Left Wing Loons and Obamacare

[huzzah]

As a Brit, I've found a lot of the stuff coming out of America pretty odd.

In the first place, there's the very 'exciteable' rhetoric being used on both sides. Then there are the blatant distortions. "Death panels", for instance. Now that is obviously a very emotive turn of phrase and one that has raised eyebrows over here, but it is perfectly true that there is a govenment panel that withdraws your treatment if it costs over a certain amount per quality adjusted year it's expected to extend life. Its decisions are not ridigly enforced, but if NHS Trusts want to fund something NICE doesn't approve of, they don't get to claim the extra cost against the taxpayer, something else has to be cut. This has resulted in a 'post code loddery' for healthcare to some extent. The NHS also tries to restrict people taking up private healthcare. Not only will they not give you back the money you put into the national insurance that has refused to pay out, they will also withdraw all your NHS care if you spend any part of your money on private treatment. There have been cases of people dying because they have been denied drugs by the NHS that they could have afforded to pay for out of their own pocket, but could not afford to pay for all the resulting extra bills when their NHS treatment would have been removed.

This I think illustrates the enormous culture difference between the US and the UK, where we would rather a rich man died so that a poor man dying anyway won't feel 'unequal'. What's most surprising for us is that America is so shocked by this, to the extent that even the proponents of the plan aren't explicitly admitting this will even happen, choosing instead to attack the propagandist, but ultimately not very important names used to describe it. In Britain a fair number of people are aware of NICE, but mostly put up with it despite the outrage some of its decisions have provoked. The NHS is pretty deeply ingrained in the national psyche. The idea that one owns one's own property, and can't morally be soaked for money to fund other people and then have their own care withdrawn because it's "too expensive" is not strong, at least on this issue. The fact that Dan Hannan was called "unpatriotic" by the Labour Party is testament to this. It may be common rhetoric in the US, but almost nothing will get you labelled unpatriotic here, even opposing the monarchy, the flag, the armed forces, etc. which are par for the course in America. It's even rarer to receive such criticism from the Labour Party, which struggles to admit that British patriotism even exists distinct from fascism most of the time.

It's not even that these people are defending state redistribution, as such, but the specific manifestation of it in the NHS. They become just as outraged if you suggest replacing it with a more effective, and just as universal system, such as that of Singapore or France, that includes private co-payments or something of that sort. There was even substantial political controversy when particular NHS hospitals outsourced certain services like cleaning to the private sector, still paid for out of the state's pocket and essentially still state employees - this is what passes for a radical move towards privatisation here.

America would find it very difficult to accept the costs of something like an NHS. Not financially, it is actually cheaper than the US system. The US state alone spends more than the British state per person on healthcare. But in human terms, I don't think the US would accept the waiting lists, the treatment cut offs, or the quality lottery. It's important to know what you're letting yourselves in for, because if Obama makes it illegal for insurers to take into account personal circumstances in offering or pricing insurance plans - in other words, makes it illegal for insurance to operate as insurance - America's health costs are going to spiral further, and Obama has made it pretty clear where he sees the savings come from: the ability of the state to force people who will no longer be able to afford private insurance to impose an American NICE, introduce long waiting lists, and so on.

[makattak]

Well said, Huzzah and welcome.

I, for one, am not willing to bear the costs of socialism and will oppose being burdened with them STRENUOUSLY.

[agricola]

And whose sock puppet is this?

As a Brit, I've found a lot of the stuff coming out of America pretty odd.

In the first place, there's the very 'exciteable' rhetoric being used on both sides. Then there are the blatant distortions. "Death panels", for instance. Now that is obviously a very emotive turn of phrase and one that has raised eyebrows over here, but it is perfectly true that there is a govenment panel that withdraws your treatment if it costs over a certain amount per quality adjusted year it's expected to extend life. Its decisions are not ridigly enforced, but if NHS Trusts want to fund something NICE doesn't approve of, they don't get to claim the extra cost against the taxpayer, something else has to be cut. This has resulted in a 'post code loddery' for healthcare to some extent. The NHS also tries to restrict people taking up private healthcare. Not only will they not give you back the money you put into the national insurance that has refused to pay out, they will also withdraw all your NHS care if you spend any part of your money on private treatment. There have been cases of people dying because they have been denied drugs by the NHS that they could have afforded to pay for out of their own pocket, but could not afford to pay for all the resulting extra bills when their NHS treatment would have been removed.

This is nonsense.  For a start, NIHCE (NICE is a stupid acronym, and is wrong anyway) does not approve what an individual gets treated with, that is left to the doctor and the Trust (apart from transplants, where a body does have to decide who gets an organ, though this is because of the rarity of some donated organs and not cost).  Secondly, the NHS does not prevent people getting private healthcare - in fact far from it, the state will pay for people to be treated in a private hospital (http://news.bbc.co.uk/1/hi/health/7742363.stm).  Yes, the NHS has on occasion withdrawn treatment from people who have paid for private healthcare (usually because of the scale of what the person has been paying, though this was a very rare occurance), though after the Richards Review this should not be happening (http://www.publications.parliament.uk/pa/cm200809/cmselect/cmhealth/194i/194i06.htm).  Yes, there are variations in standards between hospitals in various parts of the country - but what system would that not happen in?

This I think illustrates the enormous culture difference between the US and the UK, where we would rather a rich man died so that a poor man dying anyway won't feel 'unequal'. What's most surprising for us is that America is so shocked by this, to the extent that even the proponents of the plan aren't explicitly admitting this will even happen, choosing instead to attack the propagandist, but ultimately not very important names used to describe it. In Britain a fair number of people are aware of NICE, but mostly put up with it despite the outrage some of its decisions have provoked. The NHS is pretty deeply ingrained in the national psyche. The idea that one owns one's own property, and can't morally be soaked for money to fund other people and then have their own care withdrawn because it's "too expensive" is not strong, at least on this issue. The fact that Dan Hannan was called "unpatriotic" by the Labour Party is testament to this. It may be common rhetoric in the US, but almost nothing will get you labelled unpatriotic here, even opposing the monarchy, the flag, the armed forces, etc. which are par for the course in America. It's even rarer to receive such criticism from the Labour Party, which struggles to admit that British patriotism even exists distinct from fascism most of the time.

More nonsense.  If a rich man, or a moderately well-off man, wants treatment he can go to any one of the hundreds of private hospitals in the UK and have it.  As for the criticism of Hannan, that was inane (but sadly par for the course when it comes to Labour) but Hannan is wrong on this issue - perhaps after the criticism of Brown he has got too big for his boots.

It's not even that these people are defending state redistribution, as such, but the specific manifestation of it in the NHS. They become just as outraged if you suggest replacing it with a more effective, and just as universal system, such as that of Singapore or France, that includes private co-payments or something of that sort. There was even substantial political controversy when particular NHS hospitals outsourced certain services like cleaning to the private sector, still paid for out of the state's pocket and essentially still state employees - this is what passes for a radical move towards privatisation here.

The controversy was not because they were outsourcing cleaning to the private sector, the controversy was that the cleaning provided by the private firms was so sub-standard that it led to several outbreaks of infection.  Had it not been there would not have been a controversy.  As for reform of the NHS, I am unaware of any genuine reform (ie:  reform that is actually well intentioned and not an excuse for someone to make a quick buck) that has led to serious opposition - most people when questioned (including the two mentioned in the Times article) want a better NHS.

America would find it very difficult to accept the costs of something like an NHS. Not financially, it is actually cheaper than the US system. The US state alone spends more than the British state per person on healthcare. But in human terms, I don't think the US would accept the waiting lists, the treatment cut offs, or the quality lottery. It's important to know what you're letting yourselves in for, because if Obama makes it illegal for insurers to take into account personal circumstances in offering or pricing insurance plans - in other words, makes it illegal for insurance to operate as insurance - America's health costs are going to spiral further, and Obama has made it pretty clear where he sees the savings come from: the ability of the state to force people who will no longer be able to afford private insurance to impose an American NICE, introduce long waiting lists, and so on.

America wouldnt accept a system that, compared to medicare and the other state programs provided much more help, to far more people, was much less open to fraud and which was a lot cheaper?

[makattak]

America wouldnt accept a system that, compared to medicare and the other state programs provided much more help, to far more people, was much less open to fraud and which was a lot cheaper?

How?

That's the EXACT claim of the Obama administration, as well.

Just how is the government, when it has proven how inefficient and inept it is with: Amtrak, USPS, Medicare, Medicaid, Social Security, inter alia going to provide a better service to more people at a lower cost with less fraud?

HOW? Our government has already proven unfit to run virtually any business. Yet, somehow we are to suppose "it'll get this one right, we promise"?

[agricola]

How?

That's the EXACT claim of the Obama administration, as well.

Just how is the government, when it has proven how inefficient and inept it is with: Amtrak, USPS, Medicare, Medicaid, Social Security, inter alia going to provide a better service to more people at a lower cost with less fraud?

HOW? Our government has already proven unfit to run virtually any business. Yet, somehow we are to suppose "it'll get this one right, we promise"?

Did you actually read Huzzah's post or did you just agree with it?

[mtnbkr]

And whose sock puppet is this?

The IP is from Europe and hasn't been seen here before.  If it is a sock puppet, it's one who covered their tracks better than many.

Chris

[makattak]

Did you actually read Huzzah's post or did you just agree with it?

Cute.

In the first place, there's the very 'exciteable' rhetoric being used on both sides. Then there are the blatant distortions. "Death panels", for instance. Now that is obviously a very emotive turn of phrase and one that has raised eyebrows over here, but it is perfectly true that there is a govenment panel that withdraws your treatment if it costs over a certain amount per quality adjusted year it's expected to extend life. Its decisions are not ridigly enforced, but if NHS Trusts want to fund something NICE doesn't approve of, they don't get to claim the extra cost against the taxpayer, something else has to be cut. This has resulted in a 'post code loddery' for healthcare to some extent. The NHS also tries to restrict people taking up private healthcare. Not only will they not give you back the money you put into the national insurance that has refused to pay out, they will also withdraw all your NHS care if you spend any part of your money on private treatment. There have been cases of people dying because they have been denied drugs by the NHS that they could have afforded to pay for out of their own pocket, but could not afford to pay for all the resulting extra bills when their NHS treatment would have been removed.

So, what they're going to do is steal from people and put them into the government plan so that they can't afford private insurance and when they could afford to pay for it outside of the plan, drop them because it's unfair that someone pays for their own healthcare that the government didn't cover. Funny, currently my health insurance doesn't drop me if I pay for something it doesn't cover.

SECONDLY, the U.S. government has already proved itself unable to manage it's "businesses". As I recall, NHS is facing an impending funding crisis as well (My memory serves me well: http://uk.reuters.com/article/idUKTRE5591CB20090610). Again, what in our government makes us think this will be more efficient?

Your response, AGAIN, is "Well, it will be!". HOW!?

I am reminded of what one of your great leaders once said:

"Socialist governments traditionally do make a financial mess. They always run out of other people's money. It's quite a characteristic of them." (Emphasis added)

So, will it be just like Social Security and Medicare? GREAT... while the money lasts at the bottom of the pyramid.... (Social Security, incidentally, was an AMAZING deal for the first beneficiaries... it's young people like me that are ALREADY EXPECTING TO GET SCREWED. Now, I'm supposed to support ANOTHER program that will screw my children? No thank you.)

[makattak]

FURTHER...

This is the great problem with socialism in general: The problems do not immediately materialize because they are able to leech from the productive in society at first.

Socialism, at first brush, then appears to be a WONDERFUL choice...

Until there's no one left to leech off of.

Related:

I wonder what's going to happen when we kill for-profit US medical research?

[huzzah]

And whose sock puppet is this?

No one's, though I was invited to comment on this by a friend who is a regular on this board as he knows that I am both (1) British and (2) a libertarian opposed to most things socialist. I won't name names as I'm not sure if he would want to be identified.

This is nonsense.  For a start, NIHCE (NICE is a stupid acronym, and is wrong anyway)

NICE is the official version, it's even on their own website - http://www.nice.org.uk/ . Though yeah, it leaves out a letter so that it can be just slightly more sinister and Orwellian than otherwise.

does not approve what an individual gets treated with, that is left to the doctor and the Trust (apart from transplants, where a body does have to decide who gets an organ, though this is because of the rarity of some donated organs and not cost).  Secondly, the NHS does not prevent people getting private healthcare - in fact far from it, the state will pay for people to be treated in a private hospital (http://news.bbc.co.uk/1/hi/health/7742363.stm).  Yes, the NHS has on occasion withdrawn treatment from people who have paid for private healthcare (usually because of the scale of what the person has been paying, though this was a very rare occurance), though after the Richards Review this should not be happening (http://www.publications.parliament.uk/pa/cm200809/cmselect/cmhealth/194i/194i06.htm).  Yes, there are variations in standards between hospitals in various parts of the country - but what system would that not happen in?

Your first point - I did say that in my post. It doesn't mandate exactly what is allowed and disallowed. However its 'price for life' is what sets the funding allocations, so if your Trust is allowing stuff NICE doesn't approve, they are almost certainly withholding other stuff that it does (or withholding treatment from smokers, or fat people, both of which have happened here). If you really are British you presumably have heard of the post code lottery. This is the cause, not random variations that would happen regardless of the system.

Second point - I'm pleased to see that this ban was (eventually) repealed. I was not aware that it had been, probably because it has only happened in the last couple of months of the NHS's 60 year existance.

More nonsense.  If a rich man, or a moderately well-off man, wants treatment he can go to any one of the hundreds of private hospitals in the UK and have it.

He can now, it seems, but 6 months ago he couldn't. Still, I don't think that I was far wrong with the difference in mindset. Take this article, for instance, in a private healthcare industry journal, that says:

"However, there are fears that, if patients can top up their treatment, only wealthier people who can afford such treatments will benefit."

http://www.privatehealth.co.uk/news/november-2008/nhs-top-up-ban-removed-30091/

I really do not understand this sort of thing at all. Only the wealthy (or really the moderately wealthy, I suppose, as the very rich could have afforded to leave the NHS entirely even before the repeal), will be saved, therefore it's preferable that the wealthy die and the poor die, so that it's equal? It's madness. I don't know a single person who would say they're comforted by the fact that, as they lie dying, someone else is being forced to die for no good reason but to make them feel better. I think this is a repulsive thought.

As for the criticism of Hannan, that was inane (but sadly par for the course when it comes to Labour) but Hannan is wrong on this issue - perhaps after the criticism of Brown he has got too big for his boots.

I disagree. Even if you like universal healthcare (and personally I have problems with it - I would much rather a charitable system), the NHS is a pretty mediocre universal system, one of the lowest ranked in the OECD. Countries like Singapore, that spend less and get better results, while still being universal, have much greater private involvement and private funding.

The controversy was not because they were outsourcing cleaning to the private sector, the controversy was that the cleaning provided by the private firms was so sub-standard that it led to several outbreaks of infection.  Had it not been there would not have been a controversy.  As for reform of the NHS, I am unaware of any genuine reform (ie:  reform that is actually well intentioned and not an excuse for someone to make a quick buck) that has led to serious opposition - most people when questioned (including the two mentioned in the Times article) want a better NHS.

That is the stated reason, but plenty of nationalised parts of the NHS are subject to similar failures and this, while provoking criticism of their particular actions, is never presented as an attack on the idea of nationalised healthcare. Usually it is presented as a justification for giving the nationalised system even more money and control.

America wouldnt accept a system that, compared to medicare and the other state programs provided much more help, to far more people, was much less open to fraud and which was a lot cheaper?

It doesn't make sense that a programme that offers insurance at a low, equal price regardless of a person's actual requirement for treatment should be cheap. The only way it could be cheaper than what the US has now is by taking over part of the private market, and then reducing the quality of coverage.

[Jamisjockey]

America wouldnt accept a system that, compared to medicare and the other state programs provided much more help, to far more people, was much less open to fraud and which was a lot cheaper?

On what planet will this system be cheaper?  Taxes will be raised on the middle class, health benefits, small businesses, and the wealthy.  That is not cheaper.

[Headless Thompson Gunner]

Have we actually established yet whether Stephen Hawking uses NHS to pay for his health care or private alternatives?

[agricola]

Cute.

It seems you still havent read it.  I will re-quote it, and embolden the relevant text just so you have the best possible chance to read it:

America would find it very difficult to accept the costs of something like an NHS. Not financially, it is actually cheaper than the US system. The US state alone spends more than the British state per person on healthcare.

As it is you (or rather, your government) pays more money, for a worse service, that has less coverage than ours does.    

[makattak]

It seems you still havent read it.  I will re-quote it, and embolden the relevant text just so you have the best possible chance to read it:

As it is you (or rather, your government) pays more money, for a worse service, that has less coverage than ours does.    

I did read that.

YET, you've not provided an indication of HOW THAT WILL HAPPEN HERE.

I grant that your government spends less per person. My question is how that correlates to what will happen here.

Your response is unrelated to the question. Your response is "We spend less!".

That's great. How would reforming our system cause us to spend less? Obama's plan adds $1,000,000,000,000 to the debt over the next 10 years. (edit: My guess is even that is under-estimating the cost)

Now, let's say we adopt the NHS style plan. HOW are we going to cut waste, fraud, and abuse when our government has already proved it can't do that?

My question isn't: "No one can spend any less than the US does on healthcare per person!!!1111"

My question is: How would a universal plan in the U.S. actually lower costs. Responding with "It DOES!" doesn't quite answer that question, no?

[Iain]

Have we actually established yet whether Stephen Hawking uses NHS to pay for his health care or private alternatives?

Hawking has responded

‘I wouldn’t be here today if it were not for the NHS. I have received a large amount of high-quality treatment without which I would not have survived.’

Course IBD responded:

"We accept this testimony and good fortune. We will note, however, that in talking about his disability on his own Web site, Hawking makes no mention of NHS and instead says that since 1985, when he had a tracheotomy, he has had ‘24-hour nursing care … made possible by several foundations.’

Many other Britons may not be as fortunate, and we wonder how they might fare under similar circumstances in their later years.”

I can speculate too - would an insurance company have paid out for 24hr nursing care at home for the last 24 years?

A significant level of care is entirely possible through social programs such as Direct Payments, Individual Budgets and the like. I know of a young guy with terrible cerebal palsy and extreme learning difficulties that lives independently with live-in carers through schemes like this.

[Headless Thompson Gunner]

As it is you (or rather, your government) pays more money, for a worse service, that has less coverage than ours does.    

The fact that we Americans don't do cost-benefit analysis on saving lives argues strongly against your assertion that you get better service and more coverage.  

[makattak]

Hawking has responded

‘I wouldn’t be here today if it were not for the NHS. I have received a large amount of high-quality treatment without which I would not have survived.’

Course IBD responded:

"We accept this testimony and good fortune. We will note, however, that in talking about his disability on his own Web site, Hawking makes no mention of NHS and instead says that since 1985, when he had a tracheotomy, he has had ‘24-hour nursing care … made possible by several foundations.’

Many other Britons may not be as fortunate, and we wonder how they might fare under similar circumstances in their later years.”

I can speculate too - would an insurance company have paid out for 24hr nursing care at home for the last 24 years?

A significant level of care is entirely possible through social programs such as Direct Payments, Individual Budgets and the like. I know of a young guy with terrible cerebal palsy and extreme learning difficulties that lives independently with live-in carers through schemes like this.

Ah... I note this is one point where we are arguing PAST one another.

I do not think private healthcare is the solution for ALL the problems either country faces with their healthcare.

However, I think it is the solution for MOST of the problems. I would FAR rather have private charities deal with those who "fall through the cracks" than the government.

I don't want poor people to die. In fact, my wife and I give quite a bit to charities (her brother is a Marine, so much of that is to veterans groups). We have NUMEROUS charities devoted to helping children, veterans, terminally ill, etc...

If we're going to talk about misrepresentations, how is it that those pro-government run healthcare can get away with claiming we want people to die since we don't want the government to pay for their care?

[huzzah]

As it is you (or rather, your government) pays more money, for a worse service, that has less coverage than ours does.

I don't think it has been established that the NHS offers a better service. The evidence I have seen indicates the opposite. It offers some care to a greater proportion of the populace, though, yes.

I think that America's healthcare problems could be alleviated by the following:

- Removal of subsidies for employer insurance policies, preferably by removing tax on all medical activities - having something purchased for you by someone else rarely results in the best choice being made, while taxing something that you're going to provide out of tax revenue for people who can't afford it is self-defeating.

- Removal of mandatory medical licencing requirements - as it stands, the AMA is able to act as a closed shop union, driving up prices for the benefit of its members.

- Allow health insurance to be traded across state borders - fewer, larger companies is generally preferable in this industry, as there are substantial economies of scale in administration, and competition between a few readily identifiable firms for reputation is likely to result in less frivolous and fraudulent refual of claims.

- Remove mandatory items to be included in insurance - a lot of people will probably only want catastrophic insurance, and pay for 'comprehensive' items out of their own pocket. This further results in greater incentive to reduce costs through competition.

As for those who are uninsured, if you must insist on state provision there are far better ways. One would be to simply give people money. The US state spends enough on medicare and medicaid to afford NHS-standard treatment for everyone in the country, even though the majority of people have insurance. This is absurdly wasteful, but not a surprising outcome of having essentially a bottomless pit of insurance. They would be able to use this money to purchase private, probably only catastrophic health insurance, and it would certainly cost less than now. Alternative, it could adopt a system much like the UK's student loans system: healthcare is paid off by the individual, but the recipient receives an interest free state loan with repayments fixed to a % of their income. This would discourage wasteful spending and drastically reduce costs for the state, while ensuring universal provision.

The present system isn't exactly great. Going to an NHS model is merely swapping one mediocre system for another, though, with a new set of problems everyone will hate.

[makattak]

I don't think it has been established that the NHS offers a better service. The evidence I have seen indicates the opposite. It offers some care to a greater proportion of the populace, though, yes.

I think that America's healthcare problems could be alleviated by the following:

- Removal of subsidies for employer insurance policies, preferably by removing tax on all medical activities - having something purchased for you by someone else rarely results in the best choice being made, while taxing something that you're going to provide out of tax revenue for people who can't afford it is self-defeating.

- Removal of mandatory medical licencing requirements - as it stands, the AMA is able to act as a closed shop union, driving up prices for the benefit of its members.

- Allow health insurance to be traded across state borders - fewer, larger companies is generally preferable in this industry, as there are substantial economies of scale in administration, and competition between a few readily identifiable firms for reputation is likely to result in less frivolous and fraudulent refual of claims.

- Remove mandatory items to be included in insurance - a lot of people will probably only want catastrophic insurance, and pay for 'comprehensive' items out of their own pocket. This further results in greater incentive to reduce costs through competition.

As for those who are uninsured, if you must insist on state provision there are far better ways. One would be to simply give people money. The US state spends enough on medicare and medicaid to afford NHS-standard treatment for everyone in the country, even though the majority of people have insurance. This is absurdly wasteful, but not a surprising outcome of having essentially a bottomless pit of insurance. They would be able to use this money to purchase private, probably only catastrophic health insurance, and it would certainly cost less than now. Alternative, it could adopt a system much like the UK's student loans system: healthcare is paid off by the individual, but the recipient receives an interest free state loan with repayments fixed to a % of their income. This would discourage wasteful spending and drastically reduce costs for the state, while ensuring universal provision.

The present system isn't exactly great. Going to an NHS model is merely swapping one mediocre system for another, though, with a new set of problems everyone will hate.

Once again, these are reforms I can whole-heartedly support.

[agricola]

The fact that we Americans don't do cost-benefit analysis on saving lives argues strongly against your assertion that you get better service and more coverage.  

You would have a point if your country actually didnt do cost benefit analysis when it comes to saving lives, or if ours did do it.  Unfortunately neither statement is true.    

My question is: How  would a universal plan in the U.S. actually lower costs. Responding with "It DOES!" doesn't quite answer that question, no?

Thats your business.  I am here on this thread to point out that the vast majority of what you lot are being told about the NHS is either misleading, or an outright fabrication.  

[Headless Thompson Gunner]

Hawking has responded

‘I wouldn’t be here today if it were not for the NHS. I have received a large amount of high-quality treatment without which I would not have survived.’

Course IBD responded:

"We accept this testimony and good fortune. We will note, however, that in talking about his disability on his own Web site, Hawking makes no mention of NHS and instead says that since 1985, when he had a tracheotomy, he has had ‘24-hour nursing care … made possible by several foundations.’

Many other Britons may not be as fortunate, and we wonder how they might fare under similar circumstances in their later years.”

OK, so Hawking has used both NHS and private care to keep himself alive.  

But this leads to more questions than it answers.  He got some care from NHS, and that care kept him.  Could he have gotten that care without the NHS?  Would he have gotten better care through the private system?  Worse care through the private system?  If the NHS was caring for him, why did he bother involving "several foundations" in his care?  Was there something available through the foundations that wasn't available through NHS?

I can speculate too - would an insurance company have paid out for 24hr nursing care at home for the last 24 years?

A significant level of care is entirely possible through social programs such as Direct Payments, Individual Budgets and the like. I know of a young guy with terrible cerebal palsy and extreme learning difficulties that lives independently with live-in carers through schemes like this.

My grandfather needed at-home nursing for about 15 years before he passed away.  His insurance paid for the bulk of it.

[makattak]

Thats your business.  I am here on this thread to point out that the vast majority of what you lot are being told about the NHS is either misleading, or an outright fabrication.  

Thank you for answering my question.

Apparently, like the other supporters of universtal healthcare, you have no idea how that will happen either.

[agricola]

Thank you for answering my question.

Apparently, like the other supporters of universtal healthcare, you have no idea how that will happen either.

What nonsense.  I have a great idea of how universal healthcare works, how it is paid for and the pros and cons of it because I live in a country that has such a system.  How it would work, or not work, in your country is your business, not mine. 

 

[makattak]

What nonsense.  I have a great idea of how universal healthcare works, how it is paid for and the pros and cons of it because I live in a country that has such a system.  How it would work, or not work, in your country is your business, not mine. 

 

Sorry, perhaps I should have said "You have no idea how that will happen HERE, either."

My point isn't that you don't know what you're talking about. My point is that no one has been able to explain how such savings would be brought about here.

I wasn't attacking you by repeating my question, I honestly want to know how the supporters over here expect to bring costs down.

They haven't been able to answer my questions.

I don't expect you to know the workings within the U.S. anymore than I expect to know the workings within the UK beyond a broad brush understanding. I had thought that perhaps you might have an explanation that I could analyze.

I'm perfectly content to accept that you are happy with your healthcare system. I am not advocating destroying the NHS- as you said "That's your business." I will, however, get animated when speaking about the US because I don't want it forced upon me and have no where left to go if the U.S. adopts a fully socialist system as well.

[longeyes]

Well, we know it's all sweetness and light Over There, but speaking of Cambridge, here are some remarks from a friend of mine, American, a molecular biologist, who paid a visit to that lovely spot last year:

"What I do know is that when I was visiting Cambridge, England in
May 2008, one prominent article in the local daily was about an
outbreak of "C diff" (Clostridium difficile):

    http://en.wikipedia.org/wiki/Clostridium_difficile

in Addenbrooke's:

    http://www.cuh.org.uk/addenbrookes/news/2009/june/infection_control_success.html

which happens to be the main hospital in Cambridge, affiliated with
the University and its medical school.

    To get a sense of how preposterous that really was, imagine a
similar outbreak being tolerated in any of the Boston hospitals
associated with Harvard Medical School -- Massachussetts General
Hospital, Beth Israel, the Dana Farber Cancer Center, Brigham and
Women's, or *any* of them.

    There are decent, hard-working doctors in the British system.  
But I have a feeling that a lot of them are probably as frustrated
as this one was:

    http://en.wikipedia.org/wiki/Anthony_Daniels_%28psychiatrist%29"

[Headless Thompson Gunner]

You would have a point if your country actually didnt do cost benefit analysis when it comes to saving lives, or if ours did do it.  Unfortunately neither statement is true.  

With the rapid advances in modern medicine, most people accept that no publicly funded healthcare system, including the NHS, can possibly pay for every new medical treatment which becomes available. The enormous costs involved mean that choices have to be made.

...

Each drug is considered on a case-by-case basis. Generally, however, if a treatment costs more than £20,000-30,000 per QALY, then it would not be considered cost effective.

...

Patient x has a serious, life-threatening condition.

    * If he continues receiving standard treatment he will live for 1 year and his quality of life will be 0.4 (0 or below = worst possible health, 1= best possible health)
    * If he receives the new drug he will live for 1 year 3 months (1.25 years), with a quality of life of 0.6.

The new treatment is compared with standard care in terms of the QALYs gained:

    * Standard treatment: 1 (year’s extra life) x 0.4 = 0.4 QALY
    * New treatment: 1.25 (1 year, 3 months extra life) x 0.6 = 0.75 QALY

Therefore, the new treatment leads to 0.35 additional QALYs (that is: 0.75 –0.4 QALY = 0.35 QALYs).

    * The cost of the new drug is assumed to be £10,000, standard treatment costs £3000.

The difference in treatment costs (£7000) is divided by the QALYs gained (0.35) to calculate the cost per QALY. So the new treatment would cost £20,000 per QALY.