Universal healthcare has problems also - a country can end up with "cheap" healthcare

[belvoboy]

During the discussions about the medical card, I've heard some people say universal coverage is the answer and point to the UK's system.

However I've followed the UK's health system over the years (partly from spending over a decade on discussion boards for other people with my medical condition) and things are often done on the cheap there. For example, it's not uncommon to try to push patients off to "non-doctors" such as OTs, physios, psychologists, etc because they can't prescribe medications or request drugs which would cost the NHS money.

Testing generally is restricted as is what can be prescribed.

The Irish system where tax income doesn't have to pay for everything (i.e. every GP visit, every drug prescription, etc) means the tax money can go further. If people think the Irish system is bad now, imagine what the system and service would be like if the budget had to cover extra things. Of course, because of the amount of private health insurance in Ireland, again the country's pot (from tax) doesn't have to pay for as much towards some stays in hospitals and some other health expenditure.

Currently we don't have NICE which restricts access to useful drugs - it would (presumably) have to come in if everything became "universal". We have HIQA which could become like NICE but so far hasn't been acting like NICE.

There are pluses and minuses to both systems but personally I wouldn't like a healthsystem like the UK. Of course, that's not the only model available.

[20000miles]

When governments are abolished in 100 years time, we will have realised that a voluntarily provided system of healthcare is, and always has been, the most effective and the most morally sound system.

[belvoboy]

When governments are abolished in 100 years time, we will have realised that a voluntarily provided system of healthcare is, and always has been, the most effective and the most morally sound system.

Probably a silly question but do you mean a bit like non-compulsory insurance (i.e. not motor insurance) where many people would pay for health insurance, with others not paying for it but paying for healthcare whenever they had too with the hope that charities and the like would fill in the gaps for the people who couldn't pay? Maybe an example of this would be healthcare for animals.

[jc_ie]

During the discussions about the medical card, I've heard some people say universal coverage is the answer and point to the UK's system.

However I've followed the UK's health system over the years (partly from spending over a decade on discussion boards for other people with my medical condition) and things are often done on the cheap there. For example, it's not uncommon to try to push patients off to "non-doctors" such as OTs, physios, psychologists, etc because they can't prescribe medications or request drugs which would cost the NHS money.

Testing generally is restricted as is what can be prescribed.

The Irish system where tax income doesn't have to pay for everything (i.e. every GP visit, every drug prescription, etc) means the tax money can go further. If people think the Irish system is bad now, imagine what the system and service would be like if the budget had to cover extra things. Of course, because of the amount of private health insurance in Ireland, again the country's pot (from tax) doesn't have to pay for as much towards some stays in hospitals and some other health expenditure.

Currently we don't have NICE which restricts access to useful drugs - it would (presumably) have to come in if everything became "universal". We have HIQA which could become like NICE but so far hasn't been acting like NICE.

There are pluses and minuses to both systems but personally I wouldn't like a healthsystem like the UK. Of course, that's not the only model available.

How about france then?

Sorry, the idea of living in a country in which when a person is sick the 1st thing they tend to think of is "Can i afford to go to the Doctor or A&E?" just seems wrong.

Give me the NHS and its failings over our current system any day of the week.

Give me France over the NHS though....

[belvoboy]

I'm far from an expert on healthcare so don't know how the system works in France so can't comment on that. People can feel free to post info.

I did notice that there wasn't much mention in some of the recent media discussions in Ireland that there are caps on the amount people have to spend in Ireland. For example, 100 Euro per month on drugs (which can include a couple/household). There are all sorts of discretionary payments out there. And people can get discretionary medical cards if they go to the GP a lot. Or they may get a GP-only card if they don't qualify for a medical card.

As I said, I think there are a lot of problems with the NHS - it may come down to there not being enough money to go around to cover everything. I think this is going to become clearer in time with the more rulings NICE comes out with.

[20000miles]

Probably a silly question but do you mean a bit like non-compulsory insurance (i.e. not motor insurance) where many people would pay for health insurance, with others not paying for it but paying for healthcare whenever they had too with the hope that charities and the like would fill in the gaps for the people who couldn't pay? Maybe an example of this would be healthcare for animals.

I mean that there is no compulsary, involuntary taxation funding towards healthcare, and all services are being provided voluntarily.

This removes the moral hazard (smokers, drug users, risk takers) as we would all be assessed individually by medical insurance firms.

This is in combination with the abolition of all special priviliges that doctors all over the world have won over the years through intense lobbying. Time the GPs competed with one another like everyone else.

People aren't animals and they don't need to be herded about by governments.

[belvoboy]

In the UK, if NICE rules that a drug is not cost effective, a patient has to pay for the full price (and currently may have to pay other costs associated with their healthcare if they try the drug).

Some drugs cost 10,000-20,000 Euro per year (and I've heard talk that there many other drugs are going to be expensive as it costs a lot to take a drug through all the stages to get it to market and then drug companies only tend to have a certain number of years before they either lose the patent or another company comes out with a similar drug.

[toxic avenger]

During the discussions about the medical card, I've heard some people say universal coverage is the answer and point to the UK's system.

However I've followed the UK's health system over the years (partly from spending over a decade on discussion boards for other people with my medical condition) and things are often done on the cheap there. For example, it's not uncommon to try to push patients off to "non-doctors" such as OTs, physios, psychologists, etc because they can't prescribe medications or request drugs which would cost the NHS money.

Testing generally is restricted as is what can be prescribed.

The Irish system where tax income doesn't have to pay for everything (i.e. every GP visit, every drug prescription, etc) means the tax money can go further. If people think the Irish system is bad now, imagine what the system and service would be like if the budget had to cover extra things. Of course, because of the amount of private health insurance in Ireland, again the country's pot (from tax) doesn't have to pay for as much towards some stays in hospitals and some other health expenditure.

Currently we don't have NICE which restricts access to useful drugs - it would (presumably) have to come in if everything became "universal". We have HIQA which could become like NICE but so far hasn't been acting like NICE.

There are pluses and minuses to both systems but personally I wouldn't like a healthsystem like the UK. Of course, that's not the only model available.

Well, as someone who lived in Britain for years, I can tell you that the NHS piddles all over our health 'service', including in quality of service. The problems you mention, and there are many, tend to come when there is an ideological push away from universality, whether it be through years of chronic under-funding by a Thatcherite government ideologically hostile to the system and eager to run it down in order to pronounce it a 'failure' or from Blairite moves to push private finance and management on it. And still, despite these attacks on the greatest achievement of any British administration in history, the service still manages to produce a quality of service at all levels that makes ours look pre-historic.

Healthcare for all should be the hallmark of an advanced and civilised society. We instead choose to ape the American system, but with worse service and results. Makes you fantastically proud, doesn't it?...

[jc_ie]

Jesus 2000miles.. You sound like Project Exodus in the US.

The same logic can be extended to a pension or most other social services.Why bother with a firefighting force either?

Moral Hazard? Letting the private sector rule supreme and unchecked on healthcare is one hell of a moral hazard. Cant afford to pay for an electrick shock machine? Too bad.. you can just die.

Take a look at the senate hearing into the Americah HMOs trying to discredit people and get out of paying for their treatments,

Taxation is purely volentary. You dont have to live here you know.


Back to the point.

100 euro is a lot of money to be spending on drugs. And if i remember correctly its anything over 100 euro a month so you still have to pay that amount anyway.,
Throw in a visit to the GP for perscritions and you have 160 euro before you can blink.

The problem with discrestionary spending is exactly that. Its opinion based open to interpretation. If that opinion happened to be a few gps wrather then a civil servant i may not feel so bad about it but main issue on all of these limits and spending etc etc.

They change the limits at will. I think only 4 years ago the limit on drugs was 50 euro a month. In order to qualifiy for the medical card at one point 2 parents working full time at mcdonalds couldnt qualify.
And we just saw the whole mess with the income limits on medical cards.
And if the government doesnt index link all of these programs etc then by default they fall behind every year.

When you are sick i dont think money should really be the 1st thing on you mind.

I like the idea of the following quote


" It will provide you with all medical, dental, and nursing care, everyone rich or poor, man or child, can use it or part of it, there are no charges except for a few exceptional items, there are no insurance qualifications, but it is not a charity. You are paying for it mainly as taxpayers, and it will relieve your money worries in times of illness"

[belvoboy]

Just to be clear, I'm not saying what people have in Ireland is necessarily brilliant at this moment in time.

More I'm not convinced moving to giving everyone a medical card is necessarily the answer (I think this may be become a more regular discussion topic in Ireland in the future following the medical card debate recently - however I'd prefer a more general discussion rather than just the ins and outs of what has happened in Ireland in the last few weeks - there are lots of other threads for that).
[Addendum: I wasn't referring to jc_ie's post just above mine which went out just before mine, or any other post in the thread thus far]