PM Boris

Old Nov 22nd 2019, 4:22 pm
  #886  
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Default Re: PM Boris

Originally Posted by Almost Canadian View Post
This has been going on in the UK for decades. When I was a personal injury lawyer in the UK, I learned that the private care surgeons and the NHS surgeons were the same people (wearing different hats depending upon what day of the week it is) and that, when patients asked them, "When will my hip replacement operation be?" their answer was likely to be, "On the NHS, 18 months from now; if you wish to pay me privately, I can do it next week."
Yep. Living in the UK, 2016. My husband needed shoulder surgery, not a huge operation but he was in a lot of pain. His GP said he'd probably have to wait for 2 months just to get an appointment with a surgeon, so he went private and got the surgery done the next week. About £6,000 all up. The day he got out of hospital an NHS appointment letter arrived in the post - an appointment to see the same surgeon who'd just done his operation. Oh well, he did free up a space for someone else and that's good.
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Old Nov 22nd 2019, 4:37 pm
  #887  
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Default Re: PM Boris

Originally Posted by Jingsamichty View Post
Imagine you have a surgeon who can perform 10 operations a week. His NHS contract allows him to work 1 day a week privately, so he sees 2 private patients and 8 NHS patients a week.

If the NHS itself is run along more commercial lines, the 2 fully private patients will still be seen,but the 8 NHS patients will then be divided into a "pay something" or "pay nothing" camp. Meaning that those who can pay nothing (except the National Insurance) end up third class citizens, always at the back of a queue that people with money can jump. If that isn't a betrayal of what the NHS stands for, I don't know what is.
Is anyone arguing for that? When I was in England, all politicians stated that the NHS was free at the point of use. Has that changed?
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Old Nov 22nd 2019, 5:26 pm
  #888  
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Default Re: PM Boris

Originally Posted by dbd33 View Post
You know that the US has a national single payer healthcare system, right? Arguably it's world's largest. You know who used it for his recent heart attack/stroke/whatever it was? Trump. There may be room for private providers in a public healthcare system; people in Canada do get treatment comparable to that available from the NHS, but there is no way that the current US administration can sell the NHS anything that's not better bought in the UK.
I did recently learn that, but I can't profess to be that knowledgeable on any healthcare system. My question was that Canadian provinces must have some working/manageable relationships with US health companies, and it would be interesting to hear about the merits/demerits of the Canadian experience when considering the NHS. If it's as toxic a path as everyone suggests, I'm ready to accept that (preferably with evidence) but I wonder if UK is over protective of the sacrosanct NHS.
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Old Nov 22nd 2019, 5:28 pm
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Default Re: PM Boris

Originally Posted by Almost Canadian View Post
This has been going on in the UK for decades. When I was a personal injury lawyer in the UK, I learned that the private care surgeons and the NHS surgeons were the same people (wearing different hats depending upon what day of the week it is) and that, when patients asked them, "When will my hip replacement operation be?" their answer was likely to be, "On the NHS, 18 months from now; if you wish to pay me privately, I can do it next week."

If you ask me, it is the perfect solution to wait times (excepting employing more surgeons on the NHS) as the one person that decides to go private, automatically frees up a place in the NHS's queue.

One can argue about how sensible it is to pay a surgeon to perform the operation privately when s/he is operating during their NHS's rest day, but if one is willing to take a chance ...
Yes, this situation. Plenty of BUPA patients.
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Old Nov 22nd 2019, 6:19 pm
  #890  
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Default Re: PM Boris

Originally Posted by Shard View Post
I did recently learn that, but I can't profess to be that knowledgeable on any healthcare system. My question was that Canadian provinces must have some working/manageable relationships with US health companies, and it would be interesting to hear about the merits/demerits of the Canadian experience when considering the NHS. If it's as toxic a path as everyone suggests, I'm ready to accept that (preferably with evidence) but I wonder if UK is over protective of the sacrosanct NHS.
I'm not coming at this from "a deal with the Trump administration over the NHS would be a bad deal" standpoint but a "a deal with the Trump administration would be a bad deal" standpoint. Comparison with other healthcare systems isn't the guide but comparison with other deals Trump has made; the other guy always gets stiffed.
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Old Nov 22nd 2019, 7:20 pm
  #891  
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Default Re: PM Boris

It's a two edged blade isn't it.
On the one hand you have the argument that nationalisation of health services removes the profit factor and this enables all resources to be used for the service. In addition, in the case of the NHS, it enables enormous purchasing leverage due to the size and threat of purchase or non-purchase. However, history tells us that monopolies tend to grow fat and inefficient thereby soaking up valuable resources.
On the other hand you have private companies driven by the profit motive. The horrendous example of the US system shows just what happens when profit is put before health care. To be fair, if you can afford it, the US system can generate health care second to none but not for those who most need it.
The threat, being put forward by many, is that a conservative win will open the doors for private companies to hive off profitable aspects of the NHS leaving the NHS to fund the less attractive services. But it can work on a small scale. How many have seen their GP surgeries morph into small cottage hospitals that enable any number of small interventions with minimal delay and these tend to be private enterprise owned and run by the GPs themselves?
At the moment, where more serious interventions are needed, the UK has a hybrid system whereby those who can afford it can bypass some delays that inevitably form part of a comprehensive free service, after all there'll never be enough funding for such a service, but this is generally accepted because in a sense those who can afford such services remove themselves from the queues which is a good thing.
However, what those who fear the 'hiving off' process are correct to worry because the profit motive will inevitably degrade the service as corners are cut to meet both profit and targets that will certainly form part of any contract.
History has shown that politicians don't care about the future. It's what happens today and how actions reflect their popularity that's supremely important. I give you the Private Public Partnership Agreements initiative as a prime example of bad decision making that sucks resources from the NHS to this day.
In theory there's nothing to be feared really from introducing private companies into the NHS but I haven't any confidence at all in any government service that'll oversee the contractual negotiations. Commissions, promises of lucrative jobs and general incompetence of the civil service will inevitably ensure that the NHS will be ripped off by those entrusted with it's cash and others who see an opportunity to take it's cash away. I submit the example of the defence industry of what can happen.
On balance, I'd suggest that the NHS, with all it's problems, in it's current form has probably evolved into a service that does the best with the resources it has, but it ain't perfect and any political meddling will simply make it worse.
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Old Nov 22nd 2019, 7:21 pm
  #892  
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Default Re: PM Boris

Originally Posted by dbd33 View Post
I'm not coming at this from "a deal with the Trump administration over the NHS would be a bad deal" standpoint but a "a deal with the Trump administration would be a bad deal" standpoint. Comparison with other healthcare systems isn't the guide but comparison with other deals Trump has made; the other guy always gets stiffed.
Well, definitely no fan of Trump.
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Old Nov 29th 2019, 11:29 am
  #893  
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Default Re: PM Boris

The scales have fallen from me eyes. Johnson has convinced me* that there is a benefit to Brexit!

* subject to independent verification of everything he claimed to be a fact.

I hadn't realized that there is a Tampon Tax nor that the priority of a post-Brexit government would be abolishing it. It seems an apt point of focus for Mr. Johnson.
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Old Nov 29th 2019, 12:41 pm
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Default Re: PM Boris

Originally Posted by dbd33 View Post
The scales have fallen from me eyes. Johnson has convinced me* that there is a benefit to Brexit!

* subject to independent verification of everything he claimed to be a fact.

I hadn't realized that there is a Tampon Tax nor that the priority of a post-Brexit government would be abolishing it. It seems an apt point of focus for Mr. Johnson.
The EU views sanitary products as ‘luxury items’ and forces member states to apply VAT accordingly.
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Old Nov 29th 2019, 1:19 pm
  #895  
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Default Re: PM Boris

Originally Posted by BritInParis View Post
The EU views sanitary products as ‘luxury items’ and forces member states to apply VAT accordingly.
Well yes, I understand that now. A whole person might think that cheaper tampons don't outweigh the opportunity to live and work in many countries, access to a huge market and economical skilled labour force, or the loss of a universal healthcare system, but if you're a specific part of the anatomy your view might be different. I think we know what Mr. Johnson is.
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Old Nov 29th 2019, 2:52 pm
  #896  
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Default Re: PM Boris

Originally Posted by BritInParis View Post
The EU views sanitary products as ‘luxury items’ and forces member states to apply VAT accordingly.
I was curious as to the situation regarding Purchase Tax prior to it becoming VAT. Apparently purchase tax also applied to these products before VAT and membership of Europe, so it's a tad disingenuous to suggest the "tampon tax" was forced on member states when they were already charging it.

Apparently a zero rate (or one under 5%) isn't possible and that's the restriction in place - one that presumably would be changed should member states call for it.
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Old Nov 29th 2019, 3:13 pm
  #897  
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Default Re: PM Boris

Originally Posted by BristolUK View Post
- one that presumably would be changed should member states call for it.
Yeah but that's the problem, isn't it? If Boris Johnson gets it in his head to change something now, the tax on tampons, the right to work for filthy foreigners, many things, he may have to petition Brussels to make it happen. There are many players in Europe and differing points of view, it's hard to get radical changes made. In a post-Brexit world he'd only have to get President Trump to agree to whatever change it is (and be sure it wasn't offensive to President Putin) so he could do things more whimsically; that's the argument for a Johnson majority. If only there was a way of knowing what sort of thing he'd like to do.
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Old Nov 29th 2019, 3:38 pm
  #898  
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Default Re: PM Boris

Originally Posted by BritInParis View Post
The EU views sanitary products as ‘luxury items’ and forces member states to apply VAT accordingly.
Same in Oz and many other countries. It took 18 years of campaigning in Australia before the government finally dropped the Goods and Services 10% tax on sanitary products. Sunscreen lotion, toothpaste, condoms, razors - all were considered essential items so were excluded from GST - how tampons and pads could ever be designated 'non-essential luxury' items just doesn't compute!
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Old Nov 29th 2019, 3:40 pm
  #899  
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Default Re: PM Boris

Originally Posted by dbd33 View Post
Yeah but that's the problem, isn't it? If Boris Johnson gets it in his head to change something...he may have to petition Brussels to make it happen.
True enough. But for something favoured and existing already, prior to joining Europe, would there be the desire to reverse it anyway?

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Old Nov 29th 2019, 3:47 pm
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Default Re: PM Boris

Tick tock ... tick tock ... time passes.
Only two weeks remaining now for the fence sitters to decide what direction they'd like the country to take.
And how will they do this? What information will they make use of to help them decide?
What it won't be are discussions about a tampon tax or whether the PM turned up for a TV chat.
It'll be, as it always is for human beings, about the self.
And here, I'm not suggesting that people will list fors and againsts it'll be as it always is, gut feeling.
I've made this case before that highbrow arguments this way or that miss the point, you have to engage with voters at a more basic level.
Like it or not, forget arguments about policies, Boris makes people feel better. It might be the comic, the buffoon, the stuttering speech, or any other number of character traits.. but he stands out as someone approachable, someone you wouldn't mind as a neighbour whereas who wants a sour faced Corbyn living next door.
It ain't rocket science and we'll see what happens in two weeks time.
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