Anonymous C joined in and replied with this 1 year ago, 7 minutes later, 26 minutes after the original post[^][v]#1,307,357
If the British public liked the NHS it would not need to be a monopoly.
Medicaid/Medicare in the US provide publicly-funded insurance that you can redeem at competing medical providers. If Britain switched to a similar system and privatized the NHS then people could continue to use them if they chose to. They wouldn't, which is why it must be forced.
Anonymous A (OP) replied with this 1 year ago, 49 seconds later, 35 minutes after the original post[^][v]#1,307,362
@previous (C)
No they don't. I've applied for it in harder times, and not gotten it. The NHS applies to EVERY citizen no matter what. No one ever has to just choose to die or lose their entire life savings like in the US.
Anonymous C replied with this 1 year ago, 6 minutes later, 1 hour after the original post[^][v]#1,307,373
@previous (A)
They have to pay taxes to the NHS even if they want another option. They can't take the tax money they've already paid and choose their provider.
If you are forced to pay for a dysfunctional monopoly no matter what, it doesn't matter if you are "free" to pay for private too. People will take the worse option because it's already been paid for. Better competition can't win because they will lose even if they provide better results for the same cost.
The US system allows the best provider to win, and they are never entitled to the money, patients can choose to move that money to a different provider if the situation changes.
Anonymous A (OP) replied with this 1 year ago, 15 minutes later, 1 hour after the original post[^][v]#1,307,374
@previous (C)
Dude, poor people in the US have no hope for healthcare. Many do not qualify for Medicare, and it's hard to get. Also, the working poor can't get on Medicare and cannot afford insurance. They literally have to just die. There is no defense of such a barbaric system.
Anonymous C replied with this 1 year ago, 8 minutes later, 1 hour after the original post[^][v]#1,307,381
@1,307,374 (A)
You are having a lot of trouble following this conversation, I already said I was for universal coverage.
Everyone should have healthcare. That doesn't mean everyone should be forced into a monopoly. You can have universal healthcare AND let people choose their provider.
The NHS is not imposed on the British People against their will, but is rather considered an integral part of the national fabric.
Any politician seriously proposing an abolition of the NHS will never see an office of state; any politician who is elected and suddenly tries to do it will face unbearable pressure to stop.
Father Dave !RsSxeehGwc double-posted this 1 year ago, 3 minutes later, 4 hours after the original post[^][v]#1,307,395
Legit lol'd, almost the first thing Sunak did in his "resignation" speech (you were sacked you muppet) was bring up Ukraine. Not the NHS, not schools, not infrastructure, not the economy...Ukraine.
That isn't what I'm saying. In fact, people use BUPA or other private medical companies now.
The money spent on NI (which goes toward funds for the NHS) would not go very far in buying something similar in a Britain without the NHS. If you earn over £967 a week you pay 2% NI, or £18 a week; a far superior price than private companies can offer. This is accomplished by the large market that the NHS has - it can negotiate bulk discounts. Without NHS, healthcare in Britain would be fragmented and prices would rise for the individual. It would also mean that the poorest would have to deal without healthcare, or that a state healthcare solution for the poorest would be more expensive to run per person than the NHS is.
When I say undermining the NHS, I mean the suggestion that it should be dismantled or scaled away, that services should be taken off of people, that it isn't something to be proud of. The majority of Britishers consider the NHS to be a crown jewel achievement, and would react poorly to any suggestion otherwise. A minister saying what you're saying would lose his job.
Anonymous H joined in and replied with this 1 year ago, 8 minutes later, 9 hours after the original post[^][v]#1,307,420
@1,307,374 (A)
Poor people in the US can sell half of their food stamps to the local organized crime gangs for a couple months and buy a bus ticket to a more suitable US state where they qualify for more government benefits, including healthcare. Let me guess, you were living in poverty a stone's throw away from a welfare paradise? Sometime you gotta get creative.
Anonymous C replied with this 1 year ago, 1 hour later, 11 hours after the original post[^][v]#1,307,454
@1,307,398 (E)
If the NHS is getting such a good deal, then people would voluntarily stick with it wouldn't they? If it's so good they would continue to voluntarily pick it, why is it necessary to force everyone to use this provider?
You are also not considering that if those competitors had the opportunity to compete on even grounds they would be able to grow and get bulk discounts and economies of scale too.
Anonymous C replied with this 1 year ago, 45 minutes later, 2 days after the original post[^][v]#1,307,741
@previous (dw !p9hU6ckyqw)
No, they are forced to pay for the NHS whether that's what they want or not.
It's no real choice to say they can pay a second time. A more cost effective and better service will be passed over because the competition has already been paid for. No provider can compete in that environment.
The decision was already made, the best cannot win unless patients are free to take that money to their own choice. That's how medicaid/Medicare works.
There's no real competition if you have to pay for one no matter what, and the other is an optional extra expense that must be paid fully a second time.
If one hospital charges £500 for an operation, with a 10% complication rate and another charges £450 for the same operation with a 7% complication rate the latter is a better option. Patients would choose the second hospital. Save £50 and lower your complication risk by 3%, that's an easy choice.
Force someone to pay for the first, but give them the option to still pay fully out of pocket for the second and the whole equation changes. Why pay £450 for that 3% reduction unless you are wealthy? In the revised situation, most patients would "choose" to use the more expensive and more risky hospital.
A system where the less effective, and more expensive option wins out is a flawed system.
The Medicaid/Medicare system gives publicly funded coverage and let's the patients choose option 1 or 2, and the end result is the more effective systems receiving funding while the less effective systems go out of business.
Would you consider it real competition if this were anything other than healthcare? Should food stamps only cover one monopoly? Hungry people could still choose to pay for any other grocer, but must pay for that out-of-pocket. No one would thinks that's a good idea, it's only healthcare where so many people find the idea of a monopoly appealing and there's no justification for it.
Anonymous C double-posted this 1 year ago, 1 minute later, 2 days after the original post[^][v]#1,307,749
@1,307,746 (E)
You have no reading comprehension. I've said multiple times I'm not defending a system where people have no coverage, and I'm for publicly funded healthcare.
Take a deep breath, and reread the thread if you care. We are actually discussing something else, it's not hard.
Anonymous C triple-posted this 1 year ago, 2 minutes later, 2 days after the original post[^][v]#1,307,750
@1,307,743 (dw !p9hU6ckyqw)
How would that work? There are no countries that I'm aware of that have competing fire departments.
Rome had private firefighters IIRC, but they didn't have a publicly funded system where you could use money from the government to pay them. So the analogy doesn't work since I'm defending universal medicare.
You are arguing for private healthcare and a medicaid-style safety net solution, which is what is implemented in the USA and leads to people going bankrupt for getting cancer. Nobody wants that here. Nobody wants to get rid of the NHS. What don't you understand?
dw !p9hU6ckyqw replied with this 1 year ago, 13 minutes later, 2 days after the original post[^][v]#1,307,757
@1,307,748 (C)
Why are you talking about medicare this topic is about the NHS. Private companies are succesfully competiting with it while not creating healthcare debts for the working class
> Why are you talking about medicare this topic is about the NHS.
Both are medical systems, and I gave an example of a better system.
> Private companies are succesfully competiting with it while not creating healthcare debts for the working class
Those competitors will always be at a disadvantage. A better provider won't be able to grow and replace the NHS with a more innovative system even if they are better and able to show it because only the wealthy can afford to pay a second time.
Anonymous E double-posted this 1 year ago, 1 minute later, 2 days after the original post[^][v]#1,307,764
If you take a look at your link, you will notice that the lowest satisfaction is with dentistry - which was opened to private competing clinics doing NHS work just as you describe. It doesn't work.
I gave an example, a more cost-effective solution with better results will be chosen under medicare while the NHS system will reward the monopoly regardless of performance.
@previous (dw !p9hU6ckyqw)
It would not, the NHS style just conceals the costs of the first.
@1,307,763 (E)
That sounds like an excuse. If that were really the problem then why hasn't the public just voted to fix the funding? Obviously the government doesn't actually set policy based on public opinion if that isn't happening. If they aren't reflecting public opinion, then that's another sign of why people are forced to pay into a monopoly even when they are unsatisfied.
If the NHS were really so good approval wouldn't be less than 1/4, and they would let people take that funding to a competitor.
That's the crux of it: what's the harm in letting people take the same funding to another system if you're so sure the public likes the NHS? It's a non-issue if everyone would stay with the NHS.
> I gave an example, a more cost-effective solution with better results will be chosen under medicare while the NHS system will reward the monopoly regardless of performance.
Anonymous C replied with this 1 year ago, 7 minutes later, 2 days after the original post[^][v]#1,307,901
@previous (dw !p9hU6ckyqw)
It has, people with Medicare get better service than people with NHS.
If you do have Medicare and you end up at a provider with a 23% satisfaction rate you are free to move to another hospital instead. That puts pressure on hospitals to improve service, innovate, and take feedback seriously.
The NHS has no reason to do the same. They get paid even when less than 1 in 4 approve, even if someone switches to another provider.
> If that were really the problem then why hasn't the public just voted to fix the funding?
You may have noticed the recent drubbing that the previous government was given.
The people are dissatisfied with the current performance of the NHS which was caused by budget cuts and austerity measures over the last decade and a half. They are not dissatisfied with the notion of the NHS, or how it works. You seem to think that it means people would be pleased to see the NHS ho away, when it means the opposite.
People do have choices, but the NHS works by having a large single market and privatising and "selling off" the NHS will mean things are more expensive. And there's no political appetite whatsoever to do such a thing, because they know what the reactions would be.
We've been over this several times, and I still haven't heard one refutation of what I've said.
How is it a real choice is a more cost-effective, and better performing system is an irrational choice to make? I'd choose the NHS too if I had to pay for them regardless, and the better system had to be paid 100% out of pocket.
That isn't real competition, that's a rigged game where the better option can never win.
If you disagree, why do you ignore this every time I say it, instead of showing me where the reasoning is flawed here?
> but the NHS works by having a large single market and privatising and "selling off" the NHS will mean things are more expensive.
Notice that you put selling off in quotes, and yet that isn't a quote. I never said they should sell anything, you're making up a strawman because your incapable of responding to the things I actually said.
> And there's no political appetite whatsoever to do such a thing, because they know what the reactions would be.
People would not be outraged if you gave them the option, because anyone that was committed to the NHS would be able to carry on as usual. Why would they care if everything was the same for them?
Anonymous A (OP) replied with this 1 year ago, 1 minute later, 2 days after the original post[^][v]#1,307,929
@previous (C)
Here's why. Private insurance companies have only one goal: profit. That is placed above the actually good of the patient. That is why, in the US, medical claims are constantly denied and people lose their life savings and go homeless because of minor medical procedures. The government is, in theory, beholden to the people and is not in it for profiting shareholders. There is more of a motivation to actually provide healthcare. That's why "choice" is pointless if you just get denied anyway.
> Here's why. Private insurance companies have only one goal: profit.
Your reading comprehension is abysmal.
From the start, and every post I've made in this thread has been defending public health insurance. As in tax-funded, and given for free to citizens.
I've said that explicitly, and you should just know regardless that Medicare is not a private insurance company. If you are this retarded, I can't engage with you.
I ignore it because it makes no sense, you are not getting a replacement service for the NHS from a private company for the same price. It would be (and is) far more expensive.
I am telling you as someone who lives here, it would be career suicide for a politician to suggest privatising the NHS.
> I ignore it because it makes no sense, you are not getting a replacement service for the NHS from a private company for the same price. It would be (and is) far more expensive.
Why do you think that is? One is subsidized and not subject to normal business pressures. It's competitors must convince people to pay a second time, and that means being better isn't enough.
In a system like Medicare they can develop different systems and patients can choose the one that is better.
> I am telling you as someone who lives here, it would be career suicide for a politician to suggest privatising the NHS.
That may be true, but that doesn't make it right. The people you are talking about have never had choice in medicine. Even the rich can't really see competition, because even though they can afford to pay twice they are using systems that could never take advantage of scale in a rigged system.
It looks like the NHS is better because they have the government's finger on the scale. Put every organization on equal footing and eventually one of the others would make something better.
In the US we would never change because it would be an immediate noticeable downgrade. One company, that doesn't have to convince anyone its good, and everything else is a bad option even if they are more efficient.
Anonymous J joined in and replied with this 1 year ago, 1 hour later, 2 days after the original post[^][v]#1,307,953
British people are disappointed with how the NHS is underfunded and how it's been crippled intentionally. They do love it. They don't love how it's been treated. I hope things change with the Labor government.
Anonymous A (OP) replied with this 1 year ago, 7 minutes later, 3 days after the original post[^][v]#1,308,001
@1,307,993 (C)
What's the obsession with "choice"? Many Americans have no access to healthcare whatsoever, or if they do, one simple hospital stay literally bankrupts them and makes them homeless. Who the fuck cares about "choice"?
Because for the previous 14 years it has had effective and real-term cuts and is currently operating on a shoe string budget. You want to do to the wider NHS what happened to dentistry, which has been disastrous for many people who are now unable to access a dentist.
> why you think you can't pick healthcare providers under the nhs
I never said that. Again, you have very poor reading comprehension.
What I actually said was that it doesn't matter if those alternatives are better, they'll still never be able to compete on a fair playing field because the NHS gets paid whether people choose that or not. You have to pay a second time for the others.
@previous (E)
I never said they should cut benefits, only that healthcare benefits should give patients a choice.
The dentistry crisis was not because they cut benefits, instead what happened was that dentist surgeries prioritise private patients which deliver them much more money than NHS patients do. Now there aren't enough NHS spaces. This is what comes of turning the healthcare service into a for-profit corporation.
That is a stock American joke from movies, not a reflection of reality. Cultural attitudes to teeth are different in the UK and USA, with Americans wanting flashy "Kennedy" smiles and British wanting cleaning, some straightening but a generally "natural" look.
Recent changes to dentistry as I've explained above has caused tooth issues to rocket, but before these recent changes the UK was better than the USA in terms of tooth decay levels starting in the 90s.
> That is a stock American joke from movies, not a reflection of reality.
Art imitates life.
> Cultural attitudes to teeth are different in the UK and USA, with Americans wanting flashy "Kennedy" smiles and British wanting cleaning, some straightening but a generally "natural" look.
Are long wait times a reflection of the British affinity for queuing?