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It's less expensive than you'd think too. The key is that this only requires the vast majority of people to be able to work a large majority of the time. If it

by makomk 7y ago

It's less expensive than you'd think too. The key is that this only requires the vast majority of people to be able to work a large majority of the time. If it would cost more money to stop someone dying or going blind or suffering other major health problems than the typical worker is worth, the NHS just doesn't provide that treatment. There are plenty of other workers whose health care needs are much cheaper. Likewise, people wait months for the treatment of conditions that stop them going back to work, and that's fine - there are other workers. Highly-paid industries like IT which can't treat their employees like replacable cogs often offer private health insurance with lower waiting times as a perk that just happens to benefit them too. This is across the board. On the one end of the spectrum, the NHS only rolled out flu vaccination for infants this flu season and vaccinates a lot less aggressively than the US in general - if you have to vaccinate a large number of people to prevent a few serious illnesses that doesn't work out cost-wise. On the other, a lot of the expensive cancer treatments, as well as cutting-edge treatmeents for chronic conditions like cystic fibrosis, aren't available either. (Though some utterly ineffective cancer treatments have been funded for political reasons.) On the other hand, there was some bizarre business where the NHS decided not to offer a cost-effective cure for Hepatitis C to most people with it, even though it's a communicable disease with serious long-term health effects and curing them would probably save money in the long run, because the short-term cost was too high. I think they ended up making a deal with the drug companies very similar to the one a number of US states did, where they got reduced per-treatment costs as part of a program to aggressive find and treat everyone including homeless people and others who don't have access to healthcare. Sometimes the US and UK are less different than the press let on. I'm not sure how well the NHS would cope with a coronavirus pandemic either. In a good year it barely has enough resources to handle the seasonal flu, and this has been the worst flu season for it in a long time.

simonh 7y ago
All health care systems everywhere have to make decisions based on cost. Everywhere. It doesn't matter how they are funded or run, they all operate within the constraints of the resources they have available.
- sgt101 7y ago
  But the distribution of resources is significant - who they go to and what they are used for means that the value derived is very different.
sgt101 7y ago
There is a lot to disagree with in your post. >If it would cost more money to stop someone dying or going blind or suffering other major health problems than the typical worker is worth, the NHS just doesn't provide that treatment. My brother had an extensive program of neurosurgery as an infant, I would be amazed if the dedicated care that he received stacked up to less than 40 man years of expert effort (nurses, GP's, surgeons, anesthetists, radiologists, pharmacologists - the list goes on). Vast money was also spent on the equipment required to provide the care, and the drugs. This was all provided by the NHS, and is provided routinely. So - your statement is flatly untrue. On the other hand I have received very little treatment on the NHS; I have required medical interventions but only after I was rich enough to get insurance. This is the key to the economics. Some people require heroic intervention to survive, most people (until they are in their old age) require very little (especially if engaged in preventative health improvement) - this is what makes it sustainable, not parsimony with the treatment. >This is across the board. On the one end of the spectrum, the NHS only rolled out flu vaccination for infants this flu season and vaccinates a lot less aggressively than the US in general - if you have to vaccinate a large number of people to prevent a few serious illnesses that doesn't work out cost-wise. The UK and NHS have strong policies and incentive structures to drive vaccination, precisely because without it a large number of people suffer illnesses that are very expensive. I don't know the numbers but I am pretty sure that 10k vaccinations are cheaper than 2 weeks in hospital for one child with measles. Your reasoning simply makes no economic sense; prevention is clearly better than cure, and cheaper. > some bizarre business where the NHS decided not to offer a cost-effective cure for Hepatitis C to most people with it, even though it's a communicable disease with serious long-term health effects and curing them would probably save money in the long run, because the short-term cost was too high. Or you could say "the NHS used its purchasing power to drive a procurement deal which enabled it to launch a program to eliminate Hep-C by 2025, and had to fight in the courts to make it stick" which would be factual. >I'm not sure how well the NHS would cope with a coronavirus pandemic either. In a good year it barely has enough resources to handle the seasonal flu, and this has been the worst flu season for it in a long time. Well - all health services will be stretched. We will see - when the numbers are available - which ones performed the best - for all citizens. I will hazard a guess that systems that routinely leave a large proportion of their population unprotected will expose that section of society to much greater mortality than those that are comprehensive public health providers. In terms of "barely has enough resources" isn't this the optimal? Isn't the point to have just enough laid on to deal? Rather than wasting the resources that could for example buy a proton beam system covering an epidemic that doesn't arrive?

by makomk 7y ago

simonh 7y ago

All health care systems everywhere have to make decisions based on cost. Everywhere. It doesn't matter how they are funded or run, they all operate within the constraints of the resources they have available.

sgt101 7y ago
But the distribution of resources is significant - who they go to and what they are used for means that the value derived is very different.

sgt101 7y ago

There is a lot to disagree with in your post. >If it would cost more money to stop someone dying or going blind or suffering other major health problems than the typical worker is worth, the NHS just doesn't provide that treatment. My brother had an extensive program of neurosurgery as an infant, I would be amazed if the dedicated care that he received stacked up to less than 40 man years of expert effort (nurses, GP's, surgeons, anesthetists, radiologists, pharmacologists - the list goes on). Vast money was also spent on the equipment required to provide the care, and the drugs. This was all provided by the NHS, and is provided routinely. So - your statement is flatly untrue. On the other hand I have received very little treatment on the NHS; I have required medical interventions but only after I was rich enough to get insurance. This is the key to the economics. Some people require heroic intervention to survive, most people (until they are in their old age) require very little (especially if engaged in preventative health improvement) - this is what makes it sustainable, not parsimony with the treatment. >This is across the board. On the one end of the spectrum, the NHS only rolled out flu vaccination for infants this flu season and vaccinates a lot less aggressively than the US in general - if you have to vaccinate a large number of people to prevent a few serious illnesses that doesn't work out cost-wise. The UK and NHS have strong policies and incentive structures to drive vaccination, precisely because without it a large number of people suffer illnesses that are very expensive. I don't know the numbers but I am pretty sure that 10k vaccinations are cheaper than 2 weeks in hospital for one child with measles. Your reasoning simply makes no economic sense; prevention is clearly better than cure, and cheaper. > some bizarre business where the NHS decided not to offer a cost-effective cure for Hepatitis C to most people with it, even though it's a communicable disease with serious long-term health effects and curing them would probably save money in the long run, because the short-term cost was too high. Or you could say "the NHS used its purchasing power to drive a procurement deal which enabled it to launch a program to eliminate Hep-C by 2025, and had to fight in the courts to make it stick" which would be factual. >I'm not sure how well the NHS would cope with a coronavirus pandemic either. In a good year it barely has enough resources to handle the seasonal flu, and this has been the worst flu season for it in a long time. Well - all health services will be stretched. We will see - when the numbers are available - which ones performed the best - for all citizens. I will hazard a guess that systems that routinely leave a large proportion of their population unprotected will expose that section of society to much greater mortality than those that are comprehensive public health providers. In terms of "barely has enough resources" isn't this the optimal? Isn't the point to have just enough laid on to deal? Rather than wasting the resources that could for example buy a proton beam system covering an epidemic that doesn't arrive?