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Cretin is cretin

If we want to live for a reasonable time in the UK we can’t go down the US healthcare route

Amazingly, I know of precisely zero people who recommend the US health care system as a replacement for the UK one. And I’m about as privatisation and neoliberal as you can get.

As John Burn-Murdoch himself makes clear, it is shocking to realise that as a result of spending twice as much of their GDP on health care as we in the UK do the US only manage to produce an average result the same as the worst in the whole of England.

Yep, it ain’t that great a system overall. Although we do need to be more than a little careful. Strip out violence figures and the US does much better. Also, you do actually get health care quickly there, something you don’t in the UK. But still.

This though is to be a cretin:

That is not just staggering: it shows how dire Tory thinking on health is. And it shows us that the only way to deliver the healthcare we need is via a state-owned and funded NHS.

There are 192 health care systems among the members of the UN. Possibly more in fact, given that Wales, Scotland and England each have their own variations on a theme under only one UN seat. That one of the 192 ain’t good is not proof that one single other of the 192 is the only possible alternative now, is it?

What about the systems of Germany, France, Holland, Estonia, Sweden and on and on? Which of them might have useful comparative lessons? For none of them have the NHS either……

27 thoughts on “Cretin is cretin”

  1. I detect a shift in the tectonic plates on the NHS. I increasingly hear negative comments about the NHS from my non-right wing type friends these days. Mainly because they are currently going through all sorts of quite serious medical issues (they are all jabbed, and I’m not, and I’m fine, how odd…….nah, must be just coincidence…..yes thats it, coincidence….) and the NHS is treating them like sh*t, as it always did, but even more so now since Covid. And that is seeping into the cracks of the collective consciousness. When the subject of the NHS used to come up in the past, if I made any derogatory comments then there would be at least one (and often several) true believers who wanted to roast me for daring to question the sainted NHS. Now, not so much. No-one wants to defend it, because they can’t they now have examples of how sh*t it is within our social group, sometimes even personally.

    I always said that the NHS would never be reformed until it was so sh*t that it had virtually stopped treating people, and I think we are close to that now. Of course because of our political system that groundswell of public opinion will be ignored entirely by the political class, but it is there now, and eventually it will burst out somehow. And I suspect rather like Brexit it will come as a complete surprise to everyone who thinks they are someone.

  2. It’s Recent Runes’ 24-hour limpet. It’s approaching that point where it takes more than 24 hours to eat enough whales to survive for 24 hours. Only then will it shudder to a halt.

  3. Jim – have you noticed the profusion of definitely-not-planted stories in the press about how everything* causes heart problems now *(except the vax, natch)?

    To quote Dr. Evil: “Rrrrriiiiiiggghhht.”

  4. I’m glad to be approaching retirement. It can’t be long before the majority of the entire UK workforce is employed directly by the NHS, which is what Murphy impliedly wants. And of course the cretin claims it’s self-funding due to the taxes collected from wages.

  5. BlokeInTejasInNormandy

    There are two major health systems in the USA.
    One is before you hit retirement age, and the other is after.
    The first system is – you need health insurance, and if you’ve got it you can get good care very quickly. If you don’t have health insurance then you have a big, expensive, problem.
    The second is – you have health insurance.

    My experience of the US health systems is that they are excellent. My GP is competent and keeps up with new stuff. He’s also happy to discuss things. He has several nurse practitioners in his small centre who can deal with everyday complaints. The specialists I’ve had reason to deal with – so far, for suspected cancer, real cancer and real cancer again – were accessible in the next day or so; all reacted quickly; surgery when needed was quickly done; advanced CAT scans, MRI and PET scans are often same day. Results often same day or next day, especially when results were not at all what one wanted. It wasn’t as good in 1999 – bit of a wait for a PET scan, for example, because there was at that time only one in Austin. But even then, it was significantly better than modern Britain.

  6. Having been in the US healthcare system for 60+ years, my experience has been excellent. Almost any treatment or service is available quickly and I’ve had my choice of doctors and specialists.

    It may be overly expensive, but that’s largely because the gov’t is heavily involved.

    And most of the analysis that claims we get poor results ignores the higher rates of violence, car accidents, obesity, etc. The results are quite different on a risk-adjusted basis.

  7. The NHS continually complains that it needs more funding, yet does nothing to initiate ways of getting it – apart from strikes, that is.
    A friend of mine needed hospital treatment while on holiday in the USA. Tucked up in bed, he was spoken to by several people, including a very nice lady who asked, “How are you going to pay for this?”. Fortunately, he had insurance, as the final bill was more than his house was worth in the UK.
    The hospital has a whole (multi lingual) department dealing with insurance companies around the world to receive payments for treatment for non US citizens.
    Not so long ago, a woman flew from New York to Heathrow, suffering from appendicitis. She sought medical assistance once she had passed through immigration control, spent several days in hospital, pre and post operation, then flew back to the USA. Doing it this way was cheaper than having the operation done in the US. There was no attempt by the hospital to seek payment for her treatment, with one hospital administrator saying that she was not a debt collector.
    Most hospitals abroad have similar systems where insurance companies, or patients without insurance, are contacted for payment for treatment (in Spanish hospitals, a deposit has to be paid before treatment, other than that covered by the EUHC, can begin).
    The NHS is shooting itself in the foot by insisting the “free at point of attendance” covers everyone, instead of just those paying tax or on benefits.

  8. ” And it shows us that the only way to deliver the healthcare we need is via a state-owned and funded NHS”.
    Am I missing something or is that not the system we have had in place for the last 75 years and been consistently criticised since its’ inception?
    Which gave us those hilarious ‘Carry On Gynecologist’ / ‘Doctor Accused of Medical Malpractice Again’ movies starring Babs Windsors 34D’s?

    And let’s be fair, the septics probably spend more on everything: houses / clothes / cars / eating out / Hi-Fi / travel / assault weapons fitted with bump stocks, tactical laser sights, silencers and high capacity magazines / etc. etc.

    Do they spend more on boob jobs?

  9. Coupla questions. Is it true, as I have seen claimed, that US health insurers are only allowed to profit by a percentage of turnover (10%, I think) thus leading to no incentive to do things more efficiently but only to get the bills as high as possible? Bills which come from hospitals who also benefit from the highest possible figures.

    Secondly, is it true that the hospitals are required by law to have a consistent list price for any treatment no matter who is paying, this law being widely disregarded in order to overcharge anyone with the temerity to want to avoid insurance and pay their own bill, or favour commercial insurance payers over federal or state outfits?

  10. I tried to point out to the potato in the past when he was arguing for more billions to be poured into the bottomless pit, that perhaps we ought to look at other health systems who have better outcomes than the nhs and see if we should adopt some of their ideas in part or even whole if they had a better track record than the nhs. He of course accused me of wanting people to die and refused to discuss further. One may have thought that since he’s radically changed his position on the eu from capitalist conspiracy to no. 1 fanboy he might have recognised that many eu members health care systems were better than the nhs. That would of course involve intelligence and the ability to come to conclusions based on evidence rather than “feelings” something the moron conspicuously lacks. In Spud world he probably would come to the conclusion that rejoining the eu would miracuously make the nhs the equal to the better performing health care systems in the eu. How anyone except the terminally deluded and associated idiots take this cretin seriously eludes me, it can’t be because of his winning personality.

  11. “I know of precisely zero people who recommend the US health care system as a replacement for the UK one”

    Me too. Mere propaganda – like talking about all the austerity since 2010. Just bollocks.

  12. “you do actually get health care quickly there, “

    That might have something to do with the country spending more on health care. If you limit access you will spend less.

  13. TD

    The big reason is that there’s more installed kit. Austin (the greater Austin area) is about a million population, like Birmingham in the UK. There are 25+ CT Scan providers in the city and environs according to this:

    In my experience each has several machines. The list here misses many providers – eg, ARA in Cedar Park. So perhaps 50 machines per million folk. These machines are relatively expensive.

    The UK has 9 machines per million population.

    That’s why I could generally get a CAT scan the same afternoon or tomorrow in and near Austin…

    So – yes – the US spends more than the UK. But a lot of it is in more and better equipment and the trained staff to use them. It’s not “ooooh the US health system is expensive”. It’s much more like “yep, that’s how much it costs to do the job right”

    Not to say the system couldn’t be massively improved – but it’s improvement that’s desirable, not wholesale slash, burn, kill, destroy, replace.

  14. Thank Phuq I have BUPA cover through work. Recent series of tests, examinations, MRI scan and an exploratory op all done inside 4 weeks.
    God only knows how long it would have taken on the NHS. I’d probably still be waiting for the first appointment.

  15. Maybe zero people would recommend the US health care system, but somehow the US has ended up with it. Unless we undrestand how that happened, we should be watchful to ensure it doesn’t happen here as well.

    And even if our system is so clearly better than the US’s, I don’t think you’ll find many Americans campaigning to replace theirs with a copy of ours.

  16. I’d like to just observe that the NHS isn’t shite because it is a nationalised service, although that helps. It is shite because it is badly run, and it doesn’t have to be. There are some basic principles of good management practice which could be applied/. Clear responsibilities, accountability, that sort of thing. Things which are not precluded by the nationalised monolith, but which need constant pomintoring and protection from excess bureaucracy and instutionalised idleness.

  17. I wonder if one reason the US system is so expensive is because lawyers are so ready to sue that this leads to many unnecessary procedures, and because claims can be so high, premiums for the practitioners are vast too. I came across a surgeon whose professional premiums were over $130,000 a year. And that was over 25 years ago!

  18. “I’d like to just observe that the NHS isn’t shite because it is a nationalised service, although that helps. It is shite because it is badly run, and it doesn’t have to be. ”

    I have this theory that says if you sacked every woman in the NHS above staff nurse level and replaced them with men, then it would function far better. Male run organisations may be inefficient, but I suspect they never descend into the total clusterf*ck that a female run one can. At least private sector examples of such just go bust, in the public sector all they do is suck in more and more money for less and less output. Sound familiar?

    Basically my theory says that any organisation whose management is dominated by women will over time tend to complete disfunction. As evidence I offer the NHS, state run education, State run social care services, and HR departments everywhere.

  19. @Jim,

    + hundreds and hundreds. I heard something similar in a UK University context, astonishingly and bizarrely from the mouth of a middle-aged lady I would have automatically assumed from her appearance and demeanour to be a lesbian feminist!

  20. Nautical Nick, at roughly that same time (mid-1990s) I heard the point expressed as: You can have a welfare state or a litigation state; not even the USA is productive enough to support both.

  21. Charles by the M3

    There are 2 questions which come to mind:
    1. I’ve read the local news reports on the BBC website for many years and, if you pay attention to the details, many of the current problems for the NHS are caused by hospital beds being occupied by patients who are well-enough to be discharged but there’s nowhere to send them. Many of the “ambulance delay” reports are caused by this – the ambulances are spending absurd quantities of time queued-up outside hospitals because there’s no space in Accident and Emergency.
    2. Rather relevant to point 1, the amount which local councils pay for the housing of elderly residents in care homes has been below the cost of providing that care for many years (sorry, I can’t think of a relevant link just now but, if I dredge my good memory, I may be able to find the relevant reports).

    The 2 questions suggest an interesting question, “Have local councils found a way to avoid paying for care by refusing to provide accommodation?”.

    1. During the pandemic and afterwards, I attended hospital out-patients appointments, scans, and investigations without any delay or problems. There was no noticeable waiting time for any of these events. Perhaps I’ve got a very good G.P. (General Practitioner) who knows that I will only contact her when I’ve got a real problem, or that the local NHS hospital is even better-funded than I had assumed.
    2. I wonder how many hospitals simply refused to treat anyone (unless they arrived in an ambulance) during the pandemic? Behaving like this simply causes more problems and makes treatment more difficult and expensive. It’s clear from my own case that my local NHS hospital wasn’t so stupid.
    3. Perhaps I just receive prompt NHS treatment for my rarity value? I am now* extremely-painfully allergic to the leading brand of insulin sold in the UK (please see the episode of Black Adder 2 where the “baby-eating” Bishop of Bath and Wells brandishes the red-hot poker). I always suffered pain exactly where the poker would have made its mark.
    4. This first happened because I was prescribed a new, quicker-acting, insulin to improve my blood-sugar levels. I was tested every-which-way and was found to be healthy. A friend and work-colleague pointed out the coincidence – I scientifically proved that exactly 4 hours after taking the insulin, I could only go to bed because of the pain. Then the insulin which I had swigged for years appeared in new packaging and, 4 hours later …

  22. @Nautical Nick

    Ding ding ding, we have a winner.

    To give you an idea of how over-regulated healthcare is in the U.S., a doctor isn’t even allowed to have a pen at his office with the name of a pharmaceutical company printed on it. That’s before we get into the FDA restrictions and Obamacare mandates.

    Obamacare mandated that about a dozen or so items must be covered by all insurance plans. He also based some funding on patient satisfaction surveys which, while that sounds nice on the surface, punished many hospitals with great doctors because patients didn’t like the bedside manner and other such bullshit.

    My father, a cardiologist, once got dinged because one survey question asked about the doctor’s eye contact with the patient. Kinda hard to make eye contact when you have notes to type into a computer.

    But one thing that needs to stop especially, is people saying that you “can’t get healthcare” without insurance. In the U.S., you get seen for an emergency no matter what. No one is turned away. As for cost, if you’re unemployed and on welfare, there’s Medicaid for that. There are several daily cases where a patient isn’t even a citizen or legal immigrant, but rather an alcoholic from Guatemala who needed his stomach pumped for the third time that year. In those cases, the hospital covers the bill, which many times eats into state funding from the taxpayers. That might have some effect on the cost of healthcare as well.

    The few times I’ve been in between jobs, I paid for catastrophic insurance for however many months. It’s not quite as much the dystopia people make it out to be.

  23. It’s funny how it’s always the “The-EU-is-perfect” types who never consider the possibility of any of the continental healthcare models on offer.

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