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Maybe I misunderstand how the UK system is set up. I thought the NHS was not just the payer, but also the provider. How does extra insurance affect services t

Maybe I misunderstand how the UK system is set up. I thought the NHS was not just the payer, but also the provider. How does extra insurance affect services that people go to the NHS for?

michaelt 7y ago
The NHS provides and pays for NHS services. One can also buy medical care privately, outside of the NHS - paid for either with cash, or by private medical insurance (paid for either with cash, or by your employer) Services outside of the NHS may have more luxurious facilities, shorter waiting lists, and more flexible appointment times. Some doctors will do both NHS work and private work. If you need fertility treatment, a physiotherapist to look at your sport injury, speech therapy, or a 10 minute doctor's consultation over video chat at 7pm, the private medical system can provide that. On the other hand, many services are unavailable outside the NHS; there are no private ambulances or accident-and-emergency facilities.
- vonmoltke 7y ago
  That description makes the NHS sound like a two-tiered system, not a single-payer system. Digging into this on Wikipedia[1][2] and seeing the same health systems referred to as "single-payer" and "two-tier" depending on the context now has me royally confused about what "single-payer" actually means. [1] https://en.wikipedia.org/wiki/Single-payer_healthcare https://en.wikipedia.org/wiki/Single-payer_healthcare [2] https://en.wikipedia.org/wiki/Two-tier_healthcare https://en.wikipedia.org/wiki/Two-tier_healthcare
  - tomp 7y ago
    I don't think that "single payer" means anything concrete at all... it's just a question of, can a "normal person" get most of his potential medical needs covered without paying through the nose, going bankrupt, getting substantially sub-standard service, etc. For example, AFAIK in Switzerland, it's again completely different - everyone is obliged to buy medical insurance (privately, employers cannot offer it), hospitals (and insurance companies) are private, what you get depends on how much you pay (though everyone gets really good care, it's more like, do you share a room with other patients or not), the government covers if you're too poor to pay... Is this single payer or not? It doesn't matter, as long as most everyone is covered and happy. (Admittedly, Switzerland is in a privileged position with high salaries and cost of living, being the world's bank... not sure if other countries can afford to replicate their system.)

Maybe I misunderstand how the UK system is set up. I thought the NHS was not just the payer, but also the provider. How does extra insurance affect services that people go to the NHS for?

michaelt 7y ago

The NHS provides and pays for NHS services. One can also buy medical care privately, outside of the NHS - paid for either with cash, or by private medical insurance (paid for either with cash, or by your employer) Services outside of the NHS may have more luxurious facilities, shorter waiting lists, and more flexible appointment times. Some doctors will do both NHS work and private work. If you need fertility treatment, a physiotherapist to look at your sport injury, speech therapy, or a 10 minute doctor's consultation over video chat at 7pm, the private medical system can provide that. On the other hand, many services are unavailable outside the NHS; there are no private ambulances or accident-and-emergency facilities.

vonmoltke 7y ago
That description makes the NHS sound like a two-tiered system, not a single-payer system. Digging into this on Wikipedia[1][2] and seeing the same health systems referred to as "single-payer" and "two-tier" depending on the context now has me royally confused about what "single-payer" actually means. [1] https://en.wikipedia.org/wiki/Single-payer_healthcare https://en.wikipedia.org/wiki/Single-payer_healthcare [2] https://en.wikipedia.org/wiki/Two-tier_healthcare https://en.wikipedia.org/wiki/Two-tier_healthcare
- tomp 7y ago
  I don't think that "single payer" means anything concrete at all... it's just a question of, can a "normal person" get most of his potential medical needs covered without paying through the nose, going bankrupt, getting substantially sub-standard service, etc. For example, AFAIK in Switzerland, it's again completely different - everyone is obliged to buy medical insurance (privately, employers cannot offer it), hospitals (and insurance companies) are private, what you get depends on how much you pay (though everyone gets really good care, it's more like, do you share a room with other patients or not), the government covers if you're too poor to pay... Is this single payer or not? It doesn't matter, as long as most everyone is covered and happy. (Admittedly, Switzerland is in a privileged position with high salaries and cost of living, being the world's bank... not sure if other countries can afford to replicate their system.)