NPR

A good read.

_Os_ wrote: ↑Sat Jul 23, 2022 10:53 am The average UK person has about £6k of savings,

Another thing I wrote a piece on and although around beginning of COVID, I can't imagine the nos haven't gone anywhere different despite all the guff about not being able to spend during lockdown/

1) The average is a distortion because of people like you and I. The distribution is terrifying:
2) 10% have NO savings. Not a cent.
3) Something like 33% have less than £600 in savings. Lloyds came out with nos last month saying their average savings was £600. Keep in mind Lloyds is an old farts bank. WTF have youngsters got saved then?
4) The scariest one of all: 40% could not survive more than a month with no income.

Hal Jordan wrote: ↑Sat Jul 23, 2022 1:11 pm Didn't he say the loss of the manufacturing and agricultural sectors were an acceptable price to pay for Brexit?

What manufacturing? That all pretty much went with Thatcher. I don't think McLaren makes up for steel, coal and BL.

I like neeps wrote: ↑Sat Jul 23, 2022 5:08 pm The UK needs the house price collapse, it's the only way to build a better society. When that bubble bursts there is no escape from honest conversations about UK economic policy and the affects of Brexit and Austerity.

We can but hope.

Insane_Homer wrote: ↑Sun Jul 24, 2022 2:11 pm

A good read.

I’d say a lot, when I probably mean all, of the legal and taxation discussion is beyond my very limited knowledge but what I do have knowledge of is disingenuous politicians and there is a huge reek of it from Zahawi.

You can see why he doesn't want to provide a public explanation !

Torquemada 1420 wrote: ↑Sun Jul 24, 2022 3:12 pm

Hal Jordan wrote: ↑Sat Jul 23, 2022 1:11 pm Didn't he say the loss of the manufacturing and agricultural sectors were an acceptable price to pay for Brexit?

What manufacturing? That all pretty much went with Thatcher. I don't think McLaren makes up for steel, coal and BL.

Over £400 billion in 2019.

Torquemada 1420 wrote: ↑Sun Jul 24, 2022 3:11 pm

_Os_ wrote: ↑Sat Jul 23, 2022 10:53 am The average UK person has about £6k of savings,

Another thing I wrote a piece on and although around beginning of COVID, I can't imagine the nos haven't gone anywhere different despite all the guff about not being able to spend during lockdown/

1) The average is a distortion because of people like you and I. The distribution is terrifying:
2) 10% have NO savings. Not a cent.
3) Something like 33% have less than £600 in savings. Lloyds came out with nos last month saying their average savings was £600. Keep in mind Lloyds is an old farts bank. WTF have youngsters got saved then?
4) The scariest one of all: 40% could not survive more than a month with no income.

1. You're older than me, so I would hope far richer too for your own sake. As other Saffas on here know I'm in my 30s, they don't call me "Oxbot" for nothing I'm just diligent in how I build knowledge on topics.

2./3./4. Out of the people I know in my age bracket in the UK, some have a private pension and those in long term relationships usually have a house/mortgage with their partner. But the general attitude among all of them, is just to take on as much debt as possible with very little risk appreciation. The base rate of interest is definitely not a topic of conversation with them. I know a guy with £50k of student debt, £8k of personal debt, and he's now acquiring £250k of mortgage debt, it's hard to tell (as you say averages obscure much) but being about a third of a million in the hole seems quite normal. Crypto is where the lack of traditional savings, lack of risk appreciation, and financialisation all meet in an unholy mess. Pretty sure I know more people with crypto than with private pensions, I tell them to at least invest in stocks if they want to do it themselves but they'll have none of it, even the ones who have lost large amounts remain committed.

It's one of the reasons I think UK house prices aren't going to collapse, FTBs have no risk appreciation or understanding of value. They're habituated to saving nothing and stacking up as much debt as they possibly can.

_Os_ wrote: ↑Sun Jul 24, 2022 6:35 pm
1. You're older than me, so I would hope far richer too for your own sake. As other Saffas on here know I'm in my 30s, they don't call me "Oxbot" for nothing I'm just diligent in how I build knowledge on topics.

2./3./4. Out of the people I know in my age bracket in the UK, some have a private pension and those in long term relationships usually have a house/mortgage with their partner. But the general attitude among all of them, is just to take on as much debt as possible with very little risk appreciation. The base rate of interest is definitely not a topic of conversation with them. I know a guy with £50k of student debt, £8k of personal debt, and he's now acquiring £250k of mortgage debt, it's hard to tell (as you say averages obscure much) but being about a third of a million in the hole seems quite normal. Crypto is where the lack of traditional savings, lack of risk appreciation, and financialisation all meet in an unholy mess. Pretty sure I know more people with crypto than with private pensions, I tell them to at least invest in stocks if they want to do it themselves but they'll have none of it, even the ones who have lost large amounts remain committed.

It's one of the reasons I think UK house prices aren't going to collapse, FTBs have no risk appreciation or understanding of value. They're habituated to saving nothing and stacking up as much debt as they possibly can.

Terrifying and depressing in equal measure. I'm tempted by resorting to Darwin too.

In answer to your last point, right up until they are unable to service that debt.

I had a Maths lecturer who described Lotteries as a; "Tax on Stupidity"; it wasn't an original line, but I apply the same logic to anyone who invests more that they would on a Grand National punt, in Crypto !

Labour should campaign on a huge new-build programme of affordable housing for first time buyers "A land fit for PlayStation heroes"

Charge patients for hospital stays to help fund NHS, says report

https://www.theguardian.com/politics/20 ... ays-report

Tichtheid wrote: ↑Sun Jul 24, 2022 10:14 pm Charge patients for hospital stays to help fund NHS, says report

https://www.theguardian.com/politics/20 ... ays-report

Two problems with that :

1. Once a charge is introduced, it ain't going away, and will in all probability, increase. The actual cost of an acute bed is something like £ 1,000 per night, so the principle of free at the point of delivery (whether or not you agree with it), once breached, will be under severe upwards pressure.

2. Payment. What when someone says I have neither cash nor card ? Sue the poor and sick ? Take it from their old age pension ?

Camroc2 wrote: ↑Sun Jul 24, 2022 11:48 pm

Tichtheid wrote: ↑Sun Jul 24, 2022 10:14 pm Charge patients for hospital stays to help fund NHS, says report

https://www.theguardian.com/politics/20 ... ays-report

Two problems with that :

1. Once a charge is introduced, it ain't going away, and will in all probability, increase. The actual cost of an acute bed is something like £ 1,000 per night, so the principle of free at the point of delivery (whether or not you agree with it), once breached, will be under severe upwards pressure.

2. Payment. What when someone says I have neither cash nor card ? Sue the poor and sick ? Take it from their old age pension ?

A&E is the front line; I'd have everyone presenting at A&E blow in the bag, & if they're over the drink drive limit, I don't care what the fuck is wrong with them, they're paying full fucking price !!!!

I'd also stick a couple of percent on alcohol just to fund the NHS, because that's where the business is coming from; same principle with the sugar tax, but longer term, versus short term with booze

Camroc2 wrote: ↑Sun Jul 24, 2022 11:48 pm

Tichtheid wrote: ↑Sun Jul 24, 2022 10:14 pm Charge patients for hospital stays to help fund NHS, says report

https://www.theguardian.com/politics/20 ... ays-report

Two problems with that :

1. Once a charge is introduced, it ain't going away, and will in all probability, increase. The actual cost of an acute bed is something like £ 1,000 per night, so the principle of free at the point of delivery (whether or not you agree with it), once breached, will be under severe upwards pressure.

2. Payment. What when someone says I have neither cash nor card ? Sue the poor and sick ? Take it from their old age pension ?

Yup, it really is the thin edge of the wedge in a previously untouchable place.

"Run it down, cut funding, make it not work and then tell 'em the best option is the private sector"

It's a well-worn path.

With dentistry what they've done is introduce levels of payment at point of use and then make NHS dentists wait for months for reimbursements for work they've done, so the dentists decide that they can't work like that and have to introduce payment plans and the like, before going fully private.

This will happen in the NHS, in hospitals and in GP surgeries

Tichtheid wrote: ↑Mon Jul 25, 2022 12:15 am

Camroc2 wrote: ↑Sun Jul 24, 2022 11:48 pm

Tichtheid wrote: ↑Sun Jul 24, 2022 10:14 pm Charge patients for hospital stays to help fund NHS, says report

https://www.theguardian.com/politics/20 ... ays-report

Two problems with that :

1. Once a charge is introduced, it ain't going away, and will in all probability, increase. The actual cost of an acute bed is something like £ 1,000 per night, so the principle of free at the point of delivery (whether or not you agree with it), once breached, will be under severe upwards pressure.

2. Payment. What when someone says I have neither cash nor card ? Sue the poor and sick ? Take it from their old age pension ?

Yup, it really is the thin edge of the wedge in a previously untouchable place.

"Run it down, cut funding, make it not work and then tell 'em the best option is the private sector"

It's a well-worn path.

With dentistry what they've done is introduce levels of payment at point of use and then make NHS dentists wait for months for reimbursements for work they've done, so the dentists decide that they can't work like that and have to introduce payment plans and the like, before going fully private.

This will happen in the NHS, in hospitals and in GP surgeries

A particular problem for the UK is that the NHS' principle of free at the point of delivery means it hasn't, outside of BUPA (for rich people mostly), a history of health insurance, whether purchased privately or part of a remuneration package. Private Health Insurance is a very common feature of "middle class" remuneration packages in the rest of Europe including places like France, and Sweden.

I'm not sure they're quite as extensive (both in number of people covered, and what is covered under the policies) in the UK.

Also, one of the key problems in the NHS right now is a shortage of doctors and nurses. Charging does not solve that problem.

Camroc2 wrote: ↑Mon Jul 25, 2022 12:28 am

Tichtheid wrote: ↑Mon Jul 25, 2022 12:15 am

Camroc2 wrote: ↑Sun Jul 24, 2022 11:48 pm

Two problems with that :

1. Once a charge is introduced, it ain't going away, and will in all probability, increase. The actual cost of an acute bed is something like £ 1,000 per night, so the principle of free at the point of delivery (whether or not you agree with it), once breached, will be under severe upwards pressure.

2. Payment. What when someone says I have neither cash nor card ? Sue the poor and sick ? Take it from their old age pension ?

Yup, it really is the thin edge of the wedge in a previously untouchable place.

"Run it down, cut funding, make it not work and then tell 'em the best option is the private sector"

It's a well-worn path.

With dentistry what they've done is introduce levels of payment at point of use and then make NHS dentists wait for months for reimbursements for work they've done, so the dentists decide that they can't work like that and have to introduce payment plans and the like, before going fully private.

This will happen in the NHS, in hospitals and in GP surgeries

A particular problem for the UK is that the NHS' principle of free at the point of delivery means it hasn't, outside of BUPA (for rich people mostly), a history of health insurance, whether purchased privately or part of a remuneration package. Private Health Insurance is a very common feature of "middle class" remuneration packages in the rest of Europe including places like France, and Sweden.

I'm not sure they're quite as extensive (both in number of people covered, and what is covered under the policies) in the UK.

You're right, but it is increasingly a factor in employee retention. I'm currently moving jobs and one of the motivations is to stop having to pay for physio out of my own pocket.

Good to see millionaire Mad Nad concentrating on the important things in the Tory leadership contest!!!

Paddington Bear wrote: ↑Mon Jul 25, 2022 8:32 am

Camroc2 wrote: ↑Mon Jul 25, 2022 12:28 am

Tichtheid wrote: ↑Mon Jul 25, 2022 12:15 am



Yup, it really is the thin edge of the wedge in a previously untouchable place.

"Run it down, cut funding, make it not work and then tell 'em the best option is the private sector"

It's a well-worn path.

With dentistry what they've done is introduce levels of payment at point of use and then make NHS dentists wait for months for reimbursements for work they've done, so the dentists decide that they can't work like that and have to introduce payment plans and the like, before going fully private.

This will happen in the NHS, in hospitals and in GP surgeries

A particular problem for the UK is that the NHS' principle of free at the point of delivery means it hasn't, outside of BUPA (for rich people mostly), a history of health insurance, whether purchased privately or part of a remuneration package. Private Health Insurance is a very common feature of "middle class" remuneration packages in the rest of Europe including places like France, and Sweden.

I'm not sure they're quite as extensive (both in number of people covered, and what is covered under the policies) in the UK.

You're right, but it is increasingly a factor in employee retention. I'm currently moving jobs and one of the motivations is to stop having to pay for physio out of my own pocket.

It is quite clear it has been the Gov strategy to strangle the NHS through underfunding and to drive the more well off into the private sector. It is well underway.

There has always been a small private sector doing work on the fringe - the simple and less complex end of the spectrum ie physio, cataracts, plastic/cosmetic surgery, joint replacements for healthy folk, etc. However we now see the private sector delivering more NHS services including GP services. Skipping the inevitable lengthening NHS queues will drive demand for private cover via employers.

The NHS isn't set up for charging - the cost of collecting, managing, chasing up payment, etc of the small sums being suggested will outweigh the funds being brought in. Any introduction of charging would require significant set up investment so the charges would have to be significant to make it worthwhile. However there will no doubt be pressure over time to charge more for certain services ie the more complex operations should be charged more, then there will need to be systems to itemise spend per patient so drugs, consumables, staff time, meals, etc will need systems in place to ensure costs are allocated to the right patient. Patients, scared of possible costs, will begin to take out private healthcare cover and insurance systems get involved and demand prior approval before care is given, that only certain drugs are used to keep costs down ... you can see where this goes! Once we start charging then the Gov would just reduce central funding leaving healthcare deliverers no other option but to keep increasing charges until it becomes a fully privatised service. I know the Us is an extreme example but a mate of mine is an Intensivist and worked in US for a spell - he saw patients in the morning and spent the afternoon filling in all the forms for the insurance companies including having to justify why he used certain drugs etc. He couldn't stand the bureaucracy and left.

The Commonwealth Fund has always rated the NHS as one of the better performing healthcare systems compared with similar countries and the most affordable system of them all - the US model is always by some way the worst. However we do spend less % of GDP than closest comparators - c 1% of GDP less than France and Germany - and that in part explains some of our poorer outcomes. However if you compare performance to spending then we do rate slightly higher than both according to the Commonwealth Fund.

Make no mistake folks this Gov has a clear aim of getting rid of the NHS and allowing their private sector mates/vultures to strip out the profitable sections of the NHS. We will all be worse off in the end.

SaintK wrote: ↑Mon Jul 25, 2022 9:38 am Good to see millionaire Mad Nad concentrating on the important things in the Tory leadership contest!!!

They are a buckets of frogs level of mad - all of them! However they are also feckin dangerous and worked from behind by some extremely dark and dodgy money. Dangerous times folks!

Biffer wrote: ↑Mon Jul 25, 2022 8:02 am Also, one of the key problems in the NHS right now is a shortage of doctors and nurses. Charging does not solve that problem.

No, but it makes the donors rich and secures one non-exec board and consulting positions with health care companies after the political career is over (or during it), and that's real point to being a Conservative MP.

fishfoodie wrote: ↑Sun Jul 24, 2022 9:34 pm I had a Maths lecturer who described Lotteries as a; "Tax on Stupidity"; it wasn't an original line, but I apply the same logic to anyone who invests more that they would on a Grand National punt, in Crypto !

Yup: we call it the "Fools Tax".

All of these behaviours (including betting, equity trading apps etc) are rooted in some or all of
- the desire for an easy way to get rich
- the mistaken belief that there is a way to "beat the system"
- over confidence in one's own abilities: horse racing, the pools and all football betting being the most obvious examples.

dpedin wrote: ↑Mon Jul 25, 2022 10:00 am
The Commonwealth Fund has always rated the NHS as one of the better performing healthcare systems compared with similar countries and the most affordable system of them all - the US model is always by some way the worst. However we do spend less % of GDP than closest comparators - c 1% of GDP less than France and Germany - and that in part explains some of our poorer outcomes. However if you compare performance to spending then we do rate slightly higher than both according to the Commonwealth Fund.

Not sure that is the entire picture.
1) How is "most affordable" being defined here? Affordable by the patients or by the Govt? I'm sure there are other countries where healthcare is free so how is nil more affordable than nil?!
2) Would be interesting to know how poorer outcomes are affected by poorer health to start with. In simple terms we know the Yanks and Brits are the worst lard arses in the developed world and that has huge ramifications for heart disease, diabetes, cancer etc
3) Would be interesting to know how poorer outcomes are affected by the vast sums of money the NHS loses each year in compensation claims. Seems quite tricky to get these nos (wonder why?......) but my rooting suggests it's 10% of the entire health budget (i.e. not just the NHS).

Torquemada 1420 wrote: ↑Mon Jul 25, 2022 12:38 pm

dpedin wrote: ↑Mon Jul 25, 2022 10:00 am
The Commonwealth Fund has always rated the NHS as one of the better performing healthcare systems compared with similar countries and the most affordable system of them all - the US model is always by some way the worst. However we do spend less % of GDP than closest comparators - c 1% of GDP less than France and Germany - and that in part explains some of our poorer outcomes. However if you compare performance to spending then we do rate slightly higher than both according to the Commonwealth Fund.

Not sure that is the entire picture.
1) How is "most affordable" being defined here? Affordable by the patients or by the Govt? I'm sure there are other countries where healthcare is free so how is nil more affordable than nil?!
2) Would be interesting to know how poorer outcomes are affected by poorer health to start with. In simple terms we know the Yanks and Brits are the worst lard arses in the developed world and that has huge ramifications for heart disease, diabetes, cancer etc
3) Would be interesting to know how poorer outcomes are affected by the vast sums of money the NHS loses each year in compensation claims. Seems quite tricky to get these nos (wonder why?......) but my rooting suggests it's 10% of the entire health budget (i.e. not just the NHS).

Torquemada 1420 wrote: ↑Mon Jul 25, 2022 12:38 pm

dpedin wrote: ↑Mon Jul 25, 2022 10:00 am
The Commonwealth Fund has always rated the NHS as one of the better performing healthcare systems compared with similar countries and the most affordable system of them all - the US model is always by some way the worst. However we do spend less % of GDP than closest comparators - c 1% of GDP less than France and Germany - and that in part explains some of our poorer outcomes. However if you compare performance to spending then we do rate slightly higher than both according to the Commonwealth Fund.

Not sure that is the entire picture.
1) How is "most affordable" being defined here? Affordable by the patients or by the Govt? I'm sure there are other countries where healthcare is free so how is nil more affordable than nil?!
2) Would be interesting to know how poorer outcomes are affected by poorer health to start with. In simple terms we know the Yanks and Brits are the worst lard arses in the developed world and that has huge ramifications for heart disease, diabetes, cancer etc
3) Would be interesting to know how poorer outcomes are affected by the vast sums of money the NHS loses each year in compensation claims. Seems quite tricky to get these nos (wonder why?......) but my rooting suggests it's 10% of the entire health budget (i.e. not just the NHS).

From what i can remember reading the NHS was very efficient for quantity of treatment delivered for the cost. USA system very good a delivering minimum amount of treatment at maximum cost. NHS is bad at early treatment compared to other European nations. Also because it is always one of the first budgets to be cut though longterm more cost effective I recall general public health measures we are also bad compared to other European nations.

petej wrote: ↑Mon Jul 25, 2022 1:15 pm
From what i can remember reading the NHS was very efficient for quantity of treatment delivered for the cost. USA system very good a delivering minimum amount of treatment at maximum cost. NHS is bad at early treatment compared to other European nations. Also because it is always one of the first budgets to be cut though longterm more cost effective I recall general public health measures we are also bad compared to other European nations.

Cheers.

Quantity v quality......

NHS is abysmal at prevention. Utterly abysmal. Crudely, it seems
- if you are young and have an illness, it will take a f**king age to get into the system and any diagnosis before being provided treatment.
- if you are old and already with no quality of life, the NHS will spend every penny available to keep you alive.
Rather like the most broken aspect of UK policing, it seems beyond the comprehension of anyone in charge to realise that rapid diagnosis and treatment (crime prevention in the case of the police) not only is better for the patient but would save vast sums in more expensive treatments later on when the illness has significantly progressed. And that ignores the costs to the economy from working hours lost and the additional social impacts.

Torquemada 1420 wrote: ↑Mon Jul 25, 2022 12:38 pm

dpedin wrote: ↑Mon Jul 25, 2022 10:00 am
The Commonwealth Fund has always rated the NHS as one of the better performing healthcare systems compared with similar countries and the most affordable system of them all - the US model is always by some way the worst. However we do spend less % of GDP than closest comparators - c 1% of GDP less than France and Germany - and that in part explains some of our poorer outcomes. However if you compare performance to spending then we do rate slightly higher than both according to the Commonwealth Fund.

Not sure that is the entire picture.
1) How is "most affordable" being defined here? Affordable by the patients or by the Govt? I'm sure there are other countries where healthcare is free so how is nil more affordable than nil?!
2) Would be interesting to know how poorer outcomes are affected by poorer health to start with. In simple terms we know the Yanks and Brits are the worst lard arses in the developed world and that has huge ramifications for heart disease, diabetes, cancer etc
3) Would be interesting to know how poorer outcomes are affected by the vast sums of money the NHS loses each year in compensation claims. Seems quite tricky to get these nos (wonder why?......) but my rooting suggests it's 10% of the entire health budget (i.e. not just the NHS).

You’re suggesting there £19 billion of damages being paid out in the UK each year?

No.

Biffer wrote: ↑Mon Jul 25, 2022 2:06 pm
You’re suggesting there £19 billion of damages being paid out in the UK each year?

No.

Typo! Apologies.

1% ish. £2.5bn in claims pa versus a total Department for Health and Social Care budget of £190bn.

£2.5bn is a criminally negligent number in all senses. Some reports have that number much higher due to backlogged (ironic, eh?) claims
https://www.bbc.co.uk/news/health-51180944

Estimates published last year put the total cost of outstanding compensation claims at £83bn.

Did the League against blood sports step in ?

Tory leadership race: Truss refuses Andrew Neil interview as Sunak quips ‘just me then’

Liz Truss will not agree to a televised interview with Andrew Neil despite Rishi Sunak signing up for a grilling, allies of the Foreign Secretary have told The Telegraph.

Mr Sunak has agreed to be interviewed by Mr Neil in a special Tory leadership programme which will be broadcast on Channel 4 on Friday evening.

The broadcaster said Ms Truss has "so far declined to take part - but the invitation remains open" but an ally of the Foreign Secretary said she does not intend to take part because her "focus" is on speaking directly to Tory members.

https://www.telegraph.co.uk/politics/20 ... r-starmer/

fishfoodie wrote: ↑Mon Jul 25, 2022 2:41 pm Did the League against blood sports step in ?

Tory leadership race: Truss refuses Andrew Neil interview as Sunak quips ‘just me then’

Liz Truss will not agree to a televised interview with Andrew Neil despite Rishi Sunak signing up for a grilling, allies of the Foreign Secretary have told The Telegraph.

Mr Sunak has agreed to be interviewed by Mr Neil in a special Tory leadership programme which will be broadcast on Channel 4 on Friday evening.

The broadcaster said Ms Truss has "so far declined to take part - but the invitation remains open" but an ally of the Foreign Secretary said she does not intend to take part because her "focus" is on speaking directly to Tory members.

https://www.telegraph.co.uk/politics/20 ... r-starmer/

She'll have plenty of time as PM to embarrass herself on TV

Torquemada 1420 wrote: ↑Mon Jul 25, 2022 12:38 pm

dpedin wrote: ↑Mon Jul 25, 2022 10:00 am
The Commonwealth Fund has always rated the NHS as one of the better performing healthcare systems compared with similar countries and the most affordable system of them all - the US model is always by some way the worst. However we do spend less % of GDP than closest comparators - c 1% of GDP less than France and Germany - and that in part explains some of our poorer outcomes. However if you compare performance to spending then we do rate slightly higher than both according to the Commonwealth Fund.

Not sure that is the entire picture.
1) How is "most affordable" being defined here? Affordable by the patients or by the Govt? I'm sure there are other countries where healthcare is free so how is nil more affordable than nil?!
2) Would be interesting to know how poorer outcomes are affected by poorer health to start with. In simple terms we know the Yanks and Brits are the worst lard arses in the developed world and that has huge ramifications for heart disease, diabetes, cancer etc
3) Would be interesting to know how poorer outcomes are affected by the vast sums of money the NHS loses each year in compensation claims. Seems quite tricky to get these nos (wonder why?......) but my rooting suggests it's 10% of the entire health budget (i.e. not just the NHS).

Rather than go into detail just google Commonwealth Fund and you will find all the details in their reports and should answer questions re affordability above. from recollection it is based on country spend and what they get back in terms of overall performance of the system, but I could be wrong.

I agree that lifestyle and incidence of avoidable chronic disease is key determinant in outcomes ie main reasons for limb amputations are smoking and diabetes. Hence need for a better approach to public health in US and UK but this is often condemned as the 'nanny state' interfering whilst big corporations pour huge sums into marketing, sponsorship, advertising etc.

UK NHS doesn't spend huge amounts on compensation claims relative to overall spend although the litigious nature of healthcare from US is spreading here. Folk seem to forget that all interventions carry risk and the UK does relatively well in terms of clinical safety and there has been a huge push in last 5 years to reduce adverse incidents and improve quality of outcomes. Big claims tend to be in those high risk specialities ie obstetrics where clinical mistakes which lead to compensation reflect that they need to cover the whole life of the patient ie babies born with CP due to mistakes during birth. Unfortunately given healthcare is delivered by individuals then accidents do happen but systems are increasingly getting better to minimise human errors and their consequences, they won't get rid of them though!

FAO JMK - did you catch Starmer dropping his pledge to nationalise public services today?

dpedin wrote: ↑Mon Jul 25, 2022 3:34 pm

Torquemada 1420 wrote: ↑Mon Jul 25, 2022 12:38 pm

dpedin wrote: ↑Mon Jul 25, 2022 10:00 am
The Commonwealth Fund has always rated the NHS as one of the better performing healthcare systems compared with similar countries and the most affordable system of them all - the US model is always by some way the worst. However we do spend less % of GDP than closest comparators - c 1% of GDP less than France and Germany - and that in part explains some of our poorer outcomes. However if you compare performance to spending then we do rate slightly higher than both according to the Commonwealth Fund.

Not sure that is the entire picture.
1) How is "most affordable" being defined here? Affordable by the patients or by the Govt? I'm sure there are other countries where healthcare is free so how is nil more affordable than nil?!
2) Would be interesting to know how poorer outcomes are affected by poorer health to start with. In simple terms we know the Yanks and Brits are the worst lard arses in the developed world and that has huge ramifications for heart disease, diabetes, cancer etc
3) Would be interesting to know how poorer outcomes are affected by the vast sums of money the NHS loses each year in compensation claims. Seems quite tricky to get these nos (wonder why?......) but my rooting suggests it's 10% of the entire health budget (i.e. not just the NHS).

Rather than go into detail just google Commonwealth Fund and you will find all the details in their reports and should answer questions re affordability above. from recollection it is based on country spend and what they get back in terms of overall performance of the system, but I could be wrong.

I agree that lifestyle and incidence of avoidable chronic disease is key determinant in outcomes ie main reasons for limb amputations are smoking and diabetes. Hence need for a better approach to public health in US and UK but this is often condemned as the 'nanny state' interfering whilst big corporations pour huge sums into marketing, sponsorship, advertising etc.

UK NHS doesn't spend huge amounts on compensation claims relative to overall spend although the litigious nature of healthcare from US is spreading here. Folk seem to forget that all interventions carry risk and the UK does relatively well in terms of clinical safety and there has been a huge push in last 5 years to reduce adverse incidents and improve quality of outcomes. Big claims tend to be in those high risk specialities ie obstetrics where clinical mistakes which lead to compensation reflect that they need to cover the whole life of the patient ie babies born with CP due to mistakes during birth. Unfortunately given healthcare is delivered by individuals then accidents do happen but systems are increasingly getting better to minimise human errors and their consequences, they won't get rid of them though!

One of the issues with the Commonwealth Fund reports is that it was set up to promote equal access to healthcare, so it prioritizes equality of access, in its reports, and considers this to be more important than health outcomes. This means that the criteria and weightings used in its reports are almost designed to put an NHS system in top spot, and the US system at the bottom. For example, in previous reports it has rated the NHS as the best performing healthcare system, despite it having much lower health outcomes than many other countries.

Of course, equality of access is an extremely important part of a functioning healthcare system, but it’s certainly arguable that the quality of healthcare outcomes ought to be equally important.

Despite its inbuilt biases in favour of NHS style systems, in its latest report the NHS dropped from 1st to 4th place, largely because of the huge delays in treatment following the Covid pandemic.

Lobby wrote: ↑Mon Jul 25, 2022 5:13 pm

dpedin wrote: ↑Mon Jul 25, 2022 3:34 pm

Torquemada 1420 wrote: ↑Mon Jul 25, 2022 12:38 pm
Not sure that is the entire picture.
1) How is "most affordable" being defined here? Affordable by the patients or by the Govt? I'm sure there are other countries where healthcare is free so how is nil more affordable than nil?!
2) Would be interesting to know how poorer outcomes are affected by poorer health to start with. In simple terms we know the Yanks and Brits are the worst lard arses in the developed world and that has huge ramifications for heart disease, diabetes, cancer etc
3) Would be interesting to know how poorer outcomes are affected by the vast sums of money the NHS loses each year in compensation claims. Seems quite tricky to get these nos (wonder why?......) but my rooting suggests it's 10% of the entire health budget (i.e. not just the NHS).

Rather than go into detail just google Commonwealth Fund and you will find all the details in their reports and should answer questions re affordability above. from recollection it is based on country spend and what they get back in terms of overall performance of the system, but I could be wrong.

I agree that lifestyle and incidence of avoidable chronic disease is key determinant in outcomes ie main reasons for limb amputations are smoking and diabetes. Hence need for a better approach to public health in US and UK but this is often condemned as the 'nanny state' interfering whilst big corporations pour huge sums into marketing, sponsorship, advertising etc.

UK NHS doesn't spend huge amounts on compensation claims relative to overall spend although the litigious nature of healthcare from US is spreading here. Folk seem to forget that all interventions carry risk and the UK does relatively well in terms of clinical safety and there has been a huge push in last 5 years to reduce adverse incidents and improve quality of outcomes. Big claims tend to be in those high risk specialities ie obstetrics where clinical mistakes which lead to compensation reflect that they need to cover the whole life of the patient ie babies born with CP due to mistakes during birth. Unfortunately given healthcare is delivered by individuals then accidents do happen but systems are increasingly getting better to minimise human errors and their consequences, they won't get rid of them though!

One of the issues with the Commonwealth Fund reports is that it was set up to promote equal access to healthcare, so it prioritizes equality of access, in its reports, and considers this to be more important than health outcomes. This means that the criteria and weightings used in its reports are almost designed to put an NHS system in top spot, and the US system at the bottom. For example, in previous reports it has rated the NHS as the best performing healthcare system, despite it having much lower health outcomes than many other countries.

Of course, equality of access is an extremely important part of a functioning healthcare system, but it’s certainly arguable that the quality of healthcare outcomes ought to be equally important.

Despite its inbuilt biases in favour of NHS style systems, in its latest report the NHS dropped from 1st to 4th place, largely because of the huge delays in treatment following the Covid pandemic.

I would argue that the domains the Commonwealth Fund use to measure performance of healthcare systems are fairly accepted measures for assessing healthcare system performance. I don't think there is any inbuilt bias for an NHS style system - the UK only rates 4th for both access and equity - but rather that these domains are just widely accepted measures academics, Govs and others who try and do these comparisons of different healthcare systems.

From my understanding the Commonwealth Fund measure performance across 5 domains - access to care, care process, administrative efficiency, equity, and health care outcomes - and all are weighted equally. Each has a number of measures within it drawing on available data, surveys, etc.

Trying to compare different healthcare systems is difficult, as they acknowledge in their reports. However if you can't access healthcare, say due to cost, or if provision is inequitable, say certain sections of the community are excluded, then these will have as much an impact on the performance of the whole health system as specific healthcare outcomes. If you can't afford to access healthcare or if the cost of it makes you bankrupt and homeless, as often happens in America, then that has a huge negative impact on health and outcomes.

UK overall performance post covid has dropped, it is however still above the 11 country average in the study. Personally I would argue that the significant under resourcing leading to workforce issues, longer waiting times and problematic access to care is probably driving this?

Rishi needs to shut the fuck up and stop interrupting. Truss is going to hang herself but he is coming across as very annoying

Are these the £4.50 earrings btw?

Slick wrote: ↑Mon Jul 25, 2022 8:23 pm Rishi needs to shut the fuck up and stop interrupting. Truss is going to hang herself but he is coming across as very annoying

If "do it" means bickering as if they were in opposing parties instead of contesting the leadership of the same one - yes they can!

Rishi's political instincts are horrendous - yelling over a woman repeatedly is going to get him barbecued at an election.

Paddington Bear wrote: ↑Mon Jul 25, 2022 8:30 pm Rishi's political instincts are horrendous - yelling over a woman repeatedly is going to get him barbecued at an election.

Absolutely

Truss doing much better tonight. She was rocking a bit on economics mind you

Both performing better than Johnson would.