8 ms·

I don't understand how the author can praise NHS for providing this expensive surgery free of charge, whilst simultaneously noting the hundreds/thousands of pat

I don't understand how the author can praise NHS for providing this expensive surgery free of charge, whilst simultaneously noting the hundreds/thousands of patients who die while on the surgery waiting list. Not to be morbid, but every time a patient dies before this surgery, the NHS saves £50-100,000. So is it really a successful system if the only way to make the budget work is letting folks die? Why on earth would the author not be gleefully prepared to pump a little bit, or a lot, of his private funds into this system in order to improve on his chances of survival?

afterburner 3y ago
Are you advocating for increasing the NHS budget, or replacing it with privatized health care?
- NikkiA 3y ago
  Probably for privatised health care - once it's down to money it's the individual's fault for not being able to afford to live and no longer a failing of the system. Thus goes the libertarian concept of personal responsibility.
  - kouru225 3y ago
    And yet this is a terrible plan because purposely killing people is actually terrible for the economy and any money saved will be drowned by the amount of money lost, especially since the money saved will go directly into the pockets of the people who own the privatized healthcare companies and not back into the pockets of the people.
    - afterburner 3y ago
      Libertarians aren't actually that great at looking at the big picture.
      - bagacrap 3y ago
        You guys are tilting at windmills here. I didn't advocate for anything except common sense. Unless you value money more than lives, this system is clearly shite, but the author doesn't acknowledge that, probably due to politics. The budget is part of the system. If you assume unlimited resources, then every system will work flawlessly.
        kouru225 3y ago
        It’s only common sense to present the pros and cons of policy. You don’t seem to even think it’s worth your time to take an actual stab at estimating the cost of death, and so it’s only common sense to think you haven’t thought your way through this at all. You’re still arguing this is a budgetary concern without acknowledging the fact that your policy may actually result in a worse budgetary concern. You know what’s also common sense? That death isn’t a good thing. More death = worse society. Bad society = no money.
        afterburner 3y ago
        You still haven't answered whether you're advocating for improving or starving the NHS. Although if you're intent on shitting on the NHS as if it's intrinsically bad (regardless of budget), I would strongly suspect you are advocating for more private health care, and vote conservative. Feel free to elaborate on what your common sense dictates as a solution.
        pessimizer 3y ago
        The budget is also part of the insurance system. The problem is that you seem to think that resources should be expected (or demanded) to become infinite once healthcare is managed by the state. Insurance companies have turning you down for care as a priority.
ColinWright 3y ago
They don't, you have mis-read the section: > If hip, hernia and cataract waiting lists had a similar mortality rate then tens of thousands would die before they got their op. For these other types of operations there can be very long waiting lists, but these are not conditions from which people die suddenly without warning. The NHS has its problems, but I, for one, am glad that if I get a life-threatening condition I will be treated according to my need without having to bankrupt myself in the process. Additionally, I'm glad the insurance companies don't drive the pricing of quite cost effective drugs and treatments until they are out of range of the uninsured, even though they could easily be priced affordably.
- adastra22 3y ago
  He gave sufficient numbers to do the math on how many people die while waiting for their turn. It is thousands in this case. Regarding the NHS you are falling victim to the binary choice fallacy. It is not a strict choice between NHS’s model and the American hyper privatized healthcare. Where I’m writing this, Taiwan, there is a first-class healthcare system that has national single-payer insurance for all residents (only $27/mo!!), and generally no waiting list and patients can normally see any specialist they wish with walk-in appointments during usual working hours. You can have your cake and eat it too.
  - sneak 3y ago
    Also, almost anyone who wishes can, at any time, fly to a country that has affordable and efficient healthcare and be a customer. I have friends (Americans) who have had procedures recently in South Korea, Turkiye, and Germany. Sometimes it's just easier and faster, and isn't that expensive even if you don't use insurance.
    - adastra22 3y ago
      That's why I'm in Taiwan right now :)
    - tenpies 3y ago
      I'm honestly surprised there is not an entire class of insurance programs for people who happen to live in a jurisdiction that has basically said "we would rather you die on a wait list than allow private healthcare" (e.g. British Columbia in Canada[1]). That insurance would cover healthcare abroad, maybe constrained to certain geographies and conditions. Unlike travel insurance it would assume that your care abroad is necessary due to a lack of services in your home jurisdiction. Perhaps the actuarial data is hard to collect, but I suspect it would be a booming business as most countries with socialised system seem to be heading towards a total decline, if not outright collapse. --- [1] https://nationalpost.com/news/canada/b-c-upholds-ban-on-private-health-care-clinics-but-case-expected-to-go-to-supreme-court https://nationalpost.com/news/canada/b-c-upholds-ban-on-priv...
tux3 3y ago
The only way to make the budget work, for all of medicine worldwide, is to let people die (!) There's a marginal dollar cost on saving one extra life, versus not saving it. It's not that we're out of people to save, it's just not in the budget to save the next one. The one more. You can contribute using generosity.
- voakbasda 3y ago
  No one wants to believe this. But it is absolutely true: there is no healthcare system that can save everyone forever. The growing assortment of treatments to combat issues that arise naturally through aging gave rise to the expectation that we can live longer. Technically, that’s true, but the collective cost of care starts to go exponential. At some point, we must acknowledge that we will go bankrupt trying to save everyone. I wish there was a way for people to check out before they become such a burden on society. Until then, we had better make peace with the reality that “death panels” are choosing for us, because we as a civilization can’t afford for everyone to live their longest possible life.
  - MattRix 3y ago
    I see no logical reason for this to be true, certainly not in any absolute sense.
    - deleted 3y ago
      [deleted]
    - pessimizer 3y ago
      You can't see that a situation will come up, every day, where you have to make a choice between spending millions to keep someone alive for another year, or spending those millions on cheaper and more effective interventions for 100 children? Here's the logic. Budgeting doesn't suddenly disappear and resources don't suddenly become infinite when healthcare moves from insurance companies to government. People who bash the NHS as a concept are people who prefer insurers to budget their healthcare instead of civil servants. Insurers are also death panels.
kouru225 3y ago
The NHS may save that much money, but the US government currently estimate the life of the average person to be worth $10 million (btw this figure was created in the ‘80s so keep inflation in mind). So how much is the UK losing here? It’s a net negative to let people die.
- bagacrap 3y ago
  I don't know where that number comes from but I'm assuming it's a contribution to GDP over a lifetime or something. Seems high, but whatever. The people dying of aortic stenosis have already completed a large percent of their lifetime contributions and may even be into the net negative territory (when you're retired and society has to take care of you).
  - lostlogin 3y ago
    > The people dying of aortic stenosis have already completed a large percent of their lifetime contributions I was sure you’d be wrong here, as congenital stenosis is a thing. You were right - shows what you learn working in a centre when congenital disease is a specialty. Average age of death is in 70s. https://www.nature.com/articles/s41598-017-15316-6 https://www.nature.com/articles/s41598-017-15316-6
  - kouru225 3y ago
    And how much do you estimate the cost of their early death to be? Their children who mourn and become bitter at the government and their society for not providing life saving surgeries to their parents while the rich preserve their fossilized parents… how much money will you advocate we should spend on propaganda to manage their vulnerable mental state? How much less money do enemies of the state need to spend in order to bring those people over to their cause and betray your government? And when terrorist attacks become worse, how much money will you advocate wasting on an increased police state? If anything, the $10 million + inflation is an understatement. There’s no end to the potential monetary value of increased quality of life, and there’s no end to the monetary loss of decreased quality of life.
crote 3y ago
> So is it really a successful system if the only way to make the budget work is letting folks die? The NHS doesn't get to make that decision. The problem is that it has seen literally a decade of budget cuts, despite a rapidly aging population. Compared to countries like France and Germany, the UK has far fewer doctors and nurses per capita. The Tories are intentionally trying to make the NHS fail by essentially strangling it as they really want to privatize it. As the decades before have shown, the NHS can operate perfectly well when it is supplied with a proper budget.
lostlogin 3y ago
> Not to be morbid, but every time a patient dies before this surgery, the NHS saves £50-100,000. Your looking at this too narrowly. There is a point when the NHS saves money by having patients die - this is true in every other health system too. But having a young tax payer die loses them money in terms of future tax take. One can do the equation and it would be something like healthcare cost versus tax take multiplied by years of life left paying tax. https://www.myhsn.co.uk/top-tip/how-much-does-the-nhs-cost https://www.myhsn.co.uk/top-tip/how-much-does-the-nhs-cost
pessimizer 3y ago
> the only way to make the budget work is letting folks die? "The budget" isn't a constant. It's something that politicians have control over.
nvarsj 3y ago
If you live in the UK you have to be positive about the NHS. As soon as the NHS becomes broadly unpopular it will be replaced with a U.S. like system. The fact is the Tory party has been kneecapping the NHS for nearly a decade now - austerity measures to underfund it, and brexit which cut off a lot of talent. The current state is purely a result of politics - and likely lobbying efforts to change the UK system to a more profitable one.

afterburner 3y ago

Are you advocating for increasing the NHS budget, or replacing it with privatized health care?

NikkiA 3y ago
Probably for privatised health care - once it's down to money it's the individual's fault for not being able to afford to live and no longer a failing of the system. Thus goes the libertarian concept of personal responsibility.
- kouru225 3y ago
  And yet this is a terrible plan because purposely killing people is actually terrible for the economy and any money saved will be drowned by the amount of money lost, especially since the money saved will go directly into the pockets of the people who own the privatized healthcare companies and not back into the pockets of the people.
  - afterburner 3y ago
    Libertarians aren't actually that great at looking at the big picture.
    - bagacrap 3y ago
      You guys are tilting at windmills here. I didn't advocate for anything except common sense. Unless you value money more than lives, this system is clearly shite, but the author doesn't acknowledge that, probably due to politics. The budget is part of the system. If you assume unlimited resources, then every system will work flawlessly.
      - kouru225 3y ago
        It’s only common sense to present the pros and cons of policy. You don’t seem to even think it’s worth your time to take an actual stab at estimating the cost of death, and so it’s only common sense to think you haven’t thought your way through this at all. You’re still arguing this is a budgetary concern without acknowledging the fact that your policy may actually result in a worse budgetary concern. You know what’s also common sense? That death isn’t a good thing. More death = worse society. Bad society = no money.
      - afterburner 3y ago
        You still haven't answered whether you're advocating for improving or starving the NHS. Although if you're intent on shitting on the NHS as if it's intrinsically bad (regardless of budget), I would strongly suspect you are advocating for more private health care, and vote conservative. Feel free to elaborate on what your common sense dictates as a solution.
      - pessimizer 3y ago
        The budget is also part of the insurance system. The problem is that you seem to think that resources should be expected (or demanded) to become infinite once healthcare is managed by the state. Insurance companies have turning you down for care as a priority.

ColinWright 3y ago

They don't, you have mis-read the section: > If hip, hernia and cataract waiting lists had a similar mortality rate then tens of thousands would die before they got their op. For these other types of operations there can be very long waiting lists, but these are not conditions from which people die suddenly without warning. The NHS has its problems, but I, for one, am glad that if I get a life-threatening condition I will be treated according to my need without having to bankrupt myself in the process. Additionally, I'm glad the insurance companies don't drive the pricing of quite cost effective drugs and treatments until they are out of range of the uninsured, even though they could easily be priced affordably.

adastra22 3y ago
He gave sufficient numbers to do the math on how many people die while waiting for their turn. It is thousands in this case. Regarding the NHS you are falling victim to the binary choice fallacy. It is not a strict choice between NHS’s model and the American hyper privatized healthcare. Where I’m writing this, Taiwan, there is a first-class healthcare system that has national single-payer insurance for all residents (only $27/mo!!), and generally no waiting list and patients can normally see any specialist they wish with walk-in appointments during usual working hours. You can have your cake and eat it too.
- sneak 3y ago
  Also, almost anyone who wishes can, at any time, fly to a country that has affordable and efficient healthcare and be a customer. I have friends (Americans) who have had procedures recently in South Korea, Turkiye, and Germany. Sometimes it's just easier and faster, and isn't that expensive even if you don't use insurance.
  - adastra22 3y ago
    That's why I'm in Taiwan right now :)
  - tenpies 3y ago
    I'm honestly surprised there is not an entire class of insurance programs for people who happen to live in a jurisdiction that has basically said "we would rather you die on a wait list than allow private healthcare" (e.g. British Columbia in Canada[1]). That insurance would cover healthcare abroad, maybe constrained to certain geographies and conditions. Unlike travel insurance it would assume that your care abroad is necessary due to a lack of services in your home jurisdiction. Perhaps the actuarial data is hard to collect, but I suspect it would be a booming business as most countries with socialised system seem to be heading towards a total decline, if not outright collapse. --- [1] https://nationalpost.com/news/canada/b-c-upholds-ban-on-private-health-care-clinics-but-case-expected-to-go-to-supreme-court https://nationalpost.com/news/canada/b-c-upholds-ban-on-priv...

tux3 3y ago

The only way to make the budget work, for all of medicine worldwide, is to let people die (!) There's a marginal dollar cost on saving one extra life, versus not saving it. It's not that we're out of people to save, it's just not in the budget to save the next one. The one more. You can contribute using generosity.

voakbasda 3y ago
No one wants to believe this. But it is absolutely true: there is no healthcare system that can save everyone forever. The growing assortment of treatments to combat issues that arise naturally through aging gave rise to the expectation that we can live longer. Technically, that’s true, but the collective cost of care starts to go exponential. At some point, we must acknowledge that we will go bankrupt trying to save everyone. I wish there was a way for people to check out before they become such a burden on society. Until then, we had better make peace with the reality that “death panels” are choosing for us, because we as a civilization can’t afford for everyone to live their longest possible life.
- MattRix 3y ago
  I see no logical reason for this to be true, certainly not in any absolute sense.
  - deleted 3y ago
    [deleted]
  - pessimizer 3y ago
    You can't see that a situation will come up, every day, where you have to make a choice between spending millions to keep someone alive for another year, or spending those millions on cheaper and more effective interventions for 100 children? Here's the logic. Budgeting doesn't suddenly disappear and resources don't suddenly become infinite when healthcare moves from insurance companies to government. People who bash the NHS as a concept are people who prefer insurers to budget their healthcare instead of civil servants. Insurers are also death panels.

kouru225 3y ago

The NHS may save that much money, but the US government currently estimate the life of the average person to be worth $10 million (btw this figure was created in the ‘80s so keep inflation in mind). So how much is the UK losing here? It’s a net negative to let people die.

bagacrap 3y ago
I don't know where that number comes from but I'm assuming it's a contribution to GDP over a lifetime or something. Seems high, but whatever. The people dying of aortic stenosis have already completed a large percent of their lifetime contributions and may even be into the net negative territory (when you're retired and society has to take care of you).
- lostlogin 3y ago
  > The people dying of aortic stenosis have already completed a large percent of their lifetime contributions I was sure you’d be wrong here, as congenital stenosis is a thing. You were right - shows what you learn working in a centre when congenital disease is a specialty. Average age of death is in 70s. https://www.nature.com/articles/s41598-017-15316-6 https://www.nature.com/articles/s41598-017-15316-6
- kouru225 3y ago
  And how much do you estimate the cost of their early death to be? Their children who mourn and become bitter at the government and their society for not providing life saving surgeries to their parents while the rich preserve their fossilized parents… how much money will you advocate we should spend on propaganda to manage their vulnerable mental state? How much less money do enemies of the state need to spend in order to bring those people over to their cause and betray your government? And when terrorist attacks become worse, how much money will you advocate wasting on an increased police state? If anything, the $10 million + inflation is an understatement. There’s no end to the potential monetary value of increased quality of life, and there’s no end to the monetary loss of decreased quality of life.

crote 3y ago

> So is it really a successful system if the only way to make the budget work is letting folks die? The NHS doesn't get to make that decision. The problem is that it has seen literally a decade of budget cuts, despite a rapidly aging population. Compared to countries like France and Germany, the UK has far fewer doctors and nurses per capita. The Tories are intentionally trying to make the NHS fail by essentially strangling it as they really want to privatize it. As the decades before have shown, the NHS can operate perfectly well when it is supplied with a proper budget.

lostlogin 3y ago

> Not to be morbid, but every time a patient dies before this surgery, the NHS saves £50-100,000. Your looking at this too narrowly. There is a point when the NHS saves money by having patients die - this is true in every other health system too. But having a young tax payer die loses them money in terms of future tax take. One can do the equation and it would be something like healthcare cost versus tax take multiplied by years of life left paying tax. https://www.myhsn.co.uk/top-tip/how-much-does-the-nhs-cost https://www.myhsn.co.uk/top-tip/how-much-does-the-nhs-cost

pessimizer 3y ago

> the only way to make the budget work is letting folks die? "The budget" isn't a constant. It's something that politicians have control over.

nvarsj 3y ago

If you live in the UK you have to be positive about the NHS. As soon as the NHS becomes broadly unpopular it will be replaced with a U.S. like system. The fact is the Tory party has been kneecapping the NHS for nearly a decade now - austerity measures to underfund it, and brexit which cut off a lot of talent. The current state is purely a result of politics - and likely lobbying efforts to change the UK system to a more profitable one.