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Covid is one aspect of this. Another is the massive. underfunding of the NHS over the last decade. This has become much more evident post-covid thanks to the ba

Covid is one aspect of this. Another is the massive. underfunding of the NHS over the last decade. This has become much more evident post-covid thanks to the backlogs. - Getting a GP to see you in person is now quite difficult (they want to do everything via phone). - Seeing your GP (depending on your area) can involve a 2-3 week wait and waiting in an hours long phone queue. - When you are referred to hospital for tests you can be waiting 6-12 months for the most simple things if they’re not life threatening (even if they are life limiting in the meantime). I personally have gotten to the point where I would not want to live in this country without access to private healthcare. I’ve had a number of treatments privately and they’ve saved me months of pain, anxiety, and in one case outright refusal for treatment by the NHS until the issue became dangerous (which was inevitable). In the UK we treat the NHS like a sacred cow. Even people who have experienced appalling treatment feel the need to exonerate the NHS when complaining about their experience. While the people that work there are not the problem (the failures of the government are) we need to start calling a spade a spade. The current condition of the NHS is atrocious. It’s not “great/the best health system in the world” and we’re no longer “so lucky to live here with the NHS”. It’s shit and it needs massive changes. Unfortunately without a change in government we’re not going to get those and people are seemingly more concerned about refugees arriving by dinghy than health care.

bowsamic 4y ago
The Tory government are doing it on purpose to get the people to want to move to private healthcare. Amazingly it isn’t working, even tho they have basically destroyed the NHS. The silent resilience of British people has backfired on them. Truth is that many old Brits would literally rather die than kick up a fuss
Biologist123 4y ago
Price inelastic healthcare is a private equity dream. The project to leave NHS funding unreformed in order to buy acquiescence to its sell off, all the whilst leaving people to rot, is to my eyes scandalous. But somehow unremarked in the twilight zone that the UK has become.
- zimpenfish 4y ago
  > is to my eyes scandalous. But somehow unremarked There's a lot of remarking going on - Private Eye, for example, have been banging the "NHS privatisation" drum for a couple of decades at least. The Guardian, too, mention it not infrequently.
  - azalemeth 4y ago
    This is very true. The NHS has become a commissioning organisation -- it puts out a request for a service and providers bid for it. Many of these services are IT related; many of them are things like physiotherapy referral programmes. Patients may or may not know who provides their care. This is not at all how things used to be and I have noticed it get far worse of late.
    - tailspin2019 4y ago
      As an aside, I’ve had first hand experience in a couple of those outsourced IT services and the amount of wasted money in that area alone is staggering.
      - phatfish 4y ago
        Said firms are also laughably bad. A number of NHS services were taken down by a crypto-locker style attack just recently. https://www.bbc.co.uk/news/uk-wales-62442127 https://www.bbc.co.uk/news/uk-wales-62442127 The internal NHS IT services were no worse and far better value as you say.
- kranke155 4y ago
  The UK media is an example of an oligarchy successfully controlling the entire information landscape and consistently pushing for manufactured “problems of the week” while ignoring real disturbing trends in home ownership, poverty, health and inequality between London and the abandoned “regions”. The book “Fake law” was terrifying to me - it talks about a whole number of high profile judicial cases that were pretty much distorted by the Mail/Times/Telegraph into whatever propaganda they wanted to push that week, often directed just in ways that it would benefit the oligarchy. And there are multiple books like that. Fake Law, Flat Earth News, Merchants of Doubt.
mike-the-mikado 4y ago
Funding, staff shortages and Brexit don't seem to get a mention in the article. The Government blames the NHS for the problems, but the NHS has no control over its funding. Tory idealogues are determined to increase privatisation, regardless of value for money.
- Hypocritelefty 4y ago
refurb 4y ago
Very similar to Canada as well. Healthcare funding was limited before Covid (12-24 months wait for joint replacement), but with the 2 year hiatus on screening and non-urgent procedures, plus mass burnout of healthcare workers the system is close to imploding. Now it's pretty routine to just go to urgent care since it's unlikely you have a family doctor, ever. Rural hospitals and clinics are either reducing hours or just outright closing due to lack of staff. The difference is there is no private healthcare in Canada (there is, but it's minuscule). You either wait for the public system or you fly to the US. I met a guy in Vancouver who was flying to the US to pay $36,000 to get his knee replaced because his doctor told him "the wait was 2 years before Covid, now? it's indefinite". Guy was a highly active 65 year old and realized $36,000 was cheap if it meant he didn't have to give up 5 years of his best remaining years waiting for the Canadian healthcare system.
Hypocritelefty 4y ago
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SirHound 4y ago
I’m not someone who thinks the setup of the NHS is untouchable, I currently use and prefer the Dutch system. But I’m not convinced the NHS needs changing as much as it needs proper funding.
- jajahusjsna 4y ago
  Change alone would not make much of a difference. It’s definitely mainly a funding issue. But some change is necessary, particularly where the tech side is involved (lack of record sharing, old systems vulnerable to ransomeware attacks etc).
scrlk 4y ago
We are never going to get a serious debate around reforming the NHS until people move on from only comparing the UK to the US. There are many other systems that work - people only need to look across to Europe.
- kergonath 4y ago
  > people only need to look across to Europe That would be politically risky these days… The UK needs to come back to Earth before this happens.
  - heurisko 4y ago
    It's the EU that arguably needs to come back to earth, by returning to a trading bloc, rather than a halfway house pan-european state. The shared monetary system with no shared fiscal policy will come apart one day, as it nearly did with the Greek sovereign debt crisis.
    - kergonath 4y ago
      > It's the EU that arguably needs to come back to earth, by returning to a trading bloc, rather than a halfway house pan-european state. This old chestnut. Go read the Rome treaty or the Schuman declaration. The “it’s only economic” is a lie you’ve been sold by your own governments. The aim has always been political Union, from the beginning. Besides, the EU being “a trading bloc” would not solve any of the issues facing the British government, which mostly result from the government having mutually exclusive demands and being unwilling to keep its word and following the agreements it signed. Including on imports and exports, which is the essence of a trading bloc and would not be improved one bit of the EU were only one of those.
      - okeuro49 4y ago
        > This old chestnut. Go read the Rome treaty or the Schuman declaration. The “it’s only economic” is a lie you’ve been sold by your own governments. The aim has always been political Union, from the beginning. That's not true. The Schuman declaration refers to the European Coal and Steel Community, which was about making war between countries materially impossible ie. through economic, not political, integration. It doesn't refer to stopping war by creating a common European Parliament with the idea that French and Germans should be subsumed into a European citzenry, with freedom of movement. Similarly, the Rome treaty established the European Economic Community. The idea of European citzenship being only established with Maastricht as late as 1992. The history of the European Union has been that of economic integration, with political union coming afterwards. There are many who would have preferred it not come afterwards. To characterise the project soley in terms of those who wanted a pan-European political project is misleading. Political union has not really worked. The European Parliament is a weak institution, and the sovereign debt crisis showed how unpleasant the democratic deficit is, in this case for everyday Greek citizens, as the European Commission forced through austerity measures, triggering a humanitarian crisis. > Including on imports and exports, which is the essence of a trading bloc and would not be improved one bit of the EU were only one of those. The red line for the UK government is freedom of movement. If the EU remained someething akin to ASEAN, ie. prior to Maastricht, the UK would rejoin, and everyone would enjoy sensible trading amongst similarly economically developed countries again. The EU's dream of German and Greek citizens voting together as "EU citizens" in powerful European Parliament on fiscal issues such as a shared pension age and sharing taxes, will never happen, so we have to wait until that folly is over and peoples using the Euro will continue to find out that they have ceded their democracies to undemocratic institutions.
ogogmad 4y ago
One person I'm speaking to claims that the NHS hires too many bureaucrats who are impossible to fire, and who he believes provide the doctors with too much paperwork. He suggests that instead of paying those bureaucrats, the money should go to doctors, nurses and equipment. He claims that the NHS gets about the same amount of money - GDP-wise - as other European countries, while underperforming them. They already hire >1 million people out of a population of 70 million, and paying them more is unsustainable.
- nibbleshifter 4y ago
  I have relatives working in the NHS bureaucracy, even they claim its bloated - there's a fuck tonne of redundancy/duplication of effort and failures to exploit economies of scale, especially in the Trusts system where the same things are replicated dozens of times.
  - starkd 4y ago
    It's the nature of bureacracy. All the incentives are aligned so as not to prioritize efficiency.
- vintermann 4y ago
  This sounds plausible, because it's a story we hear all over the world, again and again. I'm guessing David Graeber's "Bullshit Jobs" has been discussed a few times on Hacker News?
- doliveira 4y ago
  These days doctors seem to spend more time doing paperwork than actually working.
  - retcore 4y ago
    That's because each of the several hundred billions of pounds of greenfield government software programmes is a slapdash crud forms exercise bugger the millions of man years of development by the original experts despite there's little to change in the vast majority of diagnostic pathways. In fact the Reed Codes which resulted from a immense pan European study of two decades length and became canon in ca 1988 remain canonical the only programming work involved in new processes being parsing these together with inserting a myriad of OR impedence where new forms of graft are inserted. We've just switched off national critical systems of civic function across the board over the past few years. Probate about the most egregious example the replacement system containing a mere handful out of the estimated twenty thousand expert legal assessment rules at inception. Manual operations the only alternative for at least two years that I was paying attention.
solar-ice 4y ago
Indeed; the reason people exonerate it is that the Tories have been threatening the population with a dismantling and privatisation of the NHS for over a decade now, and that's not what anyone wants. People want the NHS to work, to be funded and managed appropriately. A primary reason it doesn't is the Tories crippling it.
- thrown_22 4y ago
  The left has somehow ended up as the party of the political managerial class instead of the working class, this is one of the best explanations why we're in such a weird place where the socialists are all trust fund kids who would rather have the working class arrested than talk to them.
  - ben_w 4y ago
    If the (UK) left is the party of the political managerial class, what is the (UK) right? When I'm feeling particularly sarcastic I might call them the party of dilettantes, but is that apt?
    - thrown_22 4y ago
      The right has no identity right now, which is why someone like Trump could take it over. Depending on what happens in the next few years it could well be that they become the party against power. Which would be a rather interesting inversion from the last 40 years. Which raises a lot of uncomfortable questions for people whose world was informed by Reagan, Thatcher and Bush.
    - aaaaaaaaaaab 4y ago
      The party of old people and the underclass.
    - eunice 4y ago
      boomers obsessed with manufactured culture war garbage
    - rleigh 4y ago
thrown_22 4y ago
>Unfortunately without a change in government we’re not going to get those and people are seemingly more concerned about refugees arriving by dinghy than health care. One can be concerned about both. If we ever had a socially conservative and economically progressive government they would stay in power until they died. I mean in the US they literally had to add an amendment to make sure it didn't happen again: https://en.wikipedia.org/wiki/Twenty-second_Amendment_to_the_United_States_Constitution https://en.wikipedia.org/wiki/Twenty-second_Amendment_to_the...
- jajahusjsna 4y ago
  >> One can be concerned about both. I didn’t say that you couldn’t. But by voting for the current day Tory’s you are choosing to decimate the health system and waste money on sending Refugees to Rwanda. It’s idiotic to prioritise that over the NHS.
  - throwawayacc2 4y ago
    >> decimate the health system and waste money on sending Refugees to Rwanda. It’s idiotic to prioritise that over the NHS. It all depends how you view the world. For many people, preserving the historical character and demographic of their country is an important issue. It might not be to you, you might consider it stupid, but it is a concern many people have. So much so, they would see illegal arrivals of non historical descent as a more acute problem. One to be prioritised over what can be argued to be improvements to the existing system. I myself am one of these people. It is more important to me immigrants be sent to Rwanda than offering additional funding or reforming the NHS. If my interaction with other people sharing your beliefs ( or more accurate my assumptions about your beliefs ), you believe me to be evil. I do not believe I am and I do not believe you, who think the opposite of me to be evil. I believe you are misguided though and wrong in what your priorities are.
    - SamoyedFurFluff 4y ago
      Wait, I’m seriously confused by this. If preserving the character of one’s country is an important issue, is the NHS not part of the character of the UK? My understanding is the NHS is one of the defining symbols of the UK, a showing of communal strength and compassion, the Western sensibility in the face of the devastation of war. It touches everyone who lives there, is born there, and often when they die there. It’s erosion is changing every single citizen by shaking their faith in the underlying values the institution represents. Isn’t that a way bigger change? Genuinely, why are refugees something to be prioritized over a cultural touchstone institution if the goal is preserving historical character?
lettergram 4y ago
> Another is the massive. underfunding of the NHS over the last decade. This has become much more evident post-covid thanks to the backlogs. If this were the true issue, the excess deaths would have been starting at peak Covid hospitalization. In fact the opposite is true… That said, particularly on any bureaucracy- more money doesn’t solve issues. In fact, more money often makes more bureaucracy. Obviously that’s not only the case, but it’s one I’d seriously consider here.
- heurisko 4y ago
  The UK has been spending less on healthcare as a percentage of GDP than comparable European countries, Germany and France. I agree more money doesn't solve the issue, especially as so much money was wasted on Covid testing and private beds that were never used. However in my lifetime the difference in healthcare spending between New Labour and Conservative has been noticeable. https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?end=2019&locations=DE-FR-GB&start=2000&view=chart https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?end=2...
  - makomk 4y ago
    I'm not convinced that the UK has been all that comparable to Germany and France for years. GDP is of course an imperfect measure of the real size and capacity of the economy - Ireland has about twice the GDP per capita of all of those countries, but there's not really any way for their government to capture that economic activity as funding for stuff - and certain other metrics are not so great. For example, the average UK household is apparently £8,800 a year worse off than in Germany or France (median income, adjusted for purchasing power) and that gap's been there since about 2008: https://www.theguardian.com/business/2022/jul/13/average-uk-household-8800-a-year-worse-off-than-those-in-france-or-germany https://www.theguardian.com/business/2022/jul/13/average-uk-... In some sense, the UK became poorer than the other European countries it'd normally be compared to at the end of the previous New Labour government when the financial crisis hit and just never really recovered from that. It's possible there is no obvious way out anymore - everyone being poorer means less means less money for them to spend on consumer products and services and less tax revenue the government to spend on things like healthcare and infrastructure, and all of that means less businesses interested in setting up in the country (for reasons other than low taxes anyway) and less tax revenue, less well paying jobs... it's a vicious circle to be stuck in. Even before that happened, the New Labour-era spending was obviously unsustainable at the level of tax they were willing to charge. Despite the economy booming and a bunch of NHS infrastructure spending being moved off government books via expensive PFI programs the national debt went up consistently as a proportion of GDP year after year. Afterwards the Tories made a big fancy show of austerity and cutting back on government spending (and to be fair it did eliminate the deficit like they promised, for a while anyway) but even their big scary austerity program only froze the proportion of GDP spent on healthcare for a while.
ZeroGravitas 4y ago
Maybe I'm just a nerd, but this bit: > Getting a GP to see you in person is now quite difficult (they want to do everything via phone) Doesn't really strike me as a bad thing in itself. Once you get past the front line, things get pretty specialist and a general move to Telemedicine is probably a good thing, and is presumably happening all around the world for all sorts of reasons. People even do telesurgery now. And yeah, in a world where someone is continually lying about something good and useful, you do need to choose your words carefully to not help spread their lies. That's not anyone's fault but the liars though.
- tremon 4y ago
  Once you get past the front line, things get pretty specialist But isn't a GP (general practicioner) exactly the front line of which you speak?
  - pyrophane 4y ago
    Right. I think the argument being made here is that if the job of the GP is just to route you to the appropriate specialist, well, they can do that virtually.
- odiroot 4y ago
  Preventive care is absolutely the most important to keep the society healthy and moving forward. Currently people just give up on contacting their surgeries, letting their symptoms develop into something potentially more dangerous. Then they end up at A&E, overloading the hospitals. Maybe it's not so bad in the 3 biggest cities (possibly due competing private services), but at smaller cities and towns, it's impossible to see your GP. I see people complaining about it in pretty much every media.
  - ZeroGravitas 4y ago
    The NHS spends a lot of money trying to get people to use the right level of care, like pharmacists, info on the web https://111.nhs.uk/ https://111.nhs.uk/ and by phone. I don't particularly see a face-to-face visit to a GP when you think you have an issue as preventitive, but if it was, I still don't see how telemedecine wouldn't be a partial solution to that problem, not make it worse.
viraptor 4y ago
> Even people who have experienced appalling treatment feel the need to exonerate the NHS when complaining about their experience. It really depends on the context. Many will defend nhs because the alternative pushed from time to time is a privatised system which would only make things worse. I'm definitely in the "be careful how you criticise the nhs" camp. It's not great, but let's make sure Tories don't hear that as an encouragement to take it apart.
alecco 4y ago
An aging obese population is the elephant in the room. This problem is not only happening in UK. About 15 years ago the NHS tried to add easy to read labeling to foods with a semaphore: red, yellow, green. And it was blocked during a Labour government with majority. Giving it more and more funds while not fixing the underlying problems is going to cause a massive budget crisis. We need to fix the causes not the symptoms.
- tremon 4y ago
  We need to fix the causes not the symptoms We need both. You don't fix a skull fracture by giving the patient a helmet.
  - headsoup 4y ago
    Well you might give them a helmet to protect the injured area if serious, so bad example there I'd say.
- inglor_cz 4y ago
  "easy to read labeling to foods with a semaphore: red, yellow, green" Easy to read, OK, but would it actually be reliable? It is way too easy to label avocado red because of high fat content while labeling a candy bar orange because sugar isn't officially considered that dangerous ... and unlike avocado farmers, highly processed food producers have a good lobby.
  - jotm 4y ago
    Looking at bigger/higher res monitors getting worse "ratings" over here (obviously they use more power lol), yeah these labels are dumb as hell.
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bhk 4y ago
There has been no drop in funding that might account for the recent "soaring excess deaths". Quite the opposite. https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/nhs-budget https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/nhs-... You speak of massive underfunding, but NHS funding has increased in real terms almost every single year since the 1950s: https://fullfact.org/health/spending-english-nhs/ https://fullfact.org/health/spending-english-nhs/ "At the moment, UK public health spending is the equivalent of about 7% of GDP, similar to what it was back in 2010 and higher than in previous years. Back in 1955, it was worth about 3% of GDP." If the NHS quality of service is as poor as I hear, after decades of increases in funding, why on earth do I also hear it referred to as a "beloved public institution"? Is that just something people feel they are required to say?
- ZeroGravitas 4y ago
  So they spend slightly more than double what they did in 1955, when the cost of providing healthcare has gone up nearly 4x due to the Beaumol effect. That doesn't seem good? You'd expect the service to gradually get worse in that case, wouldn't you? https://marginalrevolution.com/marginalrevolution/2019/05/why-are-the-prices-so-dmn-high.html https://marginalrevolution.com/marginalrevolution/2019/05/wh...
  - inglor_cz 4y ago
    "worse" in what sense? Outcomes of serious diseases are probably better in 1955, because science hasn't stood still.
    - onlyrealcuzzo 4y ago
      I dunno, people are WAY fatter now. I wouldn't be surprised if it evens out.
    - wizofaus 4y ago
      So why should the Baumol effect apply so heavily to healthcare? It's true 1 on 1 patient care has limited options to increase productivity, but is that sufficient to explain it?
dominotw 4y ago
How does giving more funding to NHS solve " historic levels of obesity and heart disease." mentioned in the article. Paying people directly after every workout might have a greater impact.
zahllos 4y ago
I agree with almost everything you've written. The NHS is indeed treated like a sacred cow, and it is absolutely not world beating. I live in Switzerland, but am British, and I would infinitely prefer to get my medical care here and to pay for it. The French medical system has a better reputation than ours also. Swiss medical insurance is actually quite strongly regulated and not like the US system at all. Extras are generally where insurance make money, like having a private room in a hospital instead of a ward. Where I disagree is that a change of government will improve things, because I don't think 'more money' will magically solve all of the problems. As an example, GPs should be doing face to face appointments again as you say, and they should be on call for out of hours. Not for extra money, they're already highly paid. This is just part of the job - people aren't ill conveniently between 9-5 Mon-Fri. Before anyone says this is unfair, UK software engineer salaries look nothing like US ones most of the time, whereas doctors are 'raking it in'. Yes, being a doctor is a tough profession, undoubtedly, but getting into medical school is highly competitive and sought after. So you either want the status and money in exchange for unsocial hours and dealing with the sick and dying or you choose a different career. I don't find it a convincing argument that 'this is all the fault of the tories' because I also had a problem with panic attacks when I lived in the UK under a labour government, and was also outright refused treatment because our local area had only adult facilities and I was 17.5 when it started. I've plenty of other stories, but this is mine. Generally UK politics is polarised like the US and people who believe the conservatives' sole motive in life is to dance on the graves of the poor while watching a food bank burn are likely to be overrepresented online. Remember that austerity came on the heels of Gordon Brown trying to spend his way out of a recession, the same PM who as chancellor sold off the UK gold reserves at the bottom of gold value and tax raided a bunch of pensions. Labour are by no means perfect either, and unfortunately even governments have to budget. Don't get me wrong, the tories have been the government for quite a while now. They've had time to improve things and they definitely haven't. I'm just saying the idea Labour will magically resolve NHS issues is a fallacy. I'd argue that the real issue is the short term/electoral driven policymaking with regards to the NHS - it is a sacred cow, and even the slightest mention of change could potentially be political suicide.
mgerdts 4y ago
I live in a US city with a metropolitan population of about 600,000. The largest provider in town is a university hospital with a sprawling set of clinics that employs 1850 physicians and 21,000 staff. I have pay for insurance that provides the best coverage in my area. Last September I asked for an appointment with my GP before the end of the year. The first appointment was on January 3. I took the appointment. In October they called to reschedule that appointment. I could take a video appointment another time in early January or an in person visit in June. I took the virtual appointment. Rather than charging a $200 facility fee, they charged a $70 for the telecommunications that were pretty much the same as a zoom call. My insurance would have covered the room charge as required by law. They refused to pay the telecom charge. Last December my GP ordered a routine screening procedure at my request. I was hoping to have that complete before my January visit so we could discuss any interesting results. In July the clinic that performs that procedure called to schedule the procedure which is scheduled to happen this week. For this procedure, the clinic is requiring a negative Covid test. They scheduled this test at the one place that they provide these proactive tests. This is a drive through test site that is a 25 minute drive each way from my home. They provided an estimate of the costs for this test. That is $399, which (before taxes) would be earned in 23 hours by someone making the median wage in my city. My insurance company doesn’t think the Covid test is medically necessary so will not cover it. I canceled that Covid test appointment and got a free test at a more convenient location from public health.
- hotpotamus 4y ago
  This doesn't seem all that realistic - that's pretty surprising that they were willing to quote a price for the test ahead of time.
  - mgerdts 4y ago
    Apparently they do this so that people aren't surprised at the magnitude of the bill. Last September I got a covid test at the same place as I had symptoms and was just about to travel. They didn't provide an estimate at that time, but looking at my insurance statement, I see they billed $394.35. The negotiated rate meant that the provider was paid $184.98. Looking back at my past estimates, I see that in 2015 the estimate for the MRI ordered by an ENT that was diagnosing hearing loss was $11,427. In Canada, apparently a private MRI would cost $1,000 or less [1]. I bet the fact that they are available for free for those willing to wait a bit longer helps keep the cost down. If I was given the choice of paying $500 or waiting a few more months for free, I would have definitely taken the free option because I had already delayed care on this for over 10 years. 1. https://www.olympiabenefits.com/blog/how-much-does-a-private-mri-cost-in-canada https://www.olympiabenefits.com/blog/how-much-does-a-private... My wife works with people that are undergoing cancer treatment. One of them is single and lacks FU money in her bank account. She needs to carefully manage the 20 weeks of unpaid leave available to her (and a couple weeks of paid sick leave and vacation) so that she doesn't lose her job. While COBRA could provide continuation of benefits at her current level, that is quite expensive. The Affordable Care Act would give her a path to affordable insurance, but her recent salary would seem to put her out of the running for a full subsidy. Switching insurance in the midst of treatment could mean switching providers. Surely switching providers from one of the best in the area (which is open to Medicare) to someone else while in the midst of cancer treatment is not ideal. Per the Canada MRI pricing, a private option can be an empowering alternative. A high-quality public option is needed to keep the private options in check and to provide a base level of care for those that are not lucky enough to be able to afford private insurance and private care. Even then, surely there are horror stories.
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missedthecue 4y ago
It looks to me like NHS funding has gone up and up and up over time. https://ichef.bbci.co.uk/news/624/cpsprodpb/166A5/production/_101731819_chart-nhs_spend-srmmu-nc.png https://ichef.bbci.co.uk/news/624/cpsprodpb/166A5/production... At what point does throwing ever more money into an industrial furnace become a bad idea?
jotm 4y ago
I'll just say that it's still better than the German system. Same ridiculous waiting times for a 50/50 chance to just get a paracetamol prescription. Private is expensive as hell, nonexistent or not usable. Mental healthcare? Pay us, fuck you. Medication newer than 30 years? Stop huffing that ibuprofen, Bruder. But it's defended to death by the German Internet Chairforce, so it's got that going for it.
- bookofjoe 4y ago
  Wait a sec — paracetamol requires a prescription in Germany? Even here in the U.S. it's over the counter everywhere.
  - jandrewrogers 4y ago
    Quite a few OTC drugs in the US are prescription in many other countries. Antihistamines are another example of something that requires a prescription in some European countries.
  - jotm 4y ago
    No, it doesn't, I meant they'll either actually try to help or give you paracetamol/ibuprofen and maybe tell you to come back in 2 months
  - justsomehnguy 4y ago
    Honestly - it should be, considering how people are absolutely ignorant about it's potency to kill the liver. Especially because some use it as a hangover painkiller.
pessimizer 4y ago
The fact that the response to trashing the NHS from some sectors would be counterintuitively to insist on trashing the NHS more (as some kind of punishment I guess) is exactly what the people trashing the NHS were relying on in the first place. "It takes forever to see a doctor on the NHS, now!" "Let's get rid of the doctors altogether and see how they like it! They think they're so safe." This thread really matches well with the thread about teacher shortages. The problem with the NHS is that it should cost far more, and should turn people down when they can't pay. Then patients would understand their place in relation to doctors, like in the US, and stop complaining.
mytailorisrich 4y ago
> While the people that work there are not the problem They are not responsible for the lack of funding but my experience with NHS's admin has been pretty bad and they can't blame "government's cuts" for everything. I know people who work in consulting in the Big Four and everyone wants to avoid NHS projects because of their internal organisation and waybof working. The NHS has a big organisation and quality of people problem as well. It is a sacred cow, as you mention, and in general people are reluctant to say anything bad about it.
aprdm 4y ago
Canada is having a similar issue in all provinces and no private option…
b3nji 4y ago
Coincidentally, there have been a large increase in heart issues, and SAD (sudden adult death syndrome) happening too. This appears to have started back at the end of 2020, in waves over the last few years. First, the elderly, then filtering down to the younger age brackets. All in the wake of the terrible things you have mentioned. Having worked with the NHS for years, I've seen the good and bad of it. The nurses are the rock, a lot of the doctors seem great, others quite alarmingly without common sense. The management seem to have a policy to "promote to incompetence", and the government intervention seems to encourage the wasting of the vast sums of money they are given. It's a perfect storm, people don't want to recognise what is happening, the NHS is dead already.

bowsamic 4y ago

The Tory government are doing it on purpose to get the people to want to move to private healthcare. Amazingly it isn’t working, even tho they have basically destroyed the NHS. The silent resilience of British people has backfired on them. Truth is that many old Brits would literally rather die than kick up a fuss

Biologist123 4y ago

Price inelastic healthcare is a private equity dream. The project to leave NHS funding unreformed in order to buy acquiescence to its sell off, all the whilst leaving people to rot, is to my eyes scandalous. But somehow unremarked in the twilight zone that the UK has become.

zimpenfish 4y ago
> is to my eyes scandalous. But somehow unremarked There's a lot of remarking going on - Private Eye, for example, have been banging the "NHS privatisation" drum for a couple of decades at least. The Guardian, too, mention it not infrequently.
- azalemeth 4y ago
  This is very true. The NHS has become a commissioning organisation -- it puts out a request for a service and providers bid for it. Many of these services are IT related; many of them are things like physiotherapy referral programmes. Patients may or may not know who provides their care. This is not at all how things used to be and I have noticed it get far worse of late.
  - tailspin2019 4y ago
    As an aside, I’ve had first hand experience in a couple of those outsourced IT services and the amount of wasted money in that area alone is staggering.
    - phatfish 4y ago
      Said firms are also laughably bad. A number of NHS services were taken down by a crypto-locker style attack just recently. https://www.bbc.co.uk/news/uk-wales-62442127 https://www.bbc.co.uk/news/uk-wales-62442127 The internal NHS IT services were no worse and far better value as you say.
kranke155 4y ago
The UK media is an example of an oligarchy successfully controlling the entire information landscape and consistently pushing for manufactured “problems of the week” while ignoring real disturbing trends in home ownership, poverty, health and inequality between London and the abandoned “regions”. The book “Fake law” was terrifying to me - it talks about a whole number of high profile judicial cases that were pretty much distorted by the Mail/Times/Telegraph into whatever propaganda they wanted to push that week, often directed just in ways that it would benefit the oligarchy. And there are multiple books like that. Fake Law, Flat Earth News, Merchants of Doubt.

mike-the-mikado 4y ago

Funding, staff shortages and Brexit don't seem to get a mention in the article. The Government blames the NHS for the problems, but the NHS has no control over its funding. Tory idealogues are determined to increase privatisation, regardless of value for money.

Hypocritelefty 4y ago

refurb 4y ago

Very similar to Canada as well. Healthcare funding was limited before Covid (12-24 months wait for joint replacement), but with the 2 year hiatus on screening and non-urgent procedures, plus mass burnout of healthcare workers the system is close to imploding. Now it's pretty routine to just go to urgent care since it's unlikely you have a family doctor, ever. Rural hospitals and clinics are either reducing hours or just outright closing due to lack of staff. The difference is there is no private healthcare in Canada (there is, but it's minuscule). You either wait for the public system or you fly to the US. I met a guy in Vancouver who was flying to the US to pay $36,000 to get his knee replaced because his doctor told him "the wait was 2 years before Covid, now? it's indefinite". Guy was a highly active 65 year old and realized $36,000 was cheap if it meant he didn't have to give up 5 years of his best remaining years waiting for the Canadian healthcare system.

Hypocritelefty 4y ago

[dead]

SirHound 4y ago

I’m not someone who thinks the setup of the NHS is untouchable, I currently use and prefer the Dutch system. But I’m not convinced the NHS needs changing as much as it needs proper funding.

jajahusjsna 4y ago
Change alone would not make much of a difference. It’s definitely mainly a funding issue. But some change is necessary, particularly where the tech side is involved (lack of record sharing, old systems vulnerable to ransomeware attacks etc).

scrlk 4y ago

We are never going to get a serious debate around reforming the NHS until people move on from only comparing the UK to the US. There are many other systems that work - people only need to look across to Europe.

kergonath 4y ago
> people only need to look across to Europe That would be politically risky these days… The UK needs to come back to Earth before this happens.
- heurisko 4y ago
  It's the EU that arguably needs to come back to earth, by returning to a trading bloc, rather than a halfway house pan-european state. The shared monetary system with no shared fiscal policy will come apart one day, as it nearly did with the Greek sovereign debt crisis.
  - kergonath 4y ago
    > It's the EU that arguably needs to come back to earth, by returning to a trading bloc, rather than a halfway house pan-european state. This old chestnut. Go read the Rome treaty or the Schuman declaration. The “it’s only economic” is a lie you’ve been sold by your own governments. The aim has always been political Union, from the beginning. Besides, the EU being “a trading bloc” would not solve any of the issues facing the British government, which mostly result from the government having mutually exclusive demands and being unwilling to keep its word and following the agreements it signed. Including on imports and exports, which is the essence of a trading bloc and would not be improved one bit of the EU were only one of those.
    - okeuro49 4y ago
      > This old chestnut. Go read the Rome treaty or the Schuman declaration. The “it’s only economic” is a lie you’ve been sold by your own governments. The aim has always been political Union, from the beginning. That's not true. The Schuman declaration refers to the European Coal and Steel Community, which was about making war between countries materially impossible ie. through economic, not political, integration. It doesn't refer to stopping war by creating a common European Parliament with the idea that French and Germans should be subsumed into a European citzenry, with freedom of movement. Similarly, the Rome treaty established the European Economic Community. The idea of European citzenship being only established with Maastricht as late as 1992. The history of the European Union has been that of economic integration, with political union coming afterwards. There are many who would have preferred it not come afterwards. To characterise the project soley in terms of those who wanted a pan-European political project is misleading. Political union has not really worked. The European Parliament is a weak institution, and the sovereign debt crisis showed how unpleasant the democratic deficit is, in this case for everyday Greek citizens, as the European Commission forced through austerity measures, triggering a humanitarian crisis. > Including on imports and exports, which is the essence of a trading bloc and would not be improved one bit of the EU were only one of those. The red line for the UK government is freedom of movement. If the EU remained someething akin to ASEAN, ie. prior to Maastricht, the UK would rejoin, and everyone would enjoy sensible trading amongst similarly economically developed countries again. The EU's dream of German and Greek citizens voting together as "EU citizens" in powerful European Parliament on fiscal issues such as a shared pension age and sharing taxes, will never happen, so we have to wait until that folly is over and peoples using the Euro will continue to find out that they have ceded their democracies to undemocratic institutions.

ogogmad 4y ago

One person I'm speaking to claims that the NHS hires too many bureaucrats who are impossible to fire, and who he believes provide the doctors with too much paperwork. He suggests that instead of paying those bureaucrats, the money should go to doctors, nurses and equipment. He claims that the NHS gets about the same amount of money - GDP-wise - as other European countries, while underperforming them. They already hire >1 million people out of a population of 70 million, and paying them more is unsustainable.

nibbleshifter 4y ago
I have relatives working in the NHS bureaucracy, even they claim its bloated - there's a fuck tonne of redundancy/duplication of effort and failures to exploit economies of scale, especially in the Trusts system where the same things are replicated dozens of times.
- starkd 4y ago
  It's the nature of bureacracy. All the incentives are aligned so as not to prioritize efficiency.
vintermann 4y ago
This sounds plausible, because it's a story we hear all over the world, again and again. I'm guessing David Graeber's "Bullshit Jobs" has been discussed a few times on Hacker News?
doliveira 4y ago
These days doctors seem to spend more time doing paperwork than actually working.
- retcore 4y ago
  That's because each of the several hundred billions of pounds of greenfield government software programmes is a slapdash crud forms exercise bugger the millions of man years of development by the original experts despite there's little to change in the vast majority of diagnostic pathways. In fact the Reed Codes which resulted from a immense pan European study of two decades length and became canon in ca 1988 remain canonical the only programming work involved in new processes being parsing these together with inserting a myriad of OR impedence where new forms of graft are inserted. We've just switched off national critical systems of civic function across the board over the past few years. Probate about the most egregious example the replacement system containing a mere handful out of the estimated twenty thousand expert legal assessment rules at inception. Manual operations the only alternative for at least two years that I was paying attention.

solar-ice 4y ago

Indeed; the reason people exonerate it is that the Tories have been threatening the population with a dismantling and privatisation of the NHS for over a decade now, and that's not what anyone wants. People want the NHS to work, to be funded and managed appropriately. A primary reason it doesn't is the Tories crippling it.

thrown_22 4y ago
The left has somehow ended up as the party of the political managerial class instead of the working class, this is one of the best explanations why we're in such a weird place where the socialists are all trust fund kids who would rather have the working class arrested than talk to them.
- ben_w 4y ago
  If the (UK) left is the party of the political managerial class, what is the (UK) right? When I'm feeling particularly sarcastic I might call them the party of dilettantes, but is that apt?
  - thrown_22 4y ago
    The right has no identity right now, which is why someone like Trump could take it over. Depending on what happens in the next few years it could well be that they become the party against power. Which would be a rather interesting inversion from the last 40 years. Which raises a lot of uncomfortable questions for people whose world was informed by Reagan, Thatcher and Bush.
  - aaaaaaaaaaab 4y ago
    The party of old people and the underclass.
  - eunice 4y ago
    boomers obsessed with manufactured culture war garbage
  - rleigh 4y ago

thrown_22 4y ago

>Unfortunately without a change in government we’re not going to get those and people are seemingly more concerned about refugees arriving by dinghy than health care. One can be concerned about both. If we ever had a socially conservative and economically progressive government they would stay in power until they died. I mean in the US they literally had to add an amendment to make sure it didn't happen again: https://en.wikipedia.org/wiki/Twenty-second_Amendment_to_the_United_States_Constitution https://en.wikipedia.org/wiki/Twenty-second_Amendment_to_the...

jajahusjsna 4y ago
>> One can be concerned about both. I didn’t say that you couldn’t. But by voting for the current day Tory’s you are choosing to decimate the health system and waste money on sending Refugees to Rwanda. It’s idiotic to prioritise that over the NHS.
- throwawayacc2 4y ago
  >> decimate the health system and waste money on sending Refugees to Rwanda. It’s idiotic to prioritise that over the NHS. It all depends how you view the world. For many people, preserving the historical character and demographic of their country is an important issue. It might not be to you, you might consider it stupid, but it is a concern many people have. So much so, they would see illegal arrivals of non historical descent as a more acute problem. One to be prioritised over what can be argued to be improvements to the existing system. I myself am one of these people. It is more important to me immigrants be sent to Rwanda than offering additional funding or reforming the NHS. If my interaction with other people sharing your beliefs ( or more accurate my assumptions about your beliefs ), you believe me to be evil. I do not believe I am and I do not believe you, who think the opposite of me to be evil. I believe you are misguided though and wrong in what your priorities are.
  - SamoyedFurFluff 4y ago
    Wait, I’m seriously confused by this. If preserving the character of one’s country is an important issue, is the NHS not part of the character of the UK? My understanding is the NHS is one of the defining symbols of the UK, a showing of communal strength and compassion, the Western sensibility in the face of the devastation of war. It touches everyone who lives there, is born there, and often when they die there. It’s erosion is changing every single citizen by shaking their faith in the underlying values the institution represents. Isn’t that a way bigger change? Genuinely, why are refugees something to be prioritized over a cultural touchstone institution if the goal is preserving historical character?

lettergram 4y ago

> Another is the massive. underfunding of the NHS over the last decade. This has become much more evident post-covid thanks to the backlogs. If this were the true issue, the excess deaths would have been starting at peak Covid hospitalization. In fact the opposite is true… That said, particularly on any bureaucracy- more money doesn’t solve issues. In fact, more money often makes more bureaucracy. Obviously that’s not only the case, but it’s one I’d seriously consider here.

heurisko 4y ago
The UK has been spending less on healthcare as a percentage of GDP than comparable European countries, Germany and France. I agree more money doesn't solve the issue, especially as so much money was wasted on Covid testing and private beds that were never used. However in my lifetime the difference in healthcare spending between New Labour and Conservative has been noticeable. https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?end=2019&locations=DE-FR-GB&start=2000&view=chart https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?end=2...
- makomk 4y ago
  I'm not convinced that the UK has been all that comparable to Germany and France for years. GDP is of course an imperfect measure of the real size and capacity of the economy - Ireland has about twice the GDP per capita of all of those countries, but there's not really any way for their government to capture that economic activity as funding for stuff - and certain other metrics are not so great. For example, the average UK household is apparently £8,800 a year worse off than in Germany or France (median income, adjusted for purchasing power) and that gap's been there since about 2008: https://www.theguardian.com/business/2022/jul/13/average-uk-household-8800-a-year-worse-off-than-those-in-france-or-germany https://www.theguardian.com/business/2022/jul/13/average-uk-... In some sense, the UK became poorer than the other European countries it'd normally be compared to at the end of the previous New Labour government when the financial crisis hit and just never really recovered from that. It's possible there is no obvious way out anymore - everyone being poorer means less means less money for them to spend on consumer products and services and less tax revenue the government to spend on things like healthcare and infrastructure, and all of that means less businesses interested in setting up in the country (for reasons other than low taxes anyway) and less tax revenue, less well paying jobs... it's a vicious circle to be stuck in. Even before that happened, the New Labour-era spending was obviously unsustainable at the level of tax they were willing to charge. Despite the economy booming and a bunch of NHS infrastructure spending being moved off government books via expensive PFI programs the national debt went up consistently as a proportion of GDP year after year. Afterwards the Tories made a big fancy show of austerity and cutting back on government spending (and to be fair it did eliminate the deficit like they promised, for a while anyway) but even their big scary austerity program only froze the proportion of GDP spent on healthcare for a while.

ZeroGravitas 4y ago

Maybe I'm just a nerd, but this bit: > Getting a GP to see you in person is now quite difficult (they want to do everything via phone) Doesn't really strike me as a bad thing in itself. Once you get past the front line, things get pretty specialist and a general move to Telemedicine is probably a good thing, and is presumably happening all around the world for all sorts of reasons. People even do telesurgery now. And yeah, in a world where someone is continually lying about something good and useful, you do need to choose your words carefully to not help spread their lies. That's not anyone's fault but the liars though.

tremon 4y ago
Once you get past the front line, things get pretty specialist But isn't a GP (general practicioner) exactly the front line of which you speak?
- pyrophane 4y ago
  Right. I think the argument being made here is that if the job of the GP is just to route you to the appropriate specialist, well, they can do that virtually.
odiroot 4y ago
Preventive care is absolutely the most important to keep the society healthy and moving forward. Currently people just give up on contacting their surgeries, letting their symptoms develop into something potentially more dangerous. Then they end up at A&E, overloading the hospitals. Maybe it's not so bad in the 3 biggest cities (possibly due competing private services), but at smaller cities and towns, it's impossible to see your GP. I see people complaining about it in pretty much every media.
- ZeroGravitas 4y ago
  The NHS spends a lot of money trying to get people to use the right level of care, like pharmacists, info on the web https://111.nhs.uk/ https://111.nhs.uk/ and by phone. I don't particularly see a face-to-face visit to a GP when you think you have an issue as preventitive, but if it was, I still don't see how telemedecine wouldn't be a partial solution to that problem, not make it worse.

viraptor 4y ago

> Even people who have experienced appalling treatment feel the need to exonerate the NHS when complaining about their experience. It really depends on the context. Many will defend nhs because the alternative pushed from time to time is a privatised system which would only make things worse. I'm definitely in the "be careful how you criticise the nhs" camp. It's not great, but let's make sure Tories don't hear that as an encouragement to take it apart.

alecco 4y ago

An aging obese population is the elephant in the room. This problem is not only happening in UK. About 15 years ago the NHS tried to add easy to read labeling to foods with a semaphore: red, yellow, green. And it was blocked during a Labour government with majority. Giving it more and more funds while not fixing the underlying problems is going to cause a massive budget crisis. We need to fix the causes not the symptoms.

tremon 4y ago
We need to fix the causes not the symptoms We need both. You don't fix a skull fracture by giving the patient a helmet.
- headsoup 4y ago
  Well you might give them a helmet to protect the injured area if serious, so bad example there I'd say.
inglor_cz 4y ago
"easy to read labeling to foods with a semaphore: red, yellow, green" Easy to read, OK, but would it actually be reliable? It is way too easy to label avocado red because of high fat content while labeling a candy bar orange because sugar isn't officially considered that dangerous ... and unlike avocado farmers, highly processed food producers have a good lobby.
- jotm 4y ago
  Looking at bigger/higher res monitors getting worse "ratings" over here (obviously they use more power lol), yeah these labels are dumb as hell.

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bhk 4y ago

There has been no drop in funding that might account for the recent "soaring excess deaths". Quite the opposite. https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/nhs-budget https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/nhs-... You speak of massive underfunding, but NHS funding has increased in real terms almost every single year since the 1950s: https://fullfact.org/health/spending-english-nhs/ https://fullfact.org/health/spending-english-nhs/ "At the moment, UK public health spending is the equivalent of about 7% of GDP, similar to what it was back in 2010 and higher than in previous years. Back in 1955, it was worth about 3% of GDP." If the NHS quality of service is as poor as I hear, after decades of increases in funding, why on earth do I also hear it referred to as a "beloved public institution"? Is that just something people feel they are required to say?

ZeroGravitas 4y ago
So they spend slightly more than double what they did in 1955, when the cost of providing healthcare has gone up nearly 4x due to the Beaumol effect. That doesn't seem good? You'd expect the service to gradually get worse in that case, wouldn't you? https://marginalrevolution.com/marginalrevolution/2019/05/why-are-the-prices-so-dmn-high.html https://marginalrevolution.com/marginalrevolution/2019/05/wh...
- inglor_cz 4y ago
  "worse" in what sense? Outcomes of serious diseases are probably better in 1955, because science hasn't stood still.
  - onlyrealcuzzo 4y ago
    I dunno, people are WAY fatter now. I wouldn't be surprised if it evens out.
  - wizofaus 4y ago
    So why should the Baumol effect apply so heavily to healthcare? It's true 1 on 1 patient care has limited options to increase productivity, but is that sufficient to explain it?

dominotw 4y ago

How does giving more funding to NHS solve " historic levels of obesity and heart disease." mentioned in the article. Paying people directly after every workout might have a greater impact.

zahllos 4y ago

I agree with almost everything you've written. The NHS is indeed treated like a sacred cow, and it is absolutely not world beating. I live in Switzerland, but am British, and I would infinitely prefer to get my medical care here and to pay for it. The French medical system has a better reputation than ours also. Swiss medical insurance is actually quite strongly regulated and not like the US system at all. Extras are generally where insurance make money, like having a private room in a hospital instead of a ward. Where I disagree is that a change of government will improve things, because I don't think 'more money' will magically solve all of the problems. As an example, GPs should be doing face to face appointments again as you say, and they should be on call for out of hours. Not for extra money, they're already highly paid. This is just part of the job - people aren't ill conveniently between 9-5 Mon-Fri. Before anyone says this is unfair, UK software engineer salaries look nothing like US ones most of the time, whereas doctors are 'raking it in'. Yes, being a doctor is a tough profession, undoubtedly, but getting into medical school is highly competitive and sought after. So you either want the status and money in exchange for unsocial hours and dealing with the sick and dying or you choose a different career. I don't find it a convincing argument that 'this is all the fault of the tories' because I also had a problem with panic attacks when I lived in the UK under a labour government, and was also outright refused treatment because our local area had only adult facilities and I was 17.5 when it started. I've plenty of other stories, but this is mine. Generally UK politics is polarised like the US and people who believe the conservatives' sole motive in life is to dance on the graves of the poor while watching a food bank burn are likely to be overrepresented online. Remember that austerity came on the heels of Gordon Brown trying to spend his way out of a recession, the same PM who as chancellor sold off the UK gold reserves at the bottom of gold value and tax raided a bunch of pensions. Labour are by no means perfect either, and unfortunately even governments have to budget. Don't get me wrong, the tories have been the government for quite a while now. They've had time to improve things and they definitely haven't. I'm just saying the idea Labour will magically resolve NHS issues is a fallacy. I'd argue that the real issue is the short term/electoral driven policymaking with regards to the NHS - it is a sacred cow, and even the slightest mention of change could potentially be political suicide.

mgerdts 4y ago

I live in a US city with a metropolitan population of about 600,000. The largest provider in town is a university hospital with a sprawling set of clinics that employs 1850 physicians and 21,000 staff. I have pay for insurance that provides the best coverage in my area. Last September I asked for an appointment with my GP before the end of the year. The first appointment was on January 3. I took the appointment. In October they called to reschedule that appointment. I could take a video appointment another time in early January or an in person visit in June. I took the virtual appointment. Rather than charging a $200 facility fee, they charged a $70 for the telecommunications that were pretty much the same as a zoom call. My insurance would have covered the room charge as required by law. They refused to pay the telecom charge. Last December my GP ordered a routine screening procedure at my request. I was hoping to have that complete before my January visit so we could discuss any interesting results. In July the clinic that performs that procedure called to schedule the procedure which is scheduled to happen this week. For this procedure, the clinic is requiring a negative Covid test. They scheduled this test at the one place that they provide these proactive tests. This is a drive through test site that is a 25 minute drive each way from my home. They provided an estimate of the costs for this test. That is $399, which (before taxes) would be earned in 23 hours by someone making the median wage in my city. My insurance company doesn’t think the Covid test is medically necessary so will not cover it. I canceled that Covid test appointment and got a free test at a more convenient location from public health.

hotpotamus 4y ago
This doesn't seem all that realistic - that's pretty surprising that they were willing to quote a price for the test ahead of time.
- mgerdts 4y ago
  Apparently they do this so that people aren't surprised at the magnitude of the bill. Last September I got a covid test at the same place as I had symptoms and was just about to travel. They didn't provide an estimate at that time, but looking at my insurance statement, I see they billed $394.35. The negotiated rate meant that the provider was paid $184.98. Looking back at my past estimates, I see that in 2015 the estimate for the MRI ordered by an ENT that was diagnosing hearing loss was $11,427. In Canada, apparently a private MRI would cost $1,000 or less [1]. I bet the fact that they are available for free for those willing to wait a bit longer helps keep the cost down. If I was given the choice of paying $500 or waiting a few more months for free, I would have definitely taken the free option because I had already delayed care on this for over 10 years. 1. https://www.olympiabenefits.com/blog/how-much-does-a-private-mri-cost-in-canada https://www.olympiabenefits.com/blog/how-much-does-a-private... My wife works with people that are undergoing cancer treatment. One of them is single and lacks FU money in her bank account. She needs to carefully manage the 20 weeks of unpaid leave available to her (and a couple weeks of paid sick leave and vacation) so that she doesn't lose her job. While COBRA could provide continuation of benefits at her current level, that is quite expensive. The Affordable Care Act would give her a path to affordable insurance, but her recent salary would seem to put her out of the running for a full subsidy. Switching insurance in the midst of treatment could mean switching providers. Surely switching providers from one of the best in the area (which is open to Medicare) to someone else while in the midst of cancer treatment is not ideal. Per the Canada MRI pricing, a private option can be an empowering alternative. A high-quality public option is needed to keep the private options in check and to provide a base level of care for those that are not lucky enough to be able to afford private insurance and private care. Even then, surely there are horror stories.

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missedthecue 4y ago

It looks to me like NHS funding has gone up and up and up over time. https://ichef.bbci.co.uk/news/624/cpsprodpb/166A5/production/_101731819_chart-nhs_spend-srmmu-nc.png https://ichef.bbci.co.uk/news/624/cpsprodpb/166A5/production... At what point does throwing ever more money into an industrial furnace become a bad idea?

jotm 4y ago

I'll just say that it's still better than the German system. Same ridiculous waiting times for a 50/50 chance to just get a paracetamol prescription. Private is expensive as hell, nonexistent or not usable. Mental healthcare? Pay us, fuck you. Medication newer than 30 years? Stop huffing that ibuprofen, Bruder. But it's defended to death by the German Internet Chairforce, so it's got that going for it.

bookofjoe 4y ago
Wait a sec — paracetamol requires a prescription in Germany? Even here in the U.S. it's over the counter everywhere.
- jandrewrogers 4y ago
  Quite a few OTC drugs in the US are prescription in many other countries. Antihistamines are another example of something that requires a prescription in some European countries.
- jotm 4y ago
  No, it doesn't, I meant they'll either actually try to help or give you paracetamol/ibuprofen and maybe tell you to come back in 2 months
- justsomehnguy 4y ago
  Honestly - it should be, considering how people are absolutely ignorant about it's potency to kill the liver. Especially because some use it as a hangover painkiller.

pessimizer 4y ago

The fact that the response to trashing the NHS from some sectors would be counterintuitively to insist on trashing the NHS more (as some kind of punishment I guess) is exactly what the people trashing the NHS were relying on in the first place. "It takes forever to see a doctor on the NHS, now!" "Let's get rid of the doctors altogether and see how they like it! They think they're so safe." This thread really matches well with the thread about teacher shortages. The problem with the NHS is that it should cost far more, and should turn people down when they can't pay. Then patients would understand their place in relation to doctors, like in the US, and stop complaining.

mytailorisrich 4y ago

> While the people that work there are not the problem They are not responsible for the lack of funding but my experience with NHS's admin has been pretty bad and they can't blame "government's cuts" for everything. I know people who work in consulting in the Big Four and everyone wants to avoid NHS projects because of their internal organisation and waybof working. The NHS has a big organisation and quality of people problem as well. It is a sacred cow, as you mention, and in general people are reluctant to say anything bad about it.

aprdm 4y ago

Canada is having a similar issue in all provinces and no private option…

b3nji 4y ago

Coincidentally, there have been a large increase in heart issues, and SAD (sudden adult death syndrome) happening too. This appears to have started back at the end of 2020, in waves over the last few years. First, the elderly, then filtering down to the younger age brackets. All in the wake of the terrible things you have mentioned. Having worked with the NHS for years, I've seen the good and bad of it. The nurses are the rock, a lot of the doctors seem great, others quite alarmingly without common sense. The management seem to have a policy to "promote to incompetence", and the government intervention seems to encourage the wasting of the vast sums of money they are given. It's a perfect storm, people don't want to recognise what is happening, the NHS is dead already.