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Here are statistics for a typical day in the NHS. Welcome to the NHS
http://www.nhscareers.nhs.uk/images/general/working.jpg (broken link)
For the NHS a typical day includes:
Over 835,000 people visiting their GP practice or practice nurse
Almost 50,000 people visiting accident and emergency departments
49,000 outpatient consultations
94,000 people admitted to hospital as an emergency admission
36,000 people in hospital for planned treatment
28,000 sight tests being carried out
18,000 calls to NHS Direct
The structure of the NHS
Hospitals in the NHS are managed by NHS trusts (sometimes called acute trusts) and are run by a trust board. These trusts make sure that hospitals provide high quality health care, and that they spend their money efficiently. Mental health trusts and ambulance trusts have a similar structure but tend to cover wider areas. There are almost 300 hospital, mental health and ambulance trusts, and 152 primary care trusts in England.
Primary care is provided in your local community via your local GP, NHS walk-in centre, dentist, pharmacist and optician. NHS Direct is also responsible for providing healthcare advice and information 24 hours a day via the internet and over the telephone.
All hospital and mental health trusts are dependent on primary care trusts (PCTs) commissioning services such as elective surgery, outpatient visits and other treatments from them, but PCTs also run community-based hospitals and provide services such as district nursing and health promotion.
PCTs still tend to commission many services from their local hospital. However, under the patient choice initiative, anyone needing elective hospital treatment will be offered a choice of where it is carried out, including independent sector treatment centres (ISTCs) run by private companies.
Strategic health authorities (SHAs) cover large areas - typically neighbouring counties or large city areas - and are responsible for overseeing other NHS organisations in their area and leading on issues such as workforce development and capacity.
it is difficult to explain to people, who have never used such a system, that there is no single recipe for UHC. YOu have funds, but how you organise it... it may differ.
You can fund UHC through- general taxes, % of gross earnings, fixed amount per month etc. there are multitude of models here.
Germany does fund UHC through approximately 6-7% of tax on employee's part of gross earnings.
One other thing to note... it covers the whole family. Even kids, new baby... no additional charge. Even if you had 5 kids, and 2 parents work, kids are all insured.
Insurance starts at birth, ends at death. It is always continuous. It is, like I said, possible to opt out of UHC scheme. Then you don't pay your part and can go private entirely if you wish.
I know what you mean, Fiksi. I was once in Pamplona, Spain. One American tourist ran the bulls and got smashed and severily crippled. Although Pamplona has the best private hospital in Spain, he was taken to a public one. his family was horrified, because they thought that a public hospital would be like a third world place. They were even more stunned when they saw how good it was.
I believe politicians, media, etc, literally scare Americans with this UHC issue. They make them believe that they will die while on the waiting line. I pity them, because they are told to buy insurance and they do, even though the best some companies offer will not cover long-term treatments, hence lot of families go bankrupt because of these diseases.
I know what you mean, Fiksi. I was once in Pamplona, Spain. One American tourist ran the bulls and got smashed and severily crippled. Although Pamplona has the best private hospital in Spain, he was taken to a public one. his family was horrified, because they thought that a public health would be like a third world place. They were even more stunned when they saw how good it was.
I believe politicians, media, etc, literally scare Americans with this UHC issue. They make them believe that they will die while on the waiting line. I pity them, because they are told to buy insurance and they do, even though the best some companies offer will not cover long-term treatments, hence lot of families go bankrupt because of this diseases.
Yes, I know this. Unfortunately, private insurers in US cover only some things, some not. There may be a cap... and if you get "something not on the list", you're toast.
UHC scheme covers everything, even long term costs of treatment, income replacement etc.
Many people realised too late that there was a cap on insurance... you don't choose what you get as disease. Many go bankrupt. Not only for long term care. Even those "well insured".
Others struggle with costs of medication, even with insurance.
The citiezens in the UK are very happy with the NHS, especially any who have lived abroad in a country that doesn't have a UHI. There is NO perfect system but it would be very hard to find a better alternative to a UHI.
1. How much will the government have to tax us to even FUND UHC?
see the link in previous post.
2. Who would provide oversight of this system (self-serving politicians, incompetent civil servants, etc)? Doctors.. I think THEY should have oversight of the system. About the NHS
the problem, currently, is that self serving politicians are standing in teh way of a UHC because they are all bought by the insurance companies.. (well them and other corporate interests)
3. How would we, the taxpayers, ensure that the taxes we pay into the UHC system will actually be used for healthcare when our government has a proven track record of raiding funds from SS and other programs to fund pork projects? I think there would have to be strong wording to make sure that doesn't happen.
4. If we, the taxpayers are unsatisfied with UHC, would we have the options of repealing the program or are we just stuck with it as we are with other poorly run governmental programs (public education, Social Security, etc...)?
I think Geero has mentioned quite a few times that in Britian you can supplement your gov't program with private sector insurance.. and because demand for private sector is lower due to a National plan.. to supplement the national plan is on the cheap there. This way, if you are unsatisfied with teh gov't coverage you have extra coverage for the things the gov't denies, etc. I think they wealthy would have the peace of mind taht they are spending extra money so they are getting a little better than those that don't have the extra.. fi you know what I mean. If you use your private insurance you can pick your Dr. (as you can in a UHI) The private sector can give you any treatments that are available, if you are not happy with what is on offer on the NHS.
5. When demand exceeds supply, what criteria will the government use to ration our healthcare (long waits, denials of services, etc...)? We had a problem a few years ago when we didn't have enough beds in a certain area. The patients were asked if they wanted to wait for bed availability or be transfered to Hospitals in France. Many went to France for immediatte treatment and it was funded by the NHS. In the USA, this could be by states.
I keep hearing about suddenly more people will need healthcare all of a sudden. Well.. where I live if you want to make an appt. for a Dr. that you've never been to and are a new patient, you have to wait weeks and schedule your appt's in advance. Like when my mother in law was visiting and came down sick and needed meds.. I tried to make her an appt and they said they didn't have an opening for 2 weeks.. you could be dead by then. It all depends on where you live really. I believe strongly that with an efficiently run system : ie, money not going to lobby (purchase) politicians and CEO's fat cat bonuses and salaries, to name a few.. we won't have a supply of money problem. In the uk you book your appt. on the day you want to see the Doctor. It is mandatory that a patient must be seen within 48 hours. When you have seen the Doctor he will tell you when he wants to see you again and you book it. If you have to change the Appt. you can at any time. You can also phone the surgery and make an appt. for when it suits you or at the earliest oppertunity.
6. What will happen when the government do UHC budget cuts? What health services will the government cut? Cuts in the NHS are not common but if they have to slimline any services they must make sure that adequate cover is maintained for that service. eg. If an A&E is closed down there must be an A&E close enough to take the spillage.
7. What criteria will the government use in deciding what treatments are medically necessary? What other options would be available to those who were denied treatment because the government determined that a treatment is not medically necessary? Hospitals in the UK follow certain protocal for patients treatments etc. That is the same in all countries. You hear so much rubbish on here about treatment being denied because of smoking etc. Never seen that happen here. eg. If an alcoholic requires a liver transplant he can get one on the NHS but he must show that he has stopped drinking for a period of( i think) a few months.
I think the criteria is simple.. leave that up to the medical professional.. the Dr. As it is now, these things are determined by pencil pushers at an insurance company who's only concern is how much money the insurance company is making and NOT what is viable or in your healths 'best interest. DR's should be deciding ..not pollticians, not admin staff.. not CEO's not shareholders! One of the things that annoys the Doctors here is that they run the day to day finances of their surgeries. They have to justify what they do to the NHS. The Doctors prefer to just concentrate on the patients so they employ admin staff to run the finances and they look after the patients. In the Hospitals, the Admin is carried out by the Hospital.
8. If the government is funding our healthcare, would the doctors and nurses be governmental employees? Would they fall under civil service employment rules, which makes it difficult to fire incompetent employees? (I'm a former civil servant myself so I know incompetency abounds in governmental offices)
Staff on the NHS are employed by the Health Service. I myself work as a tutor for people with chronic conditions. Background checks are done etc. before you can work in the NHS. If there is any complaint of any kind it is taken up by the NHS and refered to the British Medical Council to investigate and make any decissions on their conduct
I hope this helps.
My wife's children came over to the UK for a holiday with us. Her daughter had caught a chest infection just before she came. We took her to our GP and he prescribed anti biotics and saw her again just before she went back to the USA. She was ok. This did not cost us anything.
My wife's children came over to the UK for a holiday with us. Her daughter had caught a chest infection just before she came. We took her to our GP and he prescribed anti biotics and saw her again just before she went back to the USA. She was ok. This did not cost us anything.
I know that students over 6 months, coming to UK, are automatically under full NHS scheme.
Location: The Chatterdome in La La Land, CaliFUNia
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When the public debates on the health care issue, they only debate two of the options = UHC versus private insurance. I think we need to explore other alternatives since I think UHC will not work and we know that private insurance is not working either.
Why do people fall for the lies that our government will actually be responsive to the people's needs when it has been proven time and again that it is not? Take SS for example, this is the biggest governmental ripoff that I know of. Most Americans pay tons of money into it for such as small return. What happens if someone dies before they can collect their benefits? If SS works so well, why do many governmental employees pay into the system instead of their pension programs? As I said previously, I have worked for two separate governmental entities in CA and a portion of my earnings went into pensions and zero into SS.
Although UHC appears to be the solution, I'm not so confident about trusting the government to handle this when it has bungled so many other programs. Take public education: We pay more per child than at any time in our history, yet we are seeing such low returns in terms of graduation rates, test scores and overall quality. Many of our public schools have turned into crime zones and the government is so apathetic.
SS and education are just two examples of government-run programs that have gone bad. How do we expect the government to be any different with UHC?
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