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Post by fascinating on Oct 16, 2011 17:24:40 GMT 1
Just to say that a national health service worthy of the name will provide treatment based solely on clinical need. If a clinician (or team of clinicians) think that a patient with an illness could benefit from a drug or other treatment, that treatment must be supplied (if the patient agrees to have it of course) regardless of the cost.
Possibly we need an organisation to state what treatments are within the remit of clinical need eg it is hard to see that breast enlargements would ever be (there again the provision of an implant to a woman who has had one breast removed might be regarded as necessary). But my point is that there must be no denial of treatments that, in the opinion of a qualified medical professional, might help to cure an illness or take away pain.
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Post by abacus9900 on Oct 16, 2011 20:34:40 GMT 1
One of the problems that places a great deal of strain on the NHS and treatment of deserving patients is the caretaker role it has had to accommodate for our older people who are basically suffering from old age. These people are not really ill in the usual sense but are dying of old age and nothing can be done for them aside from making them comfortable as they often have degenerative illnesses they are not going to recover from. I do not know what the answer is because people are living longer and not dying of heart attacks or cancer etc. as once was more the case so that they may reach the stage of having to endure a lingering death. I am a staunch supporter of the NHS but I do wonder whether some reorganization of it in terms of introducing some element of private insurance for those that can afford it might be the way forward. Considering the current downturn in the general economic lookout this is hardly tenable at present but perhaps in the future this could be looked at again. The question is how much money do you want to throw at the NHS? Is there a limit to how much public money can be used? These are difficult questions and I have no pat answers. Certainly, I would not want to copy the American model where many Americans do not even have any insurance!
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Post by fascinating on Oct 17, 2011 8:12:51 GMT 1
I know where you are coming from, but I do not think that is the question really. The question is simply how much we are prepared to care.
A parent with a child who is seriously ill will likely spend all that she has, plus going into debt, if that is what it takes to remedy the illness. This country is very far from spending all that it has on health (it's about 10% of GDP isn't it?).
The care of the old, of course, is a big problem, but we are a very long way from spending too much on their care, and I believe we should commit to making old people as comfortable as possible, giving all the medical treatment they need and want. Yes of course it will cost a lot of money, but it is important to pay it.
If you bear with me I want to illustrate with an off-topic example from history. In about 1830 the government produced a report on the state of children working in coal mines. Children as young as 5 were working underground all day, in terrible conditions. Parliament was keen to put a ban on children being employed there, but the mine owners said that they could not afford to pay only adults. Now, for some mines that were barely economic, that was probably true. Maybe those mines had to close, so there was a cost to the economy imposing the ban. But overall, and in time, employers adapted, and the amount of coal mined continued to increase, probably through technological improvements. Moreover, there would have been less children suffering from vitamin D deficiency and lung problems, so would have had more chance to grow to be adults.
So I believe that we need to make care of the needy our first priority. We make a firm decision, without compromise, to do that, then we see about how we can adapt to that. I believe that, once it is clear that we throw all the money needed to care for the elderly, then that will attract more interest and then there will be technological developments directed at this which will make it less expensive.
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Post by principled on Oct 17, 2011 9:08:08 GMT 1
I was listening to a debate on R4 this morning about bail out funds and the fact that the UK is to pour more billions into the IMF. To date we have given more money tothe Greek, Portuguese and Irish bail outs than the savings that will be generated by the painful cuts we are experiencing in government spending. As one contributor said, much of the money invested in the Eurozone bail out has gone and we will never see it again, and even though central banks are creating "new" money (how do they do that, it's even more mind boggling than QM!) we will all eventually have to pick up the bill. Add to this the fact that we are still giving development aid to countries whose economies will dwarf ours in less than a decade and one can see that the NHS needn't be short of funds at all. Health spending in the Uk is less than 8% of GDP, copmpared to 16% in the USA and 10% in Canada and is less per capita than countries such as: France, Germany and Australia to name but a few.
As for insurance, that's a no-no and impossible to take out for elderly peopl, plus the fact that our state pension as a % of the average wage is the worst in the EU and one gets the impression that our politicians are keener on playing the "big I am" on the World stage than looking after their domestic interests. They seem to think that we are stiil some colonial power, which permits them to be profligate with our money rather than a post colonial small island nation of 65 million people.
In Canada there are geriatric hospitals, and I think that this idea may reduce bed blocking in the NHS, although not necessarily reduce costs. Perhaps if such hospitals were available, run on a similar basis to hospices, then old people may be much better served than they appear to be in current NHS establishments.
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Post by abacus9900 on Oct 17, 2011 10:24:46 GMT 1
The only way you are going to get a properly funded NHS is by electing a real socialist government, which seems quite remote at present.
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Post by principled on Oct 17, 2011 12:04:27 GMT 1
Well, to answer my own question I came across this simple explanation. It makes banking appear even more Alice in Wonderland than I originally thought!
"HOW THE FED CREATES MONEY
We've been talking about how the privately owned Federal Reserve can produce money from thin air. Here's how it's done.
1. The purchase of bonds is approved by the Federal Open Market Committee.
2. The Fed buys the bonds which it pays for with electronic credits made to the sellers bank. These credits are based on nothing.
3. The receiving banks then use these credits as reserves from which they can loan out ten times the amount.
To reduce the amount of money in the economy they simply reverse the process.
The Fed sells bonds to the public and money is drawn from the purchasers bank to pay for them.
Each million withdrawn lowers the banks ability to loan by 10 million.
The Federal bank in this way has overall control of the US money supply, as each country's central bank does in the same way. The bankers, through the magic of fractional reserve banking have been delegated the right to create 90% of the money supply. This control makes a mockery of any elected government. " P
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Post by fascinating on Oct 17, 2011 13:11:44 GMT 1
It is, of course, government which ultimately creates money. That the banks can lend 10 times as much as their assets certainly warrants further investigation, though people are now complaining the banks won't lend enough.
But, though the subject of money is interesting, it is off topic.
You might be right, but I would rather steer clear of party politics here. I only want to define what we mean by a national health service (I am taking at as a given that nearly everyone wants an NHS), which to me means giving all the medical care that people need, regardless of cost.
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Post by mak2 on Oct 17, 2011 13:26:06 GMT 1
Why does having an NHS mean "giving all the medical care that people need, regardless of cost"?
If you define the NHS in this way, we can't afford it!
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Post by fascinating on Oct 17, 2011 14:08:56 GMT 1
Why do you say we can't afford it?
How would you define an NHS?
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Post by abacus9900 on Oct 17, 2011 19:31:41 GMT 1
The only problem I have with having a private insurance element to the NHS is that it could eventually lead to a two-tier system where the private sector deprives the most vulnerable of the best possible service by depleting finite resources from the public sector. After all, if you are going to pay for your medical treatment you expect to be prioritised over those that do not.
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Post by marchesarosa on Oct 17, 2011 20:21:49 GMT 1
"throw all the money needed to care for the elderly"
I agree, fascinating. If we stopped paying for Trident, subsidising banks and throwing billions into the pit of renewable energy we could afford it. Not to mention bringing the troops home.
Just think of how much good could have been done for the economy via the multiplier effect if every household in the country had been GIVEN one million pounds and told to spend it on goods and services produced in this country. Some of it could have been spent by families on caring for their own elderly at home. Instead, it was all GIVEN to international speculators, i.e. bankers to disappear forever into the usual pockets.
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Post by mak2 on Oct 20, 2011 14:34:32 GMT 1
A National Health Service is one that is provided by the state. It does not necessarily have to be completely free, at the point of use, nor does it have to be unlimited in scope.
How much is it worth spending to prolong somebody's life? Ten thousand pounds? A million pounds? A hundred million? There has to be a limit.
We can all give examples of money that we think was wasted but that does not make the money available to pay for health care.
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Post by fascinating on Oct 20, 2011 17:20:52 GMT 1
Point taken, but what treatments would you deny to whom?
I say there does not have to be a limit, but the US government this year decided that a human life is worth about £6 million, so if you insist on a limit we will have that. Make no mistake, we as a society can afford to give health care to all.
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Post by abacus9900 on Oct 21, 2011 11:49:16 GMT 1
What is also worrying is that if the trend for people to live longer and requiring long term care continues what will be the situation in say ten, twenty or fifty years? Will we reach a point when we will have to make a decision as to whether an individual's life is worth supporting and if so based on what kind of criterion? Will we have to impose an age limit on how long someone can live rather as depicted in the movie Logan's Run? This sounds far fetched but if things become bad enough it could happen.
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Post by principled on Oct 21, 2011 13:04:38 GMT 1
Abacus, perhaps the way forward is to talk about quality of life rather than quantity. There are times when we are keeping people alive by the marvels of modern medicine who are neither cognisant of their surroundings nor are physically able to live without continuous medical intervention. We need to ask ourselves what the person is gaining in quality by maintaining them artificially in that state. We are all of course coloured by our personal experiences and so come at this from various view points, including religious beliefs. My own mother spent the last 3 weeks of her life in a hospice. By that time she could hardly walk but was mentally OK. By the end she was incontinent and taking water through a syringe. Her passing away at that stage was, I'm sure, helped by the morphine she was given. Would I (or she) have wanted life to continue like that even if a drug could have been given to extend her life, I wouldn't and I'm sure she wouldn't either. How does one arrive at a decision? It can only be by agreement between the doctor, an independent arbiter and the person's family. We are all going to die at some point so doing so with dignity should be society's main aim.
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