Friday 14th to Monday 17th April 2017

PorFavor · Post by **PorFavor** » Fri 14 Apr, 2017 10:54 pm

Night night.

HindleA · Post by **HindleA** » Fri 14 Apr, 2017 10:54 pm

PF-my thought processes are a mystery to me.

HindleA · Post by **HindleA** » Fri 14 Apr, 2017 10:55 pm

Night night night

Not that I am competitive.

Post by **adam** » Fri 14 Apr, 2017 11:02 pm

Tubby Isaacs wrote:Angie Rayner.

Danielle Dax.

You're just posting pictures of Donna to get people up for tomorrow's new Doctor Who.

TechnicalEphemera · Post by **TechnicalEphemera** » Fri 14 Apr, 2017 11:47 pm

AnatolyKasparov wrote:
PorFavor wrote:
Sun suspends Kelvin MacKenzie over column on Ross Barkley (Guardian)
https://www.theguardian.com/media/2017/ ... -complaint
We need to make this "suspension" stick.

Well, the Sun has no shame, it also seems oddly hostile to Liverpool for reasons that make no sense in the modern world.

The problem is Kelvin is a vampire, no matter how many times his career should be finished the bastard still rises from the dead.

Maybe this one is one too many, the stupidity of this guy writing about Liverpool is amazing, given history. I am not sure about the race element though. The offense is real enough, but I suspect Kelvins explanation is also probably true. Still stupid article regardless so hopefully the police will take a different view.

TechnicalEphemera · Post by **TechnicalEphemera** » Fri 14 Apr, 2017 11:54 pm

Yes I know it is the ToryGraph but...

http://www.telegraph.co.uk/business/201 ... ies-gains/

In an ideal world the previous owners would get a huge tax bill. Surely the public purse should be protected from this sort of thing. It really amounts to theft from the pensioners and theft from the state (and by extension tax payers).

tinyclanger2 · Post by **tinyclanger2** » Sat 15 Apr, 2017 6:49 am

AnatolyKasparov wrote:
PorFavor wrote:
Sun suspends Kelvin MacKenzie over column on Ross Barkley (Guardian)
https://www.theguardian.com/media/2017/ ... -complaint
We need to make this "suspension" stick.

Agree - is there a way we (as individuals) can contribute to that outcome?

tinyclanger2 · Post by **tinyclanger2** » Sat 15 Apr, 2017 6:51 am

HindleA wrote:PF-my thought processes are a mystery to me.

brains. I'ts all about them

tinyclanger2 · Post by **tinyclanger2** » Sat 15 Apr, 2017 7:12 am

http://www.independent.co.uk/news/healt ... 84356.html" onclick="window.open(this.href);return false;
Children as young as 13 attending 'smartphone rehab' as concerns grow over screen time
The average age for UK children to own their own phone is seven, surveys suggest

But in the US, the problem has become so severe for some families that children as young as 13 are being treated for digital technology addiction.

It was a long time before I had access to a phone (that wasn't a public pay phone) at all, and have only ever had a mobile phone through work. I think I more or less hate mobile phones and the sight of people standing/sitting around staring at them wherever they are and whoever they are with. I particularly object to the latest trend of dispensing with headphones to listen to stuff. What's that about?

tinyclanger2 · Post by **tinyclanger2** » Sat 15 Apr, 2017 7:13 am

cantankerous? Moi?

tinyclanger2 · Post by **tinyclanger2** » Sat 15 Apr, 2017 7:17 am

http://www.independent.co.uk/news/healt ... 83521.html" onclick="window.open(this.href);return false;
Pharmaceutical giant 'plotted to destroy cancer drugs to drive prices up 4000%'
Price rises for generic cancer drugs are estimated to cost the NHS in England around £380m a year
....
Now another leaked email appears to reveal that staff at Aspen discussed destroying their supplies of the drug in the row.
....
The price increases were made possible by a loophole that allows drug companies to change the price of medicines if they are no longer branded with the same name.

tinyclanger2 · Post by **tinyclanger2** » Sat 15 Apr, 2017 7:21 am

http://www.independent.co.uk/news/educa ... 84236.html" onclick="window.open(this.href);return false;
Half of young teachers considering quitting the profession
Heavy workloads and lack of work-life balance is contributing towards a 'crisis' in teacher retention and recruitment, industry leaders warn

Great Tory Britain.

tinyclanger2 · Post by **tinyclanger2** » Sat 15 Apr, 2017 7:22 am

Pissed of with Britain? moi?

SpinningHugo · Post by **SpinningHugo** » Sat 15 Apr, 2017 7:44 am

There is some truth in this

http://www.independent.co.uk/voices/nhs ... 83541.html" onclick="window.open(this.href);return false;

But it does ignore amount spent. The problem may be that no party that could ever be elected would spend enough, so an alternative source of funds is necessary.
Anyway, a provocative link for you.

HindleA · Post by **HindleA** » Sat 15 Apr, 2017 8:25 am

Anybody that bemoans beans on toast,really has no idea.

HindleA · Post by **HindleA** » Sat 15 Apr, 2017 8:29 am

JFT 96 YNWA

SpinningHugo · Post by **SpinningHugo** » Sat 15 Apr, 2017 8:30 am

Really amusing
http://www.theguardian.com/politics/201 ... SApp_Other" onclick="window.open(this.href);return false;

HindleA · Post by **HindleA** » Sat 15 Apr, 2017 8:56 am

https://www.theguardian.com/technology/ ... ced-robots" onclick="window.open(this.href);return false;

Robots to replace 1 in 3 UK jobs over next 20 years, warns IPPR
Study calls for billions to fund retraining after pinpointing hospitality, retail, transport and manufacturing sectors and poorest parts of UK as most at risk

tinyclanger2 · Post by **tinyclanger2** » Sat 15 Apr, 2017 9:03 am

Steve Hilton:

https://www.theguardian.com/politics/20 ... SApp_Other" onclick="window.open(this.href);return false;
Does his enthusiasm for populism extend as far as hoping for a Marine Le Pen victory in France? He won’t say, because “I just don’t know enough about it”, but he will say that he’s fed up with liberals accusing politicians like her [or hardworking Sun journalists]* of racism.

*[edited by me]

tinyclanger2 · Post by **tinyclanger2** » Sat 15 Apr, 2017 9:07 am

HindleA wrote:https://www.theguardian.com/technology/ ... ced-robots

Robots to replace 1 in 3 UK jobs over next 20 years, warns IPPR
Study calls for billions to fund retraining after pinpointing hospitality, retail, transport and manufacturing sectors and poorest parts of UK as most at risk

Yep - it's obvious anyway (automatic checkouts and online shopping for a start) but there's growing evidence that things will only get worse. The masses of rewarding creative jobs that tech are going to bring us, aren't going to happen (in my opinion)

http://www.economist.com/news/special-r ... nd-anxiety" onclick="window.open(this.href);return false;
Economists are already worrying about “job polarisation”, where middle-skill jobs (such as those in manufacturing) are declining but both low-skill and high-skill jobs are expanding. In effect, the workforce bifurcates into two groups doing non-routine work: highly paid, skilled workers (such as architects and senior managers) on the one hand and low-paid, unskilled workers (such as cleaners and burger-flippers) on the other.

HindleA · Post by **HindleA** » Sat 15 Apr, 2017 9:08 am

https://www.theguardian.com/society/201 ... are_btn_tw" onclick="window.open(this.href);return false;

Guilt by association: the housing developments that went sour
Housing associations have been run for the good of tenants and communities since the 19th century. But with many new developments plagued by shoddy building and a priority on profit, are they leaving their best ideals behind?

tinyclanger2 · Post by **tinyclanger2** » Sat 15 Apr, 2017 9:10 am

I think there are two key things that Labour/the left/whoever stills gives a flying one could develop cross-party issues about. They'll take a while to get anywhere, but it's mindset shift we need.

1) PR - the time is ripe while Labour is splitting, UKIP is redundant, and "the people" feel unrepresented
2) automation, employment and underemployment

tinyclanger2 · Post by **tinyclanger2** » Sat 15 Apr, 2017 9:25 am

Homo sapiens: the only species hellbent on making itself redundant.

AnatolyKasparov · Post by **AnatolyKasparov** » Sat 15 Apr, 2017 10:18 am

Well we are all still here, so I presume Fatty Kim's "big day" hasn't produced many fireworks (metaphorical or actual) thus far?

HindleA · Post by **HindleA** » Sat 15 Apr, 2017 10:59 am

https://mainlymacro.blogspot.co.uk/2017 ... ganda.html" onclick="window.open(this.href);return false;

When journalism becomes propaganda

Mainlymacro

tinyclanger2 · Post by **tinyclanger2** » Sat 15 Apr, 2017 10:59 am

http://www.independent.co.uk/life-style ... 83556.html" onclick="window.open(this.href);return false;
Has Easter become the new Christmas? Some commentators think so.

It's almost as if we've become utterly banal and anyone who's actually got any money doesn't know what to do with it. But I doubt that's the case, cos we're British and the British are top drawer (not like Americans).

tinyclanger2 · Post by **tinyclanger2** » Sat 15 Apr, 2017 11:00 am

(theclangerhasspoken)

RogerOThornhill · Post by **RogerOThornhill** » Sat 15 Apr, 2017 11:05 am

SpinningHugo wrote:There is some truth in this

http://www.independent.co.uk/voices/nhs ... 83541.html" onclick="window.open(this.href);return false;

But it does ignore amount spent. The problem may be that no party that could ever be elected would spend enough, so an alternative source of funds is necessary.
Anyway, a provocative link for you.

I notice that the writer has penned several articles for the Indy - tells you everything you need to know about the direction they've been travelleing recently.

He has no medical background so the answer to all the issues he raises - which are serious of course - is "change the funding model"

Any evidence that by doing so, those issues will miraculously go away? Of course not.

Any idea how much an insurance-based model which he's always favoured would cost in administration? Of course not.

Post by **refitman** » Sat 15 Apr, 2017 11:15 am

RogerOThornhill wrote:
SpinningHugo wrote:There is some truth in this

http://www.independent.co.uk/voices/nhs ... 83541.html" onclick="window.open(this.href);return false;

But it does ignore amount spent. The problem may be that no party that could ever be elected would spend enough, so an alternative source of funds is necessary.
Anyway, a provocative link for you.
I notice that the writer has penned several articles for the Indy - tells you everything you need to know about the direction they've been travelleing recently.

He has no medical background so the answer to all the issues he raises - which are serious of course - is "change the funding model"

Any evidence that by doing so, those issues will miraculously go away? Of course not.

Any idea how much an insurance-based model which he's always favoured would cost in administration? Of course not.

Also, he works for the IEA. Hardly an impartial voice.

SpinningHugo · Post by **SpinningHugo** » Sat 15 Apr, 2017 11:17 am

RogerOThornhill wrote:
SpinningHugo wrote:There is some truth in this

http://www.independent.co.uk/voices/nhs ... 83541.html" onclick="window.open(this.href);return false;

But it does ignore amount spent. The problem may be that no party that could ever be elected would spend enough, so an alternative source of funds is necessary.
Anyway, a provocative link for you.
I notice that the writer has penned several articles for the Indy - tells you everything you need to know about the direction they've been travelleing recently.

He has no medical background so the answer to all the issues he raises - which are serious of course - is "change the funding model"

Any evidence that by doing so, those issues will miraculously go away? Of course not.

Any idea how much an insurance-based model which he's always favoured would cost in administration? Of course not.

1. One thing I feel quite strongly about is that those in the medical profession are exactly the wrong people to be listening to. They are trained in medical care. not the economic modelling of delivering services. The people to listen to on the delivery of heathcare are (micro-)economists.

2. The NHS does have strengths, but there are also good reasons why the UK is the only country that adopts this model.

3. The NHS is cheap, but illiberal. It is cheap because it is illiberal. Because it is illiberal there are costs it puts on to people (like me) in terms of time (ie queues) that I'd prefer to pay more to avoid, but can't without opting out of collective provision (which I don't wish to do).

4. Personally, I'd prefer the German model. One of the reasons for that is I think we now have Tory government as a more or less permanent feature of the UK (at least for the next thirteen years) and they will simply never properly fund a wholly state delivered system.

RogerOThornhill · Post by **RogerOThornhill** » Sat 15 Apr, 2017 11:29 am

SpinningHugo wrote: 1. One thing I feel quite strongly about is that those in the medical profession are exactly the wrong people to be listening to. They are trained in medical care. not the economic modelling of delivering services. The people to listen to on the delivery of heathcare are (micro-)economists.

2. The NHS does have strengths, but there are also good reasons why the UK is the only country that adopts this model.

3. The NHS is cheap, but illiberal. It is cheap because it is illiberal. Because it is illiberal there are costs it puts on to people (like me) in terms of time (ie queues) that I'd prefer to pay more to avoid, but can't without opting out of collective provision (which I don't wish to do).

4. Personally, I'd prefer the German model. One of the reasons for that is I think we now have Tory government as a more or less permanent feature of the UK (at least for the next thirteen years) and they will simply never properly fund a wholly state delivered system.

None of that addresses my central point against that writer.

He is not even a specialist in health economics - the title of his PhD was Constructing a new measure of poverty for the UK

If you're going to propose a different system then it would help if you could argue the case for it using a model and not just keep banging on about how everything is terrible...change the funding model and it'll all be fine.

I notice in that article he doesn't even say what he would propose - utterly pointless.

SpinningHugo · Post by **SpinningHugo** » Sat 15 Apr, 2017 11:35 am

RogerOThornhill wrote:
SpinningHugo wrote: 1. One thing I feel quite strongly about is that those in the medical profession are exactly the wrong people to be listening to. They are trained in medical care. not the economic modelling of delivering services. The people to listen to on the delivery of heathcare are (micro-)economists.

2. The NHS does have strengths, but there are also good reasons why the UK is the only country that adopts this model.

3. The NHS is cheap, but illiberal. It is cheap because it is illiberal. Because it is illiberal there are costs it puts on to people (like me) in terms of time (ie queues) that I'd prefer to pay more to avoid, but can't without opting out of collective provision (which I don't wish to do).

4. Personally, I'd prefer the German model. One of the reasons for that is I think we now have Tory government as a more or less permanent feature of the UK (at least for the next thirteen years) and they will simply never properly fund a wholly state delivered system.
None of that addresses my central point against that writer.

He is not even a specialist in health economics - the title of his PhD was Constructing a new measure of poverty for the UK

If you're going to propose a different system then it would help if you could argue the case for it using a model and not just keep banging on about how everything is terrible...change the funding model and it'll all be fine.

I notice in that article he doesn't even say what he would propose - utterly pointless.

I think the point that he makes no concrete proposal (ie support a move to say the Singaporean model while explaining it) is fair.

Complaining about who he is isn't really.

Willow904 · Post by **Willow904** » Sat 15 Apr, 2017 11:37 am

The article suggests that the NHS isn't efficient as a [i]model[/i], whereas it is possible it is simply not as efficient as it could be because of the way it is [i]currently[/i] run, with the internal market and outsourcing to far less efficient private providers.

I think it fair to say the NHS as it is now is not as efficient as the NHS as it was originally conceived. Evolving a decent healthcare system, however, is not the same as creating one, in an instant, from scratch. All the other healthcare systems the author admires, have been honed over the years from imperfect beginnings. Only the NHS, it seems cannot be honed to something better, but must be uprooted and replaced. Given no country has ever done such a thing, the author's confidence of success is reckless to say the least.

Why should we trust those who don't believe the NHS can be honed into something better, a far simpler task, to be able to successfully replace it with something else entirely? They must think we are idiots. That we can't see how wasteful replacing functioning PCTs with a rag bag of CCGs has been. How wasteful constant tendering and outsourcing to outside providers with no track record that are unable to do the job once done effectively by NHS employees. That the "inefficiencies" are the result of political meddling, rather than an inherent weakness in the model.

As for outcomes, there is evidence that countries with greater inequality have worse health outcomes, for both rich and poor, than countries with greater equality. Is it the model, therefore, that creates poorer outcomes, or is it an unequal society that distorts the model? Are the healthcare systems of other countries better because of the type of system or because the system is positively influenced by a society that wants the system to work better?

SpinningHugo · Post by **SpinningHugo** » Sat 15 Apr, 2017 11:38 am

Actually, i think one of the best arguments for the NHS is transition costs. On outcomes, there look to be many better systems out there, but the transition costs are just too high.

RogerOThornhill · Post by **RogerOThornhill** » Sat 15 Apr, 2017 11:42 am

SpinningHugo wrote:
Complaining about who he is isn't really.

You don't think we should question his background and expertise in the area and his motives?

Oh...OK then...

AnatolyKasparov · Post by **AnatolyKasparov** » Sat 15 Apr, 2017 12:03 pm

HindleA wrote:https://mainlymacro.blogspot.co.uk/2017 ... ganda.html

When journalism becomes propaganda

Mainlymacro

Despite its long standing nickname the Torygraph, a surprising number of left-leaning people used to read it regularly. I strongly suspect most of them don't now.

Willow904 · Post by **Willow904** » Sat 15 Apr, 2017 12:15 pm

Not sure why my italics don't work

And yes, SH has hit the nail on the head as to why I don't trust anyone who is intent on "replacing" the NHS. If we can't currently afford to fund it beyond something comparable to Finland or Iceland, then we definitely can't afford the transition costs to a completely new system and fund it in future at a higher level that would give us something more like Germany or Switzerland. I have no ideological objection to a German type system, I just don't believe that is what we would get. If all you really want is better outcomes, then simply improve the NHS so we get them. Listen to medical professionals, allow them to deliver improvements without ideologically driven political interference. Embrace the advantages of a "national" system, rather than undermine them with further fragmentation.

When discussing alternative models, no one mentions Finland, yet with similar expenditure and similar evolution from a fundamentally national model, we would surely be able to learn more lessons from them than from very differently evolved systems. Their public primary care system, for instance, could provide some inspiration for a rethink of our own outdated, privately run system. Yes, that's right, I'm suggesting the future for the NHS is in more public provision, not less. It's called working with what you've got. Because public can work and private can work, but a mixture of the two? Very difficult not to end up with the worst of both worlds and unfortunately, right now, that's exactly where we seem to be heading.

RogerOThornhill · Post by **RogerOThornhill** » Sat 15 Apr, 2017 12:16 pm

Sky News Newsdesk‏Verified account
@SkyNewsBreak

Follow
More
Everton Football Club has banned journalists from The Sun newspaper following Kelvin MacKenzie's controversial article about Ross Barkley

howsillyofme1 · Post by **howsillyofme1** » Sat 15 Apr, 2017 12:40 pm

Good afternoon

Interesting seeing the discussion on health provision today

As you know I live in Switzerland and can just give my insight on how it works in an insurance system

The NHS isn't just hospitals but a whole lot more that isnt covered by insurance here

The health service here is very good but it is expensive. Psychologically it is hard to get into your head that a visit to the doctor costs a lot of money and I haven't been for years

To keep monthly cost down (we pay around CHF1000 per month for two of us) there is a pretty high excess (CHF2500) and the costs are outstripping inflation

Luckily we can afford it but not so sure about people less fortunate than us

There is absolutely no dental provision (recent root canal and filling touched on CHF1000).

The UK doesn't spend a lot on healthcare compared to other countries and we could just look to improve on what we have rather than tearing it apart

People always seem to think the grass is greener elsewhere but I am not sure how much they know about living in another system - what would be the effects of paying for care on a society who has always seen it as just being there?

Investment in the NHS is a political decision more than economic....as I said we are not particularly high spenders now

There are also all the bureaucratic costs of admin and we would also need a national database and identication system as well to support another system

I am with Willow, make what we have better and not break it down completely

Hugo, if you want to have private treatment and pay for it no one is stopping you. What you cannot do is jump the queue for an appointment and then come back to NHS for the treatment......

SpinningHugo · Post by **SpinningHugo** » Sat 15 Apr, 2017 12:44 pm

RogerOThornhill wrote:
SpinningHugo wrote:
Complaining about who he is isn't really.
You don't think we should question his background and expertise in the area and his motives?

Oh...OK then...

Yes, so although i don't think ad hominem stuff is *necessarily* fallacious, substantive arguments are, at least, more interesting.

You wouldn't get away with the ad hominem stuff in a doctorate say.

SpinningHugo · Post by **SpinningHugo** » Sat 15 Apr, 2017 12:47 pm

howsillyofme1 wrote:Good afternoon

Interesting seeing the discussion on health provision today

As you know I live in Switzerland and can just give my insight on how it works in an insurance system

The NHS isn't just hospitals but a whole lot more that isnt covered by insurance here

The health service here is very good but it is expensive. Psychologically it is hard to get into your head that a visit to the doctor costs a lot of money and I haven't been for years

To keep monthly cost down (we pay around CHF1000 per month for two of us) there is a pretty high excess (CHF2500) and the costs are outstripping inflation

Luckily we can afford it but not so sure about people less fortunate than us

There is absolutely no dental provision (recent root canal and filling touched on CHF1000).

The UK doesn't spend a lot on healthcare compared to other countries and we could just look to improve on what we have rather than tearing it apart

People always seem to think the grass is greener elsewhere but I am not sure how much they know about living in another system - what would be the effects of paying for care on a society who has always seen it as just being there?

Investment in the NHS is a political decision more than economic....as I said we are not particularly high spenders now

There are also all the bureaucratic costs of admin and we would also need a national database and identication system as well to support another system

I am with Willow, make what we have better and not break it down completely

Hugo, if you want to have private treatment and pay for it no one is stopping you. What you cannot do is jump the queue for an appointment and then come back to NHS for the treatment......

Right. But that was of course my point. Illiberal but cheap. Cheap because illiberal. You get what you get.

howsillyofme1 · Post by **howsillyofme1** » Sat 15 Apr, 2017 12:50 pm

I think this no 'ad hominem' is as weak as 'no anecdote'

Neither can make an argument in isolation but pointing out the opinions of someone can be affected by their background and who is paying them is fair

Have you a doctorate Hugo? Both Rot and I do so I think we know a bit about what you need to do to get one!

howsillyofme1 · Post by **howsillyofme1** » Sat 15 Apr, 2017 12:51 pm

SpinningHugo wrote:
howsillyofme1 wrote:Good afternoon

Interesting seeing the discussion on health provision today

As you know I live in Switzerland and can just give my insight on how it works in an insurance system

The NHS isn't just hospitals but a whole lot more that isnt covered by insurance here

The health service here is very good but it is expensive. Psychologically it is hard to get into your head that a visit to the doctor costs a lot of money and I haven't been for years

To keep monthly cost down (we pay around CHF1000 per month for two of us) there is a pretty high excess (CHF2500) and the costs are outstripping inflation

Luckily we can afford it but not so sure about people less fortunate than us

There is absolutely no dental provision (recent root canal and filling touched on CHF1000).

The UK doesn't spend a lot on healthcare compared to other countries and we could just look to improve on what we have rather than tearing it apart

People always seem to think the grass is greener elsewhere but I am not sure how much they know about living in another system - what would be the effects of paying for care on a society who has always seen it as just being there?

Investment in the NHS is a political decision more than economic....as I said we are not particularly high spenders now

There are also all the bureaucratic costs of admin and we would also need a national database and identication system as well to support another system

I am with Willow, make what we have better and not break it down completely

Hugo, if you want to have private treatment and pay for it no one is stopping you. What you cannot do is jump the queue for an appointment and then come back to NHS for the treatment......

Right. But that was of course my point. Illiberal but cheap. Cheap because illiberal. You get what you get.

What are you on about?

RogerOThornhill · Post by **RogerOThornhill** » Sat 15 Apr, 2017 12:54 pm

SpinningHugo wrote:
Yes, so although i don't think ad hominem stuff is *necessarily* fallacious, substantive arguments are, at least, more interesting.

You wouldn't get away with the ad hominem stuff in a doctorate say.

Given that I haven't done that, this is irrelevant.

And yes, I am well aware of your second point...really I do not need this being told me. Questioning motive and knowledge is standard practice.

howsillyofme1 · Post by **howsillyofme1** » Sat 15 Apr, 2017 12:55 pm

Are you saying you want to be able to queue jump?

You are at liberty to pay for the treatment you know but in its entirety....insurance is also available to do that.

howsillyofme1 · Post by **howsillyofme1** » Sat 15 Apr, 2017 1:01 pm

I do get the feeling that Hugo is a libertarian......wants to be able to do anything and pay for anything he can afford to with the state only looking after 'the little people'

I think the NHS is the thing I am most proud of in the UK....living under an insurance system where treatment is decided by an accountant not a health professional is very difficult to get your head round

SpinningHugo · Post by **SpinningHugo** » Sat 15 Apr, 2017 1:21 pm

howsillyofme1 wrote:Are you saying you want to be able to queue jump?

You are at liberty to pay for the treatment you know but in its entirety....insurance is also available to do that.

What I am saying is that if you have a collective, but illiberal, system that doesn't permit queue jumping (or paying for a better drug, or a private room, or any other form of top up) that it will inevitably be cheaper to run than a system that does allow top ups. People are prepared to pay a lot at the margin when, say, faced with death, disability or sickness.

If as now we have a wholly collective system, should I Hugo be allowed to queue jump? Of course not. I could opt to go private entirely, but I can't opt out of paying for the collective system. The 'costs' of the current system are either hidden (eg delays for someone like me waiting hours, I have a billable rate far higher than the surgeon I'd see) or not (ie we have poorer outcome rates than other systems.)

In the 1940s-70s I think people were more prepared to accept this collective cheap acceptable system. With a government in power unprepared to fund its increasing cost, and in power for at least the next 13 years, I don't think it is viable.

Things I am sure about

1. "Listen to the producer". This is a micro-economic question, with distributive fairness questions involved. Medics are not the right people to ask at all.

2. The NHS is impossible to reform or criticise. I don't think the political will is there, and so we'll just see a steady decline as other countries continue to do better in terms of outcomes.

3. There are much more relevant comparators than the USA.

Personally, I'd choose a collective system that allows some limited top-ups, but i don't deny that is a political choice. It certainly isn't libertarian.

SpinningHugo · Post by **SpinningHugo** » Sat 15 Apr, 2017 1:36 pm

howsillyofme1 wrote:
Have you a doctorate Hugo? Both Rot and I do so I think we know a bit about what you need to do to get one!

Good question, but that would involve my revealing more about who I am than I am prepared to do.

howsillyofme1 · Post by **howsillyofme1** » Sat 15 Apr, 2017 1:40 pm

People accepted it in the 40s-70s because the Thatcher individualistic society hadn't got hold

The idea of having 'opt-outs' from things the state does that we don't like is a recipe for disaster and is mainly advocated by sections the rich who want to live outside the state

I could have some sympathy for an upgrade to a 'private room but it does sound a bit shit to be honest and how do we provide all this accommodation without increasing cost? How would this improve care anyway?

I see no justification at all for queue jumping and this idea of 'better drugs' sounds like a godsend to pharma companies preying on the ill

It may sound simple on paper to you but it would be the start of something more sinister. The Tories want to sell the NHS to the US insurance vultures and opening the door for them to do so is dangerous

This is where motive is important.

A Government who believed in the NHS but wanted to reform around the edges may (and I say may) have something to offer. Unfortunately the Tories are bastards and will sell us down the river

If people want the NHS to stay true to its principles then they shouldn't vote Tory.......if they do then they take the consequences

howsillyofme1 · Post by **howsillyofme1** » Sat 15 Apr, 2017 1:41 pm

SpinningHugo wrote:
howsillyofme1 wrote:
Have you a doctorate Hugo? Both Rot and I do so I think we know a bit about what you need to do to get one!
Good question, but that would involve my revealing more about who I am than I am prepared to do.

Oh get over yourself!