5 ms·

Counterpoint to all the "it's because it's underfunded" arguments: The money's there, it's just misspent, as with all government lead bureaucracies, resulting i

by ghusto 3y ago

Counterpoint to all the "it's because it's underfunded" arguments: The money's there, it's just misspent, as with all government lead bureaucracies, resulting in service that could and does kill. There are multiple unnecessary levels of bureaucracy being paid, leaving little room for people who do actual work. This also results in those people being stifled by busy work. Source: Doctors I'm friends with, and personal experience (with family members dying or permanently and seriously damaged).

moribvndvs 3y ago
Am I supposed to feel better or worse, considering private healthcare also has bureaucracies that could and does kill, on top of destroying people financially? Source: work in practice management and billing software, and personal experience
- ghusto 3y ago
  I was lucky enough to have private healthcare paid for me, and I the only bureaucracy I experienced was having to go to the NHS G.P. first to get a "referral". Basically this is a(n NHS side) tick-boxing exercise where you have to be "referred" to a private doctor before you're allowed to see them, even if you pay. In practice what happens is you go to your G.P. and literally say; "can you write a referral so I can go and see my private doctor", and they do so on the spot without batting an eyelid. > on top of destroying people financially? I'm not sure where that's coming from either? Mine was paid for, but it wasn't exactly extortionate. I could have afforded it myself at the time. I don't understand why it's such an emotionally charged issue for some people. If it's a poor/class thing, does it help that I grew up in a piss poor council estate, and thank god I don't have to rely on the NHS ever again.
MattPalmer1086 3y ago
Well, it is underfunded [1]. The UK spends a lot less per capita than any other developed nation. [1] https://www.bmj.com/content/367/bmj.l6326 https://www.bmj.com/content/367/bmj.l6326
- nvm0n1 3y ago
  Your study doesn't actually say that. You'd expect their comparison to be with other developed countries given how it's worded, but in reality: The UK had the lowest healthcare expenditure per capita relative to our comparator countries (UK, $3825 (£2972; €3392); study average, $5700), although this was roughly in line with the average healthcare expenditure of the OECD member states ($3854) and the EU member states So the UK spends about the same as other EU and OECD countries. It only spends less compared to a set of hand-picked "comparator countries" which are: Australia, Canada, Denmark, France, Germany, the Netherlands, Sweden, Switzerland, and the USA. That's a remarkably cherry-picked list. If you average such a small list then the mean will be dominated by healthcare spending in the USA. To get better and less cherry-picked data you can turn to the ONS. See Figure 1 (2017) here: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/articles/howdoesukhealthcarespendingcomparewithothercountries/2019-08-29 https://www.ons.gov.uk/peoplepopulationandcommunity/healthan... The UK is around the same level as Finland, New Zealand and other developed countries. This chart really makes it obvious how they picked their "comparator countries": all the countries that spend the most on healthcare. That isn't surprising. It's hard to get a more biased source on British medical spending than the British Medical Journal. Of course academics specializing in healthcare will claim the UK doesn't spend enough on healthcare.
  - MattPalmer1086 3y ago
    Thanks, must read my sources more carefully! Still second lowest in G7 though.
    - nvm0n1 3y ago
      Maybe. There's a lot of noise in these measurements. A lack of error bars doesn't mean a lack of errors. For many years activist orgs and newspapers liked to claim the UK was at the rock bottom of EU healthcare spending, that it spent far below other nations. When new accounting standards came in that tried to unify the way healthcare spending was measured between nations, overnight the UK went up to be about the middle of healthcare spending. The reason was, social care spending hadn't previously been reported as healthcare spending in the UK whereas in other places it was. Standardizing that fixed the disparity. There are still big sources of error in these numbers. It's not obvious, but spending on IT systems and hospitals (capital investment) isn't included in these numbers, yet these have sucked up a lot of NHS spending over time especially in the form of large failed IT projects, and capital expenditure on hospital buildings has often been done "off the books" in the UK using PFI schemes. Unfortunately the ideological basis of the NHS means that many people feel a nearly moral obligation to argue its failings are always about money, especially Brits who work in the healthcare world themselves. It's a risk free strategy. To criticize the way the NHS is actually structured or operates would come dangerously close to wrongthink.

by ghusto 3y ago

moribvndvs 3y ago

Am I supposed to feel better or worse, considering private healthcare also has bureaucracies that could and does kill, on top of destroying people financially? Source: work in practice management and billing software, and personal experience

ghusto 3y ago
I was lucky enough to have private healthcare paid for me, and I the only bureaucracy I experienced was having to go to the NHS G.P. first to get a "referral". Basically this is a(n NHS side) tick-boxing exercise where you have to be "referred" to a private doctor before you're allowed to see them, even if you pay. In practice what happens is you go to your G.P. and literally say; "can you write a referral so I can go and see my private doctor", and they do so on the spot without batting an eyelid. > on top of destroying people financially? I'm not sure where that's coming from either? Mine was paid for, but it wasn't exactly extortionate. I could have afforded it myself at the time. I don't understand why it's such an emotionally charged issue for some people. If it's a poor/class thing, does it help that I grew up in a piss poor council estate, and thank god I don't have to rely on the NHS ever again.

MattPalmer1086 3y ago

Well, it is underfunded [1]. The UK spends a lot less per capita than any other developed nation. [1] https://www.bmj.com/content/367/bmj.l6326 https://www.bmj.com/content/367/bmj.l6326

nvm0n1 3y ago
Your study doesn't actually say that. You'd expect their comparison to be with other developed countries given how it's worded, but in reality: The UK had the lowest healthcare expenditure per capita relative to our comparator countries (UK, $3825 (£2972; €3392); study average, $5700), although this was roughly in line with the average healthcare expenditure of the OECD member states ($3854) and the EU member states So the UK spends about the same as other EU and OECD countries. It only spends less compared to a set of hand-picked "comparator countries" which are: Australia, Canada, Denmark, France, Germany, the Netherlands, Sweden, Switzerland, and the USA. That's a remarkably cherry-picked list. If you average such a small list then the mean will be dominated by healthcare spending in the USA. To get better and less cherry-picked data you can turn to the ONS. See Figure 1 (2017) here: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/articles/howdoesukhealthcarespendingcomparewithothercountries/2019-08-29 https://www.ons.gov.uk/peoplepopulationandcommunity/healthan... The UK is around the same level as Finland, New Zealand and other developed countries. This chart really makes it obvious how they picked their "comparator countries": all the countries that spend the most on healthcare. That isn't surprising. It's hard to get a more biased source on British medical spending than the British Medical Journal. Of course academics specializing in healthcare will claim the UK doesn't spend enough on healthcare.
- MattPalmer1086 3y ago
  Thanks, must read my sources more carefully! Still second lowest in G7 though.
  - nvm0n1 3y ago
    Maybe. There's a lot of noise in these measurements. A lack of error bars doesn't mean a lack of errors. For many years activist orgs and newspapers liked to claim the UK was at the rock bottom of EU healthcare spending, that it spent far below other nations. When new accounting standards came in that tried to unify the way healthcare spending was measured between nations, overnight the UK went up to be about the middle of healthcare spending. The reason was, social care spending hadn't previously been reported as healthcare spending in the UK whereas in other places it was. Standardizing that fixed the disparity. There are still big sources of error in these numbers. It's not obvious, but spending on IT systems and hospitals (capital investment) isn't included in these numbers, yet these have sucked up a lot of NHS spending over time especially in the form of large failed IT projects, and capital expenditure on hospital buildings has often been done "off the books" in the UK using PFI schemes. Unfortunately the ideological basis of the NHS means that many people feel a nearly moral obligation to argue its failings are always about money, especially Brits who work in the healthcare world themselves. It's a risk free strategy. To criticize the way the NHS is actually structured or operates would come dangerously close to wrongthink.