Saturday, 14 March 2009

For some reason, the saintly NHS is different

For years now, I've been saying what this guy is:

People in England will get more online powers to rate GPs, police, childcare and councils, Gordon Brown has said.

He said it was wrong that consumer websites such as Amazon and eBay had "higher standards of transparency" than those for public services.

Officials liken the new approach to the Tripadvisor site, where travellers can share their thoughts on hotels.

The PM promised an "information revolution", but the Tories said public services were still too bureaucratic.

Where to begin.

Why? I'm a patient, not a fucking journalist. I don't have to rate my local Sainsbury's to keep the store on its toes. In fact a couple of years ago a small Tesco store opened just downt he road from the Sainsbury's, and geuss what: there was a price war, and most recently Sainsbury's has been shut, re-modelled, expanded, and totally overhauled. That is competition, driven by the presence of choice.

If you want to improve public services, in particular education and the NHS, then crack them open to free choice and let them compete. The change will happen naturally and miraculously.*

Why is the fucking NHS so fucking special and different that giving customers a genuine choice as to where our money goes, heresy?


*Admittedly, I swear a fucking lot more.


Anonymous said...

Cos its a sacred cow.

Anyway, as a user I don't fancy the alternative US model. No dosh, you die.

Shug Niggurath said...


In the US it's pretty much no dosh you get basic care.

All senior citizens can be covered with Medicare (ie. Paid for with tax revenues), under a certain low income threshold all families with children or pregnant women receive Medicaid, prenatal care is always taxpaid (ie. free to the user).

Either way, since our health system is paid for by the workforce, and we pay around 48% of our incomes back in tax one way or another, the NHS costs effectively one sixth of all tax I pay.

If me and my wife both work ( we do) and take out a BUPA type scheme it costs us about £40 a month through my employer. Dental and eyecare another £40. Based on that 8% the NHS costs us in excess of £250 a month. Good value eh?

I understand fully that BUPA doesn't give me some NHS services, but if they could I doubt it'd be an extra £170 a month.

So when the government use the word free, they really me paid for by me.

The Economic Voice said...

General view of citizen on cost of health - Healthcare should not be a drain or demand on me until I need it, then I don't care how much it costs the rest of society as long as I get all the care I need to stay fit and healthy.

Mark Wadsworth said...

The whole debate is confused by the fact that there are two completely different sides to this.

1. The provision side. You can either have a monolithic state-run provider or competing providers.

2. The funding side. The two extremes are funding the whole thing with taxes, or by private payment.

It helps to look at each side separately...
There is such a thing as a good compromise, e.g. most European countries:

1. They have competing providers. For sure, lots of clinics and hospitals are run by superficially not-for-profit bodies, like local councils, universities, trade unions, churches and charities (as well as completely privately run and owned ones) but the point is that they are competing.

2. Basic healthcare is financed by vouchers funded by taxes on employment. It would be better to fund it out of a flat tax on all income (why should a tenant-employee pay more than his landlord?) but hey. Then on top of this basic level, you can pay for extras privately - either out of your own pocket or via private insurance.
The MW manifesto says that a basic level of healthcare would be covered by taxpayer-funded vouchers (we can argue over what is 'basic', I would suggest at the very least A&E, immunisation and neo-natal care); that any provider can compete for these vouchers, and that any treatment above and beyond that, you have to pay for yourself out of your own pocket or out of private insurance.

A large part of tobacco, alcohol and drugs duties would be earmarked for treating related diseases (that's what the taxes are for, aren't they?)
What's not to like?

Mitch said...

Maybe because the moment it was suggested the opposition would scream selling the NHS!!! dead babies in the street and pensioners on trolleys in the carpark.

no rational debate will ever take place.

Anonymous said...

i think guido fawkes blog is broken or has been taken down!!!

Harrithebastard said...

I pay for BUPA (Lots) and still pay full NI for those less fortunate than myself ... still had to fucking queue up outside the ' private ' hospital because it was full of oiks from the NHS hospital ' overflow '


Fuck the empathy and benevolence i pays my cash i takes my chances , to absolutley no bastard benefit .