Hurray for the British NHS: Patients are just *dying* to get on it!

[paulclifford]

Britain's NHS: A truly humane, government-run, single-payer system of "universal healthcare". Here are some of its strong points:

1. NHS doctors routinely conceal from patients information about innovative new therapies that the NHS doesn’t pay for, so as to not “distress, upset or confuse” them.

http://www.telegraph.co.uk/news/uknews/3322438/Patients-left-in-the-dark-about-life-saving-drugs.html


"There is growing evidence that doctors are concealing treatment options that are not available on the National Health Service but can be obtained privately."


http://news.bbc.co.uk/2/hi/health/7581705.stm


"Doctors are keeping cancer patients in the dark about expensive new drugs that could extend their lives, a poll shows.

A quarter of specialists polled by Myeloma UK said they hid facts about treatments for bone marrow cancer that may be difficult to obtain on the NHS. Doctors said they did not want to "distress, upset or confuse" patients if drugs had not yet been approved by the NHS drugs watchdog NICE."


2. Terminally ill patients are incorrectly classified as “close to death” so as to allow the withdrawal of expensive life support.

http://www.telegraph.co.uk/health/healthnews/6127514/Sentenced-to-death-on-the-NHS.html


"Sentenced to death on the NHS

Patients with terminal illnesses are being made to die prematurely under an NHS scheme to help end their lives, leading doctors have warned.

In a letter to The Daily Telegraph, a group of experts who care for the terminally ill claim that some patients are being wrongly judged as close to death."


3. NHS expert guidelines on the management of high cholesterol are intentionally out of date, putting patients at serious risk, in order to save money.

http://www.dailymail.co.uk/health/article-419083/Sentenced-death-NICE.html


"Sentenced to death by NICE

By DR SARAH JARVIS

Last updated at 22:00 27 November 2006

It's the body that decides which drugs are allowed on the NHS. But in this blistering attack, a leading GP argues the organisation set up to improve care is obsessed by costs, discriminates against the elderly - and ultimately is killing patients:

Recently I was left feeling furious and frustrated after a visit from a patient called Peter. He'd just had a serious heart attack and my job as a GP was to reduce his very high risk of having another.

I knew what the latest research told me was the best way, but I had just basically been forbidden to use it by an official email from the Department of Health.

Instructions about what treatments I can and can't give are issued by a government body called NICE (National Institute for Health and Clinical Excellence).



4. When the government approved an innovative new treatment for elderly blindness, the NHS initially decided to reimburse for the treatment only after patients were already blind in one eye — using the logic that a person blind in one eye can still see, and is therefore not that badly off.

http://news.bbc.co.uk/2/hi/health/7582740.stm


"Lucentis: An NHS dilemma

Outraged campaigners can be found filling newspaper column inches and TV and radio airtime criticising the availability of drugs in one area and not another.

But buried beneath the headlines is a much more complex picture - and nowhere is that more apparent than in the case of the sight-saving drug Lucentis which treats wet age-related macular degeneration, the leading cause of blindness in the UK.

However, the treatment comes at a price - £10,000 for each eye to be precise.

The cost initially prompted the National Institute for Health and Clinical Excellence (NICE), the body which assesses drugs for the NHS, to say it should only be used when someone has gone blind in one eye."



5. While most NHS patients expect to wait five months for a hip operation or knee surgery, leaving them immobile and disabled in the meantime, the actual waiting times are even worse: 11 months for hips and 12 months for knees. (This compares to a wait of 3 to 4 weeks for such procedures in the United States.)

http://news.bbc.co.uk/2/hi/3749801.stm


"NHS waiting time 'underestimated'

People in Britain underestimate the time they would have to wait for an NHS operation, a survey suggests

The poll of 1,000 people, by TNS on behalf of Norwich Union Healthcare, showed most expect to wait five months for a hip operation.

Most wait nearer 11 months, independent medical researchers Dr Fosters said.

Patients also had unrealistic expectations for other operations and many said they did not know where to go to find out waiting times.

Waits 'improving'

For knee surgery, the public were prepared to wait for three months and expected to wait for five months.

The actual wait for a knee replacement is a year, data from Dr Foster suggests.

8 months for cataract surgery
11 months for a hip replacement
12 months for a knee replacement
5 months to repair a slipped disc
5 months for a hernia repair"



6. One in four Britons with cancer is denied treatment with the latest drugs proven to extend life.

http://www.dailymail.co.uk/health/article-2095087/Prostate-cancer-patients-denied-expensive-drug.html


"Now patients are denied 'breakthrough' prostate cancer drug as health watchdogs brand it too expensive

Once-daily pill giving extra months of life is 'too expensive'
Abiraterone is latest cancer drug facing an NHS ban"

Trials show men taking abiraterone and a steroid survived for nearly 15 months, while men given steroid treatment and a ‘dummy’ pill lived for 11 months on average.

But some patients live far longer than expected, including Britons who have survived on the drug for more than four years after developing advanced disease. The drug also eased pain for twice as many men in the trials.

A year’s course of treatment costs £35,000, which Nice says is too expensive.

Campaigners last night condemned the draft decision by Nice. Owen Sharp, chief executive of the Prostate Cancer Charity, which helped fund trials, said: ‘This draft decision is a bitter blow to thousands of men and their families – and must be overturned.’

Patients have been getting abiraterone, also known as Zytiga, through the Cancer Drugs Fund, set up by the Government to pay for treatments not approved by Nice.

But the fund only applies in England until 2014, which denies access to patients in Wales, Scotland and Northern Ireland."


[NB: I love how supporters of the NHS claim that it's an "equitable" system! Tell that to cancer patients denied cutting-edge treatment in Wales, Scotland, and Northern Ireland.]

http://www.dailymail.co.uk/health/article-2300362/Kidney-cancer-patients-denied-life-extending-drug-NHS-watchdog-declares-cost-effective.html


"Kidney cancer patients denied life-extending drug as NHS watchdog declares it 'not cost effective'

NICE says that the NHS should not provide axitinib

The drug can extend the lives of people with advanced kidney cancer but has been deemed not 'cost effective'

It works by cutting off the blood supply to the tumour

Thousands of people with kidney cancer that has spread are to be denied a new pill that could prolong their lives, claim doctors.

Axitinib extends the lives of advanced kidney cancer sufferers by two months on average, according to trials.

But the drug is the latest to face an NHS ban by the rationing watchdog, the National Institute for Health and Clinical Excellence (NICE).

It has already axed another drug that could be used after treatment stops working and the cancer starts growing again."


http://www.theguardian.com/lifeandstyle/2009/oct/21/women-denied-cancer-drug


"Women denied cancer drug that could extend life

The National Institute for Health and Clinical Excellence proposes to reject a breast cancer drug despite its own rule changes on end-of-life treatments

A drug which can give women with advanced breast cancer extra weeks or months of life has been turned down by a government watchdog body for use in the NHS.

The National Institute for Health and Clinical Excellence (Nice) says it proposes to reject Tyverb (lapatinib) in spite of changes in the rules brought in specifically to allow people at the end of their lives to have the chance of new and often expensive treatments.

Tyverb is the only drug licensed for women with advanced breast cancer whose tumours test positive for a protein called HER2 and for whom Herceptin, a Nice-approved drug, is no longer working. In much of the rest of Europe, Tyverb is then given, in combination with a standard chemotherapy drug called capecitabine.

Around 2,000 women in the UK could be eligible for the drug, which has the additional benefit of being taken in pill form, which means that women can stay at home and attempt to live normal lives."


[NB: But the NHS doesn't want to pay for these women to live normal lives. It wants them to die so it can save money.]


http://news.sky.com/story/1073672/cancer-drugs-fund-patients-to-lose-out


Thousands of cancer patients could be denied access to life-extending drugs when a cash pot expires at the end of the year, a charity has warned.

"The £200m-a-year Cancer Drugs Fund allows patients in England to access drugs approved by their doctors but which have not been cleared for widespread use on the NHS.

It was designed to make it easier for doctors to prescribe treatments even if they have not yet been approved by the National Institute for Health and Care Excellence (Nice).

The scheme is due to run until 2014, but charity Beating Bowel Cancer says the drugs may no longer be made available when the public funding runs out."


http://www.telegraph.co.uk/health/healthnews/8349297/Cancer-sufferers-refused-life-extending-drugs-despite-Government-pledge.html

"Cancer Sufferers Refused Life-Extending Drugs Despite Government Pledge"




7. Those who seek to pay for such drugs on their own are expelled from the NHS system, for making the government look bad, and are forced to pay for the entirety of their own care for the rest of their lives.

http://www.nationalreview.com/agenda/244934/non-demagogic-disquisition-death-panels-avik-roy


"When the British National Health Service was founded on July 5, 1948, expectations were sky-high. The NHS, in the words of one official, would be the “envy of the world.” 62 years later, by all objective measures, the NHS is the worst health-care system in the developed world. Costs have exploded. The NHS uses the most aggressive price controls and rationing procedures in the West, going so far as to assign a price to the “quality-adjusted life year” that is required to extend it. And yet, from 1996 to 2008, national health care expenditures in the U.K. have grown at 6.7% a year, compared to 5.5% in the U.S. over the same period.

These comments were not made solely with end-of-life care in mind. But they were made with the NHS in mind: a system in which treatments that don’t extend life by £20,000-30,000 per quality-adjusted life year are not paid for by the government. And if you choose to buy that forbidden treatment on your own, you are kicked off the NHS for life.

Those who are in their last years of lives are expected to do their part for the national budget, which is to die inexpensively.

The Quality-Adjusted Life Year (QALY) methodology that the British use is precisely oriented at reducing care for the elderly, and steering it to younger patients, for whom effective therapies will lead to a longer, fuller life. For those in their 80s, in Britain, the NHS offers little. Recent studies have shown that Britons have the worst survival rates in the developed world after being diagnosed with a disease, like cancer, or a chronic condition, like heart disease. Britain may have the best tennis courts in the world, but it has a broken health care system. When you’re young and healthy, it’s great. You go to do the doctor (if you can get an appointment), and you don’t have to think of any financial considerations. But if you’re old and unhealthy, watch out.

It comes down to this: if the government is funding health care, and simultaneously funding end-of-life counseling, the government has a conflict of interest. The government has a financial incentive to encourage people to “pull the plug on granny,” regardless of whether or not that is consistent with granny’s, or her family’s, wishes. It is, at bottom, the same reason we insist on a free, independent press (and free speech in general): when the government controls the media, it has a conflict of interest; i.e., an incentive to promote journalism that is favorable to the government."


8. Britons diagnosed with cancer or heart attacks are more likely to die, and more quickly, than those of most other developed nations. Britain’s survival rates for these diseases are “little better than [those] of former Communist countries.”

http://www.dailymail.co.uk/news/article-1234276/Britain-sick-man-Europe-Heart-cancer-survival-rates-worst-developed-world.html


"Britain, the sick man of Europe:
Heart and cancer survival rates among worst in developed world

"British health care is little better than that of former Communist countries, which spend a fraction of the billions poured into the NHS.
A survey published yesterday by the Organisation for Economic Cooperation and Development sees Britain languishing with the Czech Republic and Poland in international league tables on health."


* * * * * * * * * * * * * * * *

The Quality Adjusted Life Year (QALY). A wonderful idea!

If you're young and you get sick, the British government will pay your bills, but you'll wait months or years for treatment.

If you're old and you get sick, the British government will have a financial conflict-of-interest in spending taxpayer money to keep you alive beyond your useful taxpaying years. The NHS wants you to die in order to free up beds and save tax revenues on treatments for younger people. And if your family tries to purchase private treatment off the NHS system, you're kicked off of it forever.

And whether you're young or old, rich or poor, the NHS will deny you the best care with the latest drugs and therapies because their version of a "death panel" — the NICE — will decide that these cutting-edge cures are not cost-effective.

The main advantage to the NHS (and other universal, single-payer healthcare systems similar to it) is bragging rights: "Our government gives us free healthcare! What! You mean, yours doesn't? How inhumane!"

Yes, the NHS is a truly humane healthcare system — as long as you don't get sick.

[Stavros]

Britain's NHS: A truly humane, government-run, single-payer system of "universal healthcare". Here are some of its strong points:

1. NHS doctors routinely conceal from patients information about innovative new therapies that the NHS doesn’t pay for, so as to not “distress, upset or confuse” them.
2. Terminally ill patients are incorrectly classified as “close to death” so as to allow the withdrawal of expensive life support.
3. NHS expert guidelines on the management of high cholesterol are intentionally out of date, putting patients at serious risk, in order to save money.
4. When the government approved an innovative new treatment for elderly blindness, the NHS initially decided to reimburse for the treatment only after patients were already blind in one eye — using the logic that a person blind in one eye can still see, and is therefore not that badly off.
5. While most NHS patients expect to wait five months for a hip operation or knee surgery, leaving them immobile and disabled in the meantime, the actual waiting times are even worse: 11 months for hips and 12 months for knees. (This compares to a wait of 3 to 4 weeks for such procedures in the United States.)
6. One in four Britons with cancer is denied treatment with the latest drugs proven to extend life.
7. Those who seek to pay for such drugs on their own are expelled from the NHS system, for making the government look bad, and are forced to pay for the entirety of their own care for the rest of their lives.
8. Britons diagnosed with cancer or heart attacks are more likely to die, and more quickly, than those of most other developed nations. Britain’s survival rates for these diseases are “little better than [those] of former Communist countries.”


Here are some ponts which Paul Clifford did not make:

1) The NHS does not have a monopoly of health care provision in the UK, there has always been a private medical health care system payable through private health insurance schemes or cash down at the time of need. Many doctors who work in NHS hospitals also maintain a private practice, as is also the case with dentists and other health care practitioners.

2) The NHS has indeed performed poorly in some areas in recent years, and as Paul Clifford knows, there is a debate over the extent to which the internal market reforms which were introduced by the Conservative government in 1990 are responsible -in my opinion the creation of liberal market principles in health care is both impractical and immoral and a key cause of the decline of performance.
Thus, when Paul Clifford asserts:
Terminally ill patients are incorrectly classified as “close to death” so as to allow the withdrawal of expensive life support -he forgets to add that it is the market principles he is devoted to that make a dying person economically unattractive, so its best to get rid of them. It is the market principle hastening death, not respect for human life and the obligation to treat them, whatever the cost.

3) The NHS is profoundly important to the UK economy, and a major source of investment by privately owned companies, of which multinational pharmaceutical companies, and manufacturers of surgical instruments and machinery are obvious sources; moreover, the NHS is an important laboratory for the testing of drugs, and also of surgical procedures, instruments and machinery: this is a largely positive aspect of the NHS which feeds into the global repository of knowledge on medicine and medical practice and is in, in effect, subsidised by British tax payers for the benefit of all.

4) Specific examples of the benefits of the NHS are hidden from view by Paul Clifford: for example:
-some of the earliest work on smoking in relation to lung cancer was performed by Richard Doll and colleagues in Oxford in NHS facilities;
-the Hospital for Sick Children in Great Ormond St, in London, has been a pioneer of innovative medical treatment for new-born babies: an NHS facility, not private medical care: with funds from taxpayers, the govt, charities, et al.
-the NHS has been the source of pioneering heart surgery at the Harefield Hospital in Hertfordshire - knowledge shared with cardiologists throughout the world;
-Robert Winston at the Hammersmith Hospital in London pioneered In Vitro Fertilisation which has enabled women all over the world to have children, research that led to this innovation began when Winston was working at the University of Texas Health Science Center at San Antonio, proving that the NHS both takes from and gives back to the world its medical benefits;

and so on and so on:
this article is a modest record of achievement:
http://www.nihr.ac.uk/files/pdfs/60%20years%20of%20research%20in%20the%20NHS%20bene fiting%20patients%20final.pdf

Speaking for myself, I was in hospital with chicken pox and measles at the age of 2; I was involved in a road traffic accident when I was 9 years old; I had treatment for another accident when I was 11; I was in hospital for an operation in the 1990s; and am currently on medication which has relieved me of a chronic problem that I suffered from: all of the treatment was free at the time; the medication I am on is also free, without it the quality of my life would be impaired.

I paid for the NHS and its benefits throughout my working life and do not regret it; I do regret that government after government has fiddled with the management and financial structures of the NHS and that it has preferred to spend money on futile wars rather than on a broad range of health care initiatives which would prevent people from becoming ill in the first place, yet still provide them with excellent care when they need it. No system is perfect, but we have an NHS because the alternative, private health care and charity, existed for centuries before 1948, and it didn't meet the needs of the people.

[Prospero]

Clifford is using selective evidence to attack the NHS because he is one of those vehemently opposed to affordable health care. An arch conservative.

Excellent response Stavros.

[hippifried]

Oh. Same old crap on a new day? Partial anecdotes & other hooks for ditto heads, Ayn Rand cultists, & various tea bag guppies to swallow like so much bait? Wake me up if anything shows up that hasn't already been debunked over & over & over & over & over & over & over again, throughout the decades.
zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz zzzzzzz...

[paulclifford]

>>>>>he forgets to add that it is the market principles he is devoted to that make a dying person economically unattractive

I'm having a hard time deciding if that statement was typically "dingbat" or "moonbat." Both apply so aptly to the unenlightened views on economics (and other topics) wafting toward planet Earth from that barren asteroid far, far away known as the Extreme Utopian Left.

Know this:

Whether under communism, socialism, welfare statism, fascism, syndicalism, interventionism, feudalism, corporatism, capitalism, or any other kind of "-ism" on which society is organized — including, by the way, a moneyless barter society — anything that people want, need, desire, and value has a cost attached to acquiring it. It's not any particular "-ism" that makes it so; it's reality that makes it so.

You're in deep, Vulcan Mind-Meld-denial if you cannot accept this.

"Market principles" — meaning, private property, private decision-making, private, voluntary, contracts between two or more people, free association of people, and free exchange of goods, services, and ideas — simply make the costs of things people want, need, and desire apparent and verifiable to those engaged in exchange. It doesn't "create" something called a "cost" that wasn't already there by nature.

Socialized medicine can't change reality by refusing to look at it. It doesn't "reduce" or "eliminate" medical costs; the costs are THERE, OBJECTIVELY, by nature. Socialized medicine simply refuses to pay the costs, and then tells a naive, uninformed public, "Look! No more costs! It's all free now!"

That a government board doesn't acknowledge a cost, or hides a cost, in no way means that the cost isn't there.

No, the way all socialized healthcare systems actually deal with costs is by exploiting the only two "non-market" methods of dealing with them: queuing and rationing. That's why patients wait and wait and wait — they're actually incurring a very high cost, but in terms of their personal time, rather than their personal wealth; and when they're done waiting, they don't get the very best medical care that money can buy — that would be an evil "market-principle" method of treating the patient — they get whatever the cost-efficiency board permits the doctor to give them, because healthcare resources under socialism are assumed to be a static "pie" that has to be very thinly and very evenly sliced by "Ye Great Wise Ones" in government.

Come to think of it, socialism views all resources, not just those related to healthcare, as static, which is why under such "non-market-principle" systems, everything has a high time-cost in terms of queuing and everything is rationed.

But not for the governing elite, of course. They're too important and too busy "running things", so they get to have as much of everything as they want.

They understand that just so long as you — the "common man" — are guaranteed a certain minimum of things (income, food, healthcare), you won't complain too loudly, and — more importantly from their point of view — you'll uncritically accept the propaganda (meant to keep you voting them into power) that "It's all free!"

[paulclifford]

>>>Speaking for myself, I was in hospital with chicken pox and measles at the age of 2; I was involved in a road traffic accident when I was 9 years old; I had treatment for another accident when I was 11;

And the nice ones at NICE said, "Ah! Such a cute, young future taxpayer! Let's break out the slide-rule and calculate his Quality Adjusted Life Year . . . hmmm, it looks pretty good. OK, let him have his treatments. He has plenty of taxpaying years ahead of him. Heck, we NEED this guy! Just send the bill to those already paying taxes."

>>>I was in hospital for an operation in the 1990s; and am currently on medication which has relieved me of a chronic problem that I suffered from: all of the treatment was free at the time; the medication I am on is also free, without it the quality of my life would be impaired.

Talk about anecdotal information!

Anyway, as you age, your Quality Adjusted Life Year ranking will decline, and the nice folks at NICE will start denying you whatever care you actually need, and you'll either be told to "make your final arrangements" or "get treatment outside the UK."

And finally:

No, it wasn't "free." How dare you believe someone else's BS propaganda. "Free" is an illusion. There's no such thing as "free" when it comes to scarce things people want, need, and desire. Everything — including YOUR — care — has a cost associated with it. The cost was benevolently hidden from you so that you'd uncritically tell people across the pond, "I got free medical care!", but the cost was NOT hidden from someone's aged grandmother who was denied her treatment so that you could get yours. The scarce healthcare resources that were previously used to keep her alive were gently diverted from her life-support to your chronic-condition medication. In other words, her life was the cost of your medication.

There's something beautifully Christian about the whole "sacrificial lamb" thing that your system institutionalizes, if not outright mandates. The only problem is that neither granny nor her family is likely to see it that way IF (and it's a big IF) they could only "connect the dots." And the reason they probably won't "connect the dots" in this case is that they — like you — have likely also bought into the propaganda that "It's all free!" So it's not that they won't connect the dots; it's not that they can't connect the dots; it's that they will go into deep denial over acknowledging that there are actually dots that need connecting.

Oh, yes, that's exactly how your system works; and what's worse; that's how your system was designed to work. And the bureaucrats who control the system know it.

[Stavros]

[QUOTE=paulclifford;1376656]
>>>Speaking for myself, I was in hospital with chicken pox and measles at the age of 2; I was involved in a road traffic accident when I was 9 years old; I had treatment for another accident when I was 11;

And the nice ones at NICE said, "Ah! Such a cute, young future taxpayer! Let's break out the slide-rule and calculate his Quality Adjusted Life Year . . . hmmm, it looks pretty good. OK, let him have his treatments. He has plenty of taxpaying years ahead of him. Heck, we NEED this guy! Just send the bill to those already paying taxes."
--I don't know what this gibberish is meant to convey, other than your bottomless cynicism. You never experienced the NHS in the 1950s or the 1960s, you are trading on ignorance.

And finally:

No, it wasn't "free." How dare you believe someone else's BS propaganda. "Free" is an illusion. There's no such thing as "free" when it comes to scarce things people want, need, and desire. Everything — including YOUR — care — has a cost associated with it. The cost was benevolently hidden from you so that you'd uncritically tell people across the pond, "I got free medical care!", but the cost was NOT hidden from someone's aged grandmother who was denied her treatment so that you could get yours. The scarce healthcare resources that were previously used to keep her alive were gently diverted from her life-support to your chronic-condition medication. In other words, her life was the cost of your medication.

There's something beautifully Christian about the whole "sacrificial lamb" thing that your system institutionalizes, if not outright mandates. The only problem is that neither granny nor her family is likely to see it that way IF (and it's a big IF) they could only "connect the dots." And the reason they probably won't "connect the dots" in this case is that they — like you — have likely also bought into the propaganda that "It's all free!" So it's not that they won't connect the dots; it's not that they can't connect the dots; it's that they will go into deep denial over acknowledging that there are actually dots that need connecting.

Oh, yes, that's exactly how your system works; and what's worse; that's how your system was designed to work. And the bureaucrats who control the system know it.

--But this is what I wrote: I paid for the NHS and its benefits throughout my working life and do not regret it; as I am over 60 my medication is now free, and the point is that you can pay through the National Insurance scheme all your life and never need a doctor or a pill but suddenly at 60 find yourself with a heart attack -the system then provides.

As for the 'beautifully Christian' approach to healthcare, no that isn't free either but the patients are not asked for payment when they are lying on an ER table minus a leg -or struggling to breathe- or coming to terms with the fact they have cancer: Christian charity was for a very long time the only access to healthcare that people had -in some cases still have- in Africa, in Asia, in the UK and in the USA -yes, someone pays for it, but the principle of being free at the time of need for the person who needs it is established: and it works.

[Stavros]

>>>>>he forgets to add that it is the market principles he is devoted to that make a dying person economically unattractive

I'm having a hard time deciding if that statement was typically "dingbat" or "moonbat." Both apply so aptly to the unenlightened views on economics (and other topics) wafting toward planet Earth from that barren asteroid far, far away known as the Extreme Utopian Left.

Know this:

Whether under communism, socialism, welfare statism, fascism, syndicalism, interventionism, feudalism, corporatism, capitalism, or any other kind of "-ism" on which society is organized — including, by the way, a moneyless barter society — anything that people want, need, desire, and value has a cost attached to acquiring it. It's not any particular "-ism" that makes it so; it's reality that makes it so.

You're in deep, Vulcan Mind-Meld-denial if you cannot accept this.

"Market principles" — meaning, private property, private decision-making, private, voluntary, contracts between two or more people, free association of people, and free exchange of goods, services, and ideas — simply make the costs of things people want, need, and desire apparent and verifiable to those engaged in exchange. It doesn't "create" something called a "cost" that wasn't already there by nature.

Socialized medicine can't change reality by refusing to look at it. It doesn't "reduce" or "eliminate" medical costs; the costs are THERE, OBJECTIVELY, by nature. Socialized medicine simply refuses to pay the costs, and then tells a naive, uninformed public, "Look! No more costs! It's all free now!"

That a government board doesn't acknowledge a cost, or hides a cost, in no way means that the cost isn't there.

No, the way all socialized healthcare systems actually deal with costs is by exploiting the only two "non-market" methods of dealing with them: queuing and rationing. That's why patients wait and wait and wait — they're actually incurring a very high cost, but in terms of their personal time, rather than their personal wealth; and when they're done waiting, they don't get the very best medical care that money can buy — that would be an evil "market-principle" method of treating the patient — they get whatever the cost-efficiency board permits the doctor to give them, because healthcare resources under socialism are assumed to be a static "pie" that has to be very thinly and very evenly sliced by "Ye Great Wise Ones" in government.

Come to think of it, socialism views all resources, not just those related to healthcare, as static, which is why under such "non-market-principle" systems, everything has a high time-cost in terms of queuing and everything is rationed.

But not for the governing elite, of course. They're too important and too busy "running things", so they get to have as much of everything as they want.

They understand that just so long as you — the "common man" — are guaranteed a certain minimum of things (income, food, healthcare), you won't complain too loudly, and — more importantly from their point of view — you'll uncritically accept the propaganda (meant to keep you voting them into power) that "It's all free!"

If you take the trouble to read my post from yesterday you might understand that the NHS is more than the sum of its parts; that it was created to widen access to health care for the population as a whole where before the access was mediated through private health insurance schemes, and charities. The issue of cost has never been hidden so your hysterical rant is a relentless statement of the obvious.

Once again, you refuse to recognise any benefits from the system -you seem to have no interest in the way in which Britain changed after 1945, and that one of the things the NHS did was to combine with a state education sector to offer opportunities to young people that did not exist before. As a consequence, it is not just a fact that the sons of coal miners, bus drivers, dock workers, insurance clerks, shopworkers and probably a few pickpockets, became doctors and excelled in their careers: but that their daughters also graduated in medicine: the whole long term purpose of the reforms that the Attlee government initiated in 1945 or extended from state funded schemes that date back to the Liberal govt or Herbert Asquith, David Lloyd-George and Winston Churchill before 1914, was to invest in people, and given them opportunities.

As a result, and in combination with science, the NHS became part of a world-wide phase in the history of medicine in which diseases of childhood have been either eradicated or brought under control: diphtheria, whooping cough, measles, mumps, etc. Smallpox has been eradicated, River Blindness in Africa close to eradication, all courtesy of a world wide effort of science, some of it funded by the state.
The NHS has become a centre of excellence in many areas of medicine, as I pointed out, and which point you ignored because the fundamental point is that WE, the People, paid for it out of our contributions to the NHS, and not only did we benefit from it, so did everyone else- it may sound Christian to you, but surely even you know that Jews, Muslims, Buddhists, Hindus and Atheists have all made contributions to the advancement of medical science.

What sticks in your throat is the fact that the modern state has been the agency of positive change in health and education that the free market historically did not provide. Socialism, in the form of a centrally planned economy has been discredited because the experience of it in the USSR and Eastern Europe shows that it doesn't work. The NHS and our state education system sit alongside the private sector in both, which the Attlee govt could have but did not abolish. The mechanics of the NHS as it currently operates are up for debate, but the founding principle, that through contributions which people make the service is provided free at the point of need, stands as a valid economic and political justification for the provision of such services by the state.

[paulclifford]

>>>but suddenly at 60 find yourself with a heart attack -the system then provides.

But apparently you don't care about surviving that heart attack, because according to data online (and already posted here), your chances of surviving one on the NHS are pretty bad, while your chances are excellent in the US.

I guess in the UK, "free" trumps "alive."

That's the sort of patriotic esprit the NHS counts on. "What do I care if my chances of surviving a heart attack are lousy? The system provides, and the care was gloriously FREE!"

(There's no arguing with a death-wish.)

[Stavros]

>>>but suddenly at 60 find yourself with a heart attack -the system then provides.

But apparently you don't care about surviving that heart attack, because according to data online (and already posted here), your chances of surviving one on the NHS are pretty bad, while your chances are excellent in the US.

I guess in the UK, "free" trumps "alive."

That's the sort of patriotic esprit the NHS counts on. "What do I care if my chances of surviving a heart attack are lousy? The system provides, and the care was gloriously FREE!"

(There's no arguing with a death-wish.)

It is well known that heart disease in the UK is higher than in most -but not all- European countries; but it is also the case that death from heart disease has declined in the last 40 years, something you are reluctant to acknowledge, presumably because we get treatment for it on the NHS:

Despite the massive drop in deaths from heart attacks, the rate in the UK remains one of the highest in Europe, the figures from the British Heart Foundation show. Between 2002 and 2010 the death rate in men fell from 78.7 deaths per 100,000 men to 39.2 deaths per 100,000 men.
Over the same period there was a drop from 37.3 deaths per 100,000 women 2002 to 17.7 deaths per 100,000 women in 2010.
The reasons are that fewer people are now smoking meaning and preventive drugs such as blood thinners and cholesterol-lowering statins mean fewer people are suffering a heart attack in the first place. This is combined with better treatment, in the form of operations and drugs, for those who do suffer a heart attack meaning their chances of surviving have increased.
http://www.telegraph.co.uk/health/healthnews/9749683/Deaths-from-heart-attacks-halve-as-treatment-pays-off.html

In the USA, the best place to have a heart attack is in Seattle which pioneered the use of paramedical treatment in situ including the use of a defibrillator -and just in case you don't get the connection the idea which was used by Leonard Cobb - a cardiologist at the University of Washington - he borrowed the idea from Northern Ireland where it was used in a mobile heart unit, financed, as you would expect, by the NHS.
http://www.kpluwonders.org/content/why-seattle-such-great-place-have-heart-attack

If you are a woman in the US you are more likely to die from heart disease than a man; if you are an 'African-American' you are more likely to die from heart disease than a 'White American', if your income is less than $15,000 per annum you are more likely to die from a heart attack than anyone else and so on and so on.
http://www.huffingtonpost.com/barbra-streisand/womens-heart-health_b_1135486.html

Maybe you should concentrate on the inequalities in health care provision in the US instead of making random and statistically dubious comparisons with the UK.

[paulclifford]

>>>If you are a woman in the US you are more likely to die from heart disease than a man

That's true in the UK, too.


http://www.bhf.org.uk/research/statistics/morbidity/case-fatalities.aspx

Case fatalities

Cardiovascular diseases are still a major cause of death in the UK.

In England around 11 per cent of men and 15 per cent of women who were admitted to hospital with a heart attack (myocardial infarction) in 2010 had died within 30 days.

In Scotland, case fatality rates were higher, with 12 per cent of men and 19 per cent of women admitted with a heart attack dying within 30 days.

And speaking "inequities", see:


http://www.independent.co.uk/life-style/health-and-families/health-news/heart-disease-deaths-halve-but-only-if-you-live-in-the-south-8281292.html

Heart disease deaths halve –but only if you live in the South

In one of the most dramatic improvements in the nation's health, deaths from heart disease have halved since the 1980s – but the gains have not been shared equally and the "health gap" between the wealthiest and poorest communities has widened among older people, researchers say.

A map charting the death rate from heart disease and stroke across England by electoral wards shows the stark difference between communities and between the healthy and wealthy South and the poor and sickly North.

Death rates are 20 per cent above average in the poorest wards and 20 per cent below average in the wealthiest wards, among men over 65. A similar disparity is seen for women over 65.


But how could that be? I thought the NHS was supposed to provide access that was both free and equal to everyone in the UK.

Or was that simply an example of the "good intentions" of NHS supporters with no basis in reality? Maybe things like "costs" are REAL and cannot be equalized among an entire population simply by declaring costs to be non-existent.

[Stavros]

But how could that be? I thought the NHS was supposed to provide access that was both free and equal to everyone in the UK.

Or was that simply an example of the "good intentions" of NHS supporters with no basis in reality? Maybe things like "costs" are REAL and cannot be equalized among an entire population simply by declaring costs to be non-existent.

And maybe it is just one of those things that a particular specialist in Cancer is working in Leeds rather than London, or that there is a world class cardiologist in Liverpool rather than Leeds; it happens that one cohort of nurses in say, Cardiff is more passionate about their work than another cohort in Swansea, that's the way it goes at times -'free and equal access' never meant that the quality would be the same everywhere all the time, the notion is absurd. There are reasons why the Scots have a diet which is considered more damaging to health than the English, the NHS is not responsible for that. If you were not so obsessed with utopian dreams, your arguments might be more cogent.

[Ben in LA]

What is the Republicans' alternative anyway? And why don't they vote on it instead of voting to repeal "Obamacare" 40 times, wasting millions in the process?

[paulclifford]

>>>'free and equal access' never meant that the quality would be the same everywhere all the time . . .

Ah! So in other words (and more honest words), those who can afford better quality health care, can access it; those who cannot afford it, cannot access it. Hmmm. Sounds a bit like the US system, except we don't lie to people by telling them that costs can be magically legislated out of existence. We also have significantly better medical outcomes for our patients than the UK does for theirs.

So, then, what precisely does "free and equal access" mean in the UK?

I'll tell you what I think it means. It means everyone has the same right to wait on line for months and years to get treated. And everyone has the same right to be denied cutting-edge drugs.

Fantastic! Who cares about actual medical outcomes! The important thing about the NHS is how a socialized system makes you feel when you tell a Yank, "Our government pays for healthcare and it's free whenever we need it. You have to pay for yours!"

[paulclifford]

>>>And why don't they vote on it instead of voting to repeal "Obamacare" 40 times, wasting millions in the process?

The main reason for repeal is that without it, Obamacare actually impedes any other kind of alternative.

In any case, I've already posted workable alternatives:

1. Repeal Obamacare (or, at least, defund it and stick it in a closet so it can't do any more harm).

2. Repeal the McCarren-Ferguson Act (which allows insurance providers to become monopolistic cartels within their own states, thus preventing competition from other providers out-of-state). Lack of competition always drives prices up; competition always drives prices down (as well as acting as a spur for innovation and improvements).

3. Abolish any federal and state regulations requiring insurance providers to "cross-subsidize" their policies. That means, YOU don't have to pay for MY chances of getting carpel-tunnel syndrome, and I don't have to pay for YOUR chances of getting HIV or lung cancer or bi-polar disorder.

4. Abolish all restrictions on increasing the number of medical schools in the country so that we can train more doctors.

5. Put a cap on malpractice suits. Part of increasing the number of doctors is to increase the attractiveness of the profession.

These are just a modest start, but they would do more in a year to provide more high-quality medical care to more people than forcing them to pay penalties, additional taxes, "mandates", etc.

This is old news, however, known to every economist who's studied the issue. Unfortunately, economic analysis and logic are no match for the argument, "I need, I want, I deserve, therefore my neighbor is obligated to give it to me." People don't turn down something they have been conditioned to believe is "free."

[Prospero]

Clifford - you spout total prejudiced lies regarding the NHS. I know of plenty of cases of people in the US who have been financially ruined because of the high cost of medical care there. And of plenty of cases in the Uk whose lives have been saved because of the NHS.

The pejorative us of Obamacare for affordable health care is a symptom - and your denigration of the ideas behind this when it is one small step on the road to a better system of health care in what should be one of the greatest nations in the world is disgraceful.

The energy you pour into your arguments is perplexing in this place. Which right wing think tank do you work for?

Your entire philosophy seems based on a hatred of provision by Government and you borrow from the most poisonous of sources to support your spurious arguments. Your labelling of Obama and those who aspire to create a better health care system in the US as marxist is simply childish and inane. Do you actually know anything about the true nature of socialism and Marxism. I think not.

[Stavros]

[QUOTE=paulclifford;1376898]
>>>'free and equal access' never meant that the quality would be the same everywhere all the time . . .

Ah! So in other words (and more honest words), those who can afford better quality health care, can access it; those who cannot afford it, cannot access it. Hmmm. Sounds a bit like the US system, except we don't lie to people by telling them that costs can be magically legislated out of existence. We also have significantly better medical outcomes for our patients than the UK does for theirs.

-You seem to be struggling with the argument: people who can afford it, or work for companies who provide it, can get private health service treatment -the co-existence of a private health sector with a publicly-funded service was part of the deal the Attlee government made with the medical profession which insisted it retain its right to work privately. The fact is that most of today's medical professionals taking advantage of this right were trained in NHS teaching hospitals as part of a publicly-funded university system so the fundamental reality is that it is the NHS that has provided the foundations for health care in general in the UK. A solely privately funded health care system would not have provided the breadth of training or education that has emerged from the NHS.
-We do not make costs disappear as if by magic, you haven't been reading my posts with diligence.
So, then, what precisely does "free and equal access" mean in the UK?
-I didn't say it was 'free and equal' I said it was free at the time of need, which means that if someone gets knocked down by a bicycle and is taken to hospital to be patched up; or has a stroke and is treated in hospital, they are not presented with a bill for $X,000 after it. We pay for the NHS though contributions deducted from our salaries, while some people pay nothing at all -senior citizens, the unemployed, pregnant women, etc. It is not a difficult concept to understand.

The principle of equality is just that, and while it means there are cardiology, obstetrics and gynae units in every health district, the quality of care will be dependent on the staff, just as you might get better quality care for a heart attack in Seattle than in West Virginia.

We also have significantly better medical outcomes for our patients than the UK does for theirs.
Prove it.

I'll tell you what I think it means. It means everyone has the same right to wait on line for months and years to get treated. And everyone has the same right to be denied cutting-edge drugs.
--The NHS has never given patients access to all the latest surgical and medical procedures that come onto the market -in time it usually happens, perhaps your argument here should focus on the prices that the pharmaceutical companies charge for the latest drugs rather than scratching around for some other reason to knock the NHS. The cost is the same in the private sector.

Fantastic! Who cares about actual medical outcomes! The important thing about the NHS is how a socialized system makes you feel when you tell a Yank, "Our government pays for healthcare and it's free whenever we need it. You have to pay for yours!"
--Again, we pay for it, but we don't get charged per item; the costs are met from obligatory contributions along with income tax; and as far as outcomes are concerned, I pointed out that throughout my life the outcomes for me have been positive; the quality of my life would be poorer in every aspect. And yet again, you ignore completely the global linkages that outcomes of NHS research and practice has had with other medical sectors (an elementary aspect of science in the modern world), just as you ignore the fact that 'we, the people' want it, and believe it has made a profound -and profoundly positive contribution to life in this country.