11 ms·

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

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
    Oddly, things kind of flipped around (in very broad terms). The left is where some of the well-off urban middle classes are, along with the far-left socialists. The right is where the less well off but working are, along with some non-urban upper- and middle-class voters. Because for a lot of working class people (primarily those who work, and aren't living off state support), they have been entirely abandoned by Labour after being treated as guaranteed votes for decades. This is a big part of what the so-called "Red Wall" is. It's socially conservative (small "C") workers from traditionally Labour constituencies. People who have aspirations and don't want to be held back. While this wasn't previously the case, the spatial and socioeconomic patterns are increasingly similar to that of the Democrat/Republican voters in the US, from what I can tell. The leftward travel of the Democrats is a large part of that. But the left/right inversion in the UK has been slowly coming for decades, but the FPTP system hid that in the outcomes.
    - zahllos 4y ago
      Agree. As I once had it explained to me, "I don't choose parties any more, I just use my best guess as to which one will mean I take home more of my salary". There's also the European angle. Those who want to work likely faced competition from EU workers and generally feel hard done by when it comes to globalisation. After all, if you worked in coal, steel, car manufacturing or your family did, quite likely you, or a relative, has lost a good portion of that work to cheaper manufacturing abroad. Which is more appealing: Labour, who prevaricated on Brexit, or BoJo, who simply said he'd do it? It isn't all that different to 'America First' in its appeal. There probably wasn't any way to avoid the demise of coal, especially given our need to combat climate change, but did Labour provide an alternative? During the 2000s, Labour massively expanded higher education but also increased 'student debt', and only paid lip service to apprenticeships. If you're working class and working/aspirational, likely your budgeting is quite strict. Things like 'debt' and 'loans' generally mean 'trouble' and not a solution. I agree this is broad strokes, but Labour has a problem in that it no longer actually represents its traditional demographic.
      - pasabagi 4y ago
        I think the idea that working people were feeling the heat from eastern european competition is a bit simplistic. Most industries have been facing a 'skills shortage', so people are generally aware that the health of their companies, and therefore their job security and career progression, are essentially limited by the pool of skilled labour. That and, working side-by-side with people from all over europe, people tend to feel a great deal of affinity. The typical profile of a brexiteer is somebody retired, not somebody in employment, and I think the reasons are largely ideological, rather than practical; polling showed people who supported brexit would still do so if the hypothetical included economic pain.
  - throwawaylinux 4y ago
    https://www.independent.co.uk/independentpremium/long-reads/johnson-conservatives-party-working-class-b1841422.html https://www.independent.co.uk/independentpremium/long-reads/... https://www.theguardian.com/commentisfree/2022/may/10/starmer-working-class-voters-labour-leader-brexit https://www.theguardian.com/commentisfree/2022/may/10/starme... I know this is brushed off or denied by the intelligentsia, and I know the ruling class (no matter what the party) never worked for the interests of the people but themselves, but nevertheless the working class is turning to conservative politics. The really sad thing is very few people on the left seem to be honestly asking why. What is their party doing so wrong that the least advantaged working class is voting for the parties traditionally associated with capital? Instead they seem happy making up feel-good stories about "the horrible uneducated racists voting against their own interest" to tell one another, and that is about the extent of their intellectual curiosity on the matter.
- starkd 4y ago
  Indeed. A lot seem to have lost the urgency of meaningful reform, because they don't believe it can be. They are out of ideas and unable to build the momentum to get anything passed. But they already have theirs, so ...
- rcarr 4y ago
  The biggest (and, rather oddly, rarely discussed) problem for the left in the UK is actually Scotland. Before the SNP rose to power, Scotland used to be a Labour stronghold. In 1997, Tony Blair's Labour had 56 seats in Scotland. Today, Labour have just 1. Now that all of those votes go to the SNP it makes it extremely difficult for Labour to get a majority in the Commons along traditional ideological lines. There just aren't enough swing seats elsewhere to really make up for it. 200 seats haven't changed hands since WW2. Seats gained/lost by winning party in elections since 1966: 1966: Labour Win, 47 1970: Conservative Win: 77 1974: Labour Win: 14 1979: Conservative Win: 62 1983: Conservative Win: 58 1987: Conservative Win: -21 1992: Conservative Win: -40 1997: Labour Win: 145 2001: Labour Win: -6 2005: Labour Win: -48 2010: Conservative Win: 96 2015: Conservative Win: 24 2017: Conservative Win: -13 2019: Conservative Win: 48 Current Seat Breakdown: Conservative: 357 Labour: 200 SNP: 44 Lib Dem: 14 Plaid Cymru: 3 Alba: 2 Green Party: 1 NI parties: 18 (never been held by Labour or Conservative as far as I'm aware) Speaker: 1 (politically neutral so irrelevant) If SNP and Alba (Scottish Parties) are taken out of the equation entirely the way Northern Ireland currently is, Labour has only 18 seats that aren't held by Tories that they could potentially win. 326 seats are needed for a majority. That means Labour, in a best case (and very unrealistic) scenario where they gain all the seats from the minority parties, would need to gain 126 seats, with 108 of them coming from Tory seats in order to form a majority government. I don't have the data going back past 1966 but looking at what we do have, a seat gain of more than 100 has only happened once: Tony Blair's 1997 win with 145 seats gained. 7 of those gained seats were in Scotland but Labour already held 49. In 1997, Scotland had 72 Westminster MPs but today, due to the redrawing of boundaries, it now only has 59. In total, Labour had 56 seats in Scotland. This means Labour held 78% of Scottish seats, which would equate to 46 seats today. This is the real reason why Labour has had to become more and more Tory. To make up the deficit they either need to win back seats from the completely dominant Scottish National Party or win Conservative strongholds. They see the latter as more realistic so it's become their focus. When Scotland's seats are essentially out of reach of Labour, the UK becomes a de facto 1 party Conservative state. It is absolutely bizarre to me that Labour won't make proportional representation and cross party co-operation a key part of their platform. Unless there are some seriously major shifts I can only really see Labour gaining power again through a minority/coalition government. Even if another right wing party such as the Brexit party emerged to splinter votes from the tories, Labour is still looking at a minority government. They simply can't gain enough seats unless they win back Scotland. This is why they are so reluctant to engage with the SNP because if Scotland really does leave the union, Labour probably won't be seeing power again unless there's electoral reform, a revolution or the tories mess up something up so badly that literally millions die. But by that point, they will have probably been in power so long (and absolute power corrupts absolutely) that they'll have the elections rigged autocracy style so even that may not matter. https://www.electoral-reform.org.uk/latest-news-and-research/media-centre/press-releases/revealed-nearly-200-seats-havent-changed-hands-since-world-war-ii/ https://www.electoral-reform.org.uk/latest-news-and-research...
blibble 4y ago
people have been saying the NHS is 24 hours away from being privatised by the tories for 50 years
- ZeroGravitas 4y ago
  Including the Tories: https://www.independent.co.uk/news/uk/politics/jeremy-hunt-privatise-nhs-tories-privatising-private-insurance-market-replacement-direct-democracy-a6865306.html https://www.independent.co.uk/news/uk/politics/jeremy-hunt-p...
- deleted 4y ago
  [deleted]
starkd 4y ago
What makes you so sure government bureaucracy is even capable of doing this? It never had a great track record to begin with.
- jeromegv 4y ago
  They have actively worked at crippling it. Now that it’s crippled they tell you.. oh but surely the government can’t fix it, we need private enterprises to fix it! You walked right into it. What makes you think private business are capable of delivering something cheaper than what the government can do? The most expensive health care in the world is private.
  - Folcon 4y ago
    To be honest I'd be ok with private healthcare if they had to also obey the same constraints as public healthcare. IE they had to provide care to everyone at a reasonable price. I'm deeply suspicious of healthcare that gets to exclude people for cost reasons. I too can provide great healthcare if everyone is mandated to pay me for my services and I get to exclude those I treat, that's a great business, the healthy pay and I exclude the sick, what wonderful pure profit business! The insurance model bothers me for that reason, they really shouldn't be allowed to exclude anyone, if they're taking on the business of healthcare, then that's that, they are providing a utility service, which means they supply to everyone and they make money by spreading the cost between everyone. There are nuances to that, but practically that's the goal they should aspire to, but unfortunately that model isn't the most profitable. I mean take a look at the original US health insurance that existed: > The first plan guaranteed teachers 21 days of hospital care for $6 a year, and was later extended to other employee groups in Dallas, and then nationally [0] That insurance model worked, it just happened to get outcompeted by entities who were willing to undercut them by aiming to capture only the most healthy people, which is in effect a tragedy of the commons. Which is a real problem in my book, I'd be fascinated to see what innovations a private company could come up with under that model. We might have missed out on a whole slew of interesting ideas if we kept going down that route, which would still have been a pretty profitable business and would have been a great success for those who do believe that the private space can do healthcare better. As it stands I don't believe the current private model meets that criteria as it fails at the first hurdle of being a health care service, it doesn't care about health. So it seems like the choices are bad private care, good public care and bad public care. So yea, I'm leaning to the good public care. - [0]: https://en.wikipedia.org/wiki/Blue_Cross_Blue_Shield_Association https://en.wikipedia.org/wiki/Blue_Cross_Blue_Shield_Associa...
origin_path 4y ago
That's what lots of people want - I can assure you, I know quite a few - but the British left attacks anyone so viciously and nastily that they aren't ever going to admit it to anyone seen in the vicinity of a Guardian. The NHS has collapsed since COVID. No, it isn't due to lack of funding, that's a lie. NHS funding has increased massively under the Conservatives who haven't talked about even limited privatisation for the last decade or more. The reason it collapsed is that rigid commands and control systems cannot cope with change and the NHS was already dysfunctional before that. When they emptied the hospitals they created a massive backlog that they already knew they could never catch up on even with more funding. At any rate it's irrelevant. The excess deaths are much more likely to be vaccine linked despite the collapsed state of the NHS. The timing, causes of death and split between vaxxed and unvaxxed doesn't really work for the theory it's lockdown caused.
- benj111 4y ago
  Waiting lists are going down. They just cleared the backlog of people waiting 3 years for treatment
  - MagnumOpus 4y ago
    Sure, and the excess deaths above help a lot in doing that. Still, while waiting for patients to die is an cheap way to shorten backlogs, it does leave not instill confidence…
    - benj111 4y ago
      Except people don't tend to die from needing a hip replacement or other quality of life surgeries. The urgent things tend to get done first.
      - origin_path 4y ago
        They die of old age instead? Not really better. The point of the NHS is to treat people, if you have to wait three years for treatment that's the same thing as collapse, it's not really different from the user's perspective.
rleigh 4y ago
> that's not what anyone wants The NHS has been turned into what is effectively a state religion in some quarters. It's untouchable. It can't be criticised. It's immune to meaningful improvement and reform at this point. Yet everyone I know who works for the NHS has a litany of stories about the inefficiency and waste. And it consumes an increasing proportion of the GDP. Eventually, something will have to give. Its been on an unsustainable path since its inception. It's always been in crisis and needed increasing amounts of cash. Cash that we taxpayers have no choice but to pay up. The NHS isn't optional, it's mandatory. If we have the option to opt out of paying for the NHS and go private, many will do so. I already have to pay twice over. I pay privately through my employer's plan, and then again for the NHS. I suspect if there is the possibility of opting out and going entirely private, many would do so. At this point it's the only way to ever get a GP appointment for many of us. The problem with the debate here is that it's always framed in terms of UK vs US funding models, both of which are horribly broken in different ways, and never looks at other European countries or other systems around the world, some of which have systems which work better and provide better health outcomes for less money. If we were to privatise it along French lines, for example, it might be a massive improvement all around. But that debate has never happened.
- neilwilson 4y ago
  "I pay privately through my employer's plan, and then again for the NHS." And yet it is the private system in the UK that is taking away scarce supply from the NHS making it more vulnerable. There is a supply side limit on doctors and nurses, which means private healthcare works like the Fast Track queue at Alton Towers. All it does is allow people with money to jump the queue at the expense of everybody else. And remember that since the inception of the NHS Primary Care, ie the GPs, have always been private businesses. Yet that is the bit that is completely on its knees at the moment. This isn't a private vs public argument. It's far more fundamental than that. It how do we share out increasingly scarce resources in a country that is getting poorer.
  - rleigh 4y ago
    > how do we share out increasingly scarce resources We make people pay for them. Like we do with every other resource on the planet. Healthcare is something which should be accessible for all, and we can of course subsidise the less well off. But it still ultimately needs paying for.
wongarsu 4y ago
The same Tories that wanted to increase NHS funding by 350 million per week? What ever became of that? (excuse the gallows humour)
binbinbinbin 4y ago
>that's not what anyone wants. People want the NHS to work, to be funded and managed appropriately. No, they want cost-effective healthcare. Almost everywhere else in the world uses a mixed public-private model for healthcare, which IMHO keeps a lid on the excesses of government spending into the money pit of fully-public healthcare.
- _benedict 4y ago
  The UK spends less per capita (PPP) than most other equivalent country's health system [1,2]? I never quite understand the "cost effective" arguments against the NHS. These costs include all of our private health care expenditure, which are surprisingly significant. https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita https://en.wikipedia.org/wiki/List_of_countries_by_total_hea... https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/articles/howdoesukhealthcarespendingcomparewithothercountries/2019-08-29 https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...
  - usrusrusrusr 4y ago
    The two are not mutually exclusive; you can pay less for healthcare than other countries, and still get a bad deal. Eg: It's currently almost impossible to get routine or early-stage healthcare. If I want a routine doctor's appointment, I have to phone every day at 8am when the next batch of appointments are released, and hope I get one. Last time, it took hours on hold, and attempts over several days, to get one.
    - _benedict 4y ago
      Your GP surgery is privately run, so in this case the issue is likely very much an issue of the supply of available doctors, and how your GP surgery chooses to operate its appointment system. I believe appointments are now run more efficiently due to the backlog and changes in processes due to Covid, with the reason for an appointment usually submitted digitally first, followed by an efficient telephone consultation that is well prepared based on your submitted reason for needing an appointment, and a follow-up consultation as necessary. Perhaps your GP surgery in particular is struggling, or you are perhaps not engaging with the new approach. I have been surprised at just how well functioning the health service is right now despite the incredible pressures on it, but perhaps my local area is coping better than others. Importantly, however, this issue was broadly not present 10 years ago when the NHS was better funded to meet its needs, and was still cheaper than other countries. So the issue is not the NHS, but funding, which is also corroborated by our relatively low level of health spending.

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
  Oddly, things kind of flipped around (in very broad terms). The left is where some of the well-off urban middle classes are, along with the far-left socialists. The right is where the less well off but working are, along with some non-urban upper- and middle-class voters. Because for a lot of working class people (primarily those who work, and aren't living off state support), they have been entirely abandoned by Labour after being treated as guaranteed votes for decades. This is a big part of what the so-called "Red Wall" is. It's socially conservative (small "C") workers from traditionally Labour constituencies. People who have aspirations and don't want to be held back. While this wasn't previously the case, the spatial and socioeconomic patterns are increasingly similar to that of the Democrat/Republican voters in the US, from what I can tell. The leftward travel of the Democrats is a large part of that. But the left/right inversion in the UK has been slowly coming for decades, but the FPTP system hid that in the outcomes.
  - zahllos 4y ago
    Agree. As I once had it explained to me, "I don't choose parties any more, I just use my best guess as to which one will mean I take home more of my salary". There's also the European angle. Those who want to work likely faced competition from EU workers and generally feel hard done by when it comes to globalisation. After all, if you worked in coal, steel, car manufacturing or your family did, quite likely you, or a relative, has lost a good portion of that work to cheaper manufacturing abroad. Which is more appealing: Labour, who prevaricated on Brexit, or BoJo, who simply said he'd do it? It isn't all that different to 'America First' in its appeal. There probably wasn't any way to avoid the demise of coal, especially given our need to combat climate change, but did Labour provide an alternative? During the 2000s, Labour massively expanded higher education but also increased 'student debt', and only paid lip service to apprenticeships. If you're working class and working/aspirational, likely your budgeting is quite strict. Things like 'debt' and 'loans' generally mean 'trouble' and not a solution. I agree this is broad strokes, but Labour has a problem in that it no longer actually represents its traditional demographic.
    - pasabagi 4y ago
      I think the idea that working people were feeling the heat from eastern european competition is a bit simplistic. Most industries have been facing a 'skills shortage', so people are generally aware that the health of their companies, and therefore their job security and career progression, are essentially limited by the pool of skilled labour. That and, working side-by-side with people from all over europe, people tend to feel a great deal of affinity. The typical profile of a brexiteer is somebody retired, not somebody in employment, and I think the reasons are largely ideological, rather than practical; polling showed people who supported brexit would still do so if the hypothetical included economic pain.
- throwawaylinux 4y ago
  https://www.independent.co.uk/independentpremium/long-reads/johnson-conservatives-party-working-class-b1841422.html https://www.independent.co.uk/independentpremium/long-reads/... https://www.theguardian.com/commentisfree/2022/may/10/starmer-working-class-voters-labour-leader-brexit https://www.theguardian.com/commentisfree/2022/may/10/starme... I know this is brushed off or denied by the intelligentsia, and I know the ruling class (no matter what the party) never worked for the interests of the people but themselves, but nevertheless the working class is turning to conservative politics. The really sad thing is very few people on the left seem to be honestly asking why. What is their party doing so wrong that the least advantaged working class is voting for the parties traditionally associated with capital? Instead they seem happy making up feel-good stories about "the horrible uneducated racists voting against their own interest" to tell one another, and that is about the extent of their intellectual curiosity on the matter.
starkd 4y ago
Indeed. A lot seem to have lost the urgency of meaningful reform, because they don't believe it can be. They are out of ideas and unable to build the momentum to get anything passed. But they already have theirs, so ...
rcarr 4y ago
The biggest (and, rather oddly, rarely discussed) problem for the left in the UK is actually Scotland. Before the SNP rose to power, Scotland used to be a Labour stronghold. In 1997, Tony Blair's Labour had 56 seats in Scotland. Today, Labour have just 1. Now that all of those votes go to the SNP it makes it extremely difficult for Labour to get a majority in the Commons along traditional ideological lines. There just aren't enough swing seats elsewhere to really make up for it. 200 seats haven't changed hands since WW2. Seats gained/lost by winning party in elections since 1966: 1966: Labour Win, 47 1970: Conservative Win: 77 1974: Labour Win: 14 1979: Conservative Win: 62 1983: Conservative Win: 58 1987: Conservative Win: -21 1992: Conservative Win: -40 1997: Labour Win: 145 2001: Labour Win: -6 2005: Labour Win: -48 2010: Conservative Win: 96 2015: Conservative Win: 24 2017: Conservative Win: -13 2019: Conservative Win: 48 Current Seat Breakdown: Conservative: 357 Labour: 200 SNP: 44 Lib Dem: 14 Plaid Cymru: 3 Alba: 2 Green Party: 1 NI parties: 18 (never been held by Labour or Conservative as far as I'm aware) Speaker: 1 (politically neutral so irrelevant) If SNP and Alba (Scottish Parties) are taken out of the equation entirely the way Northern Ireland currently is, Labour has only 18 seats that aren't held by Tories that they could potentially win. 326 seats are needed for a majority. That means Labour, in a best case (and very unrealistic) scenario where they gain all the seats from the minority parties, would need to gain 126 seats, with 108 of them coming from Tory seats in order to form a majority government. I don't have the data going back past 1966 but looking at what we do have, a seat gain of more than 100 has only happened once: Tony Blair's 1997 win with 145 seats gained. 7 of those gained seats were in Scotland but Labour already held 49. In 1997, Scotland had 72 Westminster MPs but today, due to the redrawing of boundaries, it now only has 59. In total, Labour had 56 seats in Scotland. This means Labour held 78% of Scottish seats, which would equate to 46 seats today. This is the real reason why Labour has had to become more and more Tory. To make up the deficit they either need to win back seats from the completely dominant Scottish National Party or win Conservative strongholds. They see the latter as more realistic so it's become their focus. When Scotland's seats are essentially out of reach of Labour, the UK becomes a de facto 1 party Conservative state. It is absolutely bizarre to me that Labour won't make proportional representation and cross party co-operation a key part of their platform. Unless there are some seriously major shifts I can only really see Labour gaining power again through a minority/coalition government. Even if another right wing party such as the Brexit party emerged to splinter votes from the tories, Labour is still looking at a minority government. They simply can't gain enough seats unless they win back Scotland. This is why they are so reluctant to engage with the SNP because if Scotland really does leave the union, Labour probably won't be seeing power again unless there's electoral reform, a revolution or the tories mess up something up so badly that literally millions die. But by that point, they will have probably been in power so long (and absolute power corrupts absolutely) that they'll have the elections rigged autocracy style so even that may not matter. https://www.electoral-reform.org.uk/latest-news-and-research/media-centre/press-releases/revealed-nearly-200-seats-havent-changed-hands-since-world-war-ii/ https://www.electoral-reform.org.uk/latest-news-and-research...

blibble 4y ago

people have been saying the NHS is 24 hours away from being privatised by the tories for 50 years

ZeroGravitas 4y ago
Including the Tories: https://www.independent.co.uk/news/uk/politics/jeremy-hunt-privatise-nhs-tories-privatising-private-insurance-market-replacement-direct-democracy-a6865306.html https://www.independent.co.uk/news/uk/politics/jeremy-hunt-p...
deleted 4y ago
[deleted]

starkd 4y ago

What makes you so sure government bureaucracy is even capable of doing this? It never had a great track record to begin with.

jeromegv 4y ago
They have actively worked at crippling it. Now that it’s crippled they tell you.. oh but surely the government can’t fix it, we need private enterprises to fix it! You walked right into it. What makes you think private business are capable of delivering something cheaper than what the government can do? The most expensive health care in the world is private.
- Folcon 4y ago
  To be honest I'd be ok with private healthcare if they had to also obey the same constraints as public healthcare. IE they had to provide care to everyone at a reasonable price. I'm deeply suspicious of healthcare that gets to exclude people for cost reasons. I too can provide great healthcare if everyone is mandated to pay me for my services and I get to exclude those I treat, that's a great business, the healthy pay and I exclude the sick, what wonderful pure profit business! The insurance model bothers me for that reason, they really shouldn't be allowed to exclude anyone, if they're taking on the business of healthcare, then that's that, they are providing a utility service, which means they supply to everyone and they make money by spreading the cost between everyone. There are nuances to that, but practically that's the goal they should aspire to, but unfortunately that model isn't the most profitable. I mean take a look at the original US health insurance that existed: > The first plan guaranteed teachers 21 days of hospital care for $6 a year, and was later extended to other employee groups in Dallas, and then nationally [0] That insurance model worked, it just happened to get outcompeted by entities who were willing to undercut them by aiming to capture only the most healthy people, which is in effect a tragedy of the commons. Which is a real problem in my book, I'd be fascinated to see what innovations a private company could come up with under that model. We might have missed out on a whole slew of interesting ideas if we kept going down that route, which would still have been a pretty profitable business and would have been a great success for those who do believe that the private space can do healthcare better. As it stands I don't believe the current private model meets that criteria as it fails at the first hurdle of being a health care service, it doesn't care about health. So it seems like the choices are bad private care, good public care and bad public care. So yea, I'm leaning to the good public care. - [0]: https://en.wikipedia.org/wiki/Blue_Cross_Blue_Shield_Association https://en.wikipedia.org/wiki/Blue_Cross_Blue_Shield_Associa...

origin_path 4y ago

That's what lots of people want - I can assure you, I know quite a few - but the British left attacks anyone so viciously and nastily that they aren't ever going to admit it to anyone seen in the vicinity of a Guardian. The NHS has collapsed since COVID. No, it isn't due to lack of funding, that's a lie. NHS funding has increased massively under the Conservatives who haven't talked about even limited privatisation for the last decade or more. The reason it collapsed is that rigid commands and control systems cannot cope with change and the NHS was already dysfunctional before that. When they emptied the hospitals they created a massive backlog that they already knew they could never catch up on even with more funding. At any rate it's irrelevant. The excess deaths are much more likely to be vaccine linked despite the collapsed state of the NHS. The timing, causes of death and split between vaxxed and unvaxxed doesn't really work for the theory it's lockdown caused.

benj111 4y ago
Waiting lists are going down. They just cleared the backlog of people waiting 3 years for treatment
- MagnumOpus 4y ago
  Sure, and the excess deaths above help a lot in doing that. Still, while waiting for patients to die is an cheap way to shorten backlogs, it does leave not instill confidence…
  - benj111 4y ago
    Except people don't tend to die from needing a hip replacement or other quality of life surgeries. The urgent things tend to get done first.
    - origin_path 4y ago
      They die of old age instead? Not really better. The point of the NHS is to treat people, if you have to wait three years for treatment that's the same thing as collapse, it's not really different from the user's perspective.

rleigh 4y ago

> that's not what anyone wants The NHS has been turned into what is effectively a state religion in some quarters. It's untouchable. It can't be criticised. It's immune to meaningful improvement and reform at this point. Yet everyone I know who works for the NHS has a litany of stories about the inefficiency and waste. And it consumes an increasing proportion of the GDP. Eventually, something will have to give. Its been on an unsustainable path since its inception. It's always been in crisis and needed increasing amounts of cash. Cash that we taxpayers have no choice but to pay up. The NHS isn't optional, it's mandatory. If we have the option to opt out of paying for the NHS and go private, many will do so. I already have to pay twice over. I pay privately through my employer's plan, and then again for the NHS. I suspect if there is the possibility of opting out and going entirely private, many would do so. At this point it's the only way to ever get a GP appointment for many of us. The problem with the debate here is that it's always framed in terms of UK vs US funding models, both of which are horribly broken in different ways, and never looks at other European countries or other systems around the world, some of which have systems which work better and provide better health outcomes for less money. If we were to privatise it along French lines, for example, it might be a massive improvement all around. But that debate has never happened.

neilwilson 4y ago
"I pay privately through my employer's plan, and then again for the NHS." And yet it is the private system in the UK that is taking away scarce supply from the NHS making it more vulnerable. There is a supply side limit on doctors and nurses, which means private healthcare works like the Fast Track queue at Alton Towers. All it does is allow people with money to jump the queue at the expense of everybody else. And remember that since the inception of the NHS Primary Care, ie the GPs, have always been private businesses. Yet that is the bit that is completely on its knees at the moment. This isn't a private vs public argument. It's far more fundamental than that. It how do we share out increasingly scarce resources in a country that is getting poorer.
- rleigh 4y ago
  > how do we share out increasingly scarce resources We make people pay for them. Like we do with every other resource on the planet. Healthcare is something which should be accessible for all, and we can of course subsidise the less well off. But it still ultimately needs paying for.

wongarsu 4y ago

The same Tories that wanted to increase NHS funding by 350 million per week? What ever became of that? (excuse the gallows humour)

binbinbinbin 4y ago

>that's not what anyone wants. People want the NHS to work, to be funded and managed appropriately. No, they want cost-effective healthcare. Almost everywhere else in the world uses a mixed public-private model for healthcare, which IMHO keeps a lid on the excesses of government spending into the money pit of fully-public healthcare.

_benedict 4y ago
The UK spends less per capita (PPP) than most other equivalent country's health system [1,2]? I never quite understand the "cost effective" arguments against the NHS. These costs include all of our private health care expenditure, which are surprisingly significant. https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita https://en.wikipedia.org/wiki/List_of_countries_by_total_hea... https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/articles/howdoesukhealthcarespendingcomparewithothercountries/2019-08-29 https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...
- usrusrusrusr 4y ago
  The two are not mutually exclusive; you can pay less for healthcare than other countries, and still get a bad deal. Eg: It's currently almost impossible to get routine or early-stage healthcare. If I want a routine doctor's appointment, I have to phone every day at 8am when the next batch of appointments are released, and hope I get one. Last time, it took hours on hold, and attempts over several days, to get one.
  - _benedict 4y ago
    Your GP surgery is privately run, so in this case the issue is likely very much an issue of the supply of available doctors, and how your GP surgery chooses to operate its appointment system. I believe appointments are now run more efficiently due to the backlog and changes in processes due to Covid, with the reason for an appointment usually submitted digitally first, followed by an efficient telephone consultation that is well prepared based on your submitted reason for needing an appointment, and a follow-up consultation as necessary. Perhaps your GP surgery in particular is struggling, or you are perhaps not engaging with the new approach. I have been surprised at just how well functioning the health service is right now despite the incredible pressures on it, but perhaps my local area is coping better than others. Importantly, however, this issue was broadly not present 10 years ago when the NHS was better funded to meet its needs, and was still cheaper than other countries. So the issue is not the NHS, but funding, which is also corroborated by our relatively low level of health spending.