Why haven't other countries copied the NHS? Watch

MatureStudent36
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#61
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#61
(Original post by Bornblue)
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.
Nobody has ever said that the NHS doesn't do good, unless your on the receiving end of negligence.

Blair threw money at the NHS, created a lot of Non value added managerial posts and in quite a few cases reduced waiting times by employing nurses to see patients in a given time to tick a box saying that they've been seen, not treated.

Nobody has ever advocated scrapping the NHS and removing universal health care. The argument has always been about delivering improved services in the most cost effective manner. If the NHS can provide those services, great. If they can't then let somebody else do it.

With health, the providers are able to manipulate the story line to resist change. There's numerous cases whereby people have tried to say that services will drop if cuts or changes are made. These horror stories very rarely materialise. When the highways agency took over patrolling of the motorways from the police the end was nigh. The end result was an improved service. The same. Goes for railways, telecommunications, steel production, car manufacturing etc etc etc.

If a probate commonly can offer a better service than the public sector, why should the tax payer not get value for money.
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username878267
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(Original post by Hydeman)
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.
I haven't accused him of such. I have accused him of only focusing on the negatives though and making out it is some sort of awful system, when it clearly isn't.
Sure it's not perfect, but to make out it's awful, when it provides us all with healthcare is silly really.
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heimdala
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(Original post by Bornblue)
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?
"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.
(Original post by Bornblue)
Neither is perfect, but seeing them as 'equally bad' is absurd.
"Neither are particularly good, for different reasons."" Not the same as equally bad.
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nulli tertius
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(Original post by Bornblue)


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.
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Mpagtches
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#65
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Coz they haven't made 3D printers that large yet :sadnod:
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username878267
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(Original post by nulli tertius)
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.
Will such a system remain free at the point of use?
So far you've not mentioned one positive about the system...
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username878267
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(Original post by heimdala)
"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.
😂😂😂
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.
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nulli tertius
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#68
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(Original post by Bornblue)
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.
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username878267
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(Original post by nulli tertius)
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.
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.
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heimdala
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#70
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(Original post by Bornblue)
Advancements in research are not connected to the standard of healthcare given to the public.
No doubt. However it is connected to the enormous healthcare sector, largely dependent on the free market.
(Original post by Bornblue)
Any system which involves 40 million not getting healthcare is an awful one. It's only high quality if you can afford it.
True, but they do have Obamacare nowadays. However the system does still have faults.
(Original post by Bornblue)
The NHS is high quality for everyone.
Rubbish, its low quality at a high price. However it performs equally poor for all, which is an achievement, i guess.
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nulli tertius
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(Original post by Bornblue)
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.
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

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.
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)?
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username878267
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(Original post by heimdala)
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.
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:
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username878267
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(Original post by nulli tertius)
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)?
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?
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nulli tertius
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(Original post by Bornblue)
Low quality?
The doctors and nurses work exceptionally long hours and work tirelessly.
That is one of the defects of the system not one of its good points!
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nulli tertius
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(Original post by Bornblue)
Yet we are rated regularly as higher than most if not all.
Charges discourage people, that's logic.
You wouldn't like to share a rating that isn't by a left leaning pressure group would you?

Tell that to all the people on TSR paying £9000 a year for their education

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?
I don't trust the BMA as far as I could throw it. They run rings round government.

Alan Milburn thought he had a good deal for the taxpayer in 2003 with GP's contracts

http://www.theguardian.com/society/2...ssuesexplained

What he ended up giving was 30% pay rises with no out of hours obligation

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1693599/

I should add by way of context the average earnings of a solicitor in private practice in 2014 was £51,500

I will believe the pay cut when I see it.
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heimdala
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(Original post by Bornblue)
Low quality?
Yes, would be much higher with more competition.
(Original post by Bornblue)
The doctors and nurses work exceptionally long hours and work tirelessly.
Never said otherwise.
(Original post by Bornblue)
The standard of patient care is phenomenal
Questionable.
(Original post by Bornblue)
and all you can do is criticise?
The structure of the NHS? Absolutely.
(Original post by Bornblue)
Millions are treated each year, thousands of cancer treatments and others.
The fact that the NHS is successful in its most basic function of delivering treatment to its customers is not really something to brag about. Nor is it relevant to the discussion, as we are discussing quality and cost, not basic functions.
(Original post by Bornblue)
private healthcare means only the rich can afford it
Luckily im not recommending a completely privately run healthcare system, but a mixed between free market and state ownership.
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troubadour.
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(Original post by Bornblue)
Yet we are rated regularly as higher than most if not all.
Charges discourage people, that's logic.
Is this honestly your response to evidence suggesting the contrary? You cannot seriously be suggesting that your hunch about people's behaviour should be prioritised over actual evidence.
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Smack
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The NHS seems to be in a perpetual state of crisis. I can see why other countries would not want to copy a system that is always in crisis, although I am not well enough informed about other country's healthcare systems to accurately assess whether they have or have not adopted an identical system to the NHS, but I suspect quite a few have adopted one quite similar to it, or at least its earlier form.

The biggest problem with the NHS in my opinion is not the system itself, but the fact that quite a large amount of people are too heavily wedded to the idea that the only way to improve the NHS is to pour ever increasing amounts of money into it, and they go into an angry fit when people begin to question the efficiency and efficacy of such a system. With so many people not interested in having rational discussions about ways to improve the NHS, it's little wander that politicians on all sides of the spectrum have to promise to continually up its funding. Thus, I don't think the system will face any improvement until it's in a worse state than it is now.
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MatureStudent36
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(Original post by Bornblue)
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:
And yet private healthcare is mandatory in European countrys excluding the usual caveats.

It's odd that. Reality is competley at odds with what your saying.

It's like saying that tuition fees stop the poorest kids going to university.

http://www.scotsman.com/news/educati...sity-1-3965864
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Jammy Duel
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(Original post by JoshDawg)
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.
So great that it's mediocre at best on the global stage.

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