Skybluekyle
Well-Known Member
Do you just desperately hope for "gotcha moments", if so, your confirmation bias is stark
Do you want to discuss boring politics? (65 Viewers)
- Thread starter mrtrench
- Start date
Classy as ever.
His entire life revolves around trying to catch people out on this forum.
There is no need to accuse you of it, you literally admitted it.
Grendel
Well-Known Member
Well clearly I have seen the Road to Damascus and I am now a fully fledged member of ISIS and a strong supporter of Iran.
I did not admit anything - it does not exist. Its a curious term in reality. Still I assume you support the Iranian Islamic State or is there a bit of phobia.
Frankly you are beyond stupid. You make Tony look like a member of MENSA
I mean you did, but OK.
You can barely construct a sentence, it's actually quite rare to see a grown man with such a poor grasp of the English language.
Enjoy your afternoon on the Internet.
shmmeee
Well-Known Member
Are you calling me far right?
For god’s sake you need to learn what far right actually is. Spoiler: it’s not a term to weaponise when someone disagrees with you.
The way you’re making far too many assumptions about people you don’t know or their background is a sign of ignorance.
I’ve said on this thread that there are policies that I’d vote Labour for.
Side note: brandishing the term ‘far right’ like it’s nothing devalues the phrase when you come across people who are actually far right and nasty pieces of work.
Right/left is an economic descriptor. I’m sure you’re liberal socially. But your stated position is that the public sector can never work by design. That’s as far right economically as it gets basically.
Same as when you were a communist you thought the private sector couldn’t work by design.
As I said a sign of binary thinking.
shmmeee
Well-Known Member
I’m just having fun on the internet man
clint van damme
Well-Known Member
Personally I’m stanning the -stans
Mucca Mad Boys
Well-Known Member
I’ve never said anywhere the public sector can never work. You can’t just do away with it.
Saying the private sector is more efficient isn’t a radical thing to say. When you measure productivity/output the private sector is ahead of the public sector. One statistic to give you an idea is that the public sector productivity is still 5.7% pre-pandemic levels whereas the private sector is up 2.8%. That’s a 8.5% discrepancy. It’s a problem in both sectors - 2.8% productivity growth in the private sector isn’t anything to brag about. We lag behind the US, France and Germany by quite a bit.
In very generic terms, publicly funded enterprises tend to be chronically underfunded because government / government agencies will (generally) prioritise day-to-day expenditure rather than investment. The remedy isn’t as simple as ‘invest more’ unfortunately.
shmmeee
Well-Known Member
“I never said the public sector can’t work”
*procedes to write two paragraphs about how the public sector can never work*
Did you ever stop to think why adding marketing and other costs would make an enterprise more efficient? Walk me through the logic here.
Policing, health, education, these are labour intensive industries. You can’t automate them really (well you could a bit with police but people wouldn’t like it). These aren’t money making operations directly but designed to pay off in all other industries over time.
What’s the “output” of a teacher? How are you measuring that? A nurse? A policeman? It’s not like me where the software I produce had a direct impact on sales and the bottom line. I can maybe teach more kids at once, but it’s unlikely to remain as effective as I do (without opening the class size can of worms).
Transport is similar. What’s the economic output of a road or a train line? It’s measured in the impact on the businesses that use it. Same as public sector employees.
And the idea that private sector prioritises long term investment is mostly a joke.
Private sector is good at innovation and choice, if you want quality or reliability or value for money it’s awful. Most new businesses fail. But that’s OK in non essential industries where failure has a low cost. I don’t care if the restaurant down the road fails cos there’s three more or Tesco, I do care if my local school or police force fails.
This magical thinking that when I moved from public to private sector some ghostly spirit of capitalism entered my soul and made me more productive is ludicrous.
The reason public sector stuff often costs more is the same reason military grade stuff costs more: you have quality standards you must meet. Every government body has to follow every law, they have to maintain a given standard. Private sector can only cut corners to allow for the extra costs of the market in profit and competition costs like marketing.
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QED.
Mucca Mad Boys
Well-Known Member
I’ve not said anywhere that the public sector never works. The statement was that the private sector is more efficient than the public sector. Which is uncontroversial and backed up by data
Are you getting a better service from public services? That’s the point here because right now, our public services aren’t doing well at all.
The answer cannot be just spend more because it’s patently obvious that isn’t sustainable and the future is this perpetual need to increase taxes on people and businesses which will make us poorer as a nation.
On a lot of generic points, you’re right. It is difficult to drive output from things like teachers, GPs and so on. You expect productivity gains albeit at a slower rate - it’s still behind pre-pandemic levels. I’m sure there’s a bunch of reasons for that.
shmmeee
Well-Known Member
Feel free to post this data that backs it up.
I mean I posted health data earlier and it seems an awful lot less efficient, but maybe you’ve got some other stuff?
My entire point is that trying to measure productivity of most public sector workers is impossible.
Very few places have fully private police or education, but health gives us a direct comparator and it doesn’t come out well for a fully private system.
As for “I’m not saying it doesn’t work I’m saying it’s always less efficient”. That’s basically the same thing. We want the biggest bang for our buck obviously.
And you keep banging on about “always needs more money”, well that depends what you want. Yes if you want to give everyone free healthcare as they get older it will. The way private enterprise deals with this is by not touching certain segments of society. Is that a trade off you want to campaign for? If so we don’t need private industry we can just tell old people they aren’t covered by the NHS.
shmmeee
Well-Known Member
Fundamentally when you drill down this sort of anti-public sector stuff it’s based on magical thinking. How can you spend more and cost less? Efficiency mostly means finding things to cut. We can do that up front in legislation but people don’t actually want that. They want stuff to cover everyone and to work. When the private sector is held to the same standard it fails miserably every time because very basic maths says you can’t produce a product for less by adding more costs to it. And none of the privatisation proponents can explain how it’s supposed to work. Just “everyone knows public sector people are wasteful, I read it in the Telegraph”
D
Deleted member 9744
Guest
Yes and the disastrous water and train companies show how poor much of the private sector is in this country. It's been the same in the prison service where private prisons have been disastrous, not to forget G4S.
shmmeee
Well-Known Member
Capitalism works on competition. The idea it would still work on a monopoly is silly. That’s literally why we have the CMA.
Mucca Mad Boys
Well-Known Member
The service we’re getting is one of the worst in developed world - with only the US faring worst.
You’re making the mistake of equating SHI systems with full privatisation when it’s the same. Universal and equal access to healthcare can be achieved using insurance based models.
This provides a useful comparison of SHI systems by comparing our system with France’s which is the closest funding model to our NHS.
shmmeee
Well-Known Member
Imma read this, but posting a Tufton St think tank that starts the report like this is not giving me “reliable and unbiased reporter” vibes
Mucca Mad Boys
Well-Known Member
Imma read this, but posting a Tufton St think tank that starts the report like this is not giving me “reliable and unbiased reporter” vibes
View attachment 35944
You should, you’ll be pleasantly surprised.
shmmeee
Well-Known Member
OK this is an undergrad project with literally no data in it.
WHO rankings have us mid table
en.m.wikipedia.org
Commonwealth Fund (A US Think Tank) has us 4th:
www.commonwealthfund.org
OECD Healthcare Dashboard has us middle of the pack for pretty much everything:
WHO rankings have us mid table
World Health Organization ranking of health systems in 2000 - Wikipedia
Commonwealth Fund (A US Think Tank) has us 4th:
Mirror, Mirror 2021: Reflecting Poorly
The United States trails far behind other high-income countries on measures of health care affordability, administrative efficiency, equity, and outcomes.
OECD Healthcare Dashboard has us middle of the pack for pretty much everything:
shmmeee
Well-Known Member
So reading through this essay, the main point seems to be we should raise taxes to increase funding, specifically on tobacco and alcohol, am I reading that right?
Mucca Mad Boys
Well-Known Member
There’s a few conclusions to draw, namely that the French system is better able to allocate funds because the budget isn’t centralised. The idea of ring fencing certain taxes seems like tinkering around the edges - ‘sin taxes’ doesn’t drive that much tax revenue.
It’s worth noting that their system charges for hospital and GP visits even if it’s a nominal fee. I shared this specifically because Nigel Farage quoted this as an alternative to the UK last night on BBC QT. All this, however, was written pre-COVID and both us and France have quite similar challenges to ourselves - strikes over pay, increased demand and so on.
Then there’s the Australia model which mixes private-public healthcare and funding decentralised. However, everything is funded by Medicare and the principle of their healthcare system is like ours: free at the point of delivery with tax incentives to encourage taking of private health insurance policies out.
Everything in this system is patient driven and there’s choice to where and who sees you for treatment. You don’t get as much freedom as a patient in the UK.
Yes, we are unhealthier but things like waiting times for elective surgery and A&E waiting times aren’t related to the health of the nation.
shmmeee
Well-Known Member
But as the kid says, the cost of switching would be huge for what seem like marginal gains at best. I don’t know about France but my understanding of the Dutch system is that you leave a lot of holes in an insurance based system. My GFs brother needed a Go Fund Me for his care recently for example.
France also spends a large portion of its GDP on Health and there’s an incentive to prioritise based on profit rather than illness that Macron is currently trying to address.
What I get out of this isn’t where we started “the NHS is fucked and a massive outlier and must change or die” but “there’s tradeoffs” which is obvious.
I mean this article could have been about the NHS:
France's health system under pressure of increasing demands - BBC News
Some rural and suburban areas have no local doctors, while GPs in cities are working 60-hour weeks.
www.bbc.co.uk
Which suggests that many of these pressures are just being a western nation in 2024 and not some great indictment of public healthcare.
Mucca Mad Boys
Well-Known Member
But as the kid says, the cost of switching would be huge for what seem like marginal gains at best. I don’t know about France but my understanding of the Dutch system is that you leave a lot of holes in an insurance based system. My GFs brother needed a Go Fund Me for his care recently for example.
France also spends a large portion of its GDP on Health and there’s an incentive to prioritise based on profit rather than illness that Macron is currently trying to address.
What I get out of this isn’t where we started “the NHS is fucked and a massive outlier and must change or die” but “there’s tradeoffs” which is obvious.
I mean this article could have been about the NHS:
France's health system under pressure of increasing demands - BBC News
Some rural and suburban areas have no local doctors, while GPs in cities are working 60-hour weeks.
Which suggests that many of these pressures are just being a western nation in 2024 and not some great indictment of public healthcare.
Don’t get me wrong, insurance based systems aren’t perfect but we’re already in a two-tier system. If you can afford PHI, you get to skip the waiting lists. It’s wrong and people and the workers in the NHS deserve better.
Exactly, and if a nation chooses to fund its healthcare via taxation, as we do and our population is aging we’re inevitably heading toward a critical mass where there aren’t enough taxpayers to keep the system well funded. Without the funding, the standards will drop further. The issues today have been brewing since the 90s - again, New Labour brought in PFI to privatise the day-to-day running of the NHS i.e. building new hospitals, maintaining existing infrastructure and updating kit. That was an honest attempt at easing the funding pressures that ultimately, unravelled after they left government.
We need to pay our staff, maintain the infrastructure, update the equipment and most importantly, treat patients all on a shrinking tax base and increasing demand simultaneously.
The same is true across Europe as a whole we’re getting older, unhealthier and sustainlarge levels of migration.
Grendel
Well-Known Member
Oh dear - your mate Starmer is letting the racist stand in another classic u turn. You are as stupid as him aren’t you.
shmmeee
Well-Known Member
Isn’t it like EDF? I’ve not read into the announcement today
shmmeee
Well-Known Member
“Taxpayer funding” is just insurance on a large scale. We all put money in a pot and all draw from it. Just without the waste of a market.
I’m not sure there’s any evidence migrants are particularly net negative for the healthcare system, but not surprised that you think that. But you contradict yourself here as well later claiming declining population numbers are an issue. Well which is it? More people bad or fewer people bad?
Are we getting unhealthier? Drugs like Ozempic are looking promising for all kinds of modern illnesses, personalised medicine continues apace. We seem to have hit peak car which is the cause of most of our health issues. Smoking drinking and drug use are all down as well as risky sexual behaviour.
I’m not sure what you mean by “brought in PFI for the day to day running” PFI was mostly about fixing the crumbing estate in schools and hospitals not day to day running. And is yet another example of private sector waste and inefficiency if anything.
Your ideas on this seem all over the place and as much support publicly provided healthcare as anything else. You admit the pressures are demographic and that all countries are facing them, yet blame them on the funding model without once giving a rational explanation of why. Until you can explain how adding costs to a product is supposed to make it cheaper then really none of your other points make sense.
For “aren’t enough taxpayers” see also “aren’t enough insurance premium payers”. You either want universal healthcare or you don’t and if you don’t then you can cut those costs whatever the funding model.
This is very very basic. Explain how you are going to get more from less while paying shareholder dividends and marketing costs. Or explain who you think doesn’t deserve healthcare who gets it right now and with that accept that you’re too squeamish to make that government policy and instead want these people to lose healthcare from faceless administrators in insurance claims offices.
Ultimately there’s a good reason the only people you’ll find beating this drum are politically and not medically motivated. And why the best reports you can find are far right funded think tanks reports written by an undergrad on work experience.
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