politicalbetting.com » Blog Archive » The latest Farage farrago, Douglas Carswell is accused of helping the Tories defeat Farage in Thanet South
Forget traingate this is the political story of the week, although I can sympathise with those who say a UKIP internal squabbling story is up there with a dog bites man story, but this story has achieved that rare feat, leaving me lost for words.
Its's only 4 months isn't it? People have been betting on the next President/Next Lab Leader etc for much longer than that. But betting on markets that only offer one of the possibilities doesn't seem wise
I would be interested what people think the correct prices for Clacton at the next GE are?
I think that is the problem with the bet though, Carswell to leave in 2016/17 wouldbe a more interesting proposition, unlikely he will do so in 2016. Not the time value of money over 4 months..
Mr Charles, made a point about how a private health insurer suddenly and unilaterally withdrew cover, once it was clear to them that they would have to pay out. The good FoxinSox, medicus of this parish, has mentioned several times that insurance companies will not cover existing conditions and can get very snotty about chronic conditions.
It seems to me that private companies would have to be very heavily regulated if they are ever going to be used to assist in the funding of the NHS, so much so that they would either refuse the business or charge extraordinary premiums. Yet the idea of PMI is constantly pushed as the solution the problem that the NHS, as it stands, is unaffordable and unsustainable.
The other related problem to that solution is that the big users of the NHS are those of us richer in years, often with chronic conditions, who the insurers will not touch with a bargepole.
In all honesty I can't see a better way out of this mess than to make the state the insurer but not the provider. Set the hospitals loose, the patient can choose which one they want, they can choose which quack, surgeon, consultant they want but the insurer picks up the bills (which because the hospitals and quacks are all competing for custom ought to come down).
PB before the referendum: Farage, Banks and Leave.EU are complete idiots and they will lose the referendum for Leave.
PB after the referendum: Farage, Banks and Leave.EU were not important in the referendum.
I would, if asked, have recalled the PB consensus at the time to be: Farage: Massive personal influence on the Brexit outcome, if occasionally crass Banks: Who? Leave.EU:who?
PB before the referendum: Farage, Banks and Leave.EU are complete idiots and they will lose the referendum for Leave.
PB after the referendum: Farage, Banks and Leave.EU were not important in the referendum.
I would, if asked, have recalled the PB consensus at the time to be: Farage: Massive personal influence on the Brexit outcome, if occasionally crass Banks: Who? Leave.EU:who?
I thought PB was saying Farage should be locked in a cupboard etc ie kept away from any media as he was toxic
Maybe Leave would have won by more if he had been!
With my expert and detailed knowledge of all eras of history, I try and get in as many historical references into threads as possible. Is my way of helping those PBers like Morris Dancer who lack such detailed knowledge.
Yebbut was Suzanne ever UKIP leader for only 9 days?
Farage came to within 3,000 votes, but it wasn't enough.
Had he been up against a Europhile Tory and slightly less polarising he could have won on the day - just.
What I find interesting about South Thanet is how well the Labour vote held up given it was a two-horse race.
Mr Royale, I am sure what sunk Farage at the GE and, indeed, UKIP in several other constituencies was that poster of Milliband in Salmond's top pocket. As political campaigning goes that was pure genius.
"Sorry, Nige, I think you are correct but I can't risk it", was I think the sentiment that saved several Conservative seats.
Mr Charles, made a point about how a private health insurer suddenly and unilaterally withdrew cover, once it was clear to them that they would have to pay out. The good FoxinSox, medicus of this parish, has mentioned several times that insurance companies will not cover existing conditions and can get very snotty about chronic conditions.
It seems to me that private companies would have to be very heavily regulated if they are ever going to be used to assist in the funding of the NHS, so much so that they would either refuse the business or charge extraordinary premiums. Yet the idea of PMI is constantly pushed as the solution the problem that the NHS, as it stands, is unaffordable and unsustainable.
The other related problem to that solution is that the big users of the NHS are those of us richer in years, often with chronic conditions, who the insurers will not touch with a bargepole.
In all honesty I can't see a better way out of this mess than to make the state the insurer but not the provider. Set the hospitals loose, the patient can choose which one they want, they can choose which quack, surgeon, consultant they want but the insurer picks up the bills (which because the hospitals and quacks are all competing for custom ought to come down).
Why would prices come down? First, if the insurer (state or otherwise) is paying, what is the incentive for the patient to choose the cheapest? Second, surely competition would be based on medical quality, not price, so competition ought to drive quality up but not prices down. Third, if price is taken as a proxy for quality, and patients choose on perceived quality, prices will be driven up not down. Fourth, if patients compete to get into the best hospitals on outcome not price data, then prices will still be driven up.
The dirty little secret of the NHS is that it is cheap. There's a lot wrong with it but nothing that messing around with insurance schemes will fix or even address.
PB before the referendum: Farage, Banks and Leave.EU are complete idiots and they will lose the referendum for Leave.
PB after the referendum: Farage, Banks and Leave.EU were not important in the referendum.
I would, if asked, have recalled the PB consensus at the time to be: Farage: Massive personal influence on the Brexit outcome, if occasionally crass Banks: Who? Leave.EU:who?
I thought PB was saying Farage should be locked in a cupboard etc ie kept away from any media as he was toxic
Maybe Leave would have won by more if he had been!
Quite. Everytime Farage was on TV it was a disaster for Leave. Apparently.
PB before the referendum: Farage, Banks and Leave.EU are complete idiots and they will lose the referendum for Leave.
PB after the referendum: Farage, Banks and Leave.EU were not important in the referendum.
I would, if asked, have recalled the PB consensus at the time to be: Farage: Massive personal influence on the Brexit outcome, if occasionally crass Banks: Who? Leave.EU:who?
We can only relate anecdotes. I credit Farage for pushing Cameron into offering EUref in the first place. Obviously, he also got the UKIP vote out. However, I thought his contribution to the campaign itself, in terms of floating voters was, at best, neutral.
As I've said repeatedly, both sides were terrible. I didn't really differentiate between Vote Leave and Leave.EU. Their messages on the EU contribution and Turkey were shit.
Mr Charles, made a point about how a private health insurer suddenly and unilaterally withdrew cover, once it was clear to them that they would have to pay out. The good FoxinSox, medicus of this parish, has mentioned several times that insurance companies will not cover existing conditions and can get very snotty about chronic conditions.
It seems to me that private companies would have to be very heavily regulated if they are ever going to be used to assist in the funding of the NHS, so much so that they would either refuse the business or charge extraordinary premiums. Yet the idea of PMI is constantly pushed as the solution the problem that the NHS, as it stands, is unaffordable and unsustainable.
The other related problem to that solution is that the big users of the NHS are those of us richer in years, often with chronic conditions, who the insurers will not touch with a bargepole.
In all honesty I can't see a better way out of this mess than to make the state the insurer but not the provider. Set the hospitals loose, the patient can choose which one they want, they can choose which quack, surgeon, consultant they want but the insurer picks up the bills (which because the hospitals and quacks are all competing for custom ought to come down).
I think that to have the state as insurer of last resort is essential. There simply are a lot of people and conditions that are not insurable. It doesn't have to be a single system though, and I would personally be happy with a German style system where different companies have different levels of cover above the minimum threshold. A sort of "Speedy Boarding" supplement for example.
There are significant difficulties with consumerism in healthcare though, in particular what people want is often not what they need. Over-investigation and unnessecary interventions (often with significant iatrogenic morbidity) are near universal in such health care systems.
With my expert and detailed knowledge of all eras of history, I try and get in as many historical references into threads as possible. Is my way of helping those PBers like Morris Dancer who lack such detailed knowledge.
Yebbut was Suzanne ever UKIP leader for only 9 days?
Frequently, Mr Prasannan. Didn`t they tell you?
It's Dr. Prasannan, I didn't spend ten years in Evil Medical School Imperial College to be called "mister," thank you very much.
Omnishambles Games continues...this time probably not 100% Rio's fault.
Kenyan athletes are stranded in a Rio shanty town where gunshots can be heard, following the closure of the Olympic village, the team captain says. Officials delayed their return home as they looked for a "cheap flight", said Wesley Korir, a marathon runner who is also an independent MP.
He posted images on Twitter of dilapidated buildings in the area where he said they were forced to stay. Team Kenya has been dogged by allegations of mismanagement at Rio.
I think that to have the state as insurer of last resort is essential. There simply are a lot of people and conditions that are not insurable. It doesn't have to be a single system though, and I would personally be happy with a German style system where different companies have different levels of cover above the minimum threshold. A sort of "Speedy Boarding" supplement for example.
There are significant difficulties with consumerism in healthcare though, in particular what people want is often not what they need. Over-investigation and unnessecary interventions (often with significant iatrogenic morbidity) are near universal in such health care systems.
And Obamacare is showing that when you rely on regulating insurers to cover non-actuarial medical conditions, the net result is either the government ends up as de facto insurer of last through paying top up fees to insurers with lots of non-actuarial patients on their books, or you have insurers withdrawing from the markets entirely. Several very large insurers have withdrawn from many states in the last two months, despite the top up payments.
I have become a firm believer in a government-funded but privately operated basic healthcare system supplemented with additional health insurance for those who want treatment in hotel quality hospitals, or the ability to select their physician of choice. With that approach, much of the transaction costs that ensue from operating through insurance companies (which are huge - my wife is going through chemo a the moment and I am dealing with around 3-4 correspondences per week just with insurers and billing offices) can be eliminated, as can a lot of the excess procedures (lab tests, MRIs etc) that pay-per-procedure (rather than pay-per-patient or per-result) encourages.
Mr Charles, made a point about how a private health insurer suddenly and unilaterally withdrew cover, once it was clear to them that they would have to pay out. The good FoxinSox, medicus of this parish, has mentioned several times that insurance companies will not cover existing conditions and can get very snotty about chronic conditions.
It seems to me that private companies would have to be very heavily regulated if they are ever going to be used to assist in the funding of the NHS, so much so that they would either refuse the business or charge extraordinary premiums. Yet the idea of PMI is constantly pushed as the solution the problem that the NHS, as it stands, is unaffordable and unsustainable.
The other related problem to that solution is that the big users of the NHS are those of us richer in years, often with chronic conditions, who the insurers will not touch with a bargepole.
In all honesty I can't see a better way out of this mess than to make the state the insurer but not the provider. Set the hospitals loose, the patient can choose which one they want, they can choose which quack, surgeon, consultant they want but the insurer picks up the bills (which because the hospitals and quacks are all competing for custom ought to come down).
I think that to have the state as insurer of last resort is essential. There simply are a lot of people and conditions that are not insurable. It doesn't have to be a single system though, and I would personally be happy with a German style system where different companies have different levels of cover above the minimum threshold. A sort of "Speedy Boarding" supplement for example.
There are significant difficulties with consumerism in healthcare though, in particular what people want is often not what they need. Over-investigation and unnessecary interventions (often with significant iatrogenic morbidity) are near universal in such health care systems.
Private insurance is a non-starter as the bulk of a patient's costs are in the last 18 months or so of life.
With you on the German system. We cannot fix the NHS as it currently stands. It has to satisfy infinite demand with a finite budget.
With my expert and detailed knowledge of all eras of history, I try and get in as many historical references into threads as possible. Is my way of helping those PBers like Morris Dancer who lack such detailed knowledge.
Yebbut was Suzanne ever UKIP leader for only 9 days?
Frequently, Mr Prasannan. Didn`t they tell you?
It's Dr. Prasannan, I didn't spend ten years in Evil Medical School Imperial College to be called "mister," thank you very much.
Only 'proper' doctors get to become "Mister" again
PB before the referendum: Farage, Banks and Leave.EU are complete idiots and they will lose the referendum for Leave.
PB after the referendum: Farage, Banks and Leave.EU were not important in the referendum.
I would, if asked, have recalled the PB consensus at the time to be: Farage: Massive personal influence on the Brexit outcome, if occasionally crass Banks: Who? Leave.EU:who?
We can only relate anecdotes. I credit Farage for pushing Cameron into offering EUref in the first place. Obviously, he also got the UKIP vote out. However, I thought his contribution to the campaign itself, in terms of floating voters was, at best, neutral.
As I've said repeatedly, both sides were terrible. I didn't really differentiate between Vote Leave and Leave.EU. Their messages on the EU contribution and Turkey were shit.
Messages can be both shit and effective. Farage's immigration poster seems, from a distance, to have had a significant impact on the trajectory of the campaign.
Mr Charles, made a point about how a private health insurer suddenly and unilaterally withdrew cover, once it was clear to them that they would have to pay out. The good FoxinSox, medicus of this parish, has mentioned several times that insurance companies will not cover existing conditions and can get very snotty about chronic conditions.
It seems to me that private companies would have to be very heavily regulated if they are ever going to be used to assist in the funding of the NHS, so much so that they would either refuse the business or charge extraordinary premiums. Yet the idea of PMI is constantly pushed as the solution the problem that the NHS, as it stands, is unaffordable and unsustainable.
The other related problem to that solution is that the big users of the NHS are those of us richer in years, often with chronic conditions, who the insurers will not touch with a bargepole.
In all honesty I can't see a better way out of this mess than to make the state the insurer but not the provider. Set the hospitals loose, the patient can choose which one they want, they can choose which quack, surgeon, consultant they want but the insurer picks up the bills (which because the hospitals and quacks are all competing for custom ought to come down).
I think that to have the state as insurer of last resort is essential. There simply are a lot of people and conditions that are not insurable. It doesn't have to be a single system though, and I would personally be happy with a German style system where different companies have different levels of cover above the minimum threshold. A sort of "Speedy Boarding" supplement for example.
There are significant difficulties with consumerism in healthcare though, in particular what people want is often not what they need. Over-investigation and unnessecary interventions (often with significant iatrogenic morbidity) are near universal in such health care systems.
Private insurance is a non-starter as the bulk of a patient's costs are in the last 18 months or so of life.
With you on the German system. We cannot fix the NHS as it currently stands. It has to satisfy infinite demand with a finite budget.
I think the NHS is fine*, probably needs a couple more % of gdp thrown at it and also the Jr Docs to stop whinging.
Some fringe issues like not going for those shit pfi contracts, and stopping it becoming the IHS (A la @MaxPB) are there but all in all it does a not bad job.
Mr Charles, made a point about how a private health insurer suddenly and unilaterally withdrew cover, once it was clear to them that they would have to pay out. The good FoxinSox, medicus of this parish, has mentioned several times that insurance companies will not cover existing conditions and can get very snotty about chronic conditions.
It seems to me that private companies would have to be very heavily regulated if they are ever going to be used to assist in the funding of the NHS, so much so that they would either refuse the business or charge extraordinary premiums. Yet the idea of PMI is constantly pushed as the solution the problem that the NHS, as it stands, is unaffordable and unsustainable.
The other related problem to that solution is that the big users of the NHS are those of us richer in years, often with chronic conditions, who the insurers will not touch with a bargepole.
In all honesty I can't see a better way out of this mess than to make the state the insurer but not the provider. Set the hospitals loose, the patient can choose which one they want, they can choose which quack, surgeon, consultant they want but the insurer picks up the bills (which because the hospitals and quacks are all competing for custom ought to come down).
I think that to have the state as insurer of last resort is essential. There simply are a lot of people and conditions that are not insurable. It doesn't have to be a single system though, and I would personally be happy with a German style system where different companies have different levels of cover above the minimum threshold. A sort of "Speedy Boarding" supplement for example.
There are significant difficulties with consumerism in healthcare though, in particular what people want is often not what they need. Over-investigation and unnessecary interventions (often with significant iatrogenic morbidity) are near universal in such health care systems.
i've had a barium meal every year for about the last 10 years, I guess a third of that would have been plenty.
japanese company screening for stomach cancer (?probably)
i know it's unecessary, but it is somehow hard to refuse...
having said that, blood tests in the same health check convinced me to signif. reduce my alchohol intake...
Mr Charles, made a point about how a private health insurer suddenly and unilaterally withdrew cover, once it was clear to them that they would have to pay out. The good FoxinSox, medicus of this parish, has mentioned several times that insurance companies will not cover existing conditions and can get very snotty about chronic conditions.
It seems to me that private companies would have to be very heavily regulated if they are ever going to be used to assist in the funding of the NHS, so much so that they would either refuse the business or charge extraordinary premiums. Yet the idea of PMI is constantly pushed as the solution the problem that the NHS, as it stands, is unaffordable and unsustainable.
The other related problem to that solution is that the big users of the NHS are those of us richer in years, often with chronic conditions, who the insurers will not touch with a bargepole.
In all honesty I can't see a better way out of this mess than to make the state the insurer but not the provider. Set the hospitals loose, the patient can choose which one they want, they can choose which quack, surgeon, consultant they want but the insurer picks up the bills (which because the hospitals and quacks are all competing for custom ought to come down).
I think that to have the state as insurer of last resort is essential. There simply are a lot of people and conditions that are not insurable. It doesn't have to be a single system though, and I would personally be happy with a German style system where different companies have different levels of cover above the minimum threshold. A sort of "Speedy Boarding" supplement for example.
There are significant difficulties with consumerism in healthcare though, in particular what people want is often not what they need. Over-investigation and unnessecary interventions (often with significant iatrogenic morbidity) are near universal in such health care systems.
I'd go for a mixed system.
Create a "standard" plan with a limited number of providers (say 5-8). Government to set the terms (e.g. exclusions) and pay the premiums. Everyone is covered automatically at this basic level. Consumers are then free to choose their providers who should be forced to compete on quality of service, network, etc.
Insurers can then try to upsell customers for premium services (e.g. branded vs generic Rd, free choice of hospitals, latest cancer drug that doesn't pass the NICE tests, etc). But all these extras are paid for privately.
Mr Charles, made a point about how a private health insurer suddenly and unilaterally withdrew cover, once it was clear to them that they would have to pay out. The good FoxinSox, medicus of this parish, has mentioned several times that insurance companies will not cover existing conditions and can get very snotty about chronic conditions.
It seems to me that private companies would have to be very heavily regulated if they are ever going to be used to assist in the funding of the NHS, so much so that they would either refuse the business or charge extraordinary premiums. Yet the idea of PMI is constantly pushed as the solution the problem that the NHS, as it stands, is unaffordable and unsustainable.
The other related problem to that solution is that the big users of the NHS are those of us richer in years, often with chronic conditions, who the insurers will not touch with a bargepole.
In all honesty I can't see a better way out of this mess than to make the state the insurer but not the provider. Set the hospitals loose, the patient can choose which one they want, they can choose which quack, surgeon, consultant they want but the insurer picks up the bills (which because the hospitals and quacks are all competing for custom ought to come down).
I think that to have the state as insurer of last resort is essential. There simply are a lot of people and conditions that are not insurable. It doesn't have to be a single system though, and I would personally be happy with a German style system where different companies have different levels of cover above the minimum threshold. A sort of "Speedy Boarding" supplement for example.
There are significant difficulties with consumerism in healthcare though, in particular what people want is often not what they need. Over-investigation and unnessecary interventions (often with significant iatrogenic morbidity) are near universal in such health care systems.
Private insurance is a non-starter as the bulk of a patient's costs are in the last 18 months or so of life.
With you on the German system. We cannot fix the NHS as it currently stands. It has to satisfy infinite demand with a finite budget.
Back to work shortly for me, but happy to debate later.
Implicit in your last statement is a recognition that there needs to be rationing on either a financial or clinical basis. In practice this is much like taxes or cuts, fine for other people but not for oneself!
The actual letter is a masterpiece of illiteracy. It is addressed quite simply to "Kent police" (rather than to say the Chief Constable at such and such an address), it can't spell "centre" or "Surrey", gets apostrophes wrong twice and is headed, bafflingly, "Without Prejudice". It's a worrying thought experiment to consider what a force UKIP might be if its nastiness were not tempered by incompetence and amateurism.
''Private insurance is a non-starter as the bulk of a patient's costs are in the last 18 months or so of life. ''
Indeed. Some things that are currently done by the NHS could be hived off to the private sector though, surely, and financed via an insurance system, with the government the insurer of last resort for those who cannot pay premiums.
PB before the referendum: Farage, Banks and Leave.EU are complete idiots and they will lose the referendum for Leave.
PB after the referendum: Farage, Banks and Leave.EU were not important in the referendum.
I would, if asked, have recalled the PB consensus at the time to be: Farage: Massive personal influence on the Brexit outcome, if occasionally crass Banks: Who? Leave.EU:who?
I thought PB was saying Farage should be locked in a cupboard etc ie kept away from any media as he was toxic
Maybe Leave would have won by more if he had been!
Quite. Everytime Farage was on TV it was a disaster for Leave. Apparently.
Farage may well have been a disaster for Leave, if reports are true that his ill-timed interventions undermined Leave's persuasion of ethnic minority voters.
Farage came to within 3,000 votes, but it wasn't enough.
Had he been up against a Europhile Tory and slightly less polarising he could have won on the day - just.
What I find interesting about South Thanet is how well the Labour vote held up given it was a two-horse race.
The EU Referendum showed that there are a lot of people who agree with UKIP who, for various reasons, don't vote UKIP. The UKIP vote is really the tip of a big iceberg of Eurosceptic sentiment. Places where UKIP won c.13% at the last election typically had Leave votes of 50-60%. Places where UKIP's vote was below average typically recorded low scores for Leave. Places were UKIP were winning 25-35% were showing Leave votes of 65-75%.
PB before the referendum: Farage, Banks and Leave.EU are complete idiots and they will lose the referendum for Leave.
PB after the referendum: Farage, Banks and Leave.EU were not important in the referendum.
I would, if asked, have recalled the PB consensus at the time to be: Farage: Massive personal influence on the Brexit outcome, if occasionally crass Banks: Who? Leave.EU:who?
We can only relate anecdotes. I credit Farage for pushing Cameron into offering EUref in the first place. Obviously, he also got the UKIP vote out. However, I thought his contribution to the campaign itself, in terms of floating voters was, at best, neutral.
As I've said repeatedly, both sides were terrible. I didn't really differentiate between Vote Leave and Leave.EU. Their messages on the EU contribution and Turkey were shit.
Messages can be both shit and effective. Farage's immigration poster seems, from a distance, to have had a significant impact on the trajectory of the campaign.
On reflection, I should have written something about their messaging not resonating with me, though I doubt my demographic was being specifically targeted.
I'm still working through my guilt complex over my vote. Not helped by those on my timeline calling for an immediate repeal of the '72 act and off we go.
It's Dr. Prasannan, I didn't spend ten years in Evil Medical School Imperial College to be called "mister," thank you very much.
I have noticed, my dear fellow, as I have wandered around the world, that the only people who insist on having their doctorates mentioned in normal conversation, are those who were awarded them by third rate institutions, or in third rate countries, probably as a result of corruption.
Since I am sure this does not apply to yourself, it might be better to lay off the insistence on your title.
F1: confirmed that Hamilton has penalties, which has altered the odds (surprised, given it was strongly trailed). He's now 4.5 to win, the Red Bull's 8 apiece (had been 3 and 9 respectively this morning).
The actual letter is a masterpiece of illiteracy. It is addressed quite simply to "Kent police" (rather than to say the Chief Constable at such and such an address), it can't spell "centre" or "Surrey", gets apostrophes wrong twice and is headed, bafflingly, "Without Prejudice". It's a worrying thought experiment to consider what a force UKIP might be if its nastiness were not tempered by incompetence and amateurism.
The 'Without prejudice' really irked me too.
My life would be much more simpler if 'Without prejudice' was used less on letters, and I could use 'With extreme prejudice' on my letters.
Back to work shortly for me, but happy to debate later.
Implicit in your last statement is a recognition that there needs to be rationing on either a financial or clinical basis. In practice this is much like taxes or cuts, fine for other people but not for oneself!
I think there could be quite a lot of capacity freed up through eliminating wastage.
Non attendees for instance or non-eligible patients (ie non UK residents). I'd look at NHS entitlement cards, co-pays for treatment (at a low level say 10% and capped at a few hundred per year so people with chronic issues are protected).
How much of an issue is patients not attending appointments these days?
Mr Charles, made a point about how a private health insurer suddenly and unilaterally withdrew cover, once it was clear to them that they would have to pay out. The good FoxinSox, medicus of this parish, has mentioned several times that insurance companies will not cover existing conditions and can get very snotty about chronic conditions.
It seems to me that private companies would have to be very heavily regulated if they are ever going to be used to assist in the funding of the NHS, so much so that they would either refuse the business or charge extraordinary premiums. Yet the idea of PMI is constantly pushed as the solution the problem that the NHS, as it stands, is unaffordable and unsustainable.
The other related problem to that solution is that the big users of the NHS are those of us richer in years, often with chronic conditions, who the insurers will not touch with a bargepole.
In all honesty I can't see a better way out of this mess than to make the state the insurer but not the provider. Set the hospitals loose, the patient can choose which one they want, they can choose which quack, surgeon, consultant they want but the insurer picks up the bills (which because the hospitals and quacks are all competing for custom ought to come down).
I think that to have the state as insurer of last resort is essential. There simply are a lot of people and conditions that are not insurable. It doesn't have to be a single system though, and I would personally be happy with a German style system where different companies have different levels of cover above the minimum threshold. A sort of "Speedy Boarding" supplement for example.
There are significant difficulties with consumerism in healthcare though, in particular what people want is often not what they need. Over-investigation and unnessecary interventions (often with significant iatrogenic morbidity) are near universal in such health care systems.
Private insurance is a non-starter as the bulk of a patient's costs are in the last 18 months or so of life.
With you on the German system. We cannot fix the NHS as it currently stands. It has to satisfy infinite demand with a finite budget.
Back to work shortly for me, but happy to debate later.
Implicit in your last statement is a recognition that there needs to be rationing on either a financial or clinical basis. In practice this is much like taxes or cuts, fine for other people but not for oneself!
Maybe I'm in the minority here, but all politics is about rationing. It's just most acute in the NHS. Everything has an opportunity cost.
It's Dr. Prasannan, I didn't spend ten years in Evil Medical School Imperial College to be called "mister," thank you very much.
I have noticed, my dear fellow, as I have wandered around the world, that the only people who insist on having their doctorates mentioned in normal conversation, are those who were awarded them by third rate institutions, or in third rate countries, probably as a result of corruption.
Since I am sure this does not apply to yourself, it might be better to lay off the insistence on your title.
I enjoyed one Dave Allen sketch in which he played Ian Paisley conversing with God, saying "It's the Reverend Dr. Paisley to you!"
With my expert and detailed knowledge of all eras of history, I try and get in as many historical references into threads as possible. Is my way of helping those PBers like Morris Dancer who lack such detailed knowledge.
Yebbut was Suzanne ever UKIP leader for only 9 days?
Frequently, Mr Prasannan. Didn`t they tell you?
It's Dr. Prasannan, I didn't spend ten years in Evil Medical School Imperial College to be called "mister," thank you very much.
Only 'proper' doctors get to become "Mister" again
And then when they're really proper they get to become Professor! My consultant ophthalmologist being a case in point.
(BTW My left eye is now the Moorfields reference / teaching eye for myopic macular degeneration. How cool is that!)
I think that to have the state as insurer of last resort is essential. There simply are a lot of people and conditions that are not insurable. It doesn't have to be a single system though, and I would personally be happy with a German style system where different companies have different levels of cover above the minimum threshold. A sort of "Speedy Boarding" supplement for example.
There are significant difficulties with consumerism in healthcare though, in particular what people want is often not what they need. Over-investigation and unnessecary interventions (often with significant iatrogenic morbidity) are near universal in such health care systems.
Thanks for that, Doc, I am jolly pleased you were able to turn up and join in the discussion.
My thinking at the moment is that the state should not be the insurer of last resort, but the insurer of first, last and only resort. Otherwise the state gets all the old crocks, like me, and the expense that goes with them whilst the insurance companies get the premiums paid for by the wealthy well. I am not sure that helps anyone but the insurance companies, which as Mr. Charles's example shows are quite able just to withdraw cover when it suits them and in effect say "sue me" to the patient.
I take your point about consumerism in the health service (congratulations by the way for being the first PB correspondent for a good while to make me have to go and look up a word, "iatrogenic"). I am not sure this is too much of a problem at the moment, either in the private or public health systems, though it seems to be in the USA with its very litigious culture. I should have thought that this could be quite easily sorted out by the medical profession itself plus some small bits of legislation.
The key points of the NHS is that healthcare should be needs based and free at the point of use. How to continue to achieve that with an aging population and a population where the number of non-net contributors is also growing (as is the population at large) is something we as a nation need to look at, urgently.
The actual letter is a masterpiece of illiteracy. It is addressed quite simply to "Kent police" (rather than to say the Chief Constable at such and such an address), it can't spell "centre" or "Surrey", gets apostrophes wrong twice and is headed, bafflingly, "Without Prejudice". It's a worrying thought experiment to consider what a force UKIP might be if its nastiness were not tempered by incompetence and amateurism.
How can they write "Without Prejudice" on a complaint to the Police?
Do they mean they've done something wrong as well, and don't want it to prejudice that?
Private insurance is a non-starter as the bulk of a patient's costs are in the last 18 months or so of life.
With you on the German system. We cannot fix the NHS as it currently stands. It has to satisfy infinite demand with a finite budget.
I had heard similar figures (50% in the last 6 months) so I did a little digging. An interesting article from NIH analyzing claims data for 3.75 million insurees. Only 12% is spent on over 85s, largely because the cohort is so much smaller, many having died before then.
On the other hand, 5% of those who are in critical care, which presumably includes many older people in the last days of their lives, and many younger trauma patients who do not survive, accounts for 50% of medical spending. [These figures are from the prestigious Agency for Healthcare Research and Quality and show that most recipients in this 5% are neonates with complications and the elderly)
Another study, looking just at Medicare funding (provided for patients over 65, with end stage renal disease or on social security disability payments), shows that 30% is spent is spent on the 5% who die that year, and that one third of that expenditure is on the last month of life. Further, the study shows that those patients who received less medical care in that period ended up with better death experiences ...
The actual letter is a masterpiece of illiteracy. It is addressed quite simply to "Kent police" (rather than to say the Chief Constable at such and such an address), it can't spell "centre" or "Surrey", gets apostrophes wrong twice and is headed, bafflingly, "Without Prejudice". It's a worrying thought experiment to consider what a force UKIP might be if its nastiness were not tempered by incompetence and amateurism.
How can they write "Without Prejudice" on a complaint to the Police?
Do they mean they've done something wrong as well, and don't want it to prejudice that?
Nuts.
They think it gives a nice classy legal feel to the letter, without the expense of actually paying for advice.
As a non-lawyer, non-Kipper, could someone explain the 'Without Prejudice' business?
It's a communication that contains an admission, with a view to seeking a settlement.
"eg I am prepared to concede your claim for breach of contract, in return for your abandoning your claim for breach of trust, and I therefore offer you £...... in full and final settlement of all claims you may have against me."
If that offer is rejected then the recipient of the letter (subject to certain exceptions) can not use it at a hearing.
''Private insurance is a non-starter as the bulk of a patient's costs are in the last 18 months or so of life. ''
Indeed. Some things that are currently done by the NHS could be hived off to the private sector though, surely, and financed via an insurance system, with the government the insurer of last resort for those who cannot pay premiums.
That may be true but what would be the point? It would (arguably) make medicine a bit more like dentistry, where we are more used to base NHS + private for fancy work, but the whole debate seems a bit aimless. Are we trying to reduce costs, improve outcomes, increase patient choice or what? And by what mechanism do any of the proposed reforms address these?
Private insurance is a non-starter as the bulk of a patient's costs are in the last 18 months or so of life.
With you on the German system. We cannot fix the NHS as it currently stands. It has to satisfy infinite demand with a finite budget.
I had heard similar figures (50% in the last 6 months) so I did a little digging. An interesting article from NIH analyzing claims data for 3.75 million insurees. Only 12% is spent on over 85s, largely because the cohort is so much smaller, many having died before then.
On the other hand, 5% of those who are in critical care, which presumably includes many older people in the last days of their lives, and many younger trauma patients who do not survive, accounts for 50% of medical spending. [These figures are from the prestigious Agency for Healthcare Research and Quality and show that most recipients in this 5% are neonates with complications and the elderly)
Another study, looking just at Medicare funding (provided for patients over 65, with end stage renal disease or on social security disability payments), shows that 30% is spent is spent on the 5% who die that year, and that one third of that expenditure is on the last month of life. Further, the study shows that those patients who received less medical care in that period ended up with better death experiences ...
Mr Charles, made a point about how a private health insurer suddenly and unilaterally withdrew cover, once it was clear to them that they would have to pay out. The good FoxinSox, medicus of this parish, has mentioned several times that insurance companies will not cover existing conditions and can get very snotty about chronic conditions.
It seems to me that private companies would have to be very heavily regulated if they are ever going to be used to assist in the funding of the NHS, so much so that they would either refuse the business or charge extraordinary premiums. Yet the idea of PMI is constantly pushed as the solution the problem that the NHS, as it stands, is unaffordable and unsustainable.
The other related problem to that solution is that the big users of the NHS are those of us richer in years, often with chronic conditions, who the insurers will not touch with a bargepole.
In all honesty I can't see a better way out of this mess than to make the state the insurer but not the provider. Set the hospitals loose, the patient can choose which one they want, they can choose which quack, surgeon, consultant they want but the insurer picks up the bills (which because the hospitals and quacks are all competing for custom ought to come down).
I think that to have the state as insurer of last resort is essential. There simply are a lot of people and conditions that are not insurable. It doesn't have to be a single system though, and I would personally be happy with a German style system where different companies have different levels of cover above the minimum threshold. A sort of "Speedy Boarding" supplement for example.
There are significant difficulties with consumerism in healthcare though, in particular what people want is often not what they need. Over-investigation and unnessecary interventions (often with significant iatrogenic morbidity) are near universal in such health care systems.
I'd go for a mixed system.
Create a "standard" plan with a limited number of providers (say 5-8). Government to set the terms (e.g. exclusions) and pay the premiums. Everyone is covered automatically at this basic level. Consumers are then free to choose their providers who should be forced to compete on quality of service, network, etc.
Insurers can then try to upsell customers for premium services (e.g. branded vs generic Rd, free choice of hospitals, latest cancer drug that doesn't pass the NICE tests, etc). But all these extras are paid for privately.
Snap. See my post at 09:57, although you have described it far more clearly.
The actual letter is a masterpiece of illiteracy. It is addressed quite simply to "Kent police" (rather than to say the Chief Constable at such and such an address), it can't spell "centre" or "Surrey", gets apostrophes wrong twice and is headed, bafflingly, "Without Prejudice". It's a worrying thought experiment to consider what a force UKIP might be if its nastiness were not tempered by incompetence and amateurism.
How can they write "Without Prejudice" on a complaint to the Police?
Do they mean they've done something wrong as well, and don't want it to prejudice that?
Nuts.
They think it gives a nice classy legal feel to the letter, without the expense of actually paying for advice.
It's frequently used by litigants in person and McKenzie friends, who have no idea what they're doing.
It's Dr. Prasannan, I didn't spend ten years in Evil Medical School Imperial College to be called "mister," thank you very much.
I have noticed, my dear fellow, as I have wandered around the world, that the only people who insist on having their doctorates mentioned in normal conversation, are those who were awarded them by third rate institutions, or in third rate countries, probably as a result of corruption.
Since I am sure this does not apply to yourself, it might be better to lay off the insistence on your title.
Imperial College is hardly a third rate country, and the UK is hardly a third rate institution!
It's Dr. Prasannan, I didn't spend ten years in Evil Medical School Imperial College to be called "mister," thank you very much.
I have noticed, my dear fellow, as I have wandered around the world, that the only people who insist on having their doctorates mentioned in normal conversation, are those who were awarded them by third rate institutions, or in third rate countries, probably as a result of corruption.
Since I am sure this does not apply to yourself, it might be better to lay off the insistence on your title.
I enjoyed one Dave Allen sketch in which he played Ian Paisley conversing with God, saying "It's the Reverend Dr. Paisley to you!"
"Is it The Honourable Sergeant Wilson, or Sergeant The Honourable Wilson?"
With my expert and detailed knowledge of all eras of history, I try and get in as many historical references into threads as possible. Is my way of helping those PBers like Morris Dancer who lack such detailed knowledge.
Yebbut was Suzanne ever UKIP leader for only 9 days?
Frequently, Mr Prasannan. Didn`t they tell you?
It's Dr. Prasannan, I didn't spend ten years in Evil Medical School Imperial College to be called "mister," thank you very much.
Only 'proper' doctors get to become "Mister" again
And then when they're really proper they get to become Professor! My consultant ophthalmologist being a case in point.
(BTW My left eye is now the Moorfields reference / teaching eye for myopic macular degeneration. How cool is that!)
Congratulations to your eye. Moorfields could do with some better bus stops imo.
It's Dr. Prasannan, I didn't spend ten years in Evil Medical School Imperial College to be called "mister," thank you very much.
I have noticed, my dear fellow, as I have wandered around the world, that the only people who insist on having their doctorates mentioned in normal conversation, are those who were awarded them by third rate institutions, or in third rate countries, probably as a result of corruption.
Since I am sure this does not apply to yourself, it might be better to lay off the insistence on your title.
I enjoyed one Dave Allen sketch in which he played Ian Paisley conversing with God, saying "It's the Reverend Dr. Paisley to you!"
"Is it The Honourable Sergeant Wilson, or Sergeant The Honourable Wilson?"
Thanks for that, Doc, I am jolly pleased you were able to turn up and join in the discussion.
My thinking at the moment is that the state should not be the insurer of last resort, but the insurer of first, last and only resort. Otherwise the state gets all the old crocks, like me, and the expense that goes with them whilst the insurance companies get the premiums paid for by the wealthy well. I am not sure that helps anyone but the insurance companies, which as Mr. Charles's example shows are quite able just to withdraw cover when it suits them and in effect say "sue me" to the patient.
I take your point about consumerism in the health service (congratulations by the way for being the first PB correspondent for a good while to make me have to go and look up a word, "iatrogenic"). I am not sure this is too much of a problem at the moment, either in the private or public health systems, though it seems to be in the USA with its very litigious culture. I should have thought that this could be quite easily sorted out by the medical profession itself plus some small bits of legislation.
The key points of the NHS is that healthcare should be needs based and free at the point of use. How to continue to achieve that with an aging population and a population where the number of non-net contributors is also growing (as is the population at large) is something we as a nation need to look at, urgently.
This was the logic behind the personal mandate in Obamacare - that the carrot for insurers for being forced to take the old crocks was that the healthy young would be forced to buy insurance too.
The reason I was so opposed to that is that it represents a transfer of wealth from the young, generally poorer, to the old, generally richer, i.e. it is the worst sort of regressive taxation. If you have to resort to taxation for universal health (and I am convinced you do), then add it to general taxation and make sure it is, at the very least, not regressive.
Make the system less unwieldy? As has been said the NHS is outstanding where it is grappling with the stuff that makes the insurance companies run for the hills. The stuff they don;t want to pay for. Would, say, taking routine stuff off them help the NHS and the patient too?
''Private insurance is a non-starter as the bulk of a patient's costs are in the last 18 months or so of life. ''
Indeed. Some things that are currently done by the NHS could be hived off to the private sector though, surely, and financed via an insurance system, with the government the insurer of last resort for those who cannot pay premiums.
It's Dr. Prasannan, I didn't spend ten years in Evil Medical School Imperial College to be called "mister," thank you very much.
I have noticed, my dear fellow, as I have wandered around the world, that the only people who insist on having their doctorates mentioned in normal conversation, are those who were awarded them by third rate institutions, or in third rate countries, probably as a result of corruption.
Since I am sure this does not apply to yourself, it might be better to lay off the insistence on your title.
I enjoyed one Dave Allen sketch in which he played Ian Paisley conversing with God, saying "It's the Reverend Dr. Paisley to you!"
"Is it The Honourable Sergeant Wilson, or Sergeant The Honourable Wilson?"
The former.
It'd be neither, I think, as 'The Hon' needs to go with a forename but even then wouldn't it be the latter?
Sergeant The Hon Arthur Wilson. Likewise, Field Marshal The Duke of Wellington.
I thought one of the key issues with Obamacare was that IT IS A TAX. When it was challenged the Supreme Court agreed that it was not legal to force anyone to buy an insurance - so they deemed it legally to be a tax. I guess all the healthy younguns who don't buy theirs are strictly speaking evading tax. Never matter. What it does mean is that an incoming hostile president (Trump?) can kill Obamacare overnight by resetting the 'tax rate' on it to zero. The legislation would still stand. Obamacare as a real thing would be gone. A stunningly stupid and badly drafted piece of legislation.
It's Dr. Prasannan, I didn't spend ten years in Evil Medical School Imperial College to be called "mister," thank you very much.
I have noticed, my dear fellow, as I have wandered around the world, that the only people who insist on having their doctorates mentioned in normal conversation, are those who were awarded them by third rate institutions, or in third rate countries, probably as a result of corruption.
Since I am sure this does not apply to yourself, it might be better to lay off the insistence on your title.
I enjoyed one Dave Allen sketch in which he played Ian Paisley conversing with God, saying "It's the Reverend Dr. Paisley to you!"
"Is it The Honourable Sergeant Wilson, or Sergeant The Honourable Wilson?"
The former.
The latter, unless things have changed. The D of W started as Ensign The Hon Arthur Wesley, and ended up Field Marshal His Grace The Duke of Wellington KG GCB GCH FRS.
"His Excellency, President for Life, Field Marshal Al Hadji Doctor Idi Amin Dada, VC, DSO, MC, Lord of All the Beasts of the Earth and Fishes of the Seas and Conqueror of the British Empire in Africa in General and Uganda in Particular"
I note out of interest that he was Duke, Marquess and Earl of Wellington and Viscount Wellington, but not Baron Wellington. Not a lot of people know that.
Kate McCain More bad news for Labour. G4S declines awkward last ditch plea to provide conference security, despite boycott: https://t.co/MDzSnKH4IV
"G4S, which has policed the event for 20 years, is understood to be concerned about staff safety after Labour voted for a boycott over its prison contracts and links to Israel.
It follows a warning from union boss Len McCluskey that the conference could be cancelled unless a provider is found urgently.
Sources close to the company warned that short notice and previous incidents at the event, including staff being spat at and verbally abused, made it impossible for G4S to accept the offer.'
I thought one of the key issues with Obamacare was that IT IS A TAX. When it was challenged the Supreme Court agreed that it was not legal to force anyone to buy an insurance - so they deemed it legally to be a tax. I guess all the healthy younguns who don't buy theirs are strictly speaking evading tax. Never matter. What it does mean is that an incoming hostile president (Trump?) can kill Obamacare overnight by resetting the 'tax rate' on it to zero. The legislation would still stand. Obamacare as a real thing would be gone. A stunningly stupid and badly drafted piece of legislation.
It was sold as NOT A TAX, but then Roberts, in his opinion to let it stand, argued that it was a tax.
Mr Charles, made a point about how a private health insurer suddenly and unilaterally withdrew cover, once it was clear to them that they would have to pay out. The good FoxinSox, medicus of this parish, has mentioned several times that insurance companies will not cover existing conditions and can get very snotty about chronic conditions.
It seems to me that private companies would have to be very heavily regulated if they are ever going to be used to assist in the funding of the NHS, so much so that they would either refuse the business or charge extraordinary premiums. Yet the idea of PMI is constantly pushed as the solution the problem that the NHS, as it stands, is unaffordable and unsustainable.
The other related problem to that solution is that the big users of the NHS are those of us richer in years, often with chronic conditions, who the insurers will not touch with a bargepole.
In all honesty I can't see a better way out of this mess than to make the state the insurer but not the provider. Set the hospitals loose, the patient can choose which one they want, they can choose which quack, surgeon, consultant they want but the insurer picks up the bills (which because the hospitals and quacks are all competing for custom ought to come down).
I think that to have the state as insurer of last resort is essential. There simply are a lot of people and conditions that are not insurable. It doesn't have to be a single system though, and I would personally be happy with a German style system where different companies have different levels of cover above the minimum threshold. A sort of "Speedy Boarding" supplement for example.
There are significant difficulties with consumerism in healthcare though, in particular what people want is often not what they need. Over-investigation and unnessecary interventions (often with significant iatrogenic morbidity) are near universal in such health care systems.
Private insurance is a non-starter as the bulk of a patient's costs are in the last 18 months or so of life.
With you on the German system. We cannot fix the NHS as it currently stands. It has to satisfy infinite demand with a finite budget.
I think the NHS is fine*, probably needs a couple more % of gdp thrown at it and also the Jr Docs to stop whinging.
Some fringe issues like not going for those shit pfi contracts, and stopping it becoming the IHS (A la @MaxPB) are there but all in all it does a not bad job.
Agreed. It's similar to the Canadian system and I think theirs costs more, partly because doctors bill the government for every consultation, or so I was told when I was last there. Better to pay doctors just to have a patient on their list?
I agree the ban is daft [although I can see the reasoning behind a niqab/burkha ban].
I think it's prefectly reasonable that in some places and performing some functions, the face should be visable.
I don't see anything 'wrong' with headscarfs, but when i was on holiday in cyprus last month there was a muslim couple there and the guy was in shorts and t-shirt and the woman was covered at all times. Clearly the guy had no issues with seeing all other women in swimsuits and binikis. I just thought that was rather sad.
Funnily enough it's never the other way around, you never get guys covering up.....
Comments
LabourFarage!Is my way of helping those PBers like Morris Dancer who lack such detailed knowledge.
Had he been up against a Europhile Tory and slightly less polarising he could have won on the day - just.
What I find interesting about South Thanet is how well the Labour vote held up given it was a two-horse race.
https://twitter.com/roseyboy17/status/768720973814202368
I'll start to put money into the next GE market on Tories most seats next year, probably as soon as article 50 strategy becomes clear.
I view it as a 3 year savings plan.
Its's only 4 months isn't it? People have been betting on the next President/Next Lab Leader etc for much longer than that. But betting on markets that only offer one of the possibilities doesn't seem wise
I would be interested what people think the correct prices for Clacton at the next GE are?
If the bet was he would resign the UKIP whip in this parliament, I'd be interested.
PB after the referendum: Farage, Banks and Leave.EU were not important in the referendum.
A market on whether Carswell will be an MP after the next GE would be interesting
Mr Charles, made a point about how a private health insurer suddenly and unilaterally withdrew cover, once it was clear to them that they would have to pay out. The good FoxinSox, medicus of this parish, has mentioned several times that insurance companies will not cover existing conditions and can get very snotty about chronic conditions.
It seems to me that private companies would have to be very heavily regulated if they are ever going to be used to assist in the funding of the NHS, so much so that they would either refuse the business or charge extraordinary premiums. Yet the idea of PMI is constantly pushed as the solution the problem that the NHS, as it stands, is unaffordable and unsustainable.
The other related problem to that solution is that the big users of the NHS are those of us richer in years, often with chronic conditions, who the insurers will not touch with a bargepole.
In all honesty I can't see a better way out of this mess than to make the state the insurer but not the provider. Set the hospitals loose, the patient can choose which one they want, they can choose which quack, surgeon, consultant they want but the insurer picks up the bills (which because the hospitals and quacks are all competing for custom ought to come down).
Farage: Massive personal influence on the Brexit outcome, if occasionally crass
Banks: Who?
Leave.EU:who?
Maybe Leave would have won by more if he had been!
"Sorry, Nige, I think you are correct but I can't risk it", was I think the sentiment that saved several Conservative seats.
The dirty little secret of the NHS is that it is cheap. There's a lot wrong with it but nothing that messing around with insurance schemes will fix or even address.
As I've said repeatedly, both sides were terrible. I didn't really differentiate between Vote Leave and Leave.EU. Their messages on the EU contribution and Turkey were shit.
There are significant difficulties with consumerism in healthcare though, in particular what people want is often not what they need. Over-investigation and unnessecary interventions (often with significant iatrogenic morbidity) are near universal in such health care systems.
Evil Medical SchoolImperial College to be called "mister," thank you very much.Kenyan athletes are stranded in a Rio shanty town where gunshots can be heard, following the closure of the Olympic village, the team captain says. Officials delayed their return home as they looked for a "cheap flight", said Wesley Korir, a marathon runner who is also an independent MP.
He posted images on Twitter of dilapidated buildings in the area where he said they were forced to stay. Team Kenya has been dogged by allegations of mismanagement at Rio.
http://www.bbc.co.uk/news/world-africa-37183703
I have become a firm believer in a government-funded but privately operated basic healthcare system supplemented with additional health insurance for those who want treatment in hotel quality hospitals, or the ability to select their physician of choice. With that approach, much of the transaction costs that ensue from operating through insurance companies (which are huge - my wife is going through chemo a the moment and I am dealing with around 3-4 correspondences per week just with insurers and billing offices) can be eliminated, as can a lot of the excess procedures (lab tests, MRIs etc) that pay-per-procedure (rather than pay-per-patient or per-result) encourages.
There was a lot of talk back around May when police had to apply for time extensions as one year after GE.
Since then - total silence - and quite a while has gone by - nearly another four months.
With you on the German system. We cannot fix the NHS as it currently stands. It has to satisfy infinite demand with a finite budget.
Some fringe issues like not going for those shit pfi contracts, and stopping it becoming the IHS (A la @MaxPB) are there but all in all it does a not bad job.
japanese company screening for stomach cancer (?probably)
i know it's unecessary, but it is somehow hard to refuse...
having said that, blood tests in the same health check convinced me to signif. reduce my alchohol intake...
Create a "standard" plan with a limited number of providers (say 5-8). Government to set the terms (e.g. exclusions) and pay the premiums. Everyone is covered automatically at this basic level. Consumers are then free to choose their providers who should be forced to compete on quality of service, network, etc.
Insurers can then try to upsell customers for premium services (e.g. branded vs generic Rd, free choice of hospitals, latest cancer drug that doesn't pass the NICE tests, etc). But all these extras are paid for privately.
Implicit in your last statement is a recognition that there needs to be rationing on either a financial or clinical basis. In practice this is much like taxes or cuts, fine for other people but not for oneself!
Clinton 42 .. Trump 38
http://www.rasmussenreports.com/public_content/politics/elections/election_2016/white_house_watch
National - PRRI
Clinton 48 .. Trump 35
http://www.prri.org/research/lgbt-2016-presidential-election/
a) Go to a hospital
b) Get treated.
Nothing more, nothing less
Indeed. Some things that are currently done by the NHS could be hived off to the private sector though, surely, and financed via an insurance system, with the government the insurer of last resort for those who cannot pay premiums.
I'm still working through my guilt complex over my vote. Not helped by those on my timeline calling for an immediate repeal of the '72 act and off we go.
Since I am sure this does not apply to yourself, it might be better to lay off the insistence on your title.
F1: confirmed that Hamilton has penalties, which has altered the odds (surprised, given it was strongly trailed). He's now 4.5 to win, the Red Bull's 8 apiece (had been 3 and 9 respectively this morning).
My life would be much more simpler if 'Without prejudice' was used less on letters, and I could use 'With extreme prejudice' on my letters.
Non attendees for instance or non-eligible patients (ie non UK residents). I'd look at NHS entitlement cards, co-pays for treatment (at a low level say 10% and capped at a few hundred per year so people with chronic issues are protected).
How much of an issue is patients not attending appointments these days?
(BTW My left eye is now the Moorfields reference / teaching eye for myopic macular degeneration. How cool is that!)
My thinking at the moment is that the state should not be the insurer of last resort, but the insurer of first, last and only resort. Otherwise the state gets all the old crocks, like me, and the expense that goes with them whilst the insurance companies get the premiums paid for by the wealthy well. I am not sure that helps anyone but the insurance companies, which as Mr. Charles's example shows are quite able just to withdraw cover when it suits them and in effect say "sue me" to the patient.
I take your point about consumerism in the health service (congratulations by the way for being the first PB correspondent for a good while to make me have to go and look up a word, "iatrogenic"). I am not sure this is too much of a problem at the moment, either in the private or public health systems, though it seems to be in the USA with its very litigious culture. I should have thought that this could be quite easily sorted out by the medical profession itself plus some small bits of legislation.
The key points of the NHS is that healthcare should be needs based and free at the point of use. How to continue to achieve that with an aging population and a population where the number of non-net contributors is also growing (as is the population at large) is something we as a nation need to look at, urgently.
http://www.landlordlawblog.co.uk/2010/08/14/without-prejudice-what-does-it-mean/?doing_wp_cron=1472134057.7178950309753417968750 explains it well.
How can they write "Without Prejudice" on a complaint to the Police?
Do they mean they've done something wrong as well, and don't want it to prejudice that?
Nuts.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361028/
On the other hand, 5% of those who are in critical care, which presumably includes many older people in the last days of their lives, and many younger trauma patients who do not survive, accounts for 50% of medical spending. [These figures are from the prestigious Agency for Healthcare Research and Quality and show that most recipients in this 5% are neonates with complications and the elderly)
Another study, looking just at Medicare funding (provided for patients over 65, with end stage renal disease or on social security disability payments), shows that 30% is spent is spent on the 5% who die that year, and that one third of that expenditure is on the last month of life. Further, the study shows that those patients who received less medical care in that period ended up with better death experiences ...
http://www.forbes.com/sites/michaelbell/2013/01/10/why-5-of-patients-create-50-of-health-care-costs/#f2814d747818
Chicago university tells generation snowflake to bugger off. Hopefully the Ivy League and California colleges follow suit.
"eg I am prepared to concede your claim for breach of contract, in return for your abandoning your claim for breach of trust, and I therefore offer you £...... in full and final settlement of all claims you may have against me."
If that offer is rejected then the recipient of the letter (subject to certain exceptions) can not use it at a hearing.
https://twitter.com/OwenJones84/status/768788811522445313
That's a bit illiterate from a journalist. Oh hang on - it's not. It's from Owen jones.
And, yes, all politics is about how to allocate scarce resources, hence rationing.
http://us6.campaign-archive2.com/?u=bd29b371da295fe16a66f16f6&id=2fbc6f21a4&e=26f49e83ef
The reason I was so opposed to that is that it represents a transfer of wealth from the young, generally poorer, to the old, generally richer, i.e. it is the worst sort of regressive taxation. If you have to resort to taxation for universal health (and I am convinced you do), then add it to general taxation and make sure it is, at the very least, not regressive.
Make the system less unwieldy? As has been said the NHS is outstanding where it is grappling with the stuff that makes the insurance companies run for the hills. The stuff they don;t want to pay for. Would, say, taking routine stuff off them help the NHS and the patient too?
This is a mighty fine article by Nate Silver.
Department of Commerce and Insurance Commissioner Julie Mix McPeak made that assessment in comments to The Tennessean Tuesday
http://www.bizjournals.com/memphis/news/2016/08/25/tennessee-s-obamacare-exchange-very-near-collapse.html?ana=RSS&s=article_search&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:+bizj_memphis+(Memphis+Business+Journal)
Sergeant The Hon Arthur Wilson. Likewise, Field Marshal The Duke of Wellington.
I thought one of the key issues with Obamacare was that IT IS A TAX. When it was challenged the Supreme Court agreed that it was not legal to force anyone to buy an insurance - so they deemed it legally to be a tax. I guess all the healthy younguns who don't buy theirs are strictly speaking evading tax. Never matter. What it does mean is that an incoming hostile president (Trump?) can kill Obamacare overnight by resetting the 'tax rate' on it to zero. The legislation would still stand. Obamacare as a real thing would be gone. A stunningly stupid and badly drafted piece of legislation.
Edited extra bit: added 'Cecil'.
urgh, digusting piece in the guardian.
I'm anti the ban on any piece of clothing but claiming 'All hail the burkini’s blend of Islamic values and western lifestyle'....
f*** off. It's a symbol of male oppession and nothing to be celebrated.
"His Excellency, President for Life, Field Marshal Al Hadji Doctor Idi Amin Dada, VC, DSO, MC, Lord of All the Beasts of the Earth and Fishes of the Seas and Conqueror of the British Empire in Africa in General and Uganda in Particular"
He was also the uncrowned King of Scotland
I note out of interest that he was Duke, Marquess and Earl of Wellington and Viscount Wellington, but not Baron Wellington. Not a lot of people know that.
More bad news for Labour. G4S declines awkward last ditch plea to provide conference security, despite boycott: https://t.co/MDzSnKH4IV
"G4S, which has policed the event for 20 years, is understood to be concerned about staff safety after Labour voted for a boycott over its prison contracts and links to Israel.
It follows a warning from union boss Len McCluskey that the conference could be cancelled unless a provider is found urgently.
Sources close to the company warned that short notice and previous incidents at the event, including staff being spat at and verbally abused, made it impossible for G4S to accept the offer.'
Mr. Slackbladder, one or two are more outraged by the burkhini ban than the priest's decapitation, or the media cover-up of subsequent attacks.
I agree the ban is daft [although I can see the reasoning behind a niqab/burkha ban].
You'd have to have a heart of stone etc etc
Directly Elected Dictator of the United Kingdom of Great Britain & Northern Ireland and Viceroy of France
I don't see anything 'wrong' with headscarfs, but when i was on holiday in cyprus last month there was a muslim couple there and the guy was in shorts and t-shirt and the woman was covered at all times. Clearly the guy had no issues with seeing all other women in swimsuits and binikis. I just thought that was rather sad.
Funnily enough it's never the other way around, you never get guys covering up.....