How Palantir Will Steal the NHS
pluralistic.net
pluralistic.net
That wasn't even the main plot line, just something that was casually brought up and unchallenged by anyone.
UK doesn't need that kind of crap. No one does.
Unfortunately this country is completely unwilling to have any kind of discussion about NHS reform.
Well, there is actually a shortage in specialists here but it is true that you can see a specialist in days at least if it is acute/urgent. (Usually your general practioner will give you a letter of referral and leave it to you to make an appointment but in urgent cases they might actually call a qualified colleague to make sure you get that appointment soon).
All was fine until it came to the topic of his health insurance card: see, on the Thursday he was taken to the hospital they kept his health insurance card. When he went to his actual doctor the morning after they wouldn’t even talk to him unless he had it and getting it back from the people who took him to the hospital was taking too long; so he started the long and drawn out process of getting a temporary bit of paper mailed to his address from his insurance company stating that he had insurance.
The NHS, for all its faults and the weight of its underfunding: would never have a problem like that.
It happened to me that I saw a doctor and had forgotten to bring my health insurance card. I was then required to show it within (I think) ten days or be charged the cost of the visit myself.
All it took to fix that later that day was to log into the website of my health insurer, download said document as pdf and mail it to the doctor's office.
It might not be as simple as you might like but it does not have to be as bad as their experience was.
Of course I’m not a primary source, so the actual interaction may have been different.
The staff of the doctor you usually go knows you and don‘t ask your statuary health insurance card upon each visit. They have it in your file.
Worst case you present a paper you download from your insurance provider‘s website.
As a last resort, you declare you are privately insured and you walk out. They send the invoice to home and you send it to your insurer or pay from your pocket. A simple GP visit does not cost more than 40-50 Euros.
People are helpful. Maybe the staff of their doctor was not that day.
Another thing that's really affecting the English NHS at the moment is Brexit - it's making it very difficult to recruit and retain staff, which has pushed up staff costs because of the spend on locum doctors and agency nursing staff.
But, really, the main problem is 12 years of a Conservative government that does not believe in tax-funded public services. Cameron and May were bad, but Johnson and Truss have been catastrophic for the NHS.
particularly revealing is this line
>resistance to its privatisation and the importation of America's grisly omnishambolic health care "system."
I think anyone who knows about the current state of the NHS is under no illusions that it's in any way fit for use. I think a lot of people wouldn't mid an American-style system if it gives them access to healthcare. (edit: i'm overstating slightly. My point is that the NHS is crying out for some services to be outsourced to private companies, even if they happen to be American)
Anecdata: nah. At least of my friends in the UK, they're fine with the waits if it means they don't have to pay our ludicrous health insurance premiums, deductibles, and other costs.
A case comes to mind where a friend flew back to London for an appointment 2 months in the future in order to avoid paying tens of thousands in costs in the US. Those who know both systems (from my experience at least) overwhelmingly pick the NHS.
The NHS when it works is wonderful, but at the moment it's in deep crisis. I have no doubt they waste tremendous amounts of money. If done properly privatisation and deregulation could just save it.
(Edit: granted the American system is awful, but it's very disingenuous of this article to pretend the NHS as it stands is much better.)
Do you have any examples?
> If done properly privatisation and deregulation could just save it.
How do you de-regulate healthcare without killing people?
We already have private providers of NHS healthcare, and they usually hand the contracts back because they can't afford to do it for the money. We could experiment by paying private providers more money, but if we're doing that why not just give the money to NHS providers?
But the real problem with waste (really, dysfunction) in a Soviet-style system is that it's systemic. There isn't necessarily one big thing you can point at and say "here's a big pile labelled pure waste", if it were that easy it'd be trivially fixed and nobody would care. The problem is waste at every level of the system because nobody is incentivized to get rid of it. It's things like doctors who are supposedly on-call in a hospital but who are actually "working" from home. It's things like GPs deciding en-masse that they'll not bother seeing patients anymore, because their NHS contracts pay them regardless of whether they actually let people into their surgeries or not.
You can't fix this sort of thing with the NHS structure, it's impossible, governments spent most of the 20th century trying and failing.
"How do you de-regulate healthcare without killing people?"
The NHS is not regulation of health care. Most countries have heavily regulated but private healthcare.
Perhaps you mean, how do you privatize healthcare. The answer is you just do it, and then fewer people will die. It's as simple as that. For all the shit Europeans give the USA about healthcare, a lot of it is denial. In the USA if you read an extreme story like this which ends with a 25 year old literally dying because the health system refused to serve him:
https://www.bbc.co.uk/news/health-63057872.amp
... the reason is because the guy deliberately chose not to buy health insurance. It was their decision to take the gamble. Even then, in the USA you can get emergency healthcare even when uninsured. But in the UK, this guy did nothing wrong. He paid his taxes and then when he needed the system it simply wasn't there for him. Not at the GP, not at the emergency room - nowhere. As far as this poor man goes, 100% of the tax he ever paid for the NHS was pure waste, because even as he was dying of cancer the NHS refused to see him in person, told him to take a lemsip and go to bed. Now he is dead.
The sad thing is, cases like that one are increasingly not a mere outlier. The NHS is gone, it's collapsed, it's failed entirely. It cannot provide even the most basic emergency health care reliably. How long will it be until other countries start recommending their citizens avoid the UK due to the inability to get emergency health care? It's probably going to take a shock like that for Brits to wake up to the catastrophic failure that the NHS model represents.
How would you propose managing programs to equalize quality of care across populations when conscious, unconscious, human, and automated biases exist?
This kind of easily debunkable nonsense (the NHS act came into effect in 1948) takes much away from the rest of your forceful and evidence free argument.
As for evidence free, well, how do you explain the BBC story that was presented as evidence? Or how about the 999 callout times, or the many other metrics that show the NHS has clearly broken to the point that even the most basic healthcare cannot be taken for granted? The evidence is everywhere.
The BBC story, taken at face value, shows a system that has failed the patient. Not for the last time too.
NHS needs to be compared not to some ideal setup that never fails and is cheap to run but an actual alternative.
Here the alternative seems to be US style, privitised, extract-max-value-for-the-shareholders system.
You need a great deal more than a BBC story to justify something like that
The problem here is real and the causes are clear from history - ignoring history because you don't like it is no solution. My own father now cannot get healthcare in the UK for an injury he has, point blank cannot get it. There are no appointments at the local hospital with no information on when new appointments can be booked, it takes weeks to even see a doctor at all - maybe over the phone if you're lucky. They're talking about going private but all my family members in the UK seem to thinking that at once and the UK private sector is woefully under-provisioned due to decades of near religious pro-NHS fervor and an inability to compete against tax-funded services.
The US in particular is demonized in the UK and it's dumb. Firstly, there are tons of private healthcare systems elsewhere in the world that aren't the US, it's the default mode, not an exception. Secondly, healthcare in the USA is actually excellent. If you have insurance then what's happening to my family just wouldn't occur. All the controversy in the US is around people who can't or won't buy insurance yet who don't qualify for Medicare/Medicaid, and the employer link that is a quirk of their tax code specifically. Phasing out the NHS wouldn't require the UK to bias the tax code in favor of employment-linked health insurance, and it wouldn't mean needing to exactly duplicate their benefits schemes. Those two things aren't fundamental to the private run healthcare model.
Here's a member of staff, a black man, who was attacked by a patient. He defended himself. The patient made a complaint, and the staff member was disciplined and dismissed.
He took the case to employment tribunal, claiming that the original attack was racist, and that the complaint was racist, and that the following investigation did not account for that racism and so was itself racist.
He won, because there was clear evidence that what he said was true. He got a 7 figure pay out.
https://www.theguardian.com/money/2018/nov/23/former-nhs-tru...
You've said that fewer people die under a privatised healthcare system - the US has worse outcomes, lower life expectancy, because of its private health care. You're simply wrong.
That guy could have got emergency health care - he could have walked into an MIU, or an ED, or he could have called 999.
> The sad thing is, cases like that one are increasingly not a mere outlier.
There's a million healthcare contacts per day. So far you've highlighted one where the patient got terrible care. It made national news because it's an outlier. Where are all the others?
> The NHS is not regulation of health care. Most countries have heavily regulated but private healthcare
You brought up de-regulation. Here's what you said:
> If done properly privatisation and deregulation could just save it.
There's no point continuing the discussion if you can't keep up with your own arguments.
The US has bad healthcare outcomes for a lot of reasons unrelated to their health care system, like obesity - a problem for the UK too. It's not due to basic, fixable stuff like "the hospital has no appointments" or "doctors aren't under any obligation to actually serve patients".
"That guy could have got emergency health care - he could have walked into an MIU, or an ED, or he could have called 999."
The 999 service that's also in collapse? He'd have been told to piss off and stop wasting NHS time because it wasn't an "emergency", as it'd already been mis-diagnosed as something trivial. He didn't realize how serious it was until it was already far too late. Why are you trying to defend this outcome? It's a terrible, atrocious end for a man who did nothing wrong, and no, this sort of thing is not an outlier. We can see it in the millions of mission cancer diagnoses.
Your last points seem to be continuing the previous confusion. You can abolish the NHS and still have healthcare regulations, although the act of abolishing the NHS is itself an act of de-regulation. It means you have fewer of them, not none.
If they can't even provide adequate service in London, I don't want to imagine how bad it must be outside of it.
The NHS isn't fit for purpose because it's been deliberately undermined by decades of right-wing government. Other nations such as Australia have walked a similar path
Europeans laught at english healthcare, but even the english laugh at the neo-feudalist sistem in US.
Every poll conducted in UK confirms this
The thing is that British people pretty much uniformally reject private healthcare, because they don’t think you should pay for something as basic as healthcare.
Instead the big popular drive is to make the NHS better (even though the current government is actively trying to make it worse).
Where do you think serious surgeries are performed?
"because they don’t think you should pay for something as basic as healthcare."
Everyone pays for the NHS. The idea you don't pay is obviously wrong, you just pay in different ways and at different times.
No, the relatively low proportion (compared to other countries) is not due to some moral superiority of the British, but because the government monopolizes healthcare and forces people to pay for their service via taxes. Given how expensive healthcare is very few people can afford to pay for it twice.
The NHS' supporters are always like this - trying to present support for it as a moral issue. It never was. The NHS isn't a moral issue, it's a bureaucracy for managing resource allocation. People warned for many years that such a system could never be reliable and would eventually collapse. They were ignored and now it's too late, the collapse has happened. Not because of the current government: Labour supported the policies that triggered the collapse even more strongly than the current government did. It's collapsed simply because it was inevitable.
Gee, I wonder what gave it away that this is an op-ed/blog and not, in-fact, a news organization? The page title showing that these are links from Cory Doctorow? The editorialized title?
> I think a lot of people wouldn't mid an American-style system if it gives them access to healthcare.
Perhaps you're oblivious to the myriad of ways in which Americans are denied/discouraged from access to health care under a profit-driven system, whether it be denied claims, or in my case, HMOs trying to direct you to doctors who are not seeing new patients.
Substitute UK or US for X and see what people would rather have.