Comment by TheOtherHobbes
9 days ago
The UK spends about 18% less per capita on the NHS than the EU14 countries do on their health systems.
A lot of that money has gone on stealth privatisation through inefficient outsourcing of contract staff and PFI of infrastructure.
So the actual standard of care is far lower than the funding suggests. And it has been deliberately run down so a US-style system can be implemented.
So yes, the organisation should be improved, but in the exact opposite direction to the one you're suggesting.
The UK's real problem is that it's run by an out-of-touch inbred aristocracy with vast inherited wealth, working through a political system which prioritises stealth corruption over public service.
They don't see why they should contribute anything to the welfare of the peasants. The obligation is all one way - from the peasants to the gentry.
And there's a layer of middle class professionals who have convinced themselves they're the gentry, even though they can't afford to pay their school fees, never mind maintain a huge estate.
So - private ownership good, public spending bad. More sensible countries don't have this attitude problem, and are proud their public services actually benefit the public.
I like the cut of your jib. I see the class system in much the same way but with different analogies. The middle class professionals are like the 'house n-gro' described by Malcolm X and the minimum wage workers are like the 'field n-gro' (not sure we can use that word even in academic discussions given where the UK free speech laws are going!).
There is also a lack of a respected teaching class. With the changes to universities and schools, there is no longer any respect for those with an education and able to teach.
If you go to, say, France, you'll find that healthcare isn't free at the point of use and that the system is much more private than in the UK. I believe this is so in many other European countries, too.
So public/NHS vs private/US system is a false dichotomy, and "free at the point of use" is a red herring.
Looking at the reactions, this whole threads does exemplifies what the OP said about the NHS being a "religion".
It's not a "religion" to have people disagree with you on philosophical points.
In addition, I'd say most of this thread is a bunch of people debating what issues there are with the NHS (I don't see anyone claiming there aren't any) with some people for it, and some against it.
A fair few people believe that it is the duty of the state to care for individuals, and that one right that people have is free access to healthcare.
If someone expresses that viewpoint I don't think it's fair to say that they're being religious or dogmatic about it, just like it wouldn't be fair for people to argue that your view (which I assume is for a more privatised healthcare system) is religious or dogmatic, it's a simple disagreement.
I moved to Finland from the UK and found exactly the same thing you mentioned in France. Plus extra layers of beauracracy (there's no national health service, there are public hospitals that send a bill to the public insurer and you get a bill for an excess unless you are absolutely down-and-out. Either way, a nice job program for public administrators). Prescriptions are far more expensive than the UK (your co-pay on them is something like €600 a year)
One nice perk though is that [private, corporate] jobs offer cushy health insurance as part of the deal as standard really so you can go and see one of the many private doctors in their offices at your choice and leisure.
Same with Canada, they have public health insurance run by provinces which private hospitals bill to. While the UK has a giant national public hospital system run across an entire country (NHS England, NHS Scotland etc).
The UK has NHS trusts that run hospitals etc. For a limited period of time - just a few years -, the trusts in England were reporting to NHS England. NHS England is being abolished.
These ca. 200 trusts operate with a great degree of operational independence, though they are public entties.
The distinction is important because they are what makes the scale manageable, and it also provides resilience.
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I guess you're talking about healthcare for the unemployed or non-residents or non-French people, because if you're employed there is additionnal and mandatory healthcare. There's still basic free healthcare if you don't yet fit well in the system but it's like for example to remove a tooth instead of clean it and reconstruct it.
No, I am talking about everyone.
> because if you're employed there is additionnal and mandatory healthcare
Yes, if you are employed in the private sector there is now mandatory additional private health insurance to cover what public healthcare does not.
Healthcare isn't free at the point of use in any case. Things may be automatically paid/reimbursed as the case may be. Private sector is much more involved than in the UK, too, starting from GPs who are all private practices.
The point is that it's not because you have to pay at point of use or because things are more private that you end up like in the US. This is an FUD argument against change.
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