Ian1779
Well-Known Member
You’d have to be a mug to think this was really true.
Do you want to discuss boring politics? (39 Viewers)
- Thread starter mrtrench
- Start date
fernandopartridge
Well-Known Member
It's irrelevant anyway, even according to that noted left wing think tank the Adam Smith Institute the number of millionaires and billionaires has fluctuated, while real wages have been stagnant. It's a completely moot point that implies millionaires'' wealth isn't private.
Sky_Blue_Dreamer
Well-Known Member
Like others on here I'm no fan of private healthcare. I fail to see how adding in a profit makes it better or more affordable. A US style system especially would be truly awful.
But having said that I have considered whether, like with pensions a few years ago, large companies should be forced to provide healthcare cover for their workers to reduce the burden on the NHS? It would have benefits for the companies themselves as they would have reduced costs for absenteeism.
I don't think it's an ideal solution, as there are many potential pitfalls like employers getting rid of or just not employing people with more healthcare needs, and is there sufficient capacity as at the moment much of the NHS and private healthcare are provided by the same people.
Grendel
Well-Known Member
Yes brilliant idea. I’m sure the average worker would love their tax bill every year.
Im guessing it’s a variety of things like time to see patients, deliver procedures, turnaround of patients etc against costs, staff etc
Actually, I can do better than that. Just googled
‘Their definition of productivity measures how well the NHS turns a volume of inputs (eg staff, drugs, medical equipment) into a volume of outputs (eg surgical procedures, GP consultations, outpatient attendances).’
I’ll have a proper read when I’ve got the energy as looks quite interesting NHS England » NHS productivity
Captain Dart
Well-Known Member
It's not a health service it's an emergency repair and sickness maintenance service.
Sky_Blue_Dreamer
Well-Known Member
Ever heard of exemptions?
Grendel
Well-Known Member
How does that work? Now you want the inland revenue to change its plans. Go on explain how this actually works in practice
MalcSB
Well-Known Member
The private sector is really only interested in services with little or no ongoing commitment, so hip replacements yes - mental health services not so much.Wholesale privatisation of the NHS has never been on the table as private companies realise that keeping people alive is expensive. Thankfully, their friends in the Labour party have found a solution:
Assisted dying plan outsources provision to private companies
Ministers have ‘no in-principle objection’ to outsourcing it, if the law is changed, to minimise the effect on existing NHS serviceswww.thetimes.com
There were some areas where private suppliers, Circle and Virgin Health IIRRC, won contracts for services which ended up failing.
For example, from the Guardian
”In 2012 Circle became the first profit-driven health firm to be put in charge of an NHS hospital when it took over the running of Hinchingbrooke hospital in Cambridgeshire. It handed the contract back to the NHS in 2015 after the hospital experienced financial problems and could not keep up with rising demand. The Care Quality Commission rated the hospital’s care as inadequate.”
MalcSB
Well-Known Member
Do they now?
MalcSB
Well-Known Member
Very true. For many years there has been talk about NHS developing more health promotion measures. People need to be encouraged to take some responsibility for their own health, but why should they when treatment is free at the point of need and some boomers will have funded development of the repair service for decades.
Grendel
Well-Known Member
They would like it even less when they get a P11D bill for an extra £1,500
Brighton Sky Blue
Well-Known Member
Absolutely. Need to embrace people being bankrupted by medical expenses and being billed for holding their baby.
Sky Blue Pete
Well-Known Member
Xg on deaths avoided against xg of expected deaths
Captain Dart
Well-Known Member
Absolutely, the JustEat generation are going to be corpulent and chronically sick regardless of whatever the NHS does.
I suspect the NHS will try and fail to cure those sorts of problems with ever more medication.
Mucca Mad Boys
Well-Known Member
First and foremost, really happy that yours and Mrs BSB’s experience with the NHS during the pregnancy has been excellent. Hoping it all goes well for the remaining journey!
At least how my PHI works is that it’s paid upfront by my employer and the value of it is a benefit in kind for the financial year. In practice, the cost to my is the extra tax and/or NI I pay on that value so it’s basically the same as the NHS as that’s funded through taxation. A colleague of mine broke their leg and tear their ACL in a rugby match and they had surgery after 2-3 weeks which you wouldn’t get on the NHS. The coverage extends to things like cancer screening and other main diseases where the NHS is falling behind and, frankly, costing lives. Employers offering PHI 100% adds value and supports the NHS because less people need to go through a backlogged system.
The people least in favour of PHI are more likely than not, simply ideologically opposed to it and have no first hand experience so have this image of the $30,000 for a childbirth in the US etched in their heads.
My central point is that as a country, we need to support the growth of the private sector so it can take the slack off the NHS independently. Chucking money at the NHS is not sustainable in the long term.
Mucca Mad Boys
Well-Known Member
Out of curiosity have you ever experienced private healthcare?
Most large companies do offer PHI has a benefit in kind precisely because it reduces absenteeism. The PHI only covers ‘new illness/diseases’ so doesn’t include pre-existing health conditions.
The most successful healthcare systems have mixed systems that socialises insurance to cover pre-existing conditions and so on as well as a private sector.
We are the only major developed country to completely fund our entire health service from the infrastructure to the employment of staff. The results have pretty much always been below comparable countries (France and Germany). The NHS has never been ‘the envy of the world’ otherwise some countries would’ve thought to copy it.
fernandopartridge
Well-Known Member
It's worked brilliantly for so many other public services hasn't it.
Mucca Mad Boys
Well-Known Member
You keep fixating on this point. I’m not advocating the NHS franchising its services to private providers.
To make a clear delineation, I’m supportive of incentivising people/businesses to get PHI and they go to private hospitals/healthcare providers that is completely independent and outside of the NHS. You could argue this creates a 2 tier system but the reality is we’re already there because record numbers are resorting to PHI or complete self-funding to skip NHS backlogs.
A lot of our ‘privatisations’ of things like NHS services and railways is because the competition is only for the contract and the default option is the cheapest provider. So when you’ve got the contract, the end consumers get the 2 fingers and the state heavily subsidises these businesses. It’s a complete market distortion.
fernandopartridge
Well-Known Member
No it isn't
Mucca Mad Boys
Well-Known Member
You know how markets work, generally, the best providers and/or products win in an open market. If you can only compete for a contract every ‘x’ years, it’s not a free market and it’s the worst of both worlds, an expensive and poor service. This probably applies to the NHS as well as the railways but my point was generally on the railways there.
We’re both in agreement that privatisation within the NHS is generally not great. The point we disagree on, is incentivising individuals/companies to expand PHI provisions to grow the private sector independently to take demand off the NHS.
fernandopartridge
Well-Known Member
The more pertinent point is that natural monopoly services do not benefit from privatisation and energy, transport and utilities are all natural monopolies.
From a company point of view, it's a difficult sell to a company to say you need to continue to make NI contributions and recommend you also pay for PHI provision for your staff. I know some large companies do it as part of their benefits package but most do not and probably couldn't afford to.
Mucca Mad Boys
Well-Known Member
You’re quite right on that point, hence I suggested tax breaks for providing it. The government has got to think creatively on how to make meaningful supply-side reforms to get as many people off NHS backlogs as possible.
The natural monopolies point I don’t particularly disagree on, I don’t think nationalisations will improve those areas you listed. In any case, the government is stretched enough with other spending priorities and the population taxed too much to make nationalisation unviable even if it was desirable.
shmmeee
Well-Known Member
We don’t spend particularly high amounts on the NHS. It feels like a lot because tax is low so we can’t spend on anything else. But in terms of healthcare spend it’s pretty average. The “we can’t go on like this” would apply to any system, none of them are cheaper generally.
Sky_Blue_Dreamer
Well-Known Member
I've only ever had dental and paid for a physio for a short time to help with a back problem a few years ago.
I know some companies offer PHI but I was thinking more about it being compulsory for large businesses, like they did with pensions. When there was talk of compulsory pensions there were arguments about it being unaffordable for companies and I think this would be similar. With healthcare the companies would actually be getting something back. I have reservations about it as I wonder if it may not actually increase overall supply, and you'd just see a further migration of healthworkers into the private sector, so even though demand for the NHS would go down so would the number of staff in the NHS and the pressures would remain.
Of course, it would require a lot of planning to figure out exactly how to put it in place. This also goes into Grendel's question of how it would work, but there is no reason why a government could not just decide to make healthcare exempt from BiK or reduced rate, just as it could offer tax exemptions for the cost to companies. Sums would need to be done to see how feasible this would be. But Grendel talks about the IR changing it's plans - they literally do it all the time. We have budgets at least once a year or more where all sort of tax legislation changes. We have full, reduced, zero and exempt VAT status. I take a regular medication for a condition that's not that serious yet for some reason it qualifies me for an exemption certificate, so I don't have to pay for any prescriptions I receive. Yet other people who need far more important medications that me have to pay. You can literally make up tax as you go along - the only thing that ultimately matters is that the public accept it.
Grendel
Well-Known Member
It would bankrupt companies to offer it to workers other than management as a perk
You have many stupid ideas but this takes the biscuit.
Pensions aren’t compulsory unless you are talking about NEST and even then employees need to agree and pay contributions
chiefdave
Well-Known Member
I've worked at some places that have it and my experience, and that of my colleagues, is that if you want fairly routine stuff like scans done then it's great. You can book a convenient time with little to no wait. Not sure how much that takes the load of the NHS as a lot of the time they seem to use the same staff & facilities and they obviously can't both be using them at once!
However for anything more involved than that it seems they will do everything in their power to avoid providing treatment. They'll go over your medical records with a fine tooth comb for the slightest little thing that can allow them a pre-existing condition get out. For example one person I worked with slipped down the stairs at work and fucked their back, needed surgery. PHI went through their medical records going back decades and found that when they were in their teens, and a keen netball player, they went to the doctor with a pulled muscle in their back - claim disallowed as pre-existing condition.
That then leads you on to the fact that as you hit 40 or 50 and upwards, the people who are making the most use of the NHS, the percentage of people with ongoing health issues sky rockets, all of which would of course be excluded.
Ccfcisparks
Well-Known Member
When I broke my ankle playing football my private healthcare through work was fantastic in providing me rehab
Grendel
Well-Known Member
Certainly wasn’t my experience. They went well overboard in scans and treatment and age is irrelevant as it’s a group scheme
Didn’t expect Reform MPs to start eating each other quite this quickly
news.sky.com
Reform UK MP Rupert Lowe reported to police over alleged threats against party chair
Reform UK MP Rupert Lowe has been reported to the police over alleged threats of physical violence against the party's chair.
Mucca Mad Boys
Well-Known Member
Our taxes aren’t low, the tax burden is growing and is near war-time levels despite us being in peace-time.
Onto the NHS, the health outcomes are objectively worse, the pay and working conditions is poor. Even so, if what you say is true, the logical conclusion is to expand the private sector. It’s been growing steadily and has correlated with NHS backlogs.
SBAndy
Well-Known Member
Hope you were in a management position otherwise your company would be bankrupt.
Grendel
Well-Known Member
Well in a company of 100 people all on PHI it would
Sky_Blue_Dreamer
Well-Known Member
So it's affordable for companies to give it to the people that can afford it for themselves? And let me guess, you reckon in no way should shareholder returns be compromised to benefit the workforce...
Who are the first people to complain about absenteeism and people off sick? Companies. They claim it costs the UK economy over £100bn a year! Public health services are getting ever larger backlogs so those off sick are getting larger and being off for longer.
Bit like when the likes of Salt and Cadbury building their own worker villages. People said it was madness and would bankrupt them. Ending up being a massive benefit for them.
P.S. I love it when you call my ideas stupid - it reaffirms my belief that they most definitely aren't. If anyone is renowned for shit-takes on here it's you.
Ccfcisparks
Well-Known Member
Nah I wasn't but its a global company with plenty money to spare to be fair.