The Student Room Group

£100000 is only £65000 after taxes

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Original post by Fred5134
That myth again? The same out that was spread when various public services were privatized, which only resulted in costs increasing so that private companies could make a large enough profit?

https://corporatewatch.org/news/2014/dec/08/energy-rail-and-water-privatisation-costs-uk-households-%C2%A3250-year

The model you are suggesting didn't work out for America, so why are so so eager to force it on the UK?


Original post by Bornblue
Yet in America 40 million people could not afford health insurance.
You're simply wrong here and you are putting ideology ahead of evidence.

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Original post by inhuman
How naive.

Can you give me examples of countries with wholly private healthcare systems? And are these examples good? I.e. something worth implementing?


Private healthcare costs have risen so highly in the United States due to problems with the third party payer system and how the government has designed the system. It's not necessarily because privatisation itself. In fact, a freer market would probably help.

When you go for an injection or an x-ray, for example, you won't really be able to compare costs. There's no visible market price, and no means for you to 'shop around,' so to speak. Your insurance company pays the bill (or most of it) no matter what the healthcare provider charges. There's no market competition between the providers, which inadvertently drives up prices and insurance rates as a result, even though you can chose between insurers.

Administrative costs also skyrocket the prices. It is more expensive for a hospital to deal with insurers than with you directly. And what's bizarre is that all three parties don't want this. The hospital doesn't want to deal with insurers, insurers don't want to pay for dealing with administrators, and patients don't want to pay the higher insurance costs.

Furthermore, healthcare prices of not-for-profit hospitals are actually equally as high as for-profit hospitals (which is then passed on to insurers), despite receiving massive government subsidies and not chasing profits. Why? Lack of competition, lack of consumer freedom, and lack of a functioning market.

The US federal and state governments also require that all insurers cover certain health issues (which increases premiums) and that insurers cover anyone regardless of certian pre-existing health conditions or how recently they were injured, for example. Price control is imposed on the insurers when charging expensive, high-risk claimants, which causes them to increase rates for everyone. The government also mandates that people have coverage - this usually means they have to pay through a third party (and buy a whole bunch of other things they don't want in the plan) instead of being able to 'shop around' themselves for what they need at the best price.

Private healthcare could work like any other functioning market, but it needs to be allowed to. The system is broken because of how it's designed.
I
Original post by Dandaman1
Private healthcare costs have risen so highly in the United States due to problems with the third party payer system and how the government has designed the system. It's not necessarily because privatisation itself. In fact, a freer market would probably help.

When you go for an injection or an x-ray, for example, you won't really be able to compare costs. There's no visible market price, and no means for you to 'shop around,' so to speak. Your insurance company pays the bill (or most of it) no matter what the healthcare provider charges. There's no market competition between the providers, which inadvertently drives up prices and insurance rates as a result, even though you can chose between insurers.

Administrative costs also skyrocket the prices. It is more expensive for a hospital to deal with insurers than with you directly. And what's bizarre is that all three parties don't want this. The hospital doesn't want to deal with insurers, insurers don't want to pay for dealing with administrators, and patients don't want to pay the higher insurance costs.

Furthermore, healthcare prices of not-for-profit hospitals are actually equally as high as for-profit hospitals (which is then passed on to insurers), despite receiving massive government subsidies and not chasing profits. Why? Lack of competition, lack of consumer freedom, and lack of a functioning market.

The US federal and state governments also require that all insurers cover certain health issues (which increases premiums) and that insurers cover anyone regardless of certian pre-existing health conditions or how recently they were injured, for example. Price control is imposed on the insurers when charging expensive, high-risk claimants, which causes them to increase rates for everyone. The government also mandates that people have coverage - this usually means they have to pay through a third party (and buy a whole bunch of other things they don't want in the plan) instead of being able to 'shop around' themselves for what they need at the best price.

Private healthcare could work like any other functioning market, but it needs to be allowed to. The system is broken because of how it's designed.


Britain's nationalised health service beats America's privatised service all ends up. It is more efficient and far more accessible.

The bottom line is that if you have a privatized system, it leaves huge numbers of vulnerable people. What happens if you need treatment that your insurer won't cover? What happens if you have a history of illness and cannot get insured at all which happens a lot in the USA.

Having an NHS is far better economically than privatised health care. It's a massive fiscal multiplier, the better a country's health service, the healthier and more productive it's workers are.

The private sector is better for certain services, health care is not one of them.
(edited 7 years ago)
Reply 222
I find it amusing the OP will get more miserable the more money he makes.
I mean, I get it's not £100k, but £65k is still a lot of money.
Original post by The Awakener
Completeley agree. Another reason why our family is finding living so difficult. My dads on £110k a year. A hard working doctor, who even works weekends and privately just to keep life normal. He is hit the hardest by taxes and has a crippling mortgage. We havent been on holiday for 7 years. We have borrowed a car from my grandad for 2 years now. Admittedly we have come out from serious debt. But that dosent take away how hard it is for a "Rich" person. £110 seems a lot but its really not. Taxes at this income are crippling and living costs are huge because as a "Rich" person you are expected to have nice things like a big house and good car.

Rich is not £100k. Hec no
Rich is Phillip Green, Rich is Alan Sugar, Rich is £800 - 900k a year !

Doctors pay hasnt increased in decades !! But Inflation just keeps going up and up and up.


Are you a troll? Most idiotic thing I've read in a while.
Original post by Bornblue
I

Britain's nationalised health service beats America's privatised service all ends up. It is more efficient and far more accessible.

The bottom line is that if you have a privatized system, it leaves huge numbers of vulnerable people. What happens if you need treatment that your insurer won't cover? What happens if you have a history of illness and cannot get insured at all which happens a lot in the USA.

Having an NHS is far better economically than privatised health care. It's a massive fiscal multiplier, the better a country's health service, the healthier and more productive it's workers are.

The private sector is better for certain services, health care is not one of them.


The US healthcare system isn't exactly the perfect example of a private healthcare system for the reasons I stated. It's a broken model. However, it could be a lot more affordable if the market was allowed to operate more openly and with more consumer involvement.

Even partially privatising the healthcare system would take a huge strain off public services and government spending, and would allow more people to pay for the healthcare they need when they need it. Prices in a more free-market, consumer-driven system would be lower than they are in the current US sysyem of health care monopolies, obfuscated prices, and third party-dependent payment.

So, what if you can't afford a certain procedure? Take out a loan, or the government could help pay your bills in some cases. There are a number of systems that could be implemented here which would protect low-income families while also lowering government spending and costs for the average citizen.

There is a huge strain on the NHS that is only going to get worse. I say start handing things over to the private sector.
People who keep complaining forget the answer to a very important question, where does the money go?
The money goes into supporting the infrastructure of the UK. If we had poorer standards and worse infrastructure, your net income will be affected too, not to mention you will be living in a worse country.
The country takes money from people to build the country which the people live in, the more you pay, the more you invest in your country and its infrastructure and the more you get out in the long run for yourself and your family.

The country takes as much as it can, 65k out of a 100k does seem reasonable, given that there are lots of things in this country that are incredibly cheap (healthcare for example) because of what you pay.
Let's not forget property tax

and lmfao not even gonna get started on inheritance tax.
Original post by Dandaman1
The US healthcare system isn't exactly the perfect example of a private healthcare system for the reasons I stated. It's a broken model. However, it could be a lot more affordable if the market was allowed to operate more openly and with more consumer involvement.

Even partially privatising the healthcare system would take a huge strain off public services and government spending, and would allow more people to pay for the healthcare they need when they need it. Prices in a more free-market, consumer-driven system would be lower than they are in the current US sysyem of health care monopolies, obfuscated prices, and third party-dependent payment.

So, what if you can't afford a certain procedure? Take out a loan, or the government could help pay your bills in some cases. There are a number of systems that could be implemented here which would protect low-income families while also lowering government spending and costs for the average citizen.

There is a huge strain on the NHS that is only going to get worse. I say start handing things over to the private sector.


The moment you start handing anybody's healthcare over to the private sector you give companies the power to hold the health of citizens ransom.

The government paying bills is what it does now? And taking out a loan isn't possible in many cases (especially if you urgently need some rare and very expensive drugs - hospital bills in the US have been known to grow to several million dollars quickly), and even those taking out a loan is just delaying the debt they can't afford and in many cases making it worse

The huge strain isn't directly because it's a public system (and a minority of the strain is made up by dodgy newspapers) - plenty of them work very well around Europe. If we could collect tax properly, spend on the right issues for long term returns (rather than the governments focussing on short term returns to stay in power) and hadn't drastically increased our spending on war in the past decade it would be fine.

Honestly I think a new tax bracket on £500,000 and up annual earners would be great too :s

But that's my opinion
Original post by Dandaman1
There is a huge strain on the NHS that is only going to get worse. I say start handing things over to the private sector.


Is there a particular reason why you conveniently ignored the rest of my post, which showed you that the cost of utilities and rail services went up significantly when they were privatized? Or are you prioritizing ideology over evidence?
Original post by Dandaman1
Private healthcare could work like any other functioning market, but it needs to be allowed to. The system is broken because of how it's designed.


Nice post but so what? I didn't tell you to use USA as an example, I told you to use any system as an example.

Do you really think Britain could be the first country to implement a competitive health insurance market successfully?

The only one I know of is the one in my country, Switzerland. But that is actually highly regulated to the point that there is mandatory health insurance (unlike the US) and if you don't tell the state look here I have insurance, they will forcibly assign you an insurer, moreover the premiums these insurers can charge on the obligatory insurance are highly regulated. So in the end it might be working, but there still is great government intervention in the market.
Original post by ValerieKR
The moment you start handing anybody's healthcare over to the private sector you give companies the power to hold the health of citizens ransom.


Like supermarkets hold our nutritional needs to ransom?

Original post by ValerieKR
The government paying bills is what it does now? And taking out a loan isn't possible in many cases (especially if you urgently need some rare and very expensive drugs - hospital bills in the US have been known to grow to several million dollars quickly), and even those taking out a loan is just delaying the debt they can't afford and in many cases making it worse.


The government would be paying for fewer people's healthcare, which would reduce overall healthcare spending (and taxes). Like I said, there are a number of publicly funded (or charitably funded) programmes which could be implemented to assist low-income patients or help people out in emergencies. I'm not saying that little Timmy should be left to suffer because his parents can't afford to pay for his meds. But the government doesn't need to own (and pay for) the entire healthcare system itself. Let people take control their money and pay for their own healthcare needs, much like we do our food, in a competitive, privatised system (with state-funded support where necessary).

Prices are astronomically high in the US for the reasons I stated. Price obfuscation, third party payers, and a lack of market competition (caused by the government protecting monopolies) dramatically inflates prices well beyond what they would be on an open, consumer-driven market. These drugs and procedures don't actually cost hospitals anywhere close to millions of dollars, but even not-for-profit hospitals will charge the same because they know insurers will pay it.
Original post by Fred5134
Is there a particular reason why you conveniently ignored the rest of my post, which showed you that the cost of utilities and rail services went up significantly when they were privatized? Or are you prioritizing ideology over evidence?


So let's take the railways as an example. Average prices have actually been increasing at roughly the same rate they were before privatisation, although with more variability. Meanwhile, rail use has been increasing substantially, and the EU's 2013 Rail Study Report found that the UK rail network has improved the most out of all European networks since the 1990s. And it's costing the government (thus the taxpayer) less money.

When the rail network was privatised it fell under the control of the Association of Train Operating Companies (branded National Rail), which now effectively has a natural monopoly on rail transport, preventing most market competition. This isn't what I'm advocating for with healthcare.
Original post by Dandaman1
Like supermarkets hold our nutritional needs to ransom?



The government would be paying for fewer people's healthcare, which would reduce overall healthcare spending (and taxes). Like I said, there are a number of publicly funded (or charitably funded) programmes which could be implemented to assist low-income patients or help people out in emergencies. I'm not saying that little Timmy should be left to suffer because his parents can't afford to pay for his meds. But the government doesn't need to own (and pay for) the entire healthcare system itself. Let people take control their money and pay for their own healthcare needs, much like we do our food, in a competitive, privatised system (with state-funded support where necessary).

Prices are astronomically high in the US for the reasons I stated. Price obfuscation, third party payers, and a lack of market competition (caused by the government protecting monopolies) dramatically inflates prices well beyond what they would be on an open, consumer-driven market. These drugs and procedures don't actually cost hospitals anywhere close to millions of dollars, but even not-for-profit hospitals will charge the same because they know insurers will pay it.


So is there a country that has successfully implemented a competitive, free market health care system?
Original post by Dandaman1
Like supermarkets hold our nutritional needs to ransom?


Healthcare and food are fundamentally different because everybody always needs food - only the few need healthcare, so the companies can get away with it.

There's a long history of privatised medicine doing it and very little of the food industry doing it.
Original post by Dandaman1
The US healthcare system isn't exactly the perfect example of a private healthcare system for the reasons I stated. It's a broken model. However, it could be a lot more affordable if the market was allowed to operate more openly and with more consumer involvement.

Even partially privatising the healthcare system would take a huge strain off public services and government spending, and would allow more people to pay for the healthcare they need when they need it. Prices in a more free-market, consumer-driven system would be lower than they are in the current US sysyem of health care monopolies, obfuscated prices, and third party-dependent payment.

So, what if you can't afford a certain procedure? Take out a loan, or the government could help pay your bills in some cases. There are a number of systems that could be implemented here which would protect low-income families while also lowering government spending and costs for the average citizen.

There is a huge strain on the NHS that is only going to get worse. I say start handing things over to the private sector.

The problem is that the free market, private sector approach does not work for healthcare, certainly not as well as a nationalized service.

I am not against the private sector as a whole. In fact some things it does far better than the state could do but others, it does far worse. The problem is that there seem to be people who put ideology ahead of evidence. They assume that the private sector is always best, no matter how much contrary evidence there is and when they are proved wrong, like with healthcare or the railways, they go 'ah but the problem is that it isn't free market enough' etc. It's a policy of diversion, akin to those on the left who claim Labour weren't left wing enough every time they lose an election.


The free market model simply doesn't work for healthcare, both on an individual and economic level. Healthcare is vitally important. If you buy a cheap computer and it turns out to be rubbish, you've only lost a little bit of money, most of the time it will not have serious negative consequences. However, if you buy dodgy healthcare, or a cheap xray or cheap treatment, the consequences can be disastrous and potentially fatal.

We can never have a truly free market for healthcare because it demands regulations as an industry, constituting government interference. Do you think the state is wrong to ban the provision of medicines which have not been clinically tested? If the free market is always best then surely we should allow non-licensed doctors to perform medical operations? After all, demanding a license constitutes interference. The reality is that we do not want companies trying to undercut each other and cut corners with healthcare, it's too important and too risky. Cancer treatment can cost hundreds of thousands, if someone is fairly poor and can't afford such treatment, what's to stop some sham 'doctor' offering super cheap, but ineffective treatment? Unless of course you think there should be regulations to prevent unlicensed doctors, which contradicts your free market position.

Secondly, there is no real evidence that it reduces prices. Rail fares have increased enormously when the rail companies became privatised, same with the price of gas and electricity. Your justification that 'oh well the problem is that they aren't privatized enough' seems opportunistic and again, akin to saying Labour isn't left wing enough every time it loses an election for being too left wing.

Finally, it makes complete economic sense to invest in a Nationalized Health Service. Investing in health is a fiscal multiplier. If you have a nationalized, easily accessible health service then you have a healthier population. A healthier population is a more productive population. People spend less time off work and can work longer. They are also more unlikely to encounter huge health bills which again raises morale, reduces stress and results in higher levels of productivity. In addition, when people pay less for health, they have far more money to invest in other markets, increasing economic activity.

People say that a nationalist health service is inefficient, and it may be, but far less so than privatized services. Japan spends about a half of what the USA does on healthcare, as a proportion of GDP and people live longer and are more productive. Far more money is spent and wasted in the American system for an overall lower standard of service.

The NHS is more efficient, safe and better economically than having only a privatized health service.

To argue otherwise is to put ideology ahead of evidence.
(edited 7 years ago)
Original post by Bornblue
The problem is that the free market, private sector approach does not work for healthcare, certainly not as well as a nationalized service.


The free market model simply doesn't work for healthcare, both on an individual and economic level. Healthcare is vitally important. If you buy a cheap computer and it turns out to be rubbish, you've only lost a little bit of money, most of the time it will not have serious negative consequences. However, if you buy dodgy healthcare, or a cheap xray or cheap treatment, the consequences can be disastrous and potentially fatal.

We can never have a truly free market for healthcare because it demands regulations as an industry, constituting government interference.


This.

Is what I was getting at by asking people if they can point out one successful free market healthcare system in any country.

The Swiss market for health insurance is actually super competitive if you go by number of firms and market share (no dominant power). However, it is far from a free market, it is highly regulated to the point that the obligatory health insurance (in Switzerland if you do not have health insurance, the government will force it on you, they will go to market pick one health insurer and that's it, you have a health insurance contract).

As you say there needs to be regulation to protect consumers from quality of service. But there also needs to be regulation to protect the signalling problem. In Switzerland, a health insurer cannot cancel the contract. Why? Because if they would it would be a signal to all the other health insurers well this guy is clearly a bad risk and charge exorbitant fees. Similarly with age, if you were to switch at an older age, you are going to be a bigger risk and they will charge higher prices. So to counteract that, every year insurers must detail a pricing plan and that plan has to be submitted to the authority and if your price increases are too much, they will say no.

So tell me, does that sound like a "let's privatize the healthcare system"? No, it sounds much more like a government run healthcare system that simply outsources most of it.

Finally, the biggest reason why a privatized healthcare system CANNOT work efficiently for a nation as a whole, is asymmetric information. If a doctor tells you, I think you should have this surgery or this treatment, how many people would say no? If a dentist said oh no I need to do that and that, could you tell he is lying? Maybe he isn't even lying maybe he is somewhat right, but you don't have the knowledge to weigh the pros and cons. And health insurers don't care. They don't want to check up on procedures, the admin costs of that would be astronomical. They would just raise premiums to counter the inflated claims. The NHS has the huge advantage that doctors do not benefit financially from doing more procedures. And do not argue "doctors are so ethical they would never do that". That is so naive. Point in question, a controller (i.e. someone who has no idea what medicine is, just does financial planning) at a hospital where someone I know is a psychiatrist, told them to increase patient numbers by 10% as a target for the upcoming year. What does that mean? They should start doing their own PR and say "hey if you feel a bit mental, why not check us out". Or they should keep patience longer in the hospital? Yea...great. I know it's anecdotal evidence, but I used it just to highlight what kind of ******** can happen.
(edited 7 years ago)
Original post by Bornblue
The problem is that the free market, private sector approach does not work for healthcare, certainly not as well as a nationalized service.

I am not against the private sector as a whole. In fact some things it does far better than the state could do but others, it does far worse. The problem is that there seem to be people who put ideology ahead of evidence. They assume that the private sector is always best, no matter how much contrary evidence there is and when they are proved wrong, like with healthcare or the railways, they go 'ah but the problem is that it isn't free market enough' etc. It's a policy of diversion, akin to those on the left who claim Labour weren't left wing enough every time they lose an election.


The free market model simply doesn't work for healthcare, both on an individual and economic level. Healthcare is vitally important. If you buy a cheap computer and it turns out to be rubbish, you've only lost a little bit of money, most of the time it will not have serious negative consequences. However, if you buy dodgy healthcare, or a cheap xray or cheap treatment, the consequences can be disastrous and potentially fatal.

We can never have a truly free market for healthcare because it demands regulations as an industry, constituting government interference. Do you think the state is wrong to ban the provision of medicines which have not been clinically tested? If the free market is always best then surely we should allow non-licensed doctors to perform medical operations? After all, demanding a license constitutes interference. The reality is that we do not want companies trying to undercut each other and cut corners with healthcare, it's too important and too risky. Cancer treatment can cost hundreds of thousands, if someone is fairly poor and can't afford such treatment, what's to stop some sham 'doctor' offering super cheap, but ineffective treatment? Unless of course you think there should be regulations to prevent unlicensed doctors, which contradicts your free market position.

Secondly, there is no real evidence that it reduces prices. Rail fares have increased enormously when the rail companies became privatised, same with the price of gas and electricity. Your justification that 'oh well the problem is that they aren't privatized enough' seems opportunistic and again, akin to saying Labour isn't left wing enough every time it loses an election for being too left wing.

Finally, it makes complete economic sense to invest in a Nationalized Health Service. Investing in health is a fiscal multiplier. If you have a nationalized, easily accessible health service then you have a healthier population. A healthier population is a more productive population. People spend less time off work and can work longer. They are also more unlikely to encounter huge health bills which again raises morale, reduces stress and results in higher levels of productivity. In addition, when people pay less for health, they have far more money to invest in other markets, increasing economic activity.

People say that a nationalist health service is inefficient, and it may be, but far less so than privatized services. Japan spends about a half of what the USA does on healthcare, as a proportion of GDP and people live longer and are more productive. Far more money is spent and wasted in the American system for an overall lower standard of service.

The NHS is more efficient, safe and better economically than having only a privatized health service.

To argue otherwise is to put ideology ahead of evidence.


I'm going to backtrack a little and say a full-on laissez faire private healthcare system isn't entirely what I'm arguing for. Some government legislation is necessary - I humbly concede this.

I'm not suggesting we allow people to practice medicine without a license or sell untested drugs. There should still be an element of consumer protection involved and laws that must be followed, just as they are in restaurants, with food, and with other products and services. What I am arguing for, however, is a system where people are offered inoculations, cosmetic surgery, acne medicine, dental braces, hair plugs, checkups, and so forth, at market prices. A system where people pay for these things as and when they need them, where they want them. Private surgeries can compete for patients and not charge the extortionate prices they can in the broken US system.

And, like I've been saying, the government can pay for some of it. If you break your leg, for example, the government can pick up the bill. The government can then negotiate on prices with private healthcare providers and keep costs down for its citizens. The government can also legislate on the cost of certain medicines and medical products - this I am willing to admit is necessary to protect people. I understand that a lot of healthcare is inelastic in nature and won't necessarily work well in a free market environment. However, what I will continue to argue is the need to cut government spending on healthcare and give taxpayers more choice and flexibility when it comes to what they're paying for (and who they're paying for).

Also consider how much more disposable income people will have when they're paying less tax and can choose where this goes (even if it's for healthcare). About a fifth of the tax you pay goes to the NHS.

Freer market healthcare in some areas, more regulated market healthcare in others, and the taxpayer makes sure people don't go bankrupt if they get cancer (although don't underestimate the power of voluntary charity, either).

Also, you've cited the privatisation of the rail service and claimed that prices increased because of it. That's not exactly true. See post 235.
Original post by Dandaman1
I'm going to backtrack a little and say a full-on laissez faire private healthcare system isn't entirely what I'm arguing for. Some government legislation is necessary - I humbly concede this.

I'm not suggesting we allow people to practice medicine without a license or sell untested drugs. There should still be an element of consumer protection involved and laws that must be followed, just as they are in restaurants, with food, and with other products and services. What I am arguing for, however, is a system where people are offered inoculations, cosmetic surgery, acne medicine, dental braces, hair plugs, checkups, and so forth, at market prices. A system where people pay for these things as and when they need them, where they want them. Private surgeries can compete for patients and not charge the extortionate prices they can in the broken US system.

And, like I've been saying, the government can pay for some of it. If you break your leg, for example, the government can pick up the bill. The government can then negotiate on prices with private healthcare providers and keep costs down for its citizens. The government can also legislate on the cost of certain medicines and medical products - this I am willing to admit is necessary to protect people. I understand that a lot of healthcare is inelastic in nature and won't necessarily work well in a free market environment. However, what I will continue to argue is the need to cut government spending on healthcare and give taxpayers more choice and flexibility when it comes to what they're paying for (and who they're paying for).

Also consider how much more disposable income people will have when they're paying less tax and can choose where this goes (even if it's for healthcare). About a fifth of the tax you pay goes to the NHS.

Freer market healthcare in some areas, more regulated market healthcare in others, and the taxpayer makes sure people don't go bankrupt if they get cancer (although don't underestimate the power of voluntary charity, either).

Also, you've cited the privatisation of the rail service and claimed that prices increased because of it. That's not exactly true. See post 235.


"consider how much more disposable income people will have when they're paying less tax and can choose where this goes (even if it's for healthcare). About a fifth of the tax you pay goes to the NHS."

You could save them more money by having lower housing costs



Posted from TSR Mobile
Reply 239
Ye, and did you know 80%+ of that tax amount is a transfer from men to women. And the men get nothing in return.

So basically the feminist state has become the woman's husband at the expense of the man who has been turned into a slave.

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