[Vampyr]

What can it possibly mean that the NHS will be “on the table” in post-Brexit trade negotiations with the US but that American insurance companies will be permitted to take over the NHS and leave millions of us without affordable health care?

This is devastating.

[hrothgar]

1. Trump is a pathological liar
2. He is profoundly ignorant
3. He is most likely suffering from dementia

Why would you pay attention to anything that he says?

[FelicityR]

The NHS is rather like the European Union: it wastes millions, if not billions of pounds, I used to work for it, so I should know. However, it is part of this country's, kingdom's, heritage.

Instead of greedy US healthcare companies circling like vultures post Brexit, we need a government that preserves the NHS and makes it more efficient.

[Cyberyeti]

FelicityR, on 2019-June-28, 14:53, said:

The NHS is rather like the European Union: it wastes millions, if not billions of pounds, I used to work for it, so I should know. However, it is part of this country's, kingdom's, heritage.

Instead of greedy US healthcare companies circling like vultures post Brexit, we need a government that preserves the NHS and makes it more efficient.

There are bits of the NHS that would probably improve with privatisation. Procurement and IT are TERRIBLE. There are however other aspects which need to be kept public. I don't trust either Boris or the former hulture secretary to strike the right balance.

[johnu]

Cyberyeti, on 2019-June-28, 15:37, said:

There are bits of the NHS that would probably improve with privatisation. Procurement and IT are TERRIBLE. There are however other aspects which need to be kept public. I don't trust either Boris or the former hulture secretary to strike the right balance.

Maybe it would improve with privitisation, but not if run by US health insurance companies. The US pays more for health care per person than any country in the world by a strikingly large margin, yet many of the health metrics are comparable with 3rd world countries. Sure, if you can afford the best private care, the US is up there with the best in the world. If you can't afford the best care, you frequently get what you pay for.

[steve2005]

There was talk of losing health plan in Canada's free trade deal with USA
I don't understand how your health coverage can even be a negotiated item?

[Vampyr]

steve2005, on 2019-June-28, 21:49, said:

There was talk of losing health plan in Canada's free trade deal with USA
I don't understand how your health coverage can even be a negotiated item?

Trump and May seemed to agree that it would be.

All American congresspersons are in the pocket of the insurance companies. It is shocking how wealthy these companies are, when what they are essentially doing is stealing a big chunk of the fee paid by the patient before it gets to the healthcare provider. It is immoral.

And I am sure we have all heard horror stories about the insurance companies denying treatment resulting in people’s deaths, the bankruptcies, people reaching a “lifetime cap” and not entitled to any more coverage ever, people stuck in jobs they hate because they can’t afford to lose the insurance coverage for their family (especially if a member of the family has any kind of illness or condition, as that would preclude them from being accepted by any other insurer), GPs and hospitals having to hire entire departments to handle billing and insurance... the list goes on.

I gather that a big part of the problem is that unions have, in the past, traded better insurance coverage for higher salaries, so they don’t want to lose what they have gained. But if the insurance premiums were paid as salary instead, people will have been damaged historically but not going forward.

Also, many people on Medicare would never give it up, but somehow do not seem to understand that Medicare is a government-funded program.

And if somehow Americans do not at some point reject the insurance scam, well, the legislators have great health insurance. It would be fair, it seems, to extend the same benefit to the people who pay their salaries (and their insurance premiums). But no..

[cherdano]

Vampyr, on 2019-June-28, 14:13, said:

What can it possibly mean that the NHS will be “on the table” in post-Brexit trade negotiations with the US but that American insurance companies will be permitted to take over the NHS and leave millions of us without affordable health care?

This is devastating.

It's almost as if the UK doesn't have much leverage when trying to negotiate a trade deal with an economy seven times as big...maybe it should consider teaming up with neighbouring countries for such negotiations?

[Cyberyeti]

johnu, on 2019-June-28, 20:27, said:

Maybe it would improve with privitisation, but not if run by US health insurance companies. The US pays more for health care per person than any country in the world by a strikingly large margin, yet many of the health metrics are comparable with 3rd world countries. Sure, if you can afford the best private care, the US is up there with the best in the world. If you can't afford the best care, you frequently get what you pay for.

I don't think they'd be looking to muscle in on the bits I'd want privatised. A large part of the issue is that both local and central government in the UK seem to be absolutely awful at negotiating with the private sector. You could negotiate deals with private US health firms to do specific jobs at a fixed price, but I have no confidence that we would get those negotiations right.

[nige1]

Cyberyeti, on 2019-June-29, 03:12, said:

I don't think they'd be looking to muscle in on the bits I'd want privatised. A large part of the issue is that both local and central government in the UK seem to be absolutely awful at negotiating with the private sector. You could negotiate deals with private US health firms to do specific jobs at a fixed price, but I have no confidence that we would get those negotiations right.

State inefficiency wastes thousands of pounds; but outsourcing to private contractors, wastes much more. For example, Private Finance Initiative (PFI) contracts were intended to rely on private capital and expertise, reducing risk and running costs. They have been a disaster, chucking away millions in consultancy fees to banks and accountancy firms and nearly bankrupting NHS trusts,

IT contracts are worse. NHS Luddites collude with software-house salesman to waste billions on aborted projects that would shame a school-child, assigned the tasks as weekend homework. Auditing is inadequate and accountability virtually non-existent. Shenanigans are hidden by "Corruption Concealment Clauses" (sometimes euphemistically dubbed "Commercial Confidentiality Clauses"). Managers responsible for fiascos are promoted rather than sacked. Ludicrously, contractors escape penalty-clauses and, instead, are awarded cancellation-compensation.

[barmar]

johnu, on 2019-June-28, 20:27, said:

Maybe it would improve with privitisation, but not if run by US health insurance companies. The US pays more for health care per person than any country in the world by a strikingly large margin, yet many of the health metrics are comparable with 3rd world countries. Sure, if you can afford the best private care, the US is up there with the best in the world. If you can't afford the best care, you frequently get what you pay for.

We pay so much because so much of our healthcare system is private. And even the public portions like Medicare and Medicaid are severely limited in their ability to negotiate prices with health care providers. If our providers go over there, they'll have to abide by UK laws.

Many US drug companies sell to other countries, and those prices are significantly lower than what we pay here. I think there was a bill prohibiting drug companies from charging more domestically than they've negotiated with other countries, but of course it can never pass in the current climate.

[Cyberyeti]

nige1, on 2019-June-29, 07:16, said:

State inefficiency wastes thousands of pounds; but outsourcing to private contractors, wastes much more. For example, PFI contracts were intended to rely on private capital and expertise, reducing risk and running costs. They have been a disaster, chucking away millions in consultancy fees to banks and accountancy firms and nearly bankrupting NHS trusts,

IT contracts are worse. NHS Luddites collude with software-house salesman to waste billions on aborted projects that would shame a school-child, assigned the tasks as weekend homework. Auditing is inadequate and accountability virtually non-existent. Shenanigans are hidden by "Corruption Concealment Clauses" (sometimes euphemistically dubbed "Commercial Confidentiality Clauses"). Managers responsible for fiascos are promoted rather than sacked. Ludicrously, contractors escape penalty-clauses and, instead, are awarded cancellation-compensation.

No PFI contracts were designed to keep government borrowing down to make the balance sheet look good while screwing over future generations. Usual Blair/Brown smoke and mirrors.

I don't believe the penalty clauses are even there (or negotiated in a way that would ever make them enforcible), and this is what I mean about public server negotiators being crap.

Years ago, I had to get tenders for an IT service. The one whose example clients were all local councils charged 3x what the others did for a service that was pretty equivalent, the waste in procurement is abysmal.

[nige1]

nige1, on 2019-June-29, 07:16, said:

PFI contracts were intended to rely on private capital and expertise, reducing risk and running costs.

Cyberyeti, on 2019-June-29, 09:20, said:

No PFI contracts were designed to keep government borrowing down to make the balance sheet look good while screwing over future generations. Usual Blair/Brown smoke and mirrors.

Yes, in theory, PFI reduced capital investment by the state and a Labour government is to blame for starting it.

Although, the satirical magazine, Private Eye, kept pointing out catastrophic practical failures. Conservative governments enthusiastically continued with the discredited PFI policy, They couldn't resist the opportunity to cram tax-payers' cash into cronies' pockets.

[helene_t]

If some NHS service is up for tender, it is fair that it goes to whichever contractor gives the best offer. Doesn't matter if the contractor is owned by British, Germans, Chinese or Americans.

The worry should be if services get outsourced despite NHS being able to do it better and cheaper themselves. This is a concern regardless of whether foreign companies are allowed to bid.

[helene_t]

FelicityR, on 2019-June-28, 14:53, said:

The NHS is rather like the European Union: it wastes millions, if not billions of pounds, I used to work for it, so I should know. However, it is part of this country's, kingdom's, heritage.

Instead of greedy US healthcare companies circling like vultures post Brexit, we need a government that preserves the NHS and makes it more efficient.

I worked for the NHS also. I didn't notice much waste. On the contrary, we were quite good at keeping more-or-less afloat with a ridiculous lack of resources.

My workplace at the Preston Hospital was a an office in which some 30 desks were squeezed in, for about 45 staff. Usually at least 15 would either be in the clinic or off work so there would be a desk for me somewhere, but of the 30 computers (age appr. 10 years, running windows XP in 2017) there would usually be some 5-6 waiting for repair. So I always brought my home laptop just in case.

Everything, from toilets to staff uniforms, was in a state in which a Danish, Dutch or even New Zealand health service would have replaced it a decade ago.

NHS prioritizes keeping patients alive and can't afford luxuries. The research (which was my field) was amateuristic but as a patient I was generally happy with NHS services. Nurses and doctors always spend their precious time efficiently, and what they lacked in modern equipment they made up for in compassion and devotion. Obviously you have to be devoted to stay with the NHS. Anyone who is in it for the money or benefits would have left the service (if not the country) long time ago. You may have heard the stories about nurses relying on food banks, or quiting NHS and staffing shelves at supermarkets instead because the latter pay better.

[Cyberyeti]

helene_t, on 2019-June-30, 16:33, said:

I worked for the NHS also. I didn't notice much waste. On the contrary, we were quite good at keeping more-or-less afloat with a ridiculous lack of resources.

My workplace at the Preston Hospital was a an office in which some 30 desks were squeezed in, for about 45 staff. Usually at least 15 would either be in the clinic or off work so there would be a desk for me somewhere, but of the 30 computers (age appr. 10 years, running windows XP in 2017) there would usually be some 5-6 waiting for repair. So I always brought my home laptop just in case.

Everything, from toilets to staff uniforms, was in a state in which a Danish, Dutch or even New Zealand health service would have replaced it a decade ago.

NHS prioritizes keeping patients alive and can't afford luxuries. The research (which was my field) was amateuristic but as a patient I was generally happy with NHS services. Nurses and doctors always spend their precious time efficiently, and what they lacked in modern equipment they made up for in compassion and devotion. Obviously you have to be devoted to stay with the NHS. Anyone who is in it for the money or benefits would have left the service (if not the country) long time ago. You may have heard the stories about nurses relying on food banks, or quiting NHS and staffing shelves at supermarkets instead because the latter pay better.

I have little experience of the NHS other than using it. In Norfolk where I am, apart from the fact that there is no joined up IT, and delays for things like scans, I can only praise the service, however this is a postcode lottery, a friend in Nottingham has a continuing horror story which has caused her to move to Wales to get away from it.

What I have seen is in schools. A friend runs the IT in a school that has recently moved from state control to being an academy. This means for example that he can now pay a fraction of the cost for services that he used to have to get from the council's IT department, and the services are better.

[cherdano]

"Do the Brexit people know that a free trade deal with the United States is going to entail us demanding that they start paying much higher prices for prescription drugs?" - Matt Yglesias.
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