4 ms·

> You’ve also misrepresented the nature of private healthcare in the UK I mentioned that we don't have the right to opt out of paying for the NHS. It's not po

by rleigh 4y ago

> You’ve also misrepresented the nature of private healthcare in the UK I mentioned that we don't have the right to opt out of paying for the NHS. It's not possible go entirely private. If you could opt out, you could pay that money to a private provider instead and entirely forego the use of the NHS. That isn't an option today. But it should be.

simonswords82 4y ago
I think if you’re forced to go private due to long nhs wait times the money you have spent on paying for the nhs via your taxes should be refunded to cover private care cost
XorNot 4y ago
"opt out" is how conservative parties kill public healthcare systems. Because the public healthcare system winds up subsidizing the private one: private insurers dump bad risks onto it when they get too expensive too insure, after years or collecting the payments that don't go to the public system. It's the definition of privatizing profits and socializing risk. You want to opt out? You get to opt all the way out. You don't get to come back, it's a one way street. Still keen?
- physicsguy 4y ago
  I’m Germany, that’s the way it works, once you choose to go private you cannot opt back into the public system. People sometimes do it if they don’t plan to stay in Germany though, usually if they are immigrants.
  - detaro 4y ago
    Depends on the age. Above 55 it's indeed quite difficult, under that you can switch back if you fall back into the required status (i.e. take a job with a salary under the limit)
tehbeard 4y ago
And when you have a heart attack in the street, who's responding? In this scenario, why should an NHS ambulance pick you up when you don't contribute? Surely it should prioritize those on public healthcare? Some poor lad whose leg is broken from a fall?
- ricardobayes 4y ago
  Your insurance would pick up the tab in this scenario.
  - ljf 4y ago
    The question wasn't about the cost, is was 'who is responding'.
Teever 4y ago
Why do you think this should be an option?
- rleigh 4y ago
  Why should it be an option? Because we live in a free country, and should be free to spend our money as we see fit. Even if others don't agree with it. Why should we all be compelled by the force of law to divert a huge fraction of our income to an organisation which is so ineffective and inaccessible? We are forced to spend a significant fraction of our salaries on the NHS whether or not we want to. If we feel that this is not good value for money, or of poor quality, we don't have any real option of choosing to pay an alternative provider. Like all nationalised industries, it's inefficiently run because top-down administration of huge organisations blunts initiative and freedom of action. It's run by Whitehall and politicians, with little input from those actually doing the real work. And the result is that it's in perpetual crisis, with COVID having pushed it right over the edge. Is it really fit for purpose? I don't personally think so, and haven't for many years. Competition is good for many reasons. It improves the quality and value of goods and services. The NHS has no real competition. There's no direct cost of failure, no direct cost to poor purchasing decisions, no direct cost for poor quality of service, and no real driving reason for improvement in the quality and efficiency of its services. They get the money anyway. Other healthcare systems in Europe have fully private provision--you have the choice of where to take your money, even if you paid into a public system. If a particular hospital or clinic is providing poor or expensive service, you can take your money elsewhere which is better quality and better value for money. That's a very real incentive to drive improvement and efficiency. That is not the case for the NHS system. There is no choice, and the incentives to improve are minimal. If there is to ever be any improvement in the NHS, there needs to be competition. The NHS should be somewhere you choose to have treatment because it's the best option, not because it's the only option.
  - gautamcgoel 4y ago
    Isn't your argument really an argument against paying taxes in general?
simonh 4y ago
I have private health care through my employer, I've only used it once but it was very handy. I don't agree with your take at all, there's no way a private health care outfit could efficiently provide an effective emergency service across the entire UK for all possible injuries and illnesses, completely replacing or duplicating the NHS. The USA has tried this and it's an incredibly expensive disaster. Employed middle aged workers in the USA pay about the same as we do for the NHS to support Medicare, Medicaid and CHIP through taxes, and then have to pay about the same again to actually get health care for themselves. Plus the system that costs twice as much as ours per citizen still leaves tens of millions of Americans without health insurance. It's utterly godawful. Our current system where everyone supports the NHS, and if you want top up services you pay for it, ensures solid funding for everyone's health care. The fact that my private care actually subsidises the NHS by reducing demand on it is a feature, not a bug. There's also the fact that private health care increases overall investment in health care, so in emergencies the NHS can call on private medical facilities which otherwise wouldn't be available. I know there's a fairness argument, but in practical terms our system benefits everyone.
- koshergweilo 4y ago
  Yup, as an American this is a pretty accurate assessment for the most part. It's also worth noting that several states actually have different systems to close the gap for people who don't fit into the medicare-medicaid-chips safety nets. In California we have medical, which adds an extra tax, but does help a lot of people who would be uninsured get health insurance. Different states will have massively different levels of care and expertise available. For what it's worth if you have the money you can get some pretty world class care here. My dad had cancer and due to my mom's really good (publicly provided mind you, she worked for the school system) insurance got my dad great care and he's still out an about to this day

by rleigh 4y ago

simonswords82 4y ago

I think if you’re forced to go private due to long nhs wait times the money you have spent on paying for the nhs via your taxes should be refunded to cover private care cost

XorNot 4y ago

"opt out" is how conservative parties kill public healthcare systems. Because the public healthcare system winds up subsidizing the private one: private insurers dump bad risks onto it when they get too expensive too insure, after years or collecting the payments that don't go to the public system. It's the definition of privatizing profits and socializing risk. You want to opt out? You get to opt all the way out. You don't get to come back, it's a one way street. Still keen?

physicsguy 4y ago
I’m Germany, that’s the way it works, once you choose to go private you cannot opt back into the public system. People sometimes do it if they don’t plan to stay in Germany though, usually if they are immigrants.
- detaro 4y ago
  Depends on the age. Above 55 it's indeed quite difficult, under that you can switch back if you fall back into the required status (i.e. take a job with a salary under the limit)

tehbeard 4y ago

And when you have a heart attack in the street, who's responding? In this scenario, why should an NHS ambulance pick you up when you don't contribute? Surely it should prioritize those on public healthcare? Some poor lad whose leg is broken from a fall?

ricardobayes 4y ago
Your insurance would pick up the tab in this scenario.
- ljf 4y ago
  The question wasn't about the cost, is was 'who is responding'.

Teever 4y ago

Why do you think this should be an option?

rleigh 4y ago
Why should it be an option? Because we live in a free country, and should be free to spend our money as we see fit. Even if others don't agree with it. Why should we all be compelled by the force of law to divert a huge fraction of our income to an organisation which is so ineffective and inaccessible? We are forced to spend a significant fraction of our salaries on the NHS whether or not we want to. If we feel that this is not good value for money, or of poor quality, we don't have any real option of choosing to pay an alternative provider. Like all nationalised industries, it's inefficiently run because top-down administration of huge organisations blunts initiative and freedom of action. It's run by Whitehall and politicians, with little input from those actually doing the real work. And the result is that it's in perpetual crisis, with COVID having pushed it right over the edge. Is it really fit for purpose? I don't personally think so, and haven't for many years. Competition is good for many reasons. It improves the quality and value of goods and services. The NHS has no real competition. There's no direct cost of failure, no direct cost to poor purchasing decisions, no direct cost for poor quality of service, and no real driving reason for improvement in the quality and efficiency of its services. They get the money anyway. Other healthcare systems in Europe have fully private provision--you have the choice of where to take your money, even if you paid into a public system. If a particular hospital or clinic is providing poor or expensive service, you can take your money elsewhere which is better quality and better value for money. That's a very real incentive to drive improvement and efficiency. That is not the case for the NHS system. There is no choice, and the incentives to improve are minimal. If there is to ever be any improvement in the NHS, there needs to be competition. The NHS should be somewhere you choose to have treatment because it's the best option, not because it's the only option.
- gautamcgoel 4y ago
  Isn't your argument really an argument against paying taxes in general?

simonh 4y ago

I have private health care through my employer, I've only used it once but it was very handy. I don't agree with your take at all, there's no way a private health care outfit could efficiently provide an effective emergency service across the entire UK for all possible injuries and illnesses, completely replacing or duplicating the NHS. The USA has tried this and it's an incredibly expensive disaster. Employed middle aged workers in the USA pay about the same as we do for the NHS to support Medicare, Medicaid and CHIP through taxes, and then have to pay about the same again to actually get health care for themselves. Plus the system that costs twice as much as ours per citizen still leaves tens of millions of Americans without health insurance. It's utterly godawful. Our current system where everyone supports the NHS, and if you want top up services you pay for it, ensures solid funding for everyone's health care. The fact that my private care actually subsidises the NHS by reducing demand on it is a feature, not a bug. There's also the fact that private health care increases overall investment in health care, so in emergencies the NHS can call on private medical facilities which otherwise wouldn't be available. I know there's a fairness argument, but in practical terms our system benefits everyone.

koshergweilo 4y ago
Yup, as an American this is a pretty accurate assessment for the most part. It's also worth noting that several states actually have different systems to close the gap for people who don't fit into the medicare-medicaid-chips safety nets. In California we have medical, which adds an extra tax, but does help a lot of people who would be uninsured get health insurance. Different states will have massively different levels of care and expertise available. For what it's worth if you have the money you can get some pretty world class care here. My dad had cancer and due to my mom's really good (publicly provided mind you, she worked for the school system) insurance got my dad great care and he's still out an about to this day