Protect the NHS, part 2. Reduce avoidable hospital admissions.

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newfhouse

Regressive elitist lefty
Good value? I know people who have been left to die basically and people who have waited absolutely years before they get their routine operations. I personally think there needs to be a massive overhaul through either really upping NI contributions or introducing private health insurances. People think they will get a good service if they become ill but its often not the case. Obviously if people are not in work e.g on benefits, very low waged etc then they should be exempt from paying. It was bad even before the current crisis.
Yes, good value but far from perfect. I agree that funding needs to be increased as treatments and requirements are a moving target. I don’t know what private insurance would add apart from yet another way of extracting money into tax havens. What’s your plan?
 

Drago

Flouncing Nobber
Location
Poshshire
I place the blame squarely on the shoulders of those* who suggest/have suggested and had implemented "cost saving" schemes before moving off elsewhere. But they seldom get to be seen. When one did make an appearance whilst I was in, they got some very simple questions put to them in front of the press. They didn't answer, nor did they stay long on the ward. They'd to pass me going back out.

*They leave medical staff with more work to do, but less to do it with(time and equipment wise).

Edited to add
The problem with private medical insurance is they decide what conditions will be covered, not you. If it's not covered, where do you go?

I've yet to see a private A&E department. Judging on the number waiting to be seen on Thursday this week, it must be an untapped goldmine. That or it's left well alone by the private sector for some other reason(s).
It was like that in the police. Civilian managers whod never walked a beat in their life coming up with these wonderful efficiency ideas that invariably meant more work - usually form filling on a computer - for the frontline staff to do.
 

BurningLegs

Über Member
Fact check: This contains assertions that are not based on reality and reflects useless journalism/clickbait.
" Public Health England (PHE) released its analysis of the NHS’ Test and Trace app between 9 November and 15 November [during Lockdown 2].
The data showed that 128,808 people had tested positive for the virus over that period. Together, they provided 9,789 common settings that they had visited. The most frequent location they went to were supermarkets, followed by secondary schools, primary schools and hospitals.
"Explaining the data, Isabel Oliver, Director of the National Infection Service at PHE, said: “Suggestions that supermarkets are causing COVID-19 to spread are inaccurate. Common exposure data does not prove where people are contracting COVID-19.
“It simply shows where people who have tested positive have been in the days leading up to their test and it is used to help identify possible outbreaks,” she added."
It would be interesting to know what possible outbreaks have been identified from these data, since she says 'it helps'.
Should we be in the slightest surprised that a high percentage of normal people have visited a supermarket in the last week (during Lockdown 2)? Can any causative link be established between the infected person's visit to a supermarket and their source/location of infection? Not a chance. Now a Republican election rally maybe, or perhaps, meeting MPs in a non-socially distanced way.
Proportions of all common locations reported in the data:
Supermarket - 18.3%
Secondary school - 12.7%
Primary school - 10.1%
Hospital - 3.6%
Care home - 2.8%
College - 2.4%
Warehouse - 2.2%
Nursery preschool - 1.8%
Pub or bar - 1.6%
Hospitality - 1.5%
University - 1.4%
It could be useful to assess what % of the general population visited these environments in the week vs those that tested positive.

E.g perhaps 60% of the population visited a supermarket and 18% of people who tested positive reported a visit to a supermarket. That could suggest there isn’t a transmission problem in supermarkets...

If 2% of the population visited a care home and 3.6% of the people who tested positive reported a visit then that could suggest a problem.

I don’t have the numbers so those are just made up, but that’s one way that I can see the data being useful and it is completely at odds with the (flawed) logic in the press article!
 

classic33

Legendary Member
It could be useful to assess what % of the general population visited these environments in the week vs those that tested positive.

E.g perhaps 60% of the population visited a supermarket and 18% of people who tested positive reported a visit to a supermarket. That could suggest there isn’t a transmission problem in supermarkets...

If 2% of the population visited a care home and 3.6% of the people who tested positive reported a visit then that could suggest a problem.

I don’t have the numbers so those are just made up, but that’s one way that I can see the data being useful and it is completely at odds with the (flawed) logic in the press article!
Care homes don't seem to allowing visits by family*. Which would make those testing positive either resident or staff.

*Thread elsewhere contains this that can't be linked to.
 

BurningLegs

Über Member
Yes you’re right, those who reported to test and trace that they’ve visited a care home must have done so as staff, resident, or contractor...
 

SkipdiverJohn

Veteran
Location
London
Whilst I certainly wouldn't hold up the US system as an example (as it's about twice as expensive on percentage of GDP than European models), the British NHS is a complete mess and it really doesn't work very well at all. It's massively bureaucratic, poorly run, and extremely wasteful.
One of the biggest problems is the system gives people no incentive to stay fit and healthy. It's regarded as a free service and as a result is misused by all sorts of timewasters who really need a kick up the arse, not health treatment.
The funding model should be through individually rated public health contributions, not a flat rate on general taxation. The people that don't smoke, don't end up in the casualty dept pissed out of their minds or drugged up on a Friday night, and who maintain a sensible weight, should get a discounted level of contributions. All the idiots who clog up the system due to their behaviour should pay extra. Give everyone an annual health check at the doctors, and set their contribution level for the following year based on how healthy they are. People would soon take the NHS more seriously if the ones who create the burden had to pay twice as much NI contributions than those who take better care of themselves.
 

newfhouse

Regressive elitist lefty
Believe me, I'd save the NHS loads of money.
With 70 million annual checkups? No, I don’t believe you.
 
Believe me, I'd save the NHS loads of money. All the clowns turning up with entirely avoidable and self-inflicted problems would be sent away with a nice big invoice to pay afterwards.
You wouldn't you know, all the people I've known who have required a lot of treatment have been fit non smokers etc. Lifestyle doesn't always come into it. A lot of illnesses are just random or genetic. The people I know who have died young through excessive drinking/drugs etc have not been users of the NHS at all. They wouldn't have even got to an appointment.
 

Julia9054

Guru
Location
Knaresborough
Believe me, I'd save the NHS loads of money. All the clowns turning up with entirely avoidable and self-inflicted problems would be sent away with a nice big invoice to pay afterwards.
Would you call injuring yourself falling off your bike avoidable and self inflicted? After all, you are not forced to cycle.
Or is it just activities of which you don’t approve
What about skin cancer? After all, if I had worn sunscreen more 30 years ago . . .
 
Yes, good value but far from perfect. I agree that funding needs to be increased as treatments and requirements are a moving target. I don’t know what private insurance would add apart from yet another way of extracting money into tax havens. What’s your plan?
How is it good value if you cant even get treatment? People dont pay thousands out for private operations because they really want to.Its because they are left often with no quality of life and in agony.
 

SkipdiverJohn

Veteran
Location
London
Would you call injuring yourself falling off your bike avoidable and self inflicted? After all, you are not forced to cycle.
Or is it just activities of which you don’t approve
What about skin cancer? After all, if I had worn sunscreen more 30 years ago . . .
I think there has to be a reasonable threshold of NHS use. If you fall off your bike and end up in hospital once in a blue moon, I don't see it as a problem. If you are doing the same thing two or three times a year, then I reckon there's a good argument for saying you should pay more into the NHS because you are costing it a lot of money to keep fixing you up. It's no difference to car insurance; people who keep crashing and claiming pay higher premiums than those who don't. People who make very little use of the NHS should get a rebate on their NI contributions, those who lead unhealthy lifestyles or who keep injuring themselves playing sports should pay extra for the workload they create.
 
The funding model should be through individually rated public health contributions, not a flat rate on general taxation. The people that don't smoke, don't end up in the casualty dept pissed out of their minds or drugged up on a Friday night, and who maintain a sensible weight, should get a discounted level of contributions. All the idiots who clog up the system due to their behaviour should pay extra. Give everyone an annual health check at the doctors, and set their contribution level for the following year based on how healthy they are. People would soon take the NHS more seriously if the ones who create the burden had to pay twice as much NI contributions than those who take better care of themselves.
That's one of those things that sounds like a really sensible idea, but is a very dangerous road to go down.

Firstly, it means that you could be paying a lot of money for one mistake all your life. You could argue that's just and fine, but it gets a bit grey after a while, and it's impractical. A depressed person who OD's once and can't work but needs more healthcare is unable to pay higher contributions, but by this argument he would be forced to or would be thrown on the streets.

And where do you draw the line? If someone has heart disease but hasn't exercised to the government minimum standard for at least 10 years, do they have to pay more?

How do you prove how much you've exercised? Perhaps we could chip people.

What about people who "choose" dangerous jobs because that's all that is available? Would they be charged more, bearing in mind that many dangerous Jobs are lower paid? Would the rate go up of someone in a "dangerous job" is injured? It would also disproportionately affect men because most workplace deaths and industrial injuries happen to men. What happens when people on higher tariffs lose their job for other reasons and can't pay the high rate any more?

What about psychological issues. Whose fault is depression? It can be caused by environmental factors, so can schizophrenia. Is a soldier with PTSD partly at fault because he chose to go into the army?

But that's a side issue really.

The real question is how are you going to work all of these scales and yearly tariffs out for the entire population? There are upwards of 64 million people in the UK, so the NHS will have to potentially deal with setting tariffs for a whole catalogue of illnesses and deciding what is considered to be "self inflicted" and what isn't. Then they have to check patients once a year, evaluate each one, decide the "risk factor", set a new tariff, inform the patient, allow a period for appeals, deal with appeals, and then administer payment.

For 64 million people. You'd need a computer the size of Milton Keynes just for NHS England. And you want to reduce the amount of paperwork and admin staff in the NHS?

By the time you've done all that, how much of these new rates will be swallowed up by admin costs?

And the really daft thing is this: it's easy to complain about people being stupid and clogging up the system, but part of the problem in the UK is that the NHS has to pick up the slack because the general social system and long term care for people with mental and psychological problems has been gutted for ten years under "austerity".

Because the underlying system isn't there, then people end up in the streets instead of being in long term care, and they end up breaking things and hurting people and self medicating on drugs and you end up with the police and emergency services more stretched, so you've ended up with a worse system which is more expensive.

This is before you think about the danger of other genetic illnesses being considered as insurance risk factors. Some racial groups are more prone to certain illnesses than others. If parents have a baby with Trisomy 21 when they "could have" had an abortion should they then pay more for the healthcare that baby will need? That is the start of a very dark road of testing parents for genetic "defects" and setting healthcare accordingly. It's been tried before: don't try it again.

Also, how much is the extra for people who refuse to wear a corona mask?
 
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newfhouse

Regressive elitist lefty
How is it good value if you cant even get treatment? People dont pay thousands out for private operations because they really want to.Its because they are left often with no quality of life and in agony.
I have already agreed that there are problems, but your point was about value for money. Is there a free-at-delivery public health service in a comparable country that provides more for less? Who should we emulate?
 
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