One could introduce a fee of say 20 pound pr. visit. Something that is low enough that anyone in UK could pay it but also high enough to remind people that what they are consuming is finite resource.
That breaks when people can pay in real money. Since the system is supply constrained all that does is reserve scarce medical resources for those with money rather than those with the most need. It allows rich people to jump the queue - just like the 'VIP' lane at a theme park.
Queue jumping in the UK was always frowned upon. The ultimate social faux-pas. That seems to be weakening in recent years and the 'time as money' system is weakening with it.
Can you elaborate here?
The problem is with such things that they're regressive taxes. Rich people can still afford to go to the doctors when they have a sniffle but poor people will re-consider even when they have a life-threatening illness because £20 is a months food bills for the poor person.
Tolls on a congested bridge are "regressive" but are practical and make sense. We shouldn't structure society around what makes things less convenient for the rich, there just isn't very many of them by definition. We should structure society around what improves the lives of most people, within the current realities that exists. This is the classic sin of envy where we'd actually rather be worse off if the person we envied was also worse off.
Now maybe there are other reasons to avoid co-pays, such as higher death rates in areas with co-pays. I'd be interested to see a study that demonstrated the tradeoffs of co-pays.
What's a copayment?
There's no evidence it would work. There's some evidence it wouldn't work.
Don't forget this study was done in in-patient settings: those patients were actually ill and needed treatment.
A prescription charge doesn't work in quite the same way because if you are getting a prescription then you already know you need it, unlike going to the doctor.
This would necessarily have to function identically.
If there aren't enough nurses for the sick people, we need more nurses. We can't control the number of sick people by excluding the poor.
The whole system amazes me all the time. We have the people who need to think very clearly and be very awake do 18, 24 and more shifts. That doesn't sound like they'd be at peak performance at all times.
They're not.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200708/
> Health care workers need to begin to think of coming to work impaired by chronic sleep deprivation as similar to coming to work impaired by alcohol. Studies reveal that as ethanol and sleep loss increase, psychomotor performance decreases and memory is impaired. A 2-hour sleep loss is equivalent to a 0.045% breath-alcohol concentration, and a 4-hour sleep loss is equivalent to a 0.095% breath-alcohol concentration — above Texas' legal limit of 0.08%.
> In the traditional-schedule group, interns were on call every third night, working 24 hours or more. In the intervention group, interns worked no extended shifts (>17 hours) and averaged 65 work hours each week. Besides having about 6 hours less sleep each week and twice the number of attentional failures (EEG evidence of severe drowsiness), the traditional-schedule group made 36% more serious medical errors than the intervention group.
Nurses start at band 5 of the agenda for change pay scale, or band 6 if they're specialist, so it's not much but even this is unattainable for most NHS trusts. https://www.nhsemployers.org/pay-pensions-and-reward/agenda-...
When we ask nurses which shift pattern (8 hours, 12 hours, or 14 hours) is safest they tend to say 8 hours. But when we ask them which provides best work-life balance they tend to say 14 hours. This is apparently a really difficult problem for the workforce to tackle.