username.exe

I worked in the NHS for several years, and as much as I love it I have to agree it is heading straight into a storm. So much to fix, so little resources being committed and so many hard working people giving their all and more.

Unfortunately I don't believe that universal at point of use is a sustainable model for the NHS at the current rate of demand.... unless the public is ready to pony up some significant revenue (taxes, probably).

scrubbedexpat091

Can the UK bring in monthly healthcare premiums that are based on income and family size?

I am in Canada and our system is stretched thin in most provinces, in my province to help fund the system, we have monthly premiums that are based on family size and income.

Something like 43% of the annual provincial budget goes to healthcare, so I can only imagine the nightmare it must be to fund a national system like the UK has.

petitefrancaise

The UK has underfunded healthcare for many years. According to WHO statistics, the UK spends 9.4% GDP on healthcare, compared with 11+ % of comparable EU nations (France, Germany, Belgium for example) 17%+ in the USA yet the UK wants to have a service at least equal to other nations. I read an interesting article comparing the pay of doctors between nations, the UK was no 5 and yet it is nowhere near no 5 in terms of how much we spend on health. I know people took exception to what I wrote before about drs and especially consultant pay in the NHS but the figures back up what I say. If the UK really wants a world class health system for all the patients then it really need s to pony up more money

Pulaski

The problem is that the cost of the NHS is entirely lost in the taxes people pay and is promoted as being "free at the point of delivery", and so the NHS is being completely undermined by the marketing slogan intended to promote what some people believe is its grest strength, or at least its defining characteristic.

scrubbedexpat099

You can increase health care spending, the only certainty is that it wlll never be enough.

Of course if you look at it in percentage terms if something goes up something else has to come down.

In any event such transfers require a cohesive society and the willingness of the majority to contribute to others of the same group.

scrubbedexpat091

Are things like prescriptions covered or do the patients pay for them out of pocket or with private insurance?

I suppose Canada is kind of middle of the road where some of the cost is pushed onto the public, paying for prescriptions, and in the case where I am, monthly premiums for most people.

Doctors here are not paid a set salary, they are reimbursed X amount per patient, what they take home after expenses is anyone's guess.

My GP took in 312,000 last year, but he has to deduct his practices expenses from that, so it's not his actually take home salary.

Does the UK make available to the public what doctors take in each year?

Would people in the UK flip out if premiums or co-pays were brought in, or would they accept it with some fuss and then move on with life?

username.exe

Prescriptions are heavily subsidised, and if you tick a box for one condition or another (on a benefit, elderly, student etc.) then they're free. Last time I paid for a subscription it was less than $10. The pharmacist was a little bit puzzled that I couldn't find a box on the back to tick which would make it free.

I'm not sure if Doctor's salaries are made public, but figures are quoted in press (probably from job adverts)... I guess it would be around 120k in pounds depending on training and experience. Consultants would be making more. Many work with one foot in the private sector in order to make serious dough and take home a public pension on top.

The possibility of introducing a co-pay to visit the GP has been touted before in the past, but I suspect if it were seriously debated there would be a great deal of resistance. I think it's probably a good idea. Wards are clogged up with people who have a cough, are lonely, bit of a scratch etc. They just don't appreciate the cost of the services.

Premiums would be a very difficult concept to swallow.

Harveyspecter

It's not just for healthcare. I'm a car nut and on another forum often the topic of say people banging doors or even ramming into someone's pride and joy and when confronted they say "It's only a car". However, in my case I've worked my ass off to pay for it an only bought it after I've earned and appreciated it, whereas most of them probably (like most of my friends) have simply leased or bought a new car paying monthly. So to them it's a disposable asset that costs a few hundred a month. They don't look at it as something that costs a year or more of their salary and hence it has no value to them.

As a person of the younger generation, I have said to others that people like my parents who have paid into the system all their lives should be entitled priority NHS treatment while myself as someone of a younger generation who hasn't paid much into the "System", I would be happy to take up and start paying for 'private' healthcare just as long as I got some sort of tax break so that I'm not paying for both.

quiltman

As username says, prescriptions do cost, but there are many "classes" excluded. For example, my wife is diabetic, and in UK all her meds were free - including ones that had nothing to do with her diabetes! As she was under 60 when diagnosed, she was issued an exemption certificate to supposedly show the pharmacist. In practice, I collected her meds and just ticked the exempt box. Over 60s get them free, under 18s get them free, and in Scotland and now, I think Wales, they are free for everyone! cost is fixed at about $10 an item - so 3 different meds will cost you $30. There is no insurance to reclaim cost. The Health dept do check random prescriptions for validity, and pharmacies are supposed to confirm you are entitled to free prescriptions by seeing the appropriate document. Your regular pharmacy tends to check once and that's it! My wife has been contacted twice in 30 years to send copy of her exemption certificate for checking.

Paying to see a GP has been talked about for years but has got nowhere.The argument "free at point of delivery" is used as GPs are the first line of delivery. GPs salaries are dependent on the size of the patient list for the surgery, years of service and ability to do private practice. Each GP practice gets a lump sum for each patient on its books to cover everything. There are some grants available for upgrading surgeries and for taking on minor surgery for example.

dj6372

Or as we say here on BE...same sh*t...different bucket

Or as my Yank wife says, same sh*t different accent!

amideislas

Once you give a kid some candy, taking it back is bloody difficult.

Despite the fact that those living in the UK are receiving perhaps the best healthcare value on the planet, nobody will ever accept something like nominal fees for co-pay, GP visits, unnecessary A&E treatments, or prescriptions. That would be completely unacceptable, and a clear violation of human rights. The lefties always have a heydey whenever anyone even suggests it.

Still, many others on this planet could only wish their healthcare system provided what the NHS does (especially considering how cheap it is, and how abused it is). You may not always get everything you want, but you definitely get what you need, and served up on a rather posh plate (compared to others). But once you give a kid their candy...

EMR

News for you we do pay frp prescriptions havecdone for decades.
Only those such as pensioners, on low incomes etc do not.
The vast majority of us do.
In the UK you are not denied treatment or have to sell your home or go into debt or get treatment.

Pulaski

And the cost (per product) is less than most people carry around in their pocket or handbag. In other words, for the occasional patient, the cost is as close to "free" as literally makes no difference.

steveq

News for you, we pay very, very subsidised prices for prescriptions, often a very tiny fraction of the costs.

Jerseygirl

A few years ago I read that there were more people receiving free scripts than those who pay for them.