4 ms·

The NHS in the UK - whose low, low costs certain US political activists point to as proof public healthcare is not just better but cheaper - literally does this

by makomk 5y ago

The NHS in the UK - whose low, low costs certain US political activists point to as proof public healthcare is not just better but cheaper - literally does this. There's a fixed amount they're willing to spend per expected year of healthy life saved, adjusted for quality of life during that time, and treatments that are expected to cost more than that aren't available on the NHS. This is surprisingly uncontroversial, possibly because the NHS as an institution is basically beyond questioning. However, the same reasoning was not applied in the UK over Covid; the mainstream consensus was that anyone who prioritised the economy over stopping Covid was an evil murderer, and every single Covid death that happened was caused by our government not stopping it.

hotpotamus 5y ago
Yes, any public healthcare system will obviously make these calculations. Private insurers also do this in the US however they are more limited in what they can do to control costs. I suspect that because there is one universal system, people accept that they're all more or less bound by the same rules (I'm aware there is private care in the UK too), whereas in the US it can be pretty arbitrary as to who gets healthcare; obviously money helps but there are multiple single payer systems (lol) that some belong to also.
david38 5y ago
This is the way. Hand waving morality and preciousness of life leads to a very few getting all the treatment. (The first part)
- wolverine876 5y ago
  We could easily afford preserving as many people's lives as possible in this situation. > preciousness of life Let's not belittle it; it is indeed extremely precious.
pasabagi 5y ago
> the mainstream consensus was that anyone who prioritised the economy over stopping Covid was an evil murderer, and every single Covid death that happened was caused by our government not stopping it. This poses a false dichotomy between strict lockdowns and economic growth. The UK had both bad death rates and a bad economic hit compared to other countries in europe. I think the conservatives tried to balance the short-term interests of the economy against case numbers, and ultimately ended up muddling about in the middle, which was why they ended up with the worst of both worlds. The countries that did really well in the pandemic (east asian countries) typically went for what seemed like drastic measures in the early stages. As time went on, it's become apparent that their liberties, economies, and also case numbers were all far less impacted by the pandemic compared to western countries that had to go into emergency lockdowns as case counts soared out of control. Even in the limited context of western europe, one of the reasons why the UK had so many days in lockdown (more than France or Germany, often with more stringent rules, iirc) was because they prevaricated so much about bringing in lockdowns, then had to make them much tighter to compensate.
- lostlogin 5y ago
  Could a down voter provide a rebuttal?
  - makomk 5y ago
    I didn't downvote, but the UK was middle of the pack amongst European countries in terms of Covid deaths and economic damage. It's just our media focused on anything that'd make us look worse, like comparing total deaths without adjusting for population size or cherry-picking specific time periods to yell about. Also, pretty much the whole of Europe pursued very similar policies so that comparison isn't going to tell you much anyway.
- saghm 5y ago
  > The countries that did really well in the pandemic (east asian countries) typically went for what seemed like drastic measures in the early stages. As time went on, it's become apparent that their liberties, economies, and also case numbers were all far less impacted by the pandemic compared to western countries that had to go into emergency lockdowns as case counts soared out of control. Even in the limited context of western europe, one of the reasons why the UK had so many days in lockdown (more than France or Germany, often with more stringent rules, iirc) was because they prevaricated so much about bringing in lockdowns, then had to make them much tighter to compensate. This raises an interesting point I hadn't considered; assuming that there will still be some transfer of the virus during lockdown (although presumably more limited) due to people still needing to go out to get food (or have food delivered, which still requires someone else going out), getting medical care, etc., the amount of time needed to stay in lockdown to lower the number of cases below a given threshold seem like it would grow in relation to the number of cases at the time lockdown was initiated. To make up some numbers, if the goal is to get the number of cases below 1% of the population, it's much easier to get there if you start the lockdown with only 2% of the country infected versus 5%. I don't have anywhere near the expertise to do even the most naive of calculations of how many extra days that would translate into in the real world, but given that I imagine the virus spreads faster than it goes away, it sounds like delaying by a certain amount of time would lead to _more_ than that amount of time needed to stay in lockdown. I wonder if the US had gone into lockdown at the beginning of March or even earlier, then the lockdown might have been shortened by months.

by makomk 5y ago

hotpotamus 5y ago

Yes, any public healthcare system will obviously make these calculations. Private insurers also do this in the US however they are more limited in what they can do to control costs. I suspect that because there is one universal system, people accept that they're all more or less bound by the same rules (I'm aware there is private care in the UK too), whereas in the US it can be pretty arbitrary as to who gets healthcare; obviously money helps but there are multiple single payer systems (lol) that some belong to also.

david38 5y ago

This is the way. Hand waving morality and preciousness of life leads to a very few getting all the treatment. (The first part)

wolverine876 5y ago
We could easily afford preserving as many people's lives as possible in this situation. > preciousness of life Let's not belittle it; it is indeed extremely precious.

pasabagi 5y ago

> the mainstream consensus was that anyone who prioritised the economy over stopping Covid was an evil murderer, and every single Covid death that happened was caused by our government not stopping it. This poses a false dichotomy between strict lockdowns and economic growth. The UK had both bad death rates and a bad economic hit compared to other countries in europe. I think the conservatives tried to balance the short-term interests of the economy against case numbers, and ultimately ended up muddling about in the middle, which was why they ended up with the worst of both worlds. The countries that did really well in the pandemic (east asian countries) typically went for what seemed like drastic measures in the early stages. As time went on, it's become apparent that their liberties, economies, and also case numbers were all far less impacted by the pandemic compared to western countries that had to go into emergency lockdowns as case counts soared out of control. Even in the limited context of western europe, one of the reasons why the UK had so many days in lockdown (more than France or Germany, often with more stringent rules, iirc) was because they prevaricated so much about bringing in lockdowns, then had to make them much tighter to compensate.

lostlogin 5y ago
Could a down voter provide a rebuttal?
- makomk 5y ago
  I didn't downvote, but the UK was middle of the pack amongst European countries in terms of Covid deaths and economic damage. It's just our media focused on anything that'd make us look worse, like comparing total deaths without adjusting for population size or cherry-picking specific time periods to yell about. Also, pretty much the whole of Europe pursued very similar policies so that comparison isn't going to tell you much anyway.
saghm 5y ago
> The countries that did really well in the pandemic (east asian countries) typically went for what seemed like drastic measures in the early stages. As time went on, it's become apparent that their liberties, economies, and also case numbers were all far less impacted by the pandemic compared to western countries that had to go into emergency lockdowns as case counts soared out of control. Even in the limited context of western europe, one of the reasons why the UK had so many days in lockdown (more than France or Germany, often with more stringent rules, iirc) was because they prevaricated so much about bringing in lockdowns, then had to make them much tighter to compensate. This raises an interesting point I hadn't considered; assuming that there will still be some transfer of the virus during lockdown (although presumably more limited) due to people still needing to go out to get food (or have food delivered, which still requires someone else going out), getting medical care, etc., the amount of time needed to stay in lockdown to lower the number of cases below a given threshold seem like it would grow in relation to the number of cases at the time lockdown was initiated. To make up some numbers, if the goal is to get the number of cases below 1% of the population, it's much easier to get there if you start the lockdown with only 2% of the country infected versus 5%. I don't have anywhere near the expertise to do even the most naive of calculations of how many extra days that would translate into in the real world, but given that I imagine the virus spreads faster than it goes away, it sounds like delaying by a certain amount of time would lead to _more_ than that amount of time needed to stay in lockdown. I wonder if the US had gone into lockdown at the beginning of March or even earlier, then the lockdown might have been shortened by months.