5 ms·

Yeah, but don't methadone maintenance programs work? If the requirements here were lessened, and the woman was prescribed methadone more quickly, wouldn't this

Yeah, but don't methadone maintenance programs work? If the requirements here were lessened, and the woman was prescribed methadone more quickly, wouldn't this article not have to exist? I feel the problem is less about the "war on drugs" and more about the UK's failure to help her recover from her addiction.

beaconstudios 10y ago
the NHS has a lot of problems dealing with health issues that aren't A&E-worthy. It's understaffed, the staff they do hire are overworked, and the whole organisation is simultaneously under-budgeted and over-stuffed with bureaucracy.
- skylan_q 10y ago
  people don't realize that free means no charge, but not unlimited.
- digi_owl 10y ago
  I can't help but think that since the 80s these systems have been deliberately rigged to fail, to give an excuse to privatize or introduce parallel for-profit options.
  - beaconstudios 10y ago
    Both Labour and the Tories have gutted the NHS at various times. Bureaucracy comes from both sides too.
    - digi_owl 10y ago
      Yeah, Blair "Labour". The french term "champagne left" is very apt in that regard.
      - beaconstudios 10y ago
        You can't say someone isn't Labour just because you personally disagree with their work. New Labour was still left-of-centre, even if it was closer than previous Labour institutions. Left and right transcend economic class. The idea that the left is rooted in the working class is a complete fabrication. Gordon Brown also harmed the NHS by the way. Considerably.
        emodendroket 10y ago
        The whole thing of the "new" Democrats and "new" Labour is making a show of staking positions that are essentially a middle finger to their core constituencies.
    - laurencerowe 10y ago
      Labour did not gut the NHS. Their policy on bringing the private sector into the NHS was probably a bad one - PPI was more expensive than direct public investment for hospital rebuilding but kept the costs off the national balance sheet, maintaining a helpful fiction. But Labour significantly increased spending on the NHS, from 5% to 7% of GDP before the banking crisis (which with GDP falling saw spending rise in GDP terms by about another 1%.) Since the Tories regained power they've been cutting back on NHS spending (and more dramatically on social care, which increases the demands on the NHS.) That's why we're seeing the horror stories once again of waiting lists and winter crises, which had last been common under the previous Tory administration in the early 1990's. http://www.publicfinance.co.uk/opinion/2015/10/nhs-spending-squeezed-never http://www.publicfinance.co.uk/opinion/2015/10/nhs-spending-...
      - beaconstudios 10y ago
        decreasing spending is not the only way to gut the NHS. Increased bureacratic oversight, unionisation of the labour force, realigning the focus and core competencies, increasing demand for consultants over doctors, you name it. The NHS was in a terrible place when David Cameron came into power, and granted it's gotten worse since, but making out that the conservatives are the only ones who have pushed the NHS to breaking is ridiculous and fallacious.
        stuaxo 10y ago
        New Labour put in all the ground work, and the Conservatives ran with it. Building lots of infrastructure under Public-Private-Partnerships - built up massive bills - brought in under the Conservatives, massively expanded under New Labour. The internal market, a new Labour innovation, brought in massive inefficiencies, and private profits along the way. The current government is battering a massively weakened system.
        laurencerowe 10y ago
        Labour could have done things better (far too many public sector reorganizations to which all governments seem prone) but things were really pretty awful in the NHS in 1997 with long waiting lists and crises every winter. The public sector employment figures on page 13 of this report are pretty telling: https://www.ifs.org.uk/bns/bn145.pdf https://www.ifs.org.uk/bns/bn145.pdf 1991-1997: NHS headcount static at 1.2M under Tories 1997-2010: NHS headcount grows to 1.6M under Labour 2010-2013: NHS headcount begins falling under Tories
  - ufmace 10y ago
    That seems a bit surreal. I sometimes read free-marketers who speculate that certain people are intentionally making the US Private healthcare system worse in an attempt to get socialized medicine. That's the first time I've read a suggestion that socialized healthcare was intentionally being made worse to push a private option. I dunno, maybe healthcare is just hard to get right, whether run publicly or privately. Maybe we still know very little about how to treat and fix the human body, but rapid progress in other areas of technology and the numerous developments we have made in healthcare lead us to think otherwise.
    - beaconstudios 10y ago
      I think another part of the problem is that we still don't know how to run large centralised organisations in a way that doesn't lead to continuous bureaucratic expansion.
    - digi_owl 10y ago
      Well i base my claims on the observation that recent years have seen more and more administrative processes that have been introduced in an effort to emulate free market pressures on public health services. This based on the idea that free markets are better at operating efficiently. Thing is that the ultimate goal of any enterprise is wealth extraction. The most direct such extraction is via racketeering. But baring that the next best option is to offer a tangible product or service others are willing to pay for. But note that the goal is not to offer good product or service, it is wealth extraction. Thus one will aim to offer the most minimal product or service one can get away with at the highest price. So no, i don't think there is any reason why they should fear that the US system is being gamed to introduce public health services. It is being gamed to maximize wealth extraction by everyone involved. On the other hand, ruining existing public health services to make private equivalent look good would directly lead to increased wealth extraction by those involved with the private health services.
    - emodendroket 10y ago
      If you read about the NHS it's honestly hard to think otherwise. But also forcing cuts by underfunding programs is something conservatives talk openly about wanting to do: https://en.wikipedia.org/wiki/Starve_the_beast https://en.wikipedia.org/wiki/Starve_the_beast
Symbiote 10y ago
The immediate cause, of not being able to get methadone after the court had ordered it, seems straightforward to fix. Whatever rule prevented the GP from prescribing it can be changed. Changing the maintenance programme itself might take more effort, and according to this article, more research is needed: http://www.bbc.com/news/uk-scotland-31943109 http://www.bbc.com/news/uk-scotland-31943109
girvo 10y ago
I had to wait 7 days to get on my Suboxone treatment. My parents got me codeine and valium from our GP to help me until that point, which amazed me at the time. 7 days is pretty short at least, and it saved my life. Other countries have months long waiting lists.

beaconstudios 10y ago

the NHS has a lot of problems dealing with health issues that aren't A&E-worthy. It's understaffed, the staff they do hire are overworked, and the whole organisation is simultaneously under-budgeted and over-stuffed with bureaucracy.

skylan_q 10y ago
people don't realize that free means no charge, but not unlimited.
digi_owl 10y ago
I can't help but think that since the 80s these systems have been deliberately rigged to fail, to give an excuse to privatize or introduce parallel for-profit options.
- beaconstudios 10y ago
  Both Labour and the Tories have gutted the NHS at various times. Bureaucracy comes from both sides too.
  - digi_owl 10y ago
    Yeah, Blair "Labour". The french term "champagne left" is very apt in that regard.
    - beaconstudios 10y ago
      You can't say someone isn't Labour just because you personally disagree with their work. New Labour was still left-of-centre, even if it was closer than previous Labour institutions. Left and right transcend economic class. The idea that the left is rooted in the working class is a complete fabrication. Gordon Brown also harmed the NHS by the way. Considerably.
      - emodendroket 10y ago
        The whole thing of the "new" Democrats and "new" Labour is making a show of staking positions that are essentially a middle finger to their core constituencies.
  - laurencerowe 10y ago
    Labour did not gut the NHS. Their policy on bringing the private sector into the NHS was probably a bad one - PPI was more expensive than direct public investment for hospital rebuilding but kept the costs off the national balance sheet, maintaining a helpful fiction. But Labour significantly increased spending on the NHS, from 5% to 7% of GDP before the banking crisis (which with GDP falling saw spending rise in GDP terms by about another 1%.) Since the Tories regained power they've been cutting back on NHS spending (and more dramatically on social care, which increases the demands on the NHS.) That's why we're seeing the horror stories once again of waiting lists and winter crises, which had last been common under the previous Tory administration in the early 1990's. http://www.publicfinance.co.uk/opinion/2015/10/nhs-spending-squeezed-never http://www.publicfinance.co.uk/opinion/2015/10/nhs-spending-...
    - beaconstudios 10y ago
      decreasing spending is not the only way to gut the NHS. Increased bureacratic oversight, unionisation of the labour force, realigning the focus and core competencies, increasing demand for consultants over doctors, you name it. The NHS was in a terrible place when David Cameron came into power, and granted it's gotten worse since, but making out that the conservatives are the only ones who have pushed the NHS to breaking is ridiculous and fallacious.
      - stuaxo 10y ago
        New Labour put in all the ground work, and the Conservatives ran with it. Building lots of infrastructure under Public-Private-Partnerships - built up massive bills - brought in under the Conservatives, massively expanded under New Labour. The internal market, a new Labour innovation, brought in massive inefficiencies, and private profits along the way. The current government is battering a massively weakened system.
      - laurencerowe 10y ago
        Labour could have done things better (far too many public sector reorganizations to which all governments seem prone) but things were really pretty awful in the NHS in 1997 with long waiting lists and crises every winter. The public sector employment figures on page 13 of this report are pretty telling: https://www.ifs.org.uk/bns/bn145.pdf https://www.ifs.org.uk/bns/bn145.pdf 1991-1997: NHS headcount static at 1.2M under Tories 1997-2010: NHS headcount grows to 1.6M under Labour 2010-2013: NHS headcount begins falling under Tories
- ufmace 10y ago
  That seems a bit surreal. I sometimes read free-marketers who speculate that certain people are intentionally making the US Private healthcare system worse in an attempt to get socialized medicine. That's the first time I've read a suggestion that socialized healthcare was intentionally being made worse to push a private option. I dunno, maybe healthcare is just hard to get right, whether run publicly or privately. Maybe we still know very little about how to treat and fix the human body, but rapid progress in other areas of technology and the numerous developments we have made in healthcare lead us to think otherwise.
  - beaconstudios 10y ago
    I think another part of the problem is that we still don't know how to run large centralised organisations in a way that doesn't lead to continuous bureaucratic expansion.
  - digi_owl 10y ago
    Well i base my claims on the observation that recent years have seen more and more administrative processes that have been introduced in an effort to emulate free market pressures on public health services. This based on the idea that free markets are better at operating efficiently. Thing is that the ultimate goal of any enterprise is wealth extraction. The most direct such extraction is via racketeering. But baring that the next best option is to offer a tangible product or service others are willing to pay for. But note that the goal is not to offer good product or service, it is wealth extraction. Thus one will aim to offer the most minimal product or service one can get away with at the highest price. So no, i don't think there is any reason why they should fear that the US system is being gamed to introduce public health services. It is being gamed to maximize wealth extraction by everyone involved. On the other hand, ruining existing public health services to make private equivalent look good would directly lead to increased wealth extraction by those involved with the private health services.
  - emodendroket 10y ago
    If you read about the NHS it's honestly hard to think otherwise. But also forcing cuts by underfunding programs is something conservatives talk openly about wanting to do: https://en.wikipedia.org/wiki/Starve_the_beast https://en.wikipedia.org/wiki/Starve_the_beast

Symbiote 10y ago

The immediate cause, of not being able to get methadone after the court had ordered it, seems straightforward to fix. Whatever rule prevented the GP from prescribing it can be changed. Changing the maintenance programme itself might take more effort, and according to this article, more research is needed: http://www.bbc.com/news/uk-scotland-31943109 http://www.bbc.com/news/uk-scotland-31943109

girvo 10y ago

I had to wait 7 days to get on my Suboxone treatment. My parents got me codeine and valium from our GP to help me until that point, which amazed me at the time. 7 days is pretty short at least, and it saved my life. Other countries have months long waiting lists.