4 ms·

One of the major features of the British NHS system is virtually /eliminating/ the billing department. I really think that should be considered as a major feat

One of the major features of the British NHS system is virtually /eliminating/ the billing department. I really think that should be considered as a major feature as well. Not receiving hospital bills months after a procedure and you thought things were all taken care of.

gerdesj 9y ago
The only time you even consider thinking about money is for prescriptions and dental treatment and those are fixed price and subsidised and many exemption exist. A trip to A&E never involves money. The only thing you might get after the event is follow up appointments. A very quick run down on how we pay for all this: All employees (its a little more complicated for the self employed) have tax deducted at source, called Pay As You Earn (PAYE). There are two components: Income Tax - banded according to income and National Insurance (NI) - also banded. The NI contribution is generally to cover the NHS and Social Security, State Pension etc. Class One NI rates: https://www.gov.uk/national-insurance/how-much-you-pay https://www.gov.uk/national-insurance/how-much-you-pay so 12% up to £45,000 gross salary and 2% above that. Most people in the UK do not need to worry about filling in a tax return.
refurb 9y ago
I'm not sure what you mean by eliminating billing. Physicians and other healthcare professionals still need to bill for their services, no? That's what most of the paperwork is. Figuring out what code to bill under, someone verifying that, sending payment, etc. I agree that not billing patients reduces paperwork, but that's a relatively small part of overall billing.
- dflock 9y ago
  Successive conservative governments have introduced a fake internal market into the NHS, deliberately fragmenting the previously integrated system and forcing the severed parts to sell services to each other. The money they use to buy services from their former colleagues all comes from their individual budgets, which is centrally funded from taxation. They still don't bill patients, they just furiously do pointless paperwork to swap tax money behind the scenes. Prior to this, it was a more integrated system, where all staff just worked for one central entity - the NHS - and were just paid a salary. Medical supplies, drugs etc... were all centrally procured, as required. Turns out that if you're buying drugs for 65 million people, you can get amazingly good deals from pharmaceutical companies and quickly build up incredible procurement expertise. This is all thrown away once you smash it up, though.

gerdesj 9y ago

The only time you even consider thinking about money is for prescriptions and dental treatment and those are fixed price and subsidised and many exemption exist. A trip to A&E never involves money. The only thing you might get after the event is follow up appointments. A very quick run down on how we pay for all this: All employees (its a little more complicated for the self employed) have tax deducted at source, called Pay As You Earn (PAYE). There are two components: Income Tax - banded according to income and National Insurance (NI) - also banded. The NI contribution is generally to cover the NHS and Social Security, State Pension etc. Class One NI rates: https://www.gov.uk/national-insurance/how-much-you-pay https://www.gov.uk/national-insurance/how-much-you-pay so 12% up to £45,000 gross salary and 2% above that. Most people in the UK do not need to worry about filling in a tax return.

refurb 9y ago

I'm not sure what you mean by eliminating billing. Physicians and other healthcare professionals still need to bill for their services, no? That's what most of the paperwork is. Figuring out what code to bill under, someone verifying that, sending payment, etc. I agree that not billing patients reduces paperwork, but that's a relatively small part of overall billing.

dflock 9y ago
Successive conservative governments have introduced a fake internal market into the NHS, deliberately fragmenting the previously integrated system and forcing the severed parts to sell services to each other. The money they use to buy services from their former colleagues all comes from their individual budgets, which is centrally funded from taxation. They still don't bill patients, they just furiously do pointless paperwork to swap tax money behind the scenes. Prior to this, it was a more integrated system, where all staff just worked for one central entity - the NHS - and were just paid a salary. Medical supplies, drugs etc... were all centrally procured, as required. Turns out that if you're buying drugs for 65 million people, you can get amazingly good deals from pharmaceutical companies and quickly build up incredible procurement expertise. This is all thrown away once you smash it up, though.