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B883 - Private Healthcare (Regulation) Bill 2015 watch

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    (Original post by TheDefiniteArticle)
    As the author of this Bill, please quote me with any questions and I'll answer when I get home from work tomorrow.
    Give us a single reason this is a good idea?
    I vote: NAY
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    We should think about over the counter medicines being exempt, and what to do with dental care and holistic/alternative medicine. I don't think the Bill's authors mean to include them but it probably does.
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    Nay. Why should the government be meddling in interactions between private firms and private individuals?

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    One of the biggest noes I have given, this bill is the politics of envy, it is the same as the abolition of private schools bill but with healthcare. There are logical flaws in the bill which make the bill disastrous. If prices are going to be capped at 50% of market rate there will be a reduction in services as providing the excellent quality of care that outdoes the public sector will be loss-making. It is illogical to assume the cost of providing care in the private sector is the same as the cost of providing care in the public sector when the private sector pays its professionals more, has hospitals with more space per patient, has a higher ratio of staff to patients, uses the latests equipment and drugs, and is not committed to a quick turnover of patients to make beds free again.

    When the private companies are losing money on their products the products will not be provided, and when there is no profit the reinvestment to boost the quality of products will not take place; the whole system of private healthcare will decline to meet the mediocrity of the failing NHS. I reject the figures for the elasticity of private healthcare when the figure is taken from a report examining the military healthcare system in the USA; the figure is not applicable to Britain. According to Hall and Jones 2007 pp.22 the elasticity of private healthcare in Britain is above 1, making the bill a destructive step against a world-leading industry in Britain.
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    (Original post by cranbrook_aspie)
    Aye, fantastic idea.
    Can you just walk me through why your against not for profit healthcare provision provided by somebody that is not the NHS.
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    (Original post by Krollo)
    Nay. Why should the government be meddling in interactions between private firms and private individuals?

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    Going to start by addressing this - it's because libertarianism is complete *******s. There is no natural right to freedom, and thus the mandate of the state is limitless as long as it achieves a net increase in welfare.

    I would direct those asking for the reasons behind this to the notes.
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    (Original post by Rakas21)
    Can you just walk me through why your against not for profit healthcare provision provided by somebody that is not the NHS.
    This is a valid concern. Could you support a ban on the making of profit on healthcare (apart from R&D, which I will accept needs incentives given the levels of variance in areas such as pharmaceutical development)? I think that would be logistically tougher to implement, given demand will vary year on year and any company has fixed costs - but it's something I would be open to changing this Bill to.
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    (Original post by Nigel Farage MEP)
    One of the biggest noes I have given, this bill is the politics of envy, it is the same as the abolition of private schools bill but with healthcare. There are logical flaws in the bill which make the bill disastrous. If prices are going to be capped at 50% of market rate there will be a reduction in services as providing the excellent quality of care that outdoes the public sector will be loss-making. It is illogical to assume the cost of providing care in the private sector is the same as the cost of providing care in the public sector when the private sector pays its professionals more, has hospitals with more space per patient, has a higher ratio of staff to patients, uses the latests equipment and drugs, and is not committed to a quick turnover of patients to make beds free again.
    We also can't assume costs stay the same - the public sector costs are the relevant ones, since they demonstrate very clearly that the private sector is wasteful in healthcare provision.

    When the private companies are losing money on their products the products will not be provided, and when there is no profit the reinvestment to boost the quality of products will not take place; the whole system of private healthcare will decline to meet the mediocrity of the failing NHS. I reject the figures for the elasticity of private healthcare when the figure is taken from a report examining the military healthcare system in the USA; the figure is not applicable to Britain. According to Hall and Jones 2007 pp.22 the elasticity of private healthcare in Britain is above 1, making the bill a destructive step against a world-leading industry in Britain.
    First, given the above, there is no evidence that the private companies would lose money. My source regarding elasticity is more valid, since a) yours refers to income elasticity, which is not the same thing as price elasticity, which is the relevant piece of data; b) mine isn't limited to the military, as you suggest - it uses general data (i.e. not military specific) to reach conclusions about the military; c) price elasticity should be consistent across countries for essential goods like healthcare; d) my source aggregates numerous other sources.
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    (Original post by TheDefiniteArticle)
    This is a valid concern. Could you support a ban on the making of profit on healthcare (apart from R&D, which I will accept needs incentives given the levels of variance in areas such as pharmaceutical development)? I think that would be logistically tougher to implement, given demand will vary year on year and any company has fixed costs - but it's something I would be open to changing this Bill to.
    I'm afraid not. While I have no issue with not for profit firms I also have no issue with profit makers either, competition is what I desire whatever form of ownership that comes with. Such a measure would still be an assault on the market.

    (Original post by TheDefiniteArticle)
    Going to start by addressing this - it's because libertarianism is complete *******s. There is no natural right to freedom, and thus the mandate of the state is limitless as long as it achieves a net increase in welfare.

    I would direct those asking for the reasons behind this to the notes.
    I applaud you.

    While I may deplore your end goals, this statement indicates that you may be a rare breed in the modern left.. Somebody with resolve.

    If only you could apply that attitude to influencing foreign policy given the penchant for pacifism and general wetness from todays young.
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    Nay
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    (Original post by TheDefiniteArticle)
    We also can't assume costs stay the same - the public sector costs are the relevant ones, since they demonstrate very clearly that the private sector is wasteful in healthcare provision.

    First, given the above, there is no evidence that the private companies would lose money. My source regarding elasticity is more valid, since a) yours refers to income elasticity, which is not the same thing as price elasticity, which is the relevant piece of data; b) mine isn't limited to the military, as you suggest - it uses general data (i.e. not military specific) to reach conclusions about the military; c) price elasticity should be consistent across countries for essential goods like healthcare; d) my source aggregates numerous other sources.

    You cannot safely say the private sector is wasteful in healthcare provision, I believe the private sector is more efficient but spends more on each patient because the quality of the service provided is a lot higher. To give an example of my grandfather, he was having urinary problems which ended up with him visiting the GP, the GP did the initial prostate checks to discover an inflamed prostate indicating prostate cancer. After a referral to an NHS hospital he spent four hours sitting on a bed in a ward waiting for one round of tests with the other round of tests set to take place in three weeks. With cancer where every hour matters he made the decision to go private; he had an appointment the same day, he had all tests conducted in 12 hours, stayed overnight in a private room I would liken to a decent hotel room, was released the next morning, and received all of the test results back before seven days. The cancer was in its early stages which allowed doctors to conduct an operation to remove the prostate gland, the operation was a success, resulting in the cancer treatment being over within 10 days of the initial contact with the private health company; that is why the private sector costs more.

    Another case is childbirth, giving birth in an NHS hospital on a bed behind a curtain in a maternity ward with twelve other expectant mothers is not decent healthcare. Spending time in a private room with an en-suit, a bed for the father to stay alongside, televisions, and very nice food is luxury healthcare. Having a doctor visit every four hours when doing rounds but only having access to a nurse in between is not good healthcare, having access to a doctor at any time of the day is good healthcare. The private sector will always offer a higher standard of care when some hospitals have 1.9 patients for every doctor compared to the NHS which has an average of 369 patients for every doctor.

    I accept the NHS provides its healthcare on a small budget per patient but I would remind you the NHS does not provide good healthcare, believing the NHS provides a good standard of care is delusional, it does not, the NHS provides mediocre care, outclassed by the private sector. I suggest the answer to Britain's healthcare is to pay people money to take out insurance packages that allow them to attend private hospitals, the NHS is only good for small, non-life threatening injuries like broken arms and sprained wrists.

    According to the bill the price charged for treatment is going to be near 50% of current market value but demand for the treatment is not going to increase much due to the inelastic nature; it is simple maths to know the private companies will see a decrease in their total revenues, and the not-for-profit companies will have to counter this by reducing the level of care they give. The biggest error in the bill is the nature of the price controls, pegging prices at 50% of market value will cause problems; the bill will cause a mixture of service cuts and price increases to cover the lost revenue, but the price charged will have to be 50% of the new prices the bill causes; there will never be a stable price.

    I have a very big problem with your costings, in 2014 the private healthcare market was actually worth £40bn in total when all types of healthcare are counted, as the bill does not specify acute medical care only which is £6.71bn the total figure must be used, meaning your whole costings are wrong. But without this mistake your costings do not take into consideration the lack of medical investment which will come when total revenues for private companies are reduced, the job losses as private companies look to make savings, the fall in spending power of the staff who have lost their jobs have, and the job-seekers benefits the staff who have lost their jobs will receive.
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    (Original post by Nigel Farage MEP)
    You cannot safely say the private sector is wasteful in healthcare provision, I believe the private sector is more efficient but spends more on each patient because the quality of the service provided is a lot higher. To give an example of my grandfather, he was having urinary problems which ended up with him visiting the GP, the GP did the initial prostate checks to discover an inflamed prostate indicating prostate cancer. After a referral to an NHS hospital he spent four hours sitting on a bed in a ward waiting for one round of tests with the other round of tests set to take place in three weeks. With cancer where every hour matters he made the decision to go private; he had an appointment the same day, he had all tests conducted in 12 hours, stayed overnight in a private room I would liken to a decent hotel room, was released the next morning, and received all of the test results back before seven days. The cancer was in its early stages which allowed doctors to conduct an operation to remove the prostate gland, the operation was a success, resulting in the cancer treatment being over within 10 days of the initial contact with the private health company; that is why the private sector costs more.

    Another case is childbirth, giving birth in an NHS hospital on a bed behind a curtain in a maternity ward with twelve other expectant mothers is not decent healthcare. Spending time in a private room with an en-suit, a bed for the father to stay alongside, televisions, and very nice food is luxury healthcare. Having a doctor visit every four hours when doing rounds but only having access to a nurse in between is not good healthcare, having access to a doctor at any time of the day is good healthcare. The private sector will always offer a higher standard of care when some hospitals have 1.9 patients for every doctor compared to the NHS which has an average of 369 patients for every doctor.

    I accept the NHS provides its healthcare on a small budget per patient but I would remind you the NHS does not provide good healthcare, believing the NHS provides a good standard of care is delusional, it does not, the NHS provides mediocre care, outclassed by the private sector. I suggest the answer to Britain's healthcare is to pay people money to take out insurance packages that allow them to attend private hospitals, the NHS is only good for small, non-life threatening injuries like broken arms and sprained wrists.

    According to the bill the price charged for treatment is going to be near 50% of current market value but demand for the treatment is not going to increase much due to the inelastic nature; it is simple maths to know the private companies will see a decrease in their total revenues, and the not-for-profit companies will have to counter this by reducing the level of care they give. The biggest error in the bill is the nature of the price controls, pegging prices at 50% of market value will cause problems; the bill will cause a mixture of service cuts and price increases to cover the lost revenue, but the price charged will have to be 50% of the new prices the bill causes; there will never be a stable price.

    I have a very big problem with your costings, in 2014 the private healthcare market was actually worth £40bn in total when all types of healthcare are counted, as the bill does not specify acute medical care only which is £6.71bn the total figure must be used, meaning your whole costings are wrong. But without this mistake your costings do not take into consideration the lack of medical investment which will come when total revenues for private companies are reduced, the job losses as private companies look to make savings, the fall in spending power of the staff who have lost their jobs have, and the job-seekers benefits the staff who have lost their jobs will receive.
    This is also a good example though of why often cutting funding from the public sector hurts in the long run. Imagine your grandfather couldn't afford private healthcare. The state would've spent a small fortune on chemotherapy once the situation was acute rather than dealing this it quickly enough for cheaper and more efficient early intervention to be effective.
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    (Original post by Saoirse:3)
    This is also a good example though of why often cutting funding from the public sector hurts in the long run. Imagine your grandfather couldn't afford private healthcare. The state would've spent a small fortune on chemotherapy once the situation was acute rather than dealing this it quickly enough for cheaper and more efficient early intervention to be effective.
    Do you have any idea how much it would cost to bring the NHS on par with private?

    I can't find what percentage of healthcare is private by use, but if we assume it to be similar to education, so almost 10pc, to scale it's cost up to 100pc would have taxes newel doubling. There is no way that the public sector can feasibily compete.

    I guess on top of that we need to add in the costs for improving GP surgeries too.

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    Nay, I don't agree with this whole ideology that the private sector should be punished for the failings of the public sector. The profit margins that those private healthcare professionals earn may be their only source of income (Small private practice). Depending on their personal overhead, may actually hurt them more than intended.
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    (Original post by McRite)
    Nay, I don't agree with this whole ideology that the private sector should be punished for the failings of the public sector. The profit margins that those private healthcare professionals earn may be their only source of income (Small private practice). Depending on their personal overhead, may actually hurt them more than intended.
    I was talking to someone 5 weeks ago who would be better off still working for the NHS, the sort of person this bill would harm

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    (Original post by Jammy Duel)
    Do you have any idea how much it would cost to bring the NHS on par with private?

    I can't find what percentage of healthcare is private by use, but if we assume it to be similar to education, so almost 10pc, to scale it's cost up to 100pc would have taxes newel doubling. There is no way that the public sector can feasibily compete.

    I guess on top of that we need to add in the costs for improving GP surgeries too.

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    Not up to the same standard of course - we can't have individual rooms, cable TV, hotel standard food, etc etc. But there's much more of a case for early intervention and preventative strategies even if there's an initial cost to it.
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    Much as I'm sad to do it, I'll drop the price caps for a second reading, and just leave the VAT exemption removal.
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    (Original post by TheDefiniteArticle)
    As the author of this Bill, please quote me with any questions and I'll answer when I get home from work tomorrow.

    The biggest problem with this is the assumptions being made. The bill is assuming that the private sector benefit from the same economies of scale as the NHS. The other assumption is that care is of equal quality (which the bill notes themselves contradict)/ Neither assumption is correct; the care is better in the private sector and thus doctors/surgeons better paid, and the private sector doesn't benefit from economies of scale.
    Policy explanation:
    Spoiler:
    Show
    The existence of a market for private healthcare suggests two things: 1) private healthcare is assessed as better than public healthcare (this is probably accurate - waiting times are shorter at the very least); 2) this allocates better health based on wealth.

    While allocating health based on wealth may not be a market failure in the sense of maximising GDP, in terms of utility it necessarily is, unless one makes the incredibly questionable assumption that the lives of the wealthy are more important than the lives of the poor.

    This Bill aims to redress the balance by treating private healthcare as a luxury and taxing it accordingly, and reducing the economic incentives for healthcare providers to operate privately, hopefully retaining more and better-skilled professionals within the public sector.
    You've done a lot to not have this just be another socialist bill that wrecks a good thing, but at the same time the current system we have works well so I'd not be inclined to change it. I can't see this bringing any significant benefit with it?
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    (Original post by Indievertigo)
    The biggest problem with this is the assumptions being made. The bill is assuming that the private sector benefit from the same economies of scale as the NHS. The other assumption is that care is of equal quality (which the bill notes themselves contradict)/ Neither assumption is correct; the care is better in the private sector and thus doctors/surgeons better paid, and the private sector doesn't benefit from economies of scale.
    Policy explanation:
    Spoiler:
    Show
    The existence of a market for private healthcare suggests two things: 1) private healthcare is assessed as better than public healthcare (this is probably accurate - waiting times are shorter at the very least); 2) this allocates better health based on wealth.

    While allocating health based on wealth may not be a market failure in the sense of maximising GDP, in terms of utility it necessarily is, unless one makes the incredibly questionable assumption that the lives of the wealthy are more important than the lives of the poor.

    This Bill aims to redress the balance by treating private healthcare as a luxury and taxing it accordingly, and reducing the economic incentives for healthcare providers to operate privately, hopefully retaining more and better-skilled professionals within the public sector.
    You've done a lot to not have this just be another socialist bill that wrecks a good thing, but at the same time the current system we have works well so I'd not be inclined to change it. I can't see this bringing any significant benefit with it?
    The current system we have has significant problems, in that money plays a significant role in the health-related quality of healthcare. Frankly, I don't give a **** if people are happy to pay lots of money to avoid hospital food, to get goose feather pillows or even to avoid having to encounter poor people - what strikes me as abhorrent is that money can improve the speed of treatment as well as potentially the range of options available.

    FWIW, on reflection, I do think that it's likely that this Bill is flawed, in that it likely doesn't generate enough revenue to pay for the likely increase in demand for public healthcare (and unfortunately I doubt it's legitimate for me to attempt to levy an income tax or suchlike in a healthcare Bill). Apart from that, I think the policy's fine. The benefit this brings is increasing incentives for the best medical professionals to remain in the public sector, thus increasing the standard of healthcare for society as a whole, rather than have them wasting time providing bells and whistles for those who are happy to pay an arm and a leg. It therefore also addresses to some extent the lack of supply in the public sector for certain health services (for instance, there are waaaaay too few public sector dentists at the moment).

    I do have some ideas which are somewhat less extreme which I'll bring back for the second reading.
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    No, this is a horrible idea. Private healthcare providers shouldn't be capped and allowed to charge what they want. The government shouldn't regulate private healthcare at all and let the competitive free market set the costs. Socialism in healthcare is horrible we need less government not more, the NHS is inefficient and underfunded as it is. Having a healthcare monopoly and government beauracracy isn't going to improve healthcare. We need to encourage privatisation as much as possible.
 
 
 
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