I stated 85 – 100% medical costs provided, means-tested for low earners / welfare recipients(the poor people you’re talking about).

You have failed to grasp that I can’t go into the finer detail firstly without knowing the finer detail – this is a general synopsis of what the system could be or probably what it is likely to be in the future.

Rather than just saying to throw more money at it through increasing people’s taxes (some of whom never engage the public health services) I’m attempting to make it better and fairer for everyone and to actually give people a choice on where they can go for treatment, opening up the health market would encourage new providers for all to use.

The NHS saved your life, well that’s great for you, some people are unfortunately at the mercy of their local NHS Trust who may not be performing as well as others. Some surgery is just not offered until things are really bad, such as vascular surgery, you have to be really suffering, ulcerous and at the risk of gangrene before the NHS would even consider surgery which then potentially costs more than if it had been done earlier.

I never said or implied scaled back services in Government Hospitals only scaled back free for all service for future generations so providing affordable private services your freeing up government services. I would still expect a good level of service and facilities but without the stress of over-subscription.

Joe Bloggs probably doesn’t go to the doctors because he knows that he probably won’t get an appointment for at least 5 days, will sit in a waiting room with a load of ill people coughing and spluttering all over the place, feeling hacked off with the doctor who rushed him because he only had 7 minutes allotted to him and forgot to tell him about that other thing which he will now have to make a separate appointment for!

I’m curious as to how you see the French and Canadian healthcare systems considering they are health insurance based too and considered far superior to the UK.

Rate This Political Comment: 0

Thank you for explaining your ideas. I take issue with the majority of it on principle but would like to pick up a few points:

“The NHS has improved in the last number of years (I have never said it hasn’t) but this doesn’t mean it’s marvellous now.”

You said you you felt an NHS problem was ‘having to wait until you’re half-dead or have bits falling off you before it’s treated”. This is a massive contradiction. I’m not stupid enough to suggest the NHS is perfect, but I have faith in it’s ability to improve and give help to the general population when they most need it.

“I would define self-inflicted ailments to be those directly as a result of general self-abuse such as smoking, heavy drinking, drug-taking, obesity (through own fault) and sporting activities with a high risk of incidence.”

If a person has clinical depression, leading to morbid obesity how would you categorise this patient? If a patient has a genetic propensity for caddiovascular disease, but also drinks above the recommended number of units of alcohol (like most of the population), how would your new system prove the underlying cause of that disease? I agree that people need to take responsibility for their own health, but I believe we should drive home the message of health promotion; healthy eating, smoking cessation, drug/alcohol awareness. The smoking ban is another thing I am pleased has happened in the UK over the last 10 years.

“Cutting GP appointments through (possible reimbursable) co-payment on consultations (you might think twice about bothering your GP for that funny twinge in your left leg that you had yesterday morning, if you had to pay something towards it!)”

Do you realise that normal Joe Bloggs on the street would probably avoid going to the doctors even more if you introduced this. People with early symptoms would put off their initial GP appointment (because they are skint), and then could ultimately become a late presentation of something much more serious. People in the UK can see their GP for free. A concept such as this is abhorrent to me as it would marginalise poorer people.

“You would have choice of using a basic low-cost Government hospital or a completely private medical institution depending on your level of cover and what you are prepared to pay for.”

For this statement, I read differently:- “You would have no choice; if you’re on a low income you’d be using a basic low-cost Government hospital which will have been scaled back and stopped making progress, if you can afford it you’d be using a completely private medical institution, and how good it is will depend on how much money you’ve got.”

I appreciate you have spent time on this and thought this through carefully, and accept that you are not a policymaker; but in a general sense you don’t seem able to relate to people on low incomes and how this might effect them.

Rate This Political Comment: 0

“…they fulfill both their contracts without compromise but at the same time their NHS patients wait longer, I don’t understand this.

Happy to explain. A consultant will be salaried to work for the NHS an fulfil their duties, as in do the amount of work the primary care trust has commissioned for local patients (for example enough work to maintain or reduce an 18 week general surgery waiting list (non urgent)). He or she may also spend 1 day a week working in a private hospital under contract to them, seeing private patients.

“If I even suspect I may have cancer I don’t want to wait for up to 5-6 days to see my GP and then another 2 weeks to see a Consultant (who occasionally may not be able to do so), I want to see someone within a day or two, 3 at most! What a horrendous 2 weeks that would be for anyone!”

Indeed it would be an awful wait. The reason it is two weeks is that the majority of 2 week wait patients do not have cancer. Specialists therefore have a lot of patients to see and discharge, with a minority to continue treatment. The idea is to allow GPs to make urgent referrals for anyone suspected to have cancer, so that those unfortunate people who do need further treatment do not slip through the net. It might not be good enough for you, but this system will be saving lives every day. The aim with more investment will be to reduce this waiting time.

I completely understand why people who can be seen quicker via private option would want to do so. Not least because of the emotional stress and worry. However, I’m talking about the general population. People who haven’t got that option open to them.

I certainly am loyal to the NHS. Not just because I work for it, but because I had my life saved. I appreciate what the NHS means to normal people.

“I haven’t got a problem with those who choose to go private for healthcare, that is everyone’s perogative” – you really don’t sound like it!

I wouldn’t have typed it if I didn’t mean it. I have got a problem with marginalising the NHS, a lifeline to the normal people of the UK.

“Oh, and who would be making a big fat profit out of this new health model?” Why is this such an issue for you?

I don’t agree with profiteering out of people’s misery. It’s quite simple. On your pojnt about tax contribution of private sector emplyees; equally people who work in the public sector pay tax and spend money. Healthcare professionals add value to themselves by training for years, and their earnings are then taxed.

“It’s throwing good money after bad.” – you think like this because by your own admission you can’t see the good the NHS does.

“Maybe, but can so much be different in 5 years?” – yes, improved waiting lists, a much more modern service. Things can get better too.

Rate This Political Comment: 0

“If my understanding of your earlier comments were correct: you think most of the unemployed who are still out of work after 6 months either don’t want a job (work shy) or refuse to take a low paid job (not better off money wise than on benefits), by removing benefits at 6 months the lazy ones would be forced to find work and the ones ’stuck on benefits’ would be forced to take any job they could find?”

Goodness me, that’s a really harsh glare on it!! I think I said that there is a core of people who don’t want to work and have never have. I stick by my comment that some people consider themselves better off on benefits and really don’t want to work and that welfare should be a back-up only not a lifestyle choice.

If the tax credit system makes you better off by enabling you to take the (low paid) jobs on offer why are people not taking them? If you’re saying that you went into your local job centre and there were no jobs advertised at all then I would revisit my thinking.

I believe I said that you would get benefits for up to 6 months and then your (compulsory) insurance would then compensate you. Income policies generally run from 6 months to 2 years I believe. So in effect, yes, the Government would be removing support after a period of time particularly if the tax credit system compensates you to take a lower paid job even for the short term.

I am personally amazed by some of the barriers that people will put up themselves to not take a job and genuinely consider themselves disadvantaged because they can’t be bothered to even attempt re-arrange themselves accordingly.

Won’t consider working outside their immediate area or moving to another area for employment; won’t accommodate shift work; won’t consider a job that’s lower paid than the one they had before even temporarily; not a chance if it’s more than one bus journey. I heard some of these from my own brother-in-law.

Rate This Political Comment: 0

Two extracts from a speech by Margaret Thatcher in 1991:

“The summary of the documents for the forthcoming Luxembourg Council—I have not seen the full documents, because they came too late, and I share the views of those who protested that they were not available—reveals a quite different destiny for Europe from any that we were ever given to expect when we went in.”

“The fact is that majority voting means that we give the Community the right to impose on the British people laws with which the House—the elected representatives—may fundamentally disagree.”

http://www.margaretthatcher.org/speeches/displaydocument.asp?docid=108276

I find this horrifying.

Rate This Political Comment: 0

A better tax allowance would have been nicer and simpler to administer but in the end I didn’t get it and it wouldn’t have done me any huge favours anyway because having it so hard inspired me to improve my education and get better paid jobs. I was fortunate enough to meet my husband as well whilst getting the better paid jobs! :-)

Rate This Political Comment: 0

The NHS has improved in the last number of years (I have never said it hasn’t) but this doesn’t mean it’s marvellous now. So many people do opt privately in order to jump the queue or gain treatments not available immediately.

Overhauling the health system in the UK would require all political parties to be in agreement and be fully committed to it’s implementation. My ideas here have holes in them because I’ve taken an general overview, there is no such thing as a perfect system and I’m not a policy writer and this is just my thoughts on how better the system could be not necessarily it be set in stone.

Free point of use to only those entitled to use it at no charge, through the use of health cards issued after registration with your chosen provider to show your entitlement. At present, as a non tax paying expat I can walk into any UK hospital for treatment free of charge, maybe not legitimately, but I could do it!

Every eligible (UK Resident) person has a basic healthcare cover for healthcare provided in Government hospitals should they choose to use it. General health insurance would be provided from either Government sponsored insurance agencies (for basic cover and to provide cover (means-tested) for low income or welfare recipients), privately undertaken or provided through employers under a company umbrella with supplementary insurance to cover illnesses / injuries caused by lifestyle choices. This basic cover would need to be paid for by either a reduction in National Insurance or a pledge not to raise National Insurance.

Health care would be provided from say around 85 – 100% of the medical costs however the co-payment would be wiped out the longer the illness persists (as is the case within the French system). There would be concessions for certain illnesses deemed to be through no fault which would be set by Government policy in conjuction with insurers.

You would have choice of using a basic low-cost Government hospital or a completely private medical institution depending on your level of cover and what you are prepared to pay for. I also see the need for charity hospitals (dare I say it, not unlike the PDSA!) to cover the gap for those who individuals who do fall through the net (such as the homeless for instance).

Existing pensioners who have already paid into the National Insurance system for their working lives would continue under the present NHS system of free use for all which would be scaled back as those entitled dwindle in numbers. Those already paying into the system for a number of years would automatically receive percentage discounts on the co-payment and insurance premiums to reflect this (so for example if you had been paying into it for say 20 years you would have a 2/3 reduction in premiums and co-payment).

The points I have tried to include to consider are:
1.People tend to be motivated to some degree by money or the prospect of paying it out so therefore making people responsible to some degree for their own health and personal safety
2.Dangerous sports injuries are paid for in full by supplementary insurers or individuals
2.Long-term illness and hereditary illness provision
3.Abuse of the system by those not entitled to it’s use
4.Cutting GP appointments through (possible reimbursable) co-payment on consultations (you might think twice about bothering your GP for that funny twinge in your left leg that you had yesterday morning, if you had to pay something towards it!)
5.Reduce / remove waiting times as more health providers would come to the market providing even more choice and easing the burden on over-subscribed facilities
6.Maintaining fairness for pensioners and those already contributing into the current system
7.Provision for low income and welfare recipients
8.I’ve assumed that those people suffering long-term / hereditary health problems and self-inflicted health problems are a mix of different demographics (not exclusive to one group of people)
9. Private or company insurance would allow people to take their treatment overseas and therefore removing further burden on specialist services or equipment

Rate This Political Comment: 0

You’re correct you do have a bigger insight to the NHS and also an ingrained loyalty to it as you work for it. I have been a reluctant partaker and opted to go private.

“To be fair doctors doing private work often fulfil their NHS contract and their private one without compromise (their NHS patients simply wait longer)” – you’ll have to explain this one to me.. they fulfill both their contracts without compromise but at the same time their NHS patients wait longer, I don’t understand this.

“You did clarify your point to David about support with childcare in 1997, but in your comments to me you still seem to think of the NHS, the DSS, and the Labour party as the same entity. You claimed that the Labour party are the source of my income and haven’t clarified that to me.”

The NHS and the DSS are the entities that any new Government inherits and has to then manage and control, in effect their new employers (hence, your employers). Government policy changes directly affects both in the direction that they have to take (assuming of course, that the new Government has a majority house, which Labour does at present with a house representation of 346).

“You also haven’t answered my question about your proposed health service:
Your NHS ideas don’t include “…those with hereditary or long-term illnesses that are through no fault.”. It would be interesting to see how you would legislate for this if you have time to summarise?”

I’m going post another thread for my ideal of the NHS because of the questions you and David have put forward otherwise this would be a mammoth post!

“An example: In the UK, if your GP thinks you have symptoms suggesting a possible cancer, you wait no longer than 2 weeks to see an NHS specialist. If a hospital fails to meet the two week target (which very occasionally happens usually because of human error), it gets fined.”

If I even suspect I may have cancer I don’t want to wait for up to 5-6 days to see my GP and then another 2 weeks to see a Consultant (who occasionally may not be able to do so), I want to see someone within a day or two, 3 at most! What a horrendous 2 weeks that would be for anyone!

“You are out of touch with the NHS and are blind to the progress it has made. “ Obviously I am, I just don’t think it’s good enough, my expectations are a lot higher probably because I have experienced better (even in Government hospitals here in the ME).

“I haven’t got a problem with those who choose to go private for healthcare, that is everyone’s perogative” – you really don’t sound like it!

“I’d be really interested to know how your proposed healthcare system in the UK, only for those who are not ill through anything they have self inflicted (how do you define this?), would be rolled out to the general population without any waiting lists, and how we would expect normal people to fund this if you also advocate “allowing people to keep more of the money they work for”?”

I would define self-inflicted ailments to be those directly as a result of general self-abuse such as smoking, heavy drinking, drug-taking, obesity (through own fault) and sporting activities with a high risk of incidence.

“Oh, and who would be making a big fat profit out of this new health model?” Why is this such an issue for you? Organisations with profits pay employees (who pay tax and spend their earnings), have money to invest, grow and expand thereby creating more jobs and more tax, are generally more competitive and generally more cost efficient. Private Sector companies are not generally governed to use the EU Procurement Directives so it would be easier to work longer term with their preferred suppliers and reduce costs to supply and maintain the services.

The “right investment” that you have previously mentioned is not “investment” it’s more public money paid out of taxes and national insurance. It’s throwing good money after bad.

From David, “When it comes to the NHS there’s no comparison between Labour and the Conservatives, Labour actually care about the NHS. “ I’m really not disagreeing with you here. However, all political parties know that the NHS in its present form cannot continue forever, it has to change, the problem is that no one party has the guts to stand up there and do it because it’s such an emotive element and would be hugely unpopular if people start to think that they may have to start paying at least a proportion for their treatment.

“I’m afraid in this instance you’ve been away from the country too long to understand what it’s like now Sarah. “ Maybe, but can so much be different in 5 years? I suppose I have now other perspectives on how much better it could be if the systems were changed.

We made a choice of what kind of life we were prepared to accept for our hard work and unfortunately the one in the UK was not it, I do miss the UK but I just wouldn’t be prepared to live there again under a Labour government when all we were doing is paying into the system and not really getting anything positive out of it it made us think about why we were doing it.

Rate This Political Comment: 0

That’s clearly two categories of unemployed people, not just lazy.

I accept I didn’t make it clear what I meant, I should have said:

“With 2.5 million unemployed are you suggesting the majority of the 2.5 million unemployed could get a job **within 6 months** if the lazy ones wanted to work and the welfare system was harsher so taking a low paid job is better than living on benefits?”

Or I could have used the number 750,000 as that’s the number of people currently unemployed for over 6 months.

So I meant the majority of those who haven’t found work within a reasonable period of time, (6 months) of being unemployed.

Is that what you are suggesting?

I believe you mentioned 6 months of help then insurance should take over? that’s why I’ve used the 6 month time scale, personally I’d see long term as over 12 months.

Implication being you want government to remove support for unemployed people who fail to find work within 6 months?

For a system like that to work two things would have to be in place. First that the vast majority of the unemployed can in fact find a job within 6 months and second everyone takes out unemployment insurance (would have to be compulsory, otherwise people will fall through the system).

If my understanding of your earlier comments were correct: you think most of the unemployed who are still out of work after 6 months either don’t want a job (work shy) or refuse to take a low paid job (not better off money wise than on benefits), by removing benefits at 6 months the lazy ones would be forced to find work and the ones ’stuck on benefits’ would be forced to take any job they could find?

Based on the FT article I linked to that’s currently 30% of the unemployed would not be entitled to help under your system!

How many of the 30% do you think fall within the work shy or won’t take a job because of benefits categories?

There are currently around 750,000 people who have been unemployed over 6 months.

You can’t believe all of them could find work if they wanted to within 6 months?

At least 5% of the 30% find work within a further 6 months, so I think we can assume they aren’t work shy/stuck on benefits, they couldn’t find a job.

Lets assume it is as low as 5% that are the real long term unemployed (unemployed over 6 months), what are those current ~125,000 (that’s 5% of the unemployed today) people do when it comes to buying food for their kids etc…?

Sarah you seem to be wanting government to remove the safeguards we have so the minority of those who abuse the system don’t get away with it!

I accept there will be those who are work shy and others who won’t take a job because relative to benefits it’s not worthwhile. I can’t see it being a high % though.

From the media I’d got the perception there was a LOT of young people who are long term unemployed and sponging off the tax payer, but the numbers say otherwise! The under 25s are less likely to be long term unemployed than anyone else. If a system like yours was brought in, it would be the over 25s who are the vast majority (96%) of the long term unemployed that would suffer the most.

In your latest comment you’ve confirmed you did mean the ’stuck on benefits’ part, though not how many of the unemployed fall into this category in your opinion. Please correct me if I’ve misunderstood what you meant.

BTW don’t read me wrong on this, if unemployed people are work shy they don’t deserve a penny of our taxes and if unemployed people are refusing to take low paid work because they are better off on benefits**, again they don’t deserve our taxes.

** If you understood the current benefits system you’d realise it’s now almost impossible to be worse off in work than on benefits. You could argue not being significantly better off working than on benefits for some situations, but I don’t think you’ll find a scenario where a low paid job at minimum wage has a person worse off than on benefits now. Under the Conservatives with no minimum wage you’d have been right when you still lived in the UK.

David

Rate This Political Comment: 0

It’s the lesser of 2 evils; would I rather pay tax to keep people at home or would I rather pay tax to help people work?

Many taxpayers don’t want to pay for other people, period, but as we had to I’d prefer to pay to keep people in work, I might not like it but it would be my preference if I only had the two choices.

As it is we don’t pay any tax at all now because we got so sick of paying too much tax for little benefit of it.

Rate This Political Comment: 0