Why haven't other countries copied the NHS?

Providing a service for a nation is always going to be, but you don't seem to admit any of the good things it does......

Again I refer you to Blair's waiting lists, which dramatically reduced as he poured money into the NHS......

What do you want? To scrap the NHS? To make it not free at the point of use?
It's a great system and you seem to have nothing good to say about it.

As is treating them as the only two systems possible, which you seem to be doing here. At no point has nulli tertius argued that the NHS should be scrapped or privatised or that the USA's private healthcare model is preferable and yet you've repeatedly attacked him for apparently doing so, on the basis that he hasn't praised it enough. Please stop doing that.

Which one is better, one that ensures every single person is covered and can receive the same level of helthcare, or one in which 40 million people are priced out of healthcare?

Neither is perfect, but seeing them as 'equally bad' is absurd.

What do you want? To scrap the NHS? To make it not free at the point of use?
It's a great system and you seem to have nothing good to say about it.

I do not accept it is a great system. I accept it was a great system in 1948. It has improved since 1948 but many others have surpassed it.

To some extent it has for those 60 years been able to look across to America and point out the deficiencies of the US system particularly over coverage but also over unit cost. If Obamacare works, that will reduce opportunities to make those arguments given that the outcomes for US healthcare are significantly better than in the UK.

I am not taking part in this debate to act as a cheerleader for the NHS but to explain why no-one has followed its structure.

I think I would stop it being a national body (I wouldn't get rid of the brand) but I would localise it and promote localism to defeat the "postcode lottery" argument.

I think the day of the self-employed GP has passed. Let the elderly see out their careers but move to a clinic system with the staff on the books of the new localised services. That will affect rural areas badly and separate provision might have to be made there.

I would organise the local services so that they were not funded to create their own back office functions. I would set up the existing back offices as several commercial businesses in competition with each other and with other public sector bodies e.g local authorities and private providers,

By those means I would hope to put clinical management in charge. I would ensure that the road to senior management required a clinical skill. People criticise university VCs but they were all academics once. I would expect every senior manager to have been a doctor, nurse, radiologist etc. We are very rare in allowing pure health bureaucrats to rise to the top. Even the most commercial of US hospitals is normally headed by a doctor.

Continue and expand buying in bulk operations/services from private health care providers but introduce more rationality here. At the moment a lot of private provision is bought from organisations which are GPs' alter egos. As a GP has his own general practitioner business one can't complain about that but there needs in the future to be a clear distinction between those who are working in the NHS and those working for the NHS.

I would like to explore minimal consultation fees but I would want an evidence base here.

"Here, let me take the only advantage of the NHS and the only disadvantage of the US system, compare them and ask which one is better? That would definitely prove I'm right."

Yet again. I'm not, nor does anybody else, seem to be arguing for the introduction of US system in the UK. There is no question that affordability has been a problem in the US, however you are obviously not going to mention that Mayo Clinic, Cleveland Clinic and John hopkins medical center combined treat tens of thousands of foreigners every year. The fact the vast majority of recipients of the nobel prize in medicine have been americans or individuals doing research in the US. Like at least half of all new major medicines introduced worldwide over the past 20-30 years has come from US, as has very important medical advances. That the United States clearly outperforms the rest of the world when it comes to specific diseases like cancer, pneumonia, heart disease or aids, does of course not matter. Don't get me wrong, I'm not having a go at the doctors, nurses or other staff in the NHS. Only the structure of the NHS, of which outcome is low quality at a high price.

"Neither are particularly good, for different reasons."" Not the same as equally bad.

Will such a system remain free at the point of use?

I don't know,

I would like to see minimal consultation fees introduced ie fees that do not cover the cost of the consultation but which act as a deterrent to "wasting" the service. Most of Europe has them and they seem to work there.

However there are cultural factors at work and I would like to see if they produced the desired effects here.

I cannot see the benefit in an insurance-based scheme. As with school vouchers most of the advocates are simply wanting the state to pay for the private provision they already make. The insurance system is one of the reasons the US system is so expensive and causes huge labour market inflexibility.The European Bismarkian insurance based systems are better but they already exist. Creating them from scratch here would be an enormous futile exercise.

Advancements in research are not connected to the standard of healthcare given to the public.

Any system which involves 40 million not getting healthcare is an awful one. It's only high quality if you can afford it.

The NHS is high quality for everyone.

Awful idea based on a false presumption. Including even a small fee will dissuade large amounts of people from going to the doctors if they don't consider it serious. Thus people who have symptoms of serious illnesses will be less likely to get a life saving early diagnosis.

You really seem to have it in for the NHS and doctors. I've yet to see you say anything positive about it which is bizarre given that it does an awful lot of good stuff, like say treat everyone in the country fpou.

No doubt. However it is connected to the enormous healthcare sector, largely dependent on the free market.

True, but they do have Obamacare nowadays. However the system does still have faults.

Rubbish, its low quality at a high price. However it performs equally poor for all, which is an achievement, i guess.

There is an evidence base that co-payments elsewhere (Germany for example) have reduced waste of health services. There is no evidence base that co-payments elsewhere impede early diagnosis. Most of Europe has better early diagnosis than we do.

You assert as a matter of fact something for which there is no evidence elsewhere. I would like to establish whether what is true elsewhere is also true here



Is there any EU member that doesn't have universal health care provision?

Does it make you feel any happier if I say that I think the NHS is a better health care system than that in Slovenia (apart from the medical records system where Slovenia is ahead)?

Low quality?
The doctors and nurses work exceptionally long hours and work tirelessly.

Yet we are rated regularly as higher than most if not all.
Charges discourage people, that's logic.

You really have it in for the NHS. I take it you're one supporting the idea to pay junior doctors 26% less and then call it efficiency?

Low quality?

The doctors and nurses work exceptionally long hours and work tirelessly.

The standard of patient care is phenomenal

and all you can do is criticise?

Millions are treated each year, thousands of cancer treatments and others.

private healthcare means only the rich can afford it

Yet we are rated regularly as higher than most if not all.
Charges discourage people, that's logic.

Low quality?
The doctors and nurses work exceptionally long hours and work tirelessly. The standard of patient care is phenomenal and all you can do is criticise? Millions are treated each year, thousands of cancer treatments and others.

private healthcare means only the rich can afford it, I want High quality for everyone, which the NHS provides:

It's not been copied because it's so damn expensive x)

Great service though. Has some managerial issues but everything the NHS has done for me has been stellar.