The Politics Thread

[BWFC_Insane]

I don't have that info to hand so I won't venture a poorly-remembered version, but it's out there if you want to look for it.

And yes, obviously some metrics are heavily skewed by lifestyle factors, but there are some that are not.

http://www.telegraph.co.uk/health/healt ... world.html" onclick="window.open(this.href);return false;

The success of the NHS stands out despite the fact that per capita health spending in the UK is the third lowest of the 11, at £2,170 per head, compared with £3,200 in Switzerland and £4,950 in the US.

For example.

[mummywhycantieatcrayons]

I don't have that info to hand so I won't venture a poorly-remembered version, but it's out there if you want to look for it.

And yes, obviously some metrics are heavily skewed by lifestyle factors, but there are some that are not.

http://www.telegraph.co.uk/health/healt ... world.html" onclick="window.open(this.href);return false;

The success of the NHS stands out despite the fact that per capita health spending in the UK is the third lowest of the 11, at £2,170 per head, compared with £3,200 in Switzerland and £4,950 in the US.

For example.

That's just a DC-based lobbying group writing a report to make the US system look as bad as possible.

Notice that no actual outcome metrics are mentioned.

Just google "international health care league table" for an introduction...

[BWFC_Insane]

I don't have that info to hand so I won't venture a poorly-remembered version, but it's out there if you want to look for it.

And yes, obviously some metrics are heavily skewed by lifestyle factors, but there are some that are not.

http://www.telegraph.co.uk/health/healt ... world.html" onclick="window.open(this.href);return false;

The success of the NHS stands out despite the fact that per capita health spending in the UK is the third lowest of the 11, at £2,170 per head, compared with £3,200 in Switzerland and £4,950 in the US.

For example.

That's just a DC-based lobbying group writing a report to make the US system look as bad as possible.

Notice that no actual outcome metrics are mentioned.

Just google "international health care league table" for an introduction...

Ah I see "not thaaaaaat study, cos I don't like it".

[mummywhycantieatcrayons]

Ah I see "not thaaaaaat study, cos I don't like it".

Well I haven't read it, but if that article is a fair summary then I'd say it doesn't touch on the sorts of things I'm talking about.

Anyway, seeing as you asked further up, Singapore is my favourite healthcare model if you have time to look into it.

[BWFC_Insane]

Ah I see "not thaaaaaat study, cos I don't like it".

Well I haven't read it, but if that article is a fair summary then I'd say it doesn't touch on the sorts of things I'm talking about.

Anyway, seeing as you asked further up, Singapore is my favourite healthcare model if you have time to look into it.

What sort of "outcome metrics" are you after? The trouble with outcome metrics is that they are very hard to divorce from lifestyle choices and cultures.

I don't work in the NHS but its ethos is one I support. I do agree with you that some hard choices need to be made about what we want the NHS to do in the future, but actually the issues it faces financially are to a fairly large extent down to its own success. Keeping an ageing population alive longer. Part of that is down to medical advances sure, but a big part is down to the NHS adopting those, implementing them well and then actually treating patients with skill and ultimately success. As more and more medical advances arrive and prove successful the drains are only going to get greater. That is not an argument for abandoning free at the point of access healthcare, but an argument for deciding what we want as a nation our NHS to provide. That may mean some hard choices but rather we were given that choice than have it taken out of our hands by some back-door sneaky privatisation bill, that nobody wants, even the GP's who seemingly benefit most from it....

Also I don't know, but I'm guessing that the health demographics of Singapore with a population 10th the size of ours and presumably less diversity, are somewhat simpler than ours.

[mummywhycantieatcrayons]

I've read this before from back in 2003 and remember being impressed by its idea of 'mortality amenable to health care' excluding people over the age of 75. http://www.bmj.com/content/327/7424/1129" onclick="window.open(this.href);return false;

I agree that it's difficult to separate outcome measures from other things and 'lifestyle' choices, but it doesn't make comparison meaningless.

And, of course the next subject that might be worth discussing is whether universally free healthcare provides good incentives to make good lifestyle choices...

[Armchair Wanderer]

Listening to David Cameron speak about Scotland and them not going for devolution.

The speech is making me think they should go for it, almost wish I could personally devolve.

[Prufrock]

I have just written a ginormous offering of the sort I haven't in a long time. As such I've split it into two seperate, but related, posts. Firstly:

To dip my oar into the NHS debate again...

I find any NHS reform extremely difficult to debate, because it tends to raise the hackles of the partisans on both sides. I'm honestly not sure what these NHS reforms actually say, other than I think they take out a symbolically important sentence at the start, and have something to do with GP's having more 'power' but not really wanting it, or something. So, to talk generally:

I'm not against private sector involvement in the NHS from an ideological point of view. If I thought a privatised health system would lead to better care, I wouldn't disregard it as 'wrong'. The question is, of course, 'would it lead to better healthcare'? Another thing to bear in mind is that it isn't obviously a question of 100% privatised vs 0% privatised, as PB's optician example shows.

The problem I have is that that comparison only goes so far. An optician's doesn't require particularly complex equipment, or tests, nor, in the majority of cases, is there much cross-over with other specialties. As such it is fairly easy to set up an opticians, and they are fairly self-sufficient. That can't really be said of heart disease, or cancer treatment, where theatres, drugs, beds, round-the-clock care and so on mean everything must be centralised in one hospital. If I have a heart attack, and have the choice of privately run Chorley hospital, or privately run Preston hospital, twice the distance, I haven't really got a choice have I? I can't really shop around in those cases.

Privatisation of opticians is viable because on the same high street you can have a Specsavers, a Boots, a Tesco, an Opticals Express. There is true competition and so prices have to stay low, and standards high, otherwise people will go elsewhere. The problem with a lot of key NHS services, is they are much more like the privatisation of rail. There is ‘competition to tender’, no real competition at all, after which Northern Rail turn up when they want, for exorbitant prices, and it costs the tax payer more than it did before. I don’t have the option to catch a Virgin train instead, or a Mersey Rail, because there can only really be one provider running a particular train service. There is no competition where there is no choice. Northern know that, so their service is shit, and their prices high, because they know that if I want to get to Manchester I have to use their service.

I have assumed that the element of competition has in fact improved eye care. I neither remember the NHS days, nor wear glasses, so my own experiences are pretty useless. I don’t resent the price I pay for my yearly check up, it doesn’t seem extortionate, I have changed who I see on price and haven’t had a problem. Perhaps it is different if you require more intensive care. However, assuming it has been a good thing, I have no problem with the concept being extended to other, analogous, areas of health care, it’s just that large swathes of the NHS do not seem to be so.

[Prufrock]

NHS (remix)

That’s just the economic side. For me there must be considerations which go beyond the economic. Of course, ultimately, we must live within our means, but I still feel an unease at the language of dog eat dog in relation to healthcare, when, ultimately in such questions, a dog does indeed get eaten. To me it seems either we must be content to just allow people to die because they are not ‘affordable’, which seems a ghastly concept, or else we don’t, and so someone will end up picking up the tab, and it won’t be the private provider.

There are also further considerations. Arguably, the qualities people value most in an optician are efficiency and competence. People don’t tend to build a relationship with their optician. That is not the case even with the most closely analogous example I can think of, of dentistry. I said above I have quite happily switched between opticians. I, only really see the dentist once a year, so I probably would switch dentist too. My mother, who goes more often, and, not-uncommonly, dislikes the entire experience, would not. She feels comfortable with her current dentist and as such it would take a serious course of events to persuade her to change. I imagine the case is even more so with GP’s. Allowing GP’s to set their own prices is therefore unlikely to improve standards, or lower cost- rather, the opposite.

That said, as admitted, I don’t actually know what these ‘privatisation reforms’ actually are, so I may have just wasted half an hour talking to myself.

I’ve had worse times.

[Little Green Man]

Politics of a sort - I was amused to hear Baroness Frognal repeatedly referred to as Lady Garden on Yesterday In Parliament this morning.

Fnarr, fnarr, kyuk, kyuk etc...

[Hoboh]

Scottish Conservative leader Ruth Davidson accuses Mr Salmond of using “fantasy figures” in his economic calculations. She told BBC Radio Scotland’s Good Morning Scotland programme that figures from 2010 showed that the amount of welfare payments paid in Scotland was more than three times the North Sea oil revenue for that year.

Go Jock just go!

[Prufrock]

Yon cockend is in 'trouble' for wading in on Rangers jobbie isn't he? Celtic up in arms that he did a comment. Seemed it was a, unusually for him, ludicrous jibe at HMRC.

[Hoboh]

Yon cockend is in 'trouble' for wading in on Rangers jobbie isn't he? Celtic up in arms that he did a comment. Seemed it was a, unusually for him, ludicrous jibe at HMRC.

If Rangers is a good example of Scottish business the sooner we are shot of them the better Been crooks and bandits since Rob Roy

[mummywhycantieatcrayons]

To me it seems either we must be content to just allow people to die because they are not ‘affordable’, which seems a ghastly concept,

Again, I can't help but point out that we are already doing this. I'm sorry to be graphic about this, but: viewtopic.php?f=4&t=23045" onclick="window.open(this.href);return false;

The question is not whether this happens, but where the cut off line is in terms of what we're prepared to pay and at what chance of success and at what age.

My central contention is that the cut off line will get nearer and nearer to 'basic' care if we carry on as we are now.

And of course not all NHS services are like opticians - I just mentioned it as one other example to go with Southern Cross (which, actually, is probably more about accommodation than it is healthcare anyway).

[mummywhycantieatcrayons]

Interesting little piece on welfare in the US today. It mentions the Singapore health system in passing, too...

http://www.economist.com/blogs/democrac ... ndhatingit" onclick="window.open(this.href);return false;

[Hoboh]

Ahead of the overnight talks some critics were warning against "throwing good money after bad", but the price of letting Greece default and be forced out of the euro currency was seen as a worse option. Instead the talks concentrated on tying Greece as tightly as possible to austerity measures which will chip away at its debt and deficit levels.

Political parties on all sides were even pressed to promise no easing of the austerity package in forthcoming Greek elections. A deal was needed to give Greece enough funding to meet its next debt repayment of 14.5 billion euro (£12 billion), due on March 20.

So much for a free and democratic election held in the Eurozone!!! Germans telling politicians or candadites what their agenda is? Nazi's!

[mummywhycantieatcrayons]

http://www.economist.com/blogs/newsbook ... ingtherich" onclick="window.open(this.href);return false;

Interesting to see a French socialist candidate's radical pledge to increase the top rate of income tax to 45%.

[Athers]

75% for over E1m

Should help the Swiss and West London property markets even more..

[mummywhycantieatcrayons]

75% for over E1m

Should help the Swiss and West London property markets even more..

Ah yes, I didn't even read that! I just remember the 45% figure from when his manifesto first came out.

[Gooner Girl]

The British Medical Association has weighed in on the new Prime Minister David Cameron's health care proposals.

The Allergists voted to scratch it, but the Dermatologists advised not to make any rash moves.

The Gastroenterologists had a sort of a gut feeling about it, but the neurologists thought the Administration had a lot of nerve.

The Obstetricians felt they were all labouring under a misconception. Ophthalmologists considered the idea short-sighted.

Pathologists yelled, "Over my dead body!" while the Paediatricians said, "Oh, Grow up!"

The Psychiatrists thought the whole idea was madness, while the Radiologists could see right through it.

The Surgeons were fed up with the cuts and decided to wash their hands of the whole thing.

The ENT specialists didn't swallow it, and just wouldn't hear of it. The Pharmacologists thought it was a bitter pill to swallow, and the
Plastic Surgeons said, "This puts a whole new face on the matter...."

The Podiatrists thought it was a step forward, but the Urologists were pissed off at the whole idea.

The Anaesthetists thought the whole idea was a gas, but the Cardiologists didn't have the heart to say no.

In the end, the Proctologists won out, leaving the entire decision up to the a***holes in London