Was forced to go private to get my partner’s IUD replaced recently. Her existing one had expired and we tried for months to use the NHS booking system that had worked for us 5 and 10 years ago. Checking daily, no appointments.
Why are we paying taxes for the NHS if we need to drop £700 on a procedure that ought to be free? Ditto with dentists.
This is european levels of taxation for US levels of public service. Maybe we need to look at what France and Germany are doing with their system and copy them.
That could be part of the reason, but the NHS has rapidly deteriorated over the course of the last 5ish years. It used to be pretty decent not so long ago, and our taxes didn’t exactly drop. So while most public healthcare systems get strained over time due to the aging population problem, it shouldn’t be this drastic.
The pandemic has surely strained it, but it doesn’t feel like it’s on the path to recovery, more like circling the drain.
The 2 more obvious things (to me) as far as the reasons go: an absolutely malicious government - who would sell us all for meat if they could - with little competition and brexit (courtesy of said government)
I think narrowing it down to one tax type isn’t overly helpful. Ultimately it comes down to spending and policy. We underspend and we are more reactive: https://data.oecd.org/healthres/health-spending.htm
Systems that are insurance based (ignoring the mess that is the usa) at least have an incentive to catch things early because they are cheaper to deal with before they become chronic. With delays in primary care and waiting lists we end up getting much less bang for our buck as conditions develop before getting treatment.
Our blue powers-that-be are talking about getting rid of National Insurance as swing-voter catcher for the next election (whenever that might be). NI underpins many things, including the NHS, and is an ideal “taxation reduction” target of the sort you’re talking about.
Now there’s something about only a small percentage of NI going to the NHS, but who’s behind that exactly? Oh. Blue people again.
And then they say “See! See how rubbish the NHS is! It cannot work! Go private! What’s that? You don’t have money? Get a better job! Go private! It’s easy! This has nothing to do with ideology and we certainly haven’t been actively making the NHS worse! Go private! We have shares in private! Oops shouldn’t have said that! Vote for us!”
(And if they do get rid of NI, expect an unforeseen increase in income tax for middle earners a year or two after that happens to cover “unexpected burdens on the public purse” or some jargon like that.)
NI is just another tax that goes into the total pot, albeit one that is not progressive and adds to the cost of employment. I’d be happy with it being scrapped and it all going on income tax, perhaps with a scaled employer contribution component. How about the employer contributes a scaled percentage for all employees over the median income for the company?
NI is just another tax that goes into the total pot
It’s not supposed to be that way though. It has only become that way through many tiny changes so that now it’s indistinguishable from “yet another income tax”.
The entire point of its existence was to fund the welfare state, including the NHS, and the government we’ve had most of in the last 50 years absolutely despises welfare. Unless it’s for people who already have too much money and businesses “too big to fail” anyway.
Maybe we need to look at what France and Germany are doing with their system and copy them.
They’re funding theirs.
The Tories (and Labour) are trying to privatise ours. Which obviously won’t make it any cheaper because idle shareholders will be siphoning off a hefty chunk into the tax havens that neither the Tories nor Labour will shut down. In the meantime, they’re pulling the same trick they did with British Rail: underfund it until it’s easy to kill off and sell cheap to their rich backers so they can charge us more for less.
European systems have quite a bit of private provision but they are still generally single payer and heavily regulated. Private involvement in healthcare doesn’t automatically involve what they created in the USA.
Maybe we need to look at what France and Germany are doing with their system and copy them.
Non starter, sorry. Mention the P word in the same sentence as the NHS and get wrecked. It’s so stupidly dumb, but it’s not even a viable topic to discuss. It’s one below a hate crime.
Because it’s nearly always done disingenuously. The Tories say this and then get US health companies ready for a fire sale. They have been running down the NHS, “starving the beast”, to try and reduce public support for it so they can sell it. (To their US mates)
The reality is France and Germany have put more in for longer, so got more.
There’s that aspect, I do agree. But then there’s also the aspect that any discussion of this gets shut down and never spoken about seriously in any public debates. When was the last time you heard a sensible pro and cons debate on the French or German model on, say, Question Time? It usually gets derailed by someone claiming that mentioning these other systems equals privatisation from the US.
Actually, when was the last time you heard a sensible debate on anything on QT?
Money is clearly the big issue. It’s been underfunded for a long time, so will need more to catch up.
Anything else is almost just fiddling round the edges, or worse, an excuse to sell it to Tory’s funders. Other European more private systems are just a bait and switch because it’s US companies who’ll come in.
Other European more private systems are just a bait and switch because it’s US companies who’ll come in.
I don’t have anything against US companies on principle. I think it’s sad that the bogeyman argument is used when talking about the NHS like this. As in, “if we allow US healthcare companies to participate then the NHS will die”.
Whilst we’re talking about principles, free at the point of use is the NHS principle. So as long as it’s free at the point of use I don’t actually mind if it’s US, UK, European, Japanese, Indian, South African, or any other country’s company providing the care. I also don’t mind if our funding model changes to address this like European countries.
The NHS is built on strong principles and regulations, but that’s doesn’t mean it can never change or be flexible. That’s kinda the point of principles… they’re robust enough to apply to many situations.
Free at the point of use.
Strong regulations on export of data whilst utilising vast amounts of anonymous data to increase healthcare outcomes.
Strong regulations on healthcare standards.
Strong regulations on overall costs leveraging large economies of scale.
Can we do that and move towards a more French German model? That’s what I’d love to hear a debate on without people being shouted down as US healthcare apologists. Nobody wants the US healthcare system, not even the Yanks.
All of this won’t fix things (and may well make it worse). What is needed more that anything else is more money. And because it been starved for a decade, a lot more money.
The NHS is not the only thing that was false-economy cut. Lots of services got cut and the result where people ended up, in a worse state, falling into the NHS.
One thing that would help the NHS is to restore those other services, and deal with people before things get so bad it’s their health failing when the state helps them. Spent money on mental health and other care services to take load off the NHS.
Was forced to go private to get my partner’s IUD replaced recently. Her existing one had expired and we tried for months to use the NHS booking system that had worked for us 5 and 10 years ago. Checking daily, no appointments.
Why are we paying taxes for the NHS if we need to drop £700 on a procedure that ought to be free? Ditto with dentists.
This is european levels of taxation for US levels of public service. Maybe we need to look at what France and Germany are doing with their system and copy them.
I’ve started seeing private health insurance on job adverts as a benefit more and more as well recently… Which feels alarmingly US-like as well.
We have a lower tax burden than most of Europe, or at least the ones with decent healthcare. https://data.oecd.org/tax/tax-revenue.htm
That could be part of the reason, but the NHS has rapidly deteriorated over the course of the last 5ish years. It used to be pretty decent not so long ago, and our taxes didn’t exactly drop. So while most public healthcare systems get strained over time due to the aging population problem, it shouldn’t be this drastic.
The pandemic has surely strained it, but it doesn’t feel like it’s on the path to recovery, more like circling the drain.
The 2 more obvious things (to me) as far as the reasons go: an absolutely malicious government - who would sell us all for meat if they could - with little competition and brexit (courtesy of said government)
If you look at the tax on personal income on that graph we are above France and the OECD average.
Edit: Additionally France are getting significantly better health outcomes and resourcing in their system https://www.kingsfund.org.uk/insight-and-analysis/blogs/comparing-nhs-to-health-care-systems-other-countries
I think narrowing it down to one tax type isn’t overly helpful. Ultimately it comes down to spending and policy. We underspend and we are more reactive: https://data.oecd.org/healthres/health-spending.htm
Systems that are insurance based (ignoring the mess that is the usa) at least have an incentive to catch things early because they are cheaper to deal with before they become chronic. With delays in primary care and waiting lists we end up getting much less bang for our buck as conditions develop before getting treatment.
Our blue powers-that-be are talking about getting rid of National Insurance as swing-voter catcher for the next election (whenever that might be). NI underpins many things, including the NHS, and is an ideal “taxation reduction” target of the sort you’re talking about.
Now there’s something about only a small percentage of NI going to the NHS, but who’s behind that exactly? Oh. Blue people again.
And then they say “See! See how rubbish the NHS is! It cannot work! Go private! What’s that? You don’t have money? Get a better job! Go private! It’s easy! This has nothing to do with ideology and we certainly haven’t been actively making the NHS worse! Go private! We have shares in private! Oops shouldn’t have said that! Vote for us!”
(And if they do get rid of NI, expect an unforeseen increase in income tax for middle earners a year or two after that happens to cover “unexpected burdens on the public purse” or some jargon like that.)
NI is just another tax that goes into the total pot, albeit one that is not progressive and adds to the cost of employment. I’d be happy with it being scrapped and it all going on income tax, perhaps with a scaled employer contribution component. How about the employer contributes a scaled percentage for all employees over the median income for the company?
It’s not supposed to be that way though. It has only become that way through many tiny changes so that now it’s indistinguishable from “yet another income tax”.
The entire point of its existence was to fund the welfare state, including the NHS, and the government we’ve had most of in the last 50 years absolutely despises welfare. Unless it’s for people who already have too much money and businesses “too big to fail” anyway.
They’re funding theirs.
The Tories (and Labour) are trying to privatise ours. Which obviously won’t make it any cheaper because idle shareholders will be siphoning off a hefty chunk into the tax havens that neither the Tories nor Labour will shut down. In the meantime, they’re pulling the same trick they did with British Rail: underfund it until it’s easy to kill off and sell cheap to their rich backers so they can charge us more for less.
European systems have quite a bit of private provision but they are still generally single payer and heavily regulated. Private involvement in healthcare doesn’t automatically involve what they created in the USA.
That always the argument made, while possible contracted are lined up with big US private health companies.
Non starter, sorry. Mention the P word in the same sentence as the NHS and get wrecked. It’s so stupidly dumb, but it’s not even a viable topic to discuss. It’s one below a hate crime.
Because it’s nearly always done disingenuously. The Tories say this and then get US health companies ready for a fire sale. They have been running down the NHS, “starving the beast”, to try and reduce public support for it so they can sell it. (To their US mates)
The reality is France and Germany have put more in for longer, so got more.
https://www.health.org.uk/news-and-comment/charts-and-infographics/how-does-uk-health-spending-compare-across-europe-over-the-past-decade
https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?locations=FR-GB-DE
There’s that aspect, I do agree. But then there’s also the aspect that any discussion of this gets shut down and never spoken about seriously in any public debates. When was the last time you heard a sensible pro and cons debate on the French or German model on, say, Question Time? It usually gets derailed by someone claiming that mentioning these other systems equals privatisation from the US.
Actually, when was the last time you heard a sensible debate on anything on QT?
Money is clearly the big issue. It’s been underfunded for a long time, so will need more to catch up.
Anything else is almost just fiddling round the edges, or worse, an excuse to sell it to Tory’s funders. Other European more private systems are just a bait and switch because it’s US companies who’ll come in.
I don’t have anything against US companies on principle. I think it’s sad that the bogeyman argument is used when talking about the NHS like this. As in, “if we allow US healthcare companies to participate then the NHS will die”.
Whilst we’re talking about principles, free at the point of use is the NHS principle. So as long as it’s free at the point of use I don’t actually mind if it’s US, UK, European, Japanese, Indian, South African, or any other country’s company providing the care. I also don’t mind if our funding model changes to address this like European countries.
The NHS is built on strong principles and regulations, but that’s doesn’t mean it can never change or be flexible. That’s kinda the point of principles… they’re robust enough to apply to many situations.
Can we do that and move towards a more French German model? That’s what I’d love to hear a debate on without people being shouted down as US healthcare apologists. Nobody wants the US healthcare system, not even the Yanks.
All of this won’t fix things (and may well make it worse). What is needed more that anything else is more money. And because it been starved for a decade, a lot more money.
The NHS is not the only thing that was false-economy cut. Lots of services got cut and the result where people ended up, in a worse state, falling into the NHS.
One thing that would help the NHS is to restore those other services, and deal with people before things get so bad it’s their health failing when the state helps them. Spent money on mental health and other care services to take load off the NHS.
I hear you. It needs more money. Great. But how? Maybe it’s time to rethink how we raise funds for the NHS?
Tax wealthy people and corporations more. There is a lot of wealth untapped and obscene levels of wealth.