375 for family cover, so the actual number of people covered factoring in partners and children would have been much more and that would have included dental cover. (But that very high cost might go some way towards explaining why US salaries aren't that great?)
    Nonetheless, if a UK politician asks if you want the sort of health service they have in America the answer is well, maybe I do, as long as you are NOT the UK equivalent of an illegal immigrant from Mexico or someone living in the dirt poor regions of the South or the Rust Belt.
    Richest country in the world, 40 million people who can't afford basic health care.
  • cafcfan said:

    And a private hospital would be telling us it's all about the patient when, in reality, it's all about making the investors a profit.

    Just caught up with this thread. Interesting discussion.

    Let's take BUPA as an example of a private health organisation. The clue is in its full name: British United Provident Association. It's a private company limited by guarantee; it has no shareholders, and any profits (after tax) are reinvested in the business. I don't think it still runs its own hospitals but nonetheless it goes some way towards blowing the "private health care only in it for the money" argument out of the water.
    iaitch said:


    Also consultants should either work for the NHS or private not both. Again you're offered an appointment for six months time to see a consultant but if you want to pay then he's free tomorrow.

    This is an over-simplification of the issues. Take my plastic surgeon for example. His main job is working with kids for the NHS, he specialises in cleft palates and does a lot of work on burns. He also spends a fair bit of the year working in places like Sri Lanka and Bangladesh undertaking cleft lip and palate surgery that would not otherwise get done. But he still cuts out the odd bit of skin cancer for me at a private hospital. The hours he works are very scary indeed but he still prefers to take out stitches himself.

    He doesn't do so much private stuff these days but I wonder if people of his ilk would be forced to go totally to the dark side (which funds much of his philanthropic work) if that was the stark choice being offered. They'd then be lost to the NHS for good.
    I think you're being extremely generous in your description of BUPA as something akin to a social enterprise. BUPA makes profits in the £100's millions per year, partly underwritten by keeping the fees it pays to it contractors, medical consultants, at 1990's levels. In theory these profits are for the benefit of its UK members (according to the charter that was used to set it up) but instead it has used them to buy up similar companies around the world, potentially in breach of it's own charter.

    The board appears answerable only to itself or its associate board (which it apoints) and has the final say it who joins, leaves and how much they pay themselves.

    It has faced judicial criticism in criminal trials for putting profits first as well as from its own staff over pay, working practices and conditions. It has more recently seen an increase in complaints to the Financial Ombudsman due to it trying to wriggle out of paying or hiking fees.

    It has an unusual business structure agreed, but it is most certainly profit focussed.
  • edited February 2015

    cafcfan said:

    Good points CAFC fan. Now instead of Bupa, which has to "compete" with the NHS tell me about the private health companies in the USA?

    Okay. 58% of US community hospitals are non-profit, 21% are government owned, and 21% are for-profit.

    The US solely developed or contributed significantly to 9 of the top 10 most important medical innovations since 1975.

    In 2012, per capita health spend in the USA (public and private) was $8,895. In the UK it was $3,647. GOVERNMENT spending on healthcare in the States as a portion of the $8,895 was around $4,400. A figure in isolation that's only beaten by Luxembourg, Monaco and Norway. By comparison the UK figure was $2,919.
    But we have 27 doctors per 10,000 population while the States only has 24. Portugal BTW has 39 doctors per 10,000 population. Meanwhile, that well known impoverished nation, Greece, has 61!
    It seems that in theory US doctors are either more efficient or work longer hours maybe? In researching this, I was staggered to find out the UK has 613,000 nurses and midwives. That seems like a huge number to me and works out as 101 nurses per 10,000 people.

    In 2012 around 60% of the American workforce had their healthcare insurance paid for by their employers. That cost around $13,375 for family cover, so the actual number of people covered factoring in partners and children would have been much more and that would have included dental cover. (But that very high cost might go some way towards explaining why US salaries aren't that great?)
    Nonetheless, if a UK politician asks if you want the sort of health service they have in America the answer is well, maybe I do, as long as you are NOT the UK equivalent of an illegal immigrant from Mexico or someone living in the dirt poor regions of the South or the Rust Belt.
    Richest country in the world, 40 million people who can't afford basic health care.
    I'm not defending the system, merely pointing out that the US Govt. spends more on health care per capita than we do DESPITE having the back-stop of private medical cover. In any event, what you say is not quite right. There are about 40 million people who cannot (or will not) pay for private health insurance. That means that they are likely to avoid visits to an equivalent of a GP. They can still pitch up at the local hospital or a clinic and get free medical treatment.

    It is an irony that the high cost of medical treatment in the US makes innovation through research and development, more attractive and viable. That in turn means that the Land of the Free are in many ways subsidising the costs of equipment and drugs for the NHS.
  • cafcfan said:

    Good points CAFC fan. Now instead of Bupa, which has to "compete" with the NHS tell me about the private health companies in the USA?

    Okay. 58% of US community hospitals are non-profit, 21% are government owned, and 21% are for-profit.

    The US solely developed or contributed significantly to 9 of the top 10 most important medical innovations since 1975.

    In 2012, per capita health spend in the USA (public and private) was $8,895. In the UK it was $3,647. GOVERNMENT spending on healthcare in the States as a portion of the $8,895 was around $4,400. A figure in isolation that's only beaten by Luxembourg, Monaco and Norway. By comparison the UK figure was $2,919.
    But we have 27 doctors per 10,000 population while the States only has 24. Portugal BTW has 39 doctors per 10,000 population. Meanwhile, that well known impoverished nation, Greece, has 61!
    It seems that in theory US doctors are either more efficient or work longer hours maybe? In researching this, I was staggered to find out the UK has 613,000 nurses and midwives. That seems like a huge number to me and works out as 101 nurses per 10,000 people.

    In 2012 around 60% of the American workforce had their healthcare insurance paid for by their employers. That cost around $13,375 for family cover, so the actual number of people covered factoring in partners and children would have been much more and that would have included dental cover. (But that very high cost might go some way towards explaining why US salaries aren't that great?)
    Nonetheless, if a UK politician asks if you want the sort of health service they have in America the answer is well, maybe I do, as long as you are NOT the UK equivalent of an illegal immigrant from Mexico or someone living in the dirt poor regions of the South or the Rust Belt.
    I have highlighted the bit that I think is of no relevance to this discussion as it involves research not treatment. One in five hospitals is purely for profit, unlucky if you happen to fall ill near there then... I think that the NHS is still far preferable personally.

  • cafcfan said:

    cafcfan said:

    Good points CAFC fan. Now instead of Bupa, which has to "compete" with the NHS tell me about the private health companies in the USA?

    Okay. 58% of US community hospitals are non-profit, 21% are government owned, and 21% are for-profit.

    The US solely developed or contributed significantly to 9 of the top 10 most important medical innovations since 1975.

    In 2012, per capita health spend in the USA (public and private) was $8,895. In the UK it was $3,647. GOVERNMENT spending on healthcare in the States as a portion of the $8,895 was around $4,400. A figure in isolation that's only beaten by Luxembourg, Monaco and Norway. By comparison the UK figure was $2,919.
    But we have 27 doctors per 10,000 population while the States only has 24. Portugal BTW has 39 doctors per 10,000 population. Meanwhile, that well known impoverished nation, Greece, has 61!
    It seems that in theory US doctors are either more efficient or work longer hours maybe? In researching this, I was staggered to find out the UK has 613,000 nurses and midwives. That seems like a huge number to me and works out as 101 nurses per 10,000 people.

    In 2012 around 60% of the American workforce had their healthcare insurance paid for by their employers. That cost around $13,375 for family cover, so the actual number of people covered factoring in partners and children would have been much more and that would have included dental cover. (But that very high cost might go some way towards explaining why US salaries aren't that great?)
    Nonetheless, if a UK politician asks if you want the sort of health service they have in America the answer is well, maybe I do, as long as you are NOT the UK equivalent of an illegal immigrant from Mexico or someone living in the dirt poor regions of the South or the Rust Belt.
    Richest country in the world, 40 million people who can't afford basic health care.
    I'm not defending the system, merely pointing out that the US Govt. spends more on health care per capita than we do DESPITE having the back-stop of private medical cover. In any event, what you say is not quite right. There are about 40 million people who cannot (or will not) pay for private health insurance. That means that they are likely to avoid visits to an equivalent of a GP, They can still pitch up at the local hospital or a clinic and get free medical treatment.
    Free clinics offer limited services and rarely provide emergency services. For instance, they do not cater for chronic pain. They also could not exist without huge numbers of volunteers. So what you say is not quite right either!
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  • After many years of heart trouble, including replacement valves and recovery from a cardiac arrest, I was revived after about thirty minutes in Kettering general, to say how grateful to the NHS is an understatement. These days I'm looked after at Papworth, having seen and used their private services, if my family ever have the need, I will send them there.
  • Anyone else seen the new Public Contracts Regulations 2015? Seem to mean that, from April 2016, all NHS health services must be put out to tender to the private sector. They appear to be sneaking this one out under cover of the General Election palaver, and no one's picked up on it.
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