NHS/Medical Insurance

[Deleted member 15344]

Simple question

Is it time for us to stop paying National Insurance and for people to take out medical insurance to cover medical costs ?

Is the UK medical services and public able to work like the US does ?

Is it time to privatise the NHS ?

Would we see an improved service overall and enough "pro bono" clinics to provide the care needed for the UK

 

[SocketRocket]

A mixture of the two seems to work well in some countries. Germany do it and it appears to provide a good service.

 

[Papas1982]

Simple question

Is it time for us to stop paying National Insurance and for people to take out medical insurance to cover medical costs ?

Is the UK medical services and public able to work like the US does ?

Is it time to privatise the NHS ?

Would we see an improved service overall and enough "pro bono" clinics to provide the care needed for the UK

I certainly hope not.
My reasoning. My youngest has just been diagnosed with Turner syndrome. Treatments being suggested, a hormone injection daily til she's in her late teens. A total cost of approx $20k-$40k. Without the treatment she'll lack female features growing up and get no taller than 4ft.

Now, if we suddenly had to get our own insurance now, who would touch us? In us everyone has to have t, so we'd of had insurance for her from day she was born. But now? Is their an amnesty? Or are all people currently with ongoing treatments buggered?

 

[SocketRocket]

I certainly hope not.
My reasoning. My youngest has just been diagnosed with Turner syndrome. Treatments being suggested, a hormone injection daily til she's in her late teens. A total cost of approx $20k-$40k. Without the treatment she'll lack female features growing up and get no taller than 4ft.

Now, if we suddenly had to get our own insurance now, who would touch us? In us everyone has to have t, so we'd of had insurance for her from day she was born. But now? Is their an amnesty? Or are all people currently with ongoing treatments buggered?

As you suggest, you would have been OK as you would have always been insured or covered by the State.

 

[Papas1982]

As you suggest, you would have been OK as you would have always been insured or covered by the State.

So as long as your diagnosed prior to privatisation, you're covered?

 

[Rooter]

In reply to papas post above; Typically that's how bupa for example work, they will cover you for everything except pre existing conditions. ( note even if you went to your gp once and discussed said issue, that counts as pre existing, even though you have not been formally diagnosed!!) I had a huge argument with bupa about this years ago..

 

[palindromicbob]

Simple question

Is it time for us to stop paying National Insurance and for people to take out medical insurance to cover medical costs ?

Is the UK medical services and public able to work like the US does ?

Is it time to privatise the NHS ?

Would we see an improved service overall and enough "pro bono" clinics to provide the care needed for the UK

:rofl: If you think the US system works then you are sorely mistaken.

In this US based report the UK actually ranks 1st out of 11 countries.

http://www.commonwealthfund.org/~/m...rt/2014/jun/1755_davis_mirror_mirror_2014.pdf

And in world wide reports the UK fairs well ranking into the top 30 world wide and is always above the US and many other systems in the developed world. Not bad considering our spending as a percentage of GDP is actually quiet low.

We have become a nation of terrible self care and highly elevated expections that's putting a massive stain on the system. Here in N. Ireland the biggest and stupidest move made was free prescriptions. Great vote winner but I've seen people book appointments with a G.P to get a free prescription for paracetamol rather than spend 50p themselves in a chemist. I've also seen people roll into A&E because they have flu. This is physical health problems but what about looking at mental health problems?

US style insurance companies are grand to cover a transient mental health problem but once thats on your record you can expect costs to rise.

Insurance for long term and severe and enduring mental illness? Not a hope. I know of some (thankfully not common) cases where care costs in the region of £300,000 per year.

Even as we currently stand the under investment is huge and those with severe and enduring mental health problems are more likely to develop co-morbid conditions such as being overweight, diabetes, hypertension etc. Also more likely to smoke leading to increased risk of cancer, COPD, and in some cases need higher amounts of medication for treatment compared to a non-smoker and therefore the cost of their prescription are higher. Any insurance company willing to take that person on without charging them an unaffordable amount of money would need to be willing to make a loss.

Then there is addiction.

Some studies have shown that for every £1 spent on treatment for substance abuse it will save £2.50 in costs to society. http://www.nta.nhs.uk/uploads/whyinvest2final.pdf

Other studies I've seen would actually place this figure higher. Yet there is still a massive underinvestment in services. Why is this? Probably because it isn't pretty and a heroine user doesn't exactly make a great "poster child" for an election campaigns.


Again good luck helping these people on a two tier system.


That's also forgetting to add that saying goodbye to the N.I contributions would also be saying good bye to the state pension. As poor as it might seem, and as far away as it is going to be, it's not a bad thing. Especially if you also have opted into another pension scheme.


Ok to answer your last question.

Would we see an improved service overall?

Yes if you could afford the insurance you would see an improvement. Same as you would if you were to take out private insurance now but if it were purely a voluntary insurance system then expect costs for even basic cover to be in the region of £1200+ a year, rising as you age and renewals to spike after every new diagnosis.

Those who aren't in a position to take out the insurance however would be, quiet frankly, screwed.

 

[Biggleswade Blue]

I think many people who be absolutely gobsmacked at the cost of Private Medical Insurance. for me and my family it costs way more than my National Insurance Contribution.

 

[Ethan]

The US system is one that no sane country aspires to. Even the US are trying to get away from it. It is very very expensive and encourages usage and consumption to drive billing.

The NHS is a pretty efficient system, and could be improved with less political interference and a stripping out of unnecessary pseudo-corporate structures. The introduction of the purchaser-provider (internal market) split in the late 80s started the current rot which will end with parts of the system (the most profitable ones, natch) being hived off to US private healthcare companies. The social insurance model is basically the same but the precise method of funding just looks different. You still pay for it, one way via taxation, the other directly.

 

[KhalJimbo]

I'm of the persuasion that the NHS should be treated the same as child tax credits.

If you earn over a certain amount you can't use the NHS and need to rely on medical insurance, either through employment benefit or funding it yourself. You should be able to use NHS doctors, NHS ambulances etc, but main operations and hospital stays should be taken care of out of your medical aid.

Thats obviously a general idea and I am obviously not qualified to speak into specifics etc but that how I think it should work.

I also think that people under 35 with a private pension over a certain amount (again, not sure on the amount) should be allowed to withdraw a certain percentage of it provided its used solely for a housing deposit.

 

[SwingsitlikeHogan]

I'm of the persuasion that the NHS should be treated the same as child tax credits.

If you earn over a certain amount you can't use the NHS and need to rely on medical insurance, either through work or funding it yourself. You should be able to use NHS doctors, NHS ambulances etc, but main operations and hospital stays should be taken care of out of your medical aid.

Thats obviously a general idea and I am obviously not qualified to speak into specifics etc but that how I think it should work.

I also think that people under 35 with a private pension over a certain amount (again, not sure on the amount) should be allowed to withdraw a certain percentage of it provided its used solely for a housing deposit.

You do know that you can get treated 'in the NHS' and have your medical insurance charged for the cost of your treatment. Private Hospitals are limited in the services they provide - they are currently not a complete alternative to the NHS and often private patients have to have some or indeed much of their treatment delivered by the NHS - but paid for by the insurance company - how good the NHS is at collecting payments is another thing.

 

[KhalJimbo]

You do know that you can get treated 'in the NHS' and have your medical insurance charged for the cost of your treatment. Private Hospitals are limited in the services they provide - they are currently not a complete alternative to the NHS and often private patients have to have some or indeed much of their treatment delivered by the NHS - but paid for by the insurance company - how good the NHS is at collecting payments is another thing.

Didn't know that the NHS charged the private insurance companies. I do know that if I choose to rather use an NHS hospital for my treatment my private insurance will pay me for using the NHS instead! As I said before, not entirely sure how it all works, I just don't think its entirely fair for people who have private insurance to be offered the use of the NHS that is already stretched as it is if an option of a private hospital is available via your insurance.

 

[SwingsitlikeHogan]

Didn't know that the NHS charged the private insurance companies. I do know that if I choose to rather use an NHS hospital for my treatment my private insurance will pay me for using the NHS instead! As I said before, not entirely sure how it all works, I just don't think its entirely fair for people who have private insurance to be offered the use of the NHS that is already stretched as it is if an option of a private hospital is available via your insurance.

The internal market in the NHS and how it extends into the private sector are very complicated/messy. If you start out in the Private Sector then you stay in the Private Sector - even if you choose part way through to have treatment or consultations done in the NHS - you are still deemed to be a private patient and will be charged accordingly. If you have private health insurance you can still choose to go NHS - but you have to go NHS from the word go. And that means you are just like everyone else when it comes to choices, timing etc.

If down the line you decide to move out of the NHS into private then it is up to your insurance whether or not they'll pay - and of course you can't take your consultant and/or nurse specialist etc with you. You get what private has to offer - and in many situations all that private has to offer is choice of consultant; prompt initial consultation and less time between consultations/treatments if that is possible.

 

[HomerJSimpson]

No!

 

[Hobbit]

Simple question
Is it time for us to stop paying National Insurance and for people to take out medical insurance to cover medical costs ?
Is the UK medical services and public able to work like the US does ?
Is it time to privatise the NHS ?
Would we see an improved service overall and enough "pro bono" clinics to provide the care needed for the UK

Good thread Phil. I was about to post something a little different, "Our NHS, what sort of NHS do you want?"

We all want it to be there when we desperately need it, and we want it to be the best at that time. Until that time we all make the right noises but do we really have the desire to make it happen? What would you give to turn the NHS into a healthy beast rather than an ailing, failing monolith?

For me, ring fence it from politics, and have it controlled by a decent non-profit mgt company. Increase NI contributions to a level that significantly improves the funding the NHS receives - might as well do that than pay out significant sums in private insurance, of which a % is creamed off as profit.

If we want a decent NHS, we have to pay for it. The Govt isn't a business that funds the NHS, we fund it. And if we want the best, we have to accept the cost.... what is the alternative? Paying a lump to a private company that creams off the top, no thanks.

 

[PhilTheFragger]

The main problem with private medical insurance is as you get older (typically over 60) it becomes prohibitively expensive, so whilst you can enjoy private insurance till you retire, the nhs becomes lumbered with everything that an elderly population suffers from,

 

[chrisd]

The main problem with private medical insurance is as you get older (typically over 60) it becomes prohibitively expensive, so whilst you can enjoy private insurance till you retire, the nhs becomes lumbered with everything that an elderly population suffers from,

I have found it necessary to have private cover for the last 25 years as I and a pal had our own small business. We cover him and me and our wives. I have had several operations, including both hips replaced privately and now that all four of us are over 60 and a largish claims experience our premiums have rocketed to a point that we almost certainly will be forced to cease the scheme.

We have also paid full wack into the NHS as well plus employers contributions with no reduction for the fact that we use the NHS much less than we otherwise would have. Quite honestly most people wouldn't be able to cover their personal medical needs especially if they have a serious long term problem and they would eventually become uninsurable after all their assets were spent

 

[SocketRocket]

I referred previously to the German health system. It is a mix of state and private, the private part is provided by non-profit suppliers (I believe most UK private suppliers are non-profit) Their system always seemed to provide good health care when I worked there.

 

[bluewolf]

I referred previously to the German health system. It is a mix of state and private, the private part is provided by non-profit suppliers (I believe most UK private suppliers are non-profit) Their system always seemed to provide good health care when I worked there.

I have Family who use the German Healthcare system and they like it. However, it should be pointed out that the average Citizen only pays half of the cost of the Healthcare system. The other half is funded by the Company they work for. This is true for the average worker. For people who don't work, the Government pays the entire bill. For those in the higher earnings bracket, they are encouraged to join fully Private healthcare (but this is not compulsary).

Most Germans actually want the Fully Private system scrapped as it encourages a 2 tier healthcare system that penalizes those in rural communities as the Doctors don't want to work there as they don't earn as much money.

It should also be stated that the system is one of the most expensive in Europe as it encourages overspending by the frontline health professionals.

 

[Del_Boy]

Good thread Phil. I was about to post something a little different, "Our NHS, what sort of NHS do you want?"

We all want it to be there when we desperately need it, and we want it to be the best at that time. Until that time we all make the right noises but do we really have the desire to make it happen? What would you give to turn the NHS into a healthy beast rather than an ailing, failing monolith?

For me, ring fence it from politics, and have it controlled by a decent non-profit mgt company. Increase NI contributions to a level that significantly improves the funding the NHS receives - might as well do that than pay out significant sums in private insurance, of which a % is creamed off as profit.

If we want a decent NHS, we have to pay for it. The Govt isn't a business that funds the NHS, we fund it. And if we want the best, we have to accept the cost.... what is the alternative? Paying a lump to a private company that creams off the top, no thanks.

we currently fund the nhs to the tune of 115 billion per annum, how much more money does the NHS need