NHS/healthcare cost query.

[int]

Someone made a comment in the HIV thread, which stated that they think the NHS should be closed, thus forcing everyone to pay for their own healthcare.

My question is, if the NHS were to close, how much money would each person "save" in taxes (assuming we would get a tax cut due to the closure).

My bet is that we'd barely save any money personally and forcing us to pay for our own healthcare would result in a lot of poorer people dying/suffering. Anyone have any idea on figures?

 

[scorza]

I guess it'd work out at a flat rate per person of £2-3k, but if God forbid it ever happens it wouldn't be a flat rate per person - the higher your income the more you'd save by scrapping the NHS.

 

[iraiguana]

Cost of NHS is ~ £122 billion pounds or ~ 8.5% GDP.

England has rough costs of ~ £1900 per person per year for the NHS.
60% of which is on staff, 20% on drugs and 20% on buildings and other bits.

The cost to provide a similar service by insurance would be very high to the individual, especially those who are in need and/or lose access to company discounted policies.

There is no simple solution and private insurance results in scaled structures of care, depending on the levels of cover one can afford.

 

[drunkenmaster]

There isn't a simple solution, but there are many pretty decent things that can be done to help out.

£50 GP charge if nothing is wrong with you would put off almost everyone with a cold/flu from going to a GP and wasting a crapload of time. This should be waived for certain people who are higher risk from simple infections, immune compromised patients, elderly. Frankly the big girls blouses who run to the doctor over nothing are just another line of people who bog down the system.

Endless bureaucracy is one of the biggest problems in the NHS, and its also not a complete fix nor a simple fix, but one that HAS to happen be it private, or public paid for healthcare as it would save either system billions a year. The amount of idiots being paid huge sums to push around pointless paperwork is laughable.

Its the age old thing, you start with a budget of 50billion, then idiot governments want efficiency increases and end up spending 10billion in increased paperwork, to save 200million in wasted costs.

At some point you have to accept a "decent" level of efficiency and not waste money going after every last penny. I always end up referring to the utterly daft allocation of money, Ealing hospital had JUST redecorated and arranged the ER to be told they can have something along the lines of a couple hundred grand, but the only use it had was updating the ER as this was given to a bunch of hospitals, and instead of giving them the 200k or so to put in their budget against money they already took out to do the work, they did up the ER, again, within months when there was nothing at all wrong with it.

Too much bureaucracy and efficiency planning and you get this kind of utter waste going on. You can have 500k, but you can't spend it on what you the individual hospital needs, we've deemed that every hospital needs X so you can spend it on that, but nothing else.

Private insurance has upsides and downsides, people are MUCH less likely to claim for minor things, but insurance being insurance, far more people get screwed out of treatment they need and everyone could end up paying the same under each system. Private insurance/healthcare at this point has a better chance of somewhat "starting from scratch" and not adding every single level of bureaucracy the NHS currently has and people shouldn't pretend under the NHS lots of people don't already get screwed out of treatment, the NHS works very similarly, just less to save money and more for whatever idiot party is in charge having their "targets" met which are political and not medical.

If you have a disease that plays well politically at the right time you're golden, if you have a disease no politician has ever heard of, you could get screwed.

 

[Xordium]

I guess it'd work out at a flat rate per person of £2-3k, but if God forbid it ever happens it wouldn't be a flat rate per person - the higher your income the more you'd save by scrapping the NHS.

But research shows that the richer/educated people get far more services provided for things they present with. Not saying it balances out but it is not quite as simple as you make out there.

 

[Kutter]

Having gone from being covered by the NHS to private health care, getting rid of the NHS would be the worst possible thing for the British people. The NHS, even when abused is fantastic. When my daughter was born they saved her life, and the treatment she recieved must have cost 10's of thousands. If she would have been born here, maybe things would have been different.
Luckly i have a good employer and it costs me $80 a week for family cover including dental and vision. I have to pay the first $4000 in costs a year, but this is reduced to $2000 due to my employer putting $2k a year in a HSA for me.
If you don't have insurance a trip to accident and emergancy could cost you $5k plus.

Then of course your insurance company could drop you due to some small print and not cover any costs, when you need it the most.
People may have bad experiences with the NHS but its a great system and you don't realise how good until you don't have it.

 

[Orford]

I've never understood, why people who's companies provide private medical insurance get taxed on it as a benefit. When if they need treatment and use the insurance it is in effect saving the NHS money. Sort of paying twice in my view. Yes, the amount of extra tax you pay for the benefit of private health care is small, paying tax for it baffles me.

Back to the OP. The question should be. how much is raised in National insurance, Alcohol duty, Tabacco Duty and all other tax's that are imposed to pay for the NHS including the tax's to cover the cost of the damages caused by the above products. How much of that revenue actually goes to the NHS?
What you find is a tax in name isn't the nature of the money it's spent on.
Road fund licence, there's another one. Is all that money used to pay for the roads, no.
We should be asking where is all the money we pay in tax's going, what other countries are we funding, we as a nation pay way more than it cost to run the country.

Ah grrr, work work work, I need more fun not tax's.

 

[Rich_L]

Put it this way, every day I spend under (and working in) the US health system, the better the NHS looks.

 

[scorza]

I've never understood, why people who's companies provide private medical insurance get taxed on it as a benefit. When if they need treatment and use the insurance it is in effect saving the NHS money. Sort of paying twice in my view. Yes, the amount of extra tax you pay for the benefit of private health care is small, paying tax for it baffles me.

It's against the law to force your employees to join the private medical insurance schemes at work, if it wasn't a benefit people wouldn't join it.

The private healthcare industry in the UK compliments the NHS and doesn't compete with it. For example the private medical insurance I have arranged through my employer is worth £350 a year, compared with the sort of premiums you have to pay for comprehensive cover in the USA that's a tiny amount of money.

 

[RDM]

£50 GP charge if nothing is wrong with you would put off almost everyone with a cold/flu from going to a GP and wasting a crapload of time. This should be waived for certain people who are higher risk from simple infections, immune compromised patients, elderly. Frankly the big girls blouses who run to the doctor over nothing are just another line of people who bog down the system.

That could end up costing more in the long run as people would put off seeing their GP for as long as possible meaning something that could be easy to treat suddenly becomes much more serious and costly due to delay in treatment.

 

[xarr]

I always end up referring to the utterly daft allocation of money, Ealing hospital had JUST redecorated and arranged the ER to be told they can have something along the lines of a couple hundred grand, but the only use it had was updating the ER as this was given to a bunch of hospitals, and instead of giving them the 200k or so to put in their budget against money they already took out to do the work, they did up the ER, again, within months when there was nothing at all wrong with it.

This is where the public fail to understand the NHS, it spends quite large sums of money on looking at how to best serve its local community.

Ealing Hospital serves Southall and Greenford, two areas with very high percentages of recent migrants, many of whom come from the developing world. Here healthcare is provided by hospitals and clinics and so if you want healthcare (be it a for major accident or a sniffle) you present at the hospital. This behavior is hard to break, for many people in this area it is all the know. That combined with many people don't know how to or won't (for a variety of reasons) register with a GP means that Ealing Hospitals A&E experiences a higher than average number of attendances for minor complaints. This is a pattern across a number of local hospitals (West Middlesex, Central Middlesex and Northwick Park) and perhaps further afield (I speak from local knowledge not a great understanding of healthcare patterns across London/UK).

In response to this local PCT's are working with Care UK (a private company I know nothing about) to provide Urgent Care Centres (UCC) in many hospitals. These are staffed with GP's and nurse practitioners and are designed to replace the old minors side of A&E with a service that more readily meets the needs of its community. This urgent care centre was created at Ealing around 2010/2011 and when I have taken my brother to it as a patient (sprained ankle, ?fracture) it was efficient and the staff pleasant in a nice environment.

A&E Majors at Ealing hasn't had much more than a lick of paint in many years and as such updating it to a 21st century style of medicine with a few hundred grand wouldn't be a bad thing. I really can't imagine that they would redo a brand new urgent care centre at this stage in the game, the paint had only just dried. I really fail to see your argument, if they have money I can only assume that they are using it to redo majors and resus?


On the other point, I would love to see a co-pay system introduced for GP visits, £25-50 per visit. I can only see it being another tax on the working though. Those on benefits or with chronic conditions wouldn't have to pay, so instead the person who has had to take time off work to see their GP (which is the case for many unless your part of a poly clinic practice) then has to pay on top of that. It might stop a few with a sniffle seeing GP's but how many people are using the service incorrectly? Would it lead to an increase in A&E/UCC attendances as people do in the US (no access to primary healthcare=increased attendances at secondary healthcare).

I would also love people to be presented with a bill for their care if they attend hospital/the GP, not to pay but to give them an understanding of how much the NHS costs to run, many peoples short stays in hospital would run in to the thousands.

Perhaps if the government stopped policitising the NHS and let the people that run it (and know whats best for it) get on with it then maybe we would see some real innovation, real savings and real improvements.

 

[Participant]

That could end up costing more in the long run as people would put off seeing their GP for as long as possible meaning something that could be easy to treat suddenly becomes much more serious and costly due to delay in treatment.

And also people would be disputing the charge left right and centre, saying that there was something wrong with them but the GP was incorrect, which would cost more than £50 to administrate.

 

[DanielMMS]

£50 GP charge if nothing is wrong with you would put off almost everyone with a cold/flu from going to a GP and wasting a crapload of time. This should be waived for certain people who are higher risk from simple infections, immune compromised patients, elderly. Frankly the big girls blouses who run to the doctor over nothing are just another line of people who bog down the system.

It costs £40+ to visit your GP here is Jersey. The result is that (a) more people end up visiting the Emergency Department at the General Hospital for minor ailments; and (b) people tend to leave visiting their GP until they are very ill. The result of (a) is that ED ends up being burdened with treating huge numbers of patients for inapppropriate problems. The result of (b) is that, by the time care is sought, hospitalisation - or worse - is far more likely again placing an additional burden on hospital care. So the result would merely be shifting the funding need away from GPs to the hospital.