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Post by fascinating on Oct 22, 2011 17:13:56 GMT 1
There is only one criterion, does the patient want to have the medical he/she needs? If they do, then give it.
The increase in life expectancy is great news, but we do need to offer incentives to keep people working longer, so the concept of retirement will become fuzzier. In fact it would be good if people could work (probably part-time) nearly all of their lives. But of course we have to solve the general economic problems and make sure that there is almost no unemployment.
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Post by rsmith7 on Oct 22, 2011 21:12:56 GMT 1
"of course we have to solve the general economic problems"
And how are you going to do that??? Central planning?? A command economy??? Been tried and failed many, many times. Economics is simply the science of understanding peoples decisions. Many have tried to understand and all have failed miserably.
I presume you hate the free market - we'll gloss over the fact that such a thing has never existed. But for the sake of argument, all it is is people deciding with their own free will what to do with their wad. If something is good/appealling/fashionable/cheap/nice etc they will buy it. If it is crap they will not (theoretically). The free(ish) decisions of billions of people is self regulating and finds a reasonable balance...most of the time. It's not without problems but compared with the alternatives..... No contest.
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Post by rsmith7 on Oct 22, 2011 21:18:09 GMT 1
The NHS is a good example of a centrally planned "economy". The distortion of the free market within the nhs leads to unbelievable inefficiency. e.g. Friend of mine who's an engineer went for a x ray. Discovered the trolley he was placed on cost £70,000. Gob smacked he measured it up and priced a replacement...(to a higher spec). The total cost with a 20% profit was £600.
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Post by fascinating on Oct 23, 2011 7:58:22 GMT 1
Not so, I think it is great actually. Of course a free market does not mean a free-for-all, a market is a human institution that has to be regulated, that is you need a government to produce and regulate the currency, provide weights and measures, inspect the goods sold, and ensure that property rights are maintained (a police force) etc etc. You call the NHS inefficient, but it is efficient in comparison to the American system, where a much higher proportion of GDP is spent on health, but many millions of people are not even covered. The £70,000 wasted on a trolley is small in comparison to the billions wasted by private companies who were contracted to install a new computer system for the NHS. See www.independent.co.uk/life-style/health-and-families/health-news/nhs-pulls-the-plug-on-its-11bn-it-system-2330906.html
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Post by Progenitor A on Oct 23, 2011 8:07:31 GMT 1
How odd! In a private Corpration if a new computer system was needed, a tight binding contract would be drawn up with the supplier and a Manager appointed by the customer with responsibility to keep the costs within contract and to ensure that the work proceeded satisfactorily. If the project failed then the supplier would be be liable to pay for the missing system and its effect upon thebusiness. If it was a total mess then the Manager would be sacked In other words, when a complex new system is purchased, the buyer must ensure that it meets the requirement The NHS doesn't have such a simple system it seems as they have absorbed the losses - why should they bother - there is no 'bottom line ' to worry about - just like the USSR in its heyday
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Post by abacus9900 on Oct 23, 2011 11:02:08 GMT 1
One of the problems with the planned NHS computer system was that there was a 'disconnect' between the IT professionals contracted to come up with a system and the NHS personnel who were responsibly for project-managing the thing. The lack of expertise on the part of the latter meant that they did not possess the ability to form an accurate plan of what the requirements were so that the IT people produced something that was not fit for purpose. If, at least, some of NHS managers had some experience of what was involved in producing a complex IT system they might have been able to foresee some of the inherent problems in such a huge project.
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Post by fascinating on Oct 23, 2011 11:36:34 GMT 1
Yes, the government is obsessed with trying to privatise as much as possible (likewise the previous Labour government) but it became obvious (obvious to those who worked there, but not obvious to ministers) early on that civil servants were not skilled in negotiating with private firms. What happened in the NHS was that companies like Accenture forsook their contracts and took losses of millions. It appears that the NHS kept changing the specifications, and the private firms could not cope with that.
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Post by principled on Oct 23, 2011 11:41:25 GMT 1
Nay There is definitely something wrong with the procurement process of government bodies. The money we are saving in "cuts" pales into insignificance compared to the billions lost on abandoned projects. Most expensive systems never seem to see the light of day or are so riddled with problems and cost overruns that they are scrapped or are pared back after introduction. There can't be a whole load of reasons why this should be, so it seems to me that the project is either: A political expedience with no real outcomes defined. Only broad outcomes are defined and the rest added/deleted on an adhoc basis. Or those doing the procurement are either not aware of the complexities of the system wanted or aren't really aware of what they need it to deliver. I imagine it as a sort of "Yes Minister" process with the blind leading the blind. Such as:
Procurement: (P): "We want you to make something that will take us from A to B" Company (C): "Do you want it to have pedals or an engine?" P : "Um, we'll get back to you on that" C: "Is this for travel by land, sea or air?" P: "Yes" C: "How many seats?" P: "Um, definitely two, then again four would be nice, but six would be good. We can decide that detail later" C: "So you want an engine/man driven travel pod that can fly, travel on the road and by sea and that can take possibly two, four, six people" P: "That about sums it up. I think you've got enough to be going on with. Can you report back in a year?". C: " And the contract?" P: "Costs plus, of course".
P
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Post by rsmith7 on Oct 23, 2011 18:37:30 GMT 1
Yes, the government is obsessed with trying to privatise as much as possible (likewise the previous Labour government) but it became obvious (obvious to those who worked there, but not obvious to ministers) early on that civil servants were not skilled in negotiating with private firms. What happened in the NHS was that companies like Accenture forsook their contracts and took losses of millions. It appears that the NHS kept changing the specifications, and the private firms could not cope with that. The last 100 odd years has shown that governments cannot run a piss up in a brewery. It follows that privatisation is obviously the way forward.
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Post by fascinating on Oct 24, 2011 18:26:22 GMT 1
You do not know how lucky you are to have government that is as efficient as ours. A recent TV program showed what would happen to a street if the functions of local government were withdrawn. The residents quickly realised how difficult it was, and were VERY grateful when the services, such as the garbage collection, were restored.
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Post by rsmith7 on Oct 25, 2011 10:16:58 GMT 1
Was that street in stupidsville? Thinnest argument I've heard in ages. I remember when the government looked after defence, health and security and that's about it. After the disasterous communism of the 70's when we were left in the shit...again...all it took was a tax cut and slight deregulation and the economy was off like a scalded cat. Now we're so wrapped up in government sludge it's going to take a decade to emerge from the socialist depression after 13 years of lunacy.
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Post by fascinating on Oct 25, 2011 20:36:12 GMT 1
Is that all? So you must be remembering the situation before 1876, when government provided free and compulsory education to all young children.
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Post by rsmith7 on Oct 25, 2011 22:00:45 GMT 1
Is that all? So you must be remembering the situation before 1876, when government provided free and compulsory education to all young children. Nope, I'm remembering the late seventies and eighties. Ok, the government did slightly more than I said but not much. The rise of the EU and 13 years of nulabour inflated the welfare state into a lifestyle choice and destroyed personal responsibility. Now comes the bill....
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Post by fascinating on Oct 26, 2011 9:24:02 GMT 1
You just make it up as you go along don't you? In 1985, out of a total government spend of £151 billion, about £78 billion was spent on health, defence and [social] security. About £73 billion was spent on other things. See www.ukpublicspending.co.uk/uk_year1985_0.html
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Post by rsmith7 on Oct 26, 2011 19:13:13 GMT 1
You just make it up as you go along don't you? In 1985, out of a total government spend of £151 billion, about £78 billion was spent on health, defence and [social] security. About £73 billion was spent on other things. See www.ukpublicspending.co.uk/uk_year1985_0.htmlI don't think it's valid to imply that the welfare state and it's subsequent dependency hasn't grown since 1985. In fact, it's silly.
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