UK: Excess deaths in 2022 among worst in 50 years
bbc.co.uk
bbc.co.uk
All of which I mean to say: No. Shit. Sherlock.
It's all so painfully obvious to anyone paying attention. The doctors and nurses and care homes and mental health workers have all been screaming about this for a decade. Cuts upon cuts upon redirected funding upon private providers upon universal credit cutting benefits upon cuts and failures and all that before covid, all before inflation lowering everyone's incomes.
We need to hire. We need to train. We need to retain. We need to build. We need to instill the fact that care home workers, pastoral carers for our elderly are such bloody important roles because without them helping people live outside hospital, nobody else gets seen. We need to pay them, we need to pay them to pick up shit and talked to dementia sufferers more than Jeff Bezos can pay them to pack boxes.
If we can't do that… It's over. But we need to have a serious conversation about what we actually want to do with the infirm in this country. Letting them freeze to death in their own homes feels like state-mandated euthanasia without the "eu". Huh, a wild Brexit joke appeared.
We need a General Election.
1. Find some convoluted way that it's actually the fault of people who need treatment or front line staff and hammer that in compliant media and have it regurgitated by the BBC and pundits till it becomes received wisdom
2. Some sort of window dressing policy/mandated clapping and declare mission success. Anyone who continues to criticise about the fundamental problems is shouted down as just being anti-tory/political activist. E.g the other days wheeze where we banned plastic cutlery therefore releasing tons of human waste into rivers on the regular doesn't matter anymore.
The bit I'm curious about is if that is done deliberately or if British people are just culturally favourable to flagrant gaslighting.
It's the same trap that a lot of countries fall into.
I have experience the 48 minutes ambulance wait second hand. A friend of mine was having heartache and called ambulance. He was told to wait for 45 minutes. His wife insisted to drive him straight to A&E instead. The moment he steps out of his car he crashed. That's was about 20 minutes after the emergency call. Had he waited longer he would be gone.
On another occasion, I had simultaneously received a letter from NHS, telling me to return for minor operation, and a phone call from doctor, telling me no further follow up needed. I can't reach the doctor through phone call so I go for the consultation anyway. Turns out the hospital did schedule an appointment for me, a different doctor did prepare to perform a biopsy on me, upon further clarification, the doctors did discharge me. I wonder how much is it due to the system being overwhelmed, how much is just normal error.
My point was that it's the government running the health service. Name and shame the person responsible.
"The NHS in Scotland is totally devolved to the Scottish Parliament and all policy and spending decisions are made in Scotland."
https://www.gov.uk/government/news/facts-about-nhs-funding-i...
Even if they could raise income tax (3p i think?) to fund extra in the nhs that’s a drastically unlikely scenario.
Ultimately i think the nhs is Scotland is likely to be as underfunded as the nhs in England.
IMO voters should be able to hold each other for their choices.
These taxes should show up as a health levy on people's paycheques like they do in British Columbia.
This body should be responsible for education, recruiting and staffing be it via universities or immigration.
The Conservative government are deliberately running it into the ground and only true independence in terms of funding and management would be enough to isolate it from further sabotage.
That's the idea. Not sure how the the board would be chosen mind, elections along the lines of PFCC? If ministers were involved it would probably devolve into the status-quo.
My local GP was near by so I went there first, described what was happening to the receptionist... they said 'Call 111' (NHS non-emergency triage, for non-Brits) and shoo'd me off; I loitered around and Googled symptoms and yea... 'possible heart attack, go to A&E NOW' was the general gist. Called 111 from within view of the receptionist in case I collapsed, 15 minutes later I'm still on hold - I figured all they'd do would put me through to 999 after spending 10 mins asking questions.
Got an Uber to A&E, and had an EKG within about 20 minutes of arriving. They said it's not a heart attack, probably isn't myocarditis or pericarditis, then the weird question 'do you suffer from anxiety or any mental health problems?'...
I'm 100% sure it wasn't psychosomatic or an anxiety attack. But that was the point where their concern ended and I was discharged with no follow up from GP or any idea of what had happened. Turns out, it was acute pancreatitis caused by a gall stone - I had to pay privately to find that out because repeated GP appointments they couldn't care less.
Either way, it's an absolute clusterfuck, and this same pattern of systemic dysfunction has been repeated with pretty much every interaction I've had with NHS funded services (both hospitals and GPs), and I'm fairly sure - like in a_c's friends case - if it had've been a heart attack it would've required me to drop dead in the GPs reception for them to do anything more than just pass the buck.
https://pubmed.ncbi.nlm.nih.gov/10170226/
The study is from 1997, and the NHS has definitely changed in the 25 years since, arguably becoming more privatised since the Health and Social Care Act 2012 (among other decisions).
Btw, NHS is not socialism.
> Despite the NHS’s clear need for more medics, the number of medical and dentistry students each year is capped by the government to control costs, as it subsidises the courses.
> The Secretary of State for Education, James Cleverly, commented recently that it's not possible to "flick a switch" to increase the numbers of doctors undergoing training, due to having to ensure there is enough funding and capacity for teaching and placements.
1. https://www.newstatesman.com/spotlight/healthcare/2022/08/am...
It’s an awful excuse; I agree with you. If we were to be quite "cold" about this and think of it in a purely beneficial sense to the economy, surely the economic benefits of a healthy population far outweigh the costs, although I imagine it’s quite hard to "quantify" such a measurement?
> BMA meeting: Doctors vote to limit number of medical students (Andrew Cole)
> Delegates at the annual BMA conference voted by a narrow majority to restrict the number of places at medical schools to avoid “overproduction of doctors with limited career opportunities.” They also agreed on a complete ban on opening new medical schools.
> David Sochart, from Manchester and Salford, warned that in the current job climate allowing too many new doctors into the market would risk devaluing the profession and make newly qualified doctors prey to “unscrupulous profiteers.” A glut of doctors would undermine competition and would therefore lower standards and ensure mediocrity, he claimed. He said, “Patients and health care should not be treated as mere commodities, and neither should medical students. We must not allow another lost tribe of doctors to be consigned to the wilderness.”
> Grant Ingrams, representing GPs, said that doctors should not be trained if there was no job at the end. He warned that this could spark another “brain drain,” adding: “It is wrong and immoral and a waste of taxpayers’ and students’ money.”
> But Paul Flynn from the consultants committee said that the root problem was a lack of effective workforce planning and warned members against a kneejerk response. “This is what blighted workforce planning. It would be hypocritical if we were to do it ourselves.”
> The BMA’s chairman, Hamish Meldrum, said he sympathised with the sentiments of the motion but asked members to vote on evidence rather than “gut reactions.” “We want to see an expansion of [the numbers of] GPs and consultants,” he said, “and for that we need more students.” But the motion was passed by a small majority (58% versus 42%).
> Members also agreed to a motion accepting that some specialties might need to raise the total number of years spent in training to accommodate the demands of the European Working Time Directive.
> Stephen Austin, from the consultants committee, said that the time needed to acquire the necessary competences was likely to increase—especially in procedure based specialties—and that the only sensible solution was to increase the total amount of time in training.
> Members also voted to press for an agreed minimum national level of funding for study leave to overcome the widespread national variation in the amounts that are currently available.
https://www.proquest.com/openview/b0c6c69bed2854a96acfd2889d...
From 2008, but I haven't been able to find any publicly-available discussion from within the medical profession that's more recent.
https://www.proquest.com/openview/b0c6c69bed2854a96acfd2889d...
Matters like this are normally discussed behind closed doors, and there is plenty of horse-trading, with favours being negotiated, and assurances, and understandings that are reached before major changes are "unilaterally" "announced" by the Government. There are different factions within the medical profession, and none of them want to lose out when there are changes. Priced into the government's announcement they they are going to train more doctors, therefore, are a range of promises and commitments to the medical profession to make sure that this will proceed without incident.
From what I can see elsewhere, the tone seems to have changed slightly since then?
> “We welcome the news that there will be extra funding for medical school places as this desperate need for more doctors in training is a recommendation that we made in our Medical Staffing in England report, which we issued last month.“
> “However, this increase in student places must not come at the expense of extra funding for the existing workforce or reductions in funding in future years, because tackling the waiting lists and backlog are going to require sustained investment over many years. And the government must make clear that there will be sufficient clinical placements for all those who succeed at medical school.
https://www.bma.org.uk/bma-media-centre/bma-says-increased-m...
A generous take on it seems that the BMA don’t want to make things worse for existing doctors.
I suppose if the government funded the NHS more, ensured that existing doctors wouldn’t be worse off, one would hope that the BMA would be fully supportive of training new doctors?
Part of the difference is probably that the 2021 article is a press release aimed at the public, rather than an internal discussion that lead to a vote. With enough money I imagine you could make everyone happy, and doctors' standard of living is at just as much risk of being inflated away as anyone else's, so it's no surprise that the professional body would support training more doctors subject to guaranteed funding including for medical educators and clinical placements (all of which will have a direct impact on their members' salaries, bonuses and allowances). How exactly that will work out, and how's it's going to play to the public, we'll have to wait and see.
Twitter summary from the journalist:
Article> [2022] represents one of the largest excess death levels outside the pandemic in 50 years.
Article> Though far below peak pandemic levels…
2022 is not even “the worst in 3 years” which would be a reasonable inference from their headline.
For example, turns out the lockdowns got one of my family members by making it difficult to get a diagnosis on what turned out to be a cancer. Hopefully the 6 months (approx) delay on getting it dealt with doesn't turn out to be important.
https://www.statista.com/statistics/525353/sweden-number-of-...
https://mobile.twitter.com/RiskeO/status/1614117492950966273
Not to mention supply chain shortages in medical and medical-adjacent fields, paramedics, etc. at a time where some people have overlooked long COVID symptoms
As well as an economic depression at a time where we're suffering a cultural PTSD from the previous few years.
Even if COVID isn't found directly responsible for these deaths, I suspect it is indirectly responsible.
What may be unpopular is the idea that you need a workplace that enforces on-site working for remote-possible work being a requirement to get your daily social interactions done. You're essentially saying you're looking for an employer that cares more about their middle management than their workers. Just be careful what you wish for.
If I were you, I'd join a club.
So I’m left either deciding if social interaction or personal time is more important. While previously when working in the office I got both.
The current job has just been sitting at home endlessly.
The main way is via your allocated General Practitioner (GP). To see a GP you need to telephone the GP's place of work, known as a surgery, and to have any chance of getting a same day appointment you need to call at 8am precisely. Don't call at 7.59 because you won't be connected, and don't leave it until 8.01 because it will be far too late. Call within the first few seconds after 8am and you'll be informed that you're in a queue, behind several dozen earlier callers.
After an hour of waiting you'll get through to a non-medical receptionist who will ask you about your symptoms, and make a judgement about whether or not you or your child is worthy of one of the few remaining appointments for that day. If you're a very pushy mother, or someone who really enjoys talking with GPs' receptionists (which most people don't) then you may have some success in this. If you're just a chilled out guy who doesn't like to fuss, you've got no chance.
You'll then be informed that to make an appointment for a later date you need to try again for a same-day appointment the next day by repeating the process above the following morning. It is not possible to arrange an appointment for any time further in the future no matter how long you are prepared to wait.
The only other means of accessing the NHS is by rocking up at the Accident and Emergency (A&E) department of your nearest large enough hospital. Unsurprisingly given the above, these are rather busy and you may be waiting for a day or so before you get seen. To avoid adding to this delay you should make you own way to A&E because ambulances routinely take several hours to reach you for the most urgent cases (heart attacks, stokes etc) or up to a few days for, say, a fallen elderly person, and on reaching the hospital you wont be able to leave the ambulance and enter the A&E department for up to another day.
However, once you're in the system and being seen by a specialist then by all accounts you do get fairly well looked after, so putting in the hours at A&E or regularly playing the GP telephone lottery may well prove worth your while if you wish to make use of our envy of the world NHS.
- you speak to a nurse on the phone, not a non-medical receptionist (frankly, that sounds insane)
- the Vårdcentral (equivalent to surgery) prioritizes children in my experience
- your Vårdcentral is not allocated, but you can choose one. Some have better capacity, some have worse.
- there is another layer between Vårdcentral and Akuten in a hospital called Närakuten where you can go to get checked out. The waiting times are anywhere between 30 minutes and a couple of hours.
I would even guess that the British situation is not unique but the medical system is overloaded everywhere in Europe.. Most people I know, including myself pay for private care.
1) Genuinely baffling to see people who think their individual sucky experience is universal. What you describe is how your gp works. Change GPs! There are better surgeries around.
I called my GP after 12 midday and explained that I had turned a bit yellow and had pain under my right ribcage, and they booked me in for an appointment a couple of hours later, and after I'd send them they booked me into my local hospital's surgical assessment unit (thus bypassing A&E) where I was hooked up to IV fluids and antibiotics. I got scans that day, I got surgery the day after, I was discharged a few days later when the infection had clear and my numbers were better.
Same day appointments are for emergencies, and if you have an emergency you will get a same day appoint
> The only other means of accessing the NHS is by rocking up at the Accident and Emergency (A&E)
No, this simply isn't true. In this order depending on severity of illness, people can chose to get support from: NHS Website, NHS 111, Pharmacy, GP, Minor Injury and Illness Units, Emergency Departments, or Ambos.
Plenty of services now have self referral - podiatry, physiotherapy, dietetics, eating disorder, mental health crisis, antenatal, etc etc. So you don't have to go via your gp, you just phone them up and make an appointment.
Okay, I may have over-extrapolated for effect, after all some surgeries don't even have telephone queuing, you just keep getting the engaged tone and redialing until your call is finally answered at half past ten, to be told the same thing.
I don't know the exact circumstances of your case but it sounds quite likely you wouldn't have lived to tell the tale if you'd been registered with my GP.
I think you're overestimating the ease with which most people can swap surgeries, and you're definately overstating the extent to which your list of NHS hacks are a realistic prospect for most people, who by and large don't even want to bother thier doctor unless they really have to, and then when they really have to - they can't.
There better be at least a decade until the next pandemic, at this point even the black death wouldnt convince people to go back into lock down.
"The difference in 2022 - compared with 2020 and 2021 - is that Covid deaths were one of several factors, rather than the main explanation for this excess"
One of the other factors is the crisis in the NHS:
"At the start of 2022, death rates were looking like they'd returned to pre-pandemic levels. It wasn't until June that excess deaths really started to rise - just as the number of people waiting for hours on trolleys in English hospitals hit levels normally seen in winter."
So, I don't think people's propensity to go into lockdown is particularly relevant here.
They succeeded in finding a causal link between austerity measures and increased mortality.
At the end of the paper they estimated that 120,000+ people have died as a result. Additionally: that the the rate of excess deaths was increasing year on year.
There is an issue with highlighting this;
For starters, many people are very likely to bury their heads in the sand:
* "How do you know that it's related to Austerity" (not reading the paper)
* "They would have died anyway"
* "The world is different from the time period it is modelled from" (it corrects for this by comparing also to other roughly equivalent economies)
* "The UK is different than other advanced economies!"
The other issue is that it sounds so insane and conspiratorial.
120,000 is a large number. It's approximately the size of Stratford upon Avon.
A follow up study puts the number now closer to 330,000, around the population of Coventry.
Somehow people will blame the NHS for not being efficient, though evidence to the contrary exists throughout its history, often being one of the most cost effective healthcare systems in operation; or that COVID is a contributing cause to these figures.
People are unwilling to hear this: This was a problem well before the pandemic.
Source (2017): https://bmjopen.bmj.com/content/7/11/e017722
Source (2022): https://www.gla.ac.uk/news/headline_885099_en.html
And if you do not compare it with other causes of death, someone that doesn't deal routinely with these numbers (so, most people) still has no idea how much of a problem it is. (For instance I've been comparing war deaths in Ukraine to roadkills in Ukraine to gauge this.)
As in "7% of people who died, have died in excess of what we expect".
It should be noted that in the years prior to this, excess deaths were falling precipitously. (10-20%)
Eitherway, it's well documented in the studies.
It's quite clear that the NHS has been underfunded, and under resourced, for the last decade. However the government still try to argue that the inefficiencies are a organisational problem rather than a funding problem. Which is still laughable when they have presided over it during the whole time period in question.
So someone with ethics might argue that if you are in an uncertain area between over and underfunding then it will kill fewer people to err on overfunding.
If management doesn't flow the extra funding to front line staff or resources, it can easily be wasted for zero added value.
Renationalising the NHS and limiting the private sector to those few expensive services that are essential would fix this.
But both political parties are working for the people who profit from this situation.
Something involving killing patients if you don't build some leeway into the system.
ex. How many ambulances at a few pounds in 1948, which were vans with a stretcher in the back and a couple of blokes to drive it. What about 2022? The cost, roughly £150K for the ambulance, goodness knows what to train up ambulance technicians and paramedics. If the kit is broken, the ambulance can be out of service, which means more units to provide cover (or not if you can't afford it!). The on top of all that, many more people go to hospital because the care is leagues above what you got in 1948.
Ditto for equipment costs like Digital XRays, MRIS etc.
All of that is not surprising or even undesirable but it would be interesting to see the additional tax that you should be taking per-person to pay for all of this additional equipment. If the NHS costs around 30% of expenditure i.e. 30% of my tax then roughly 7.5% of my income covers the cost of the NHS, maybe £6K per year. When we look at things that way, you can see why the Government doesn't want to take any money in tax because that sounds like a lot of money. You can also see how they can't reduce costs by going backwards in replacing high-tech with no-tech.
[1] https://www.kingsfund.org.uk/projects/health-and-social-care... [2] https://jamanetwork.com/journals/jama/fullarticle/2785479
I’m not sure I can take the report seriously after that. You can’t write a report on management in the NHS and refuse to give a definition of manager. Also, how many of these managers are directly employed by the NHS and how many are employed as consultants?
I’m not saying you’re necessarily wrong but that report is hand wavey.
What is a manager? Are you only including non-clinical staff? Or do clinical staff count too? If you're including clinical staff, how many hours of their working week are you counting as clinical hours and how many are you counting as managerial hours? Are you converting people who work part time as managers to Full Time Equivalent positions, or not?
If you want to poke the data it's here: https://digital.nhs.uk/data-and-information/publications/sta...
If you want more description of the complications of counting managers in the NHS I found these useful (if a bit old now):
https://www.kingsfund.org.uk/publications/future-leadership-...
https://www.kingsfund.org.uk/projects/general-election-2010/...
https://www.kingsfund.org.uk/projects/health-and-social-care...
"The NHS is full of bureaucracy" but it is a bureaucratic system so of course it is. People to charge hospital costs back to GPs, people to investigate trends and make sure that some GPs are not under-referring people to hospital, etc. but when I worked in the NHS many moons ago, it didn't seem particularly disproportionate to the size of the organisation. There were many more problems with people not doing their jobs properly but that was everyone, not just this nebulous "middle management" that everyone likes to cite!
Certainly, some hospitals under-perform and have issues with culture and discipline but that's the same as any business.
There are also some quite ridiculous cash handouts for little or no taxpayer benefit. Like the notorious £37bn that failed to provide an efficient Covid test and trace system. Or the >£100m in the Michelle Mone scandal, which seems to have been just one of many. Or the £45bn in tax cuts in Kwasi Kwarteng's recent budget, which were supposed to "promote growth" but have done the opposite.
The UK is one of the richest countries in the world. It has also become one of the most corrupt.
A penny or two on tax is not the problem.
i don’t think you realise how much the health service costs. you can tax all of the richest and it will represent a few days of the health budget. a new funding model is needed. otherwise there will have to be tax increases.
The tl;dr here is that there's a striking number of patients in hospitals (up to 30% in some areas) which are ready to be discharged from hospital, but cannot yet be discharged since they're waiting for the availability of social services that aren't handled by the NHS. I've mentioned it in all my comments here but this is the cost of austerity, and it's making healthcare not just worse but more expensive.
Usually the way you achieve this is by reducing spending to reduce the deficit.
But you could also increase taxes.
Government spending will eventually be paid. It's whether it gets by the people now, the people in the future, or the bagholders (bond holders when the government or currency collapses).
Of course life expectancy is going to decline if you can't force your grandchildren to pay for your healthcare costs now.
But it's not clear to me that's the most evil thing in the world.
Back when most spending was infrastructure and growth was high, you could argue this would be around forever, and it should be financed to a large degree on future generations.
But now that a huge percentage of spending is entitlements and growth has slowed, it's less clear.
Oxford prof Simon Wren-Lewis explains it better than I could: https://www.lrb.co.uk/the-paper/v37/n04/simon-wren-lewis/the...
I can't help but think that efficiency should be a secondary metric when it comes to health care. If you can get the same treatment, capacity, resilence etc. cheaper, go for it – sure. But as soon as you start to save money by sacrificing those more important metrics the price will be paid in human lifes eventually.
Anything "unlimited" is impossible in a constrained physical world. So I am not sure what contribution you like to make by stating the obvious here.
For most economies delivering reasonable high quality care to everyone who needs it is totally a thing they can (and in some cases: do) afford. It is just a matter of priorities. You would be surprising what nations can sustain if they really want it. War is a good example. When a nation goes into a long war and changes its economy to support that war we call that a war-economy. It is an economy, that priorizes a lot of what it produces and outputs for the war effort. Nations can be years or even decades in war-economy mode without going under and that works because they priorize the nations existence (and thus the war) above other financial goals. And in war nations also make companies do things that would be otherwise unthinkable, e.g. make a company share blueprints with a competitor, favour certain industries with resources, etc. If any nation knows that, it would be the UK.
So if any modern western government goes all cheap and naive big eyes on health care, it is not because they can't do better, but because they don't want to. Not wanting to do better is a very easy opinion to have, especially if one earns money by being of that opinion. Those who suffer and die are also a different demographic than them, so even easier to pretend all is going well.
I am not saying that any health care system should be inefficient. It should be efficient in certain way (e.g. prevent funneling government money into pockets, prevent paying too much for medicine and equipment and so on). But efficieny is not the primary goal here, the primary goal is to have an adequate health care system. And you will always get unethical rich people saying private payer is adequate, because THEY are covered by it. But the fact of the matter is that everybody profits when a nation has a good working health care system for all, even the rich egomaniacs. After all they cannot decide where they will have a medical emergency as well.
I posted that there would likely be one of two outcomes - a lost decade, we'd be in a worse position and no one should ever again think that the Conservatives are economic masters compared to Labour again, or that George Osborne was a bona fide economic genius and the UK would come out of this extended austerity in a fitter and leaner state ready for the challenges ahead (ala early Thatcherism).
The answer is the the first one - we had the lost decade, are looking at potential second lost decade and we're now equivalent to a central European country not France.
The Conservatives deserve to die at the next general election for this and should be replaced by a completely new right of centre political party as the opposition.
I can't go very far in a discussion about the liberal democrats without hearing that they didn't follow through on a manifesto pledge.
Which is wild because in a minority government, where you're given the option of electoral reform or sticking to another manifesto pledge; you have to pick one.
You're a minority government! You can't do terribly much.
Then the most recent leader of the lib dems being crucified publicly for being religious in some manner, (tbf: he said "I think Homosexuality is a sin but I support equal rights; and everyone should live free and with dignity")
Yet, the Conservatives do much worse and face no indigence in votes.
It's baffling.
FD: I'm not terribly supportive of any particular political party, but Liberal Democrats is one of the "more supported" ones of mine, along with SNP and Greens.
My main quarrel was hypocrisy.
I do care that they enabled the Conservatives to impose austerity.
I voted for them on the basis of that pledge and I have never felt more betrayed by a political party in my life. It sickens me to my stomach. In this country you can only get four years of loans for university. I ended up dropping out of university because I was a mess in my late teens/early twenties. It means I now only have two years of funding left - not enough to get a degree unless I do a two year fast track course which are only available in certain subjects and of questionable quality. To go back, I would have to find a spare £9000 out of nowhere plus living costs which are most likely at least another £9000. This is particularly difficult when you can’t access high paying jobs because you don’t have a degree.
I’ve long since sorted myself out but I am now effectively priced out of bettering myself in my own country, directly as a response of the decision of this Lib Dem government. I taught myself to code to finally escape the minimum wage job trap. I have also been teaching myself Spanish over the last few years and I am seriously considering moving to Argentina or another Latin American country in order to access the affordable education. I am also going to start teaching myself German to open up the option of staying in Europe as the university costs there are minimal or free. Once I leave, I am planning on never coming back if I can help it. I feel that betrayed by my own country and have zero faith in it as a democratic representation of its citizens.
The Lib Dems could absolutely have not voted for that issue. They could have walked away and dissolved the coalition government. They chose not to. Well, decisions have consequences as I found out the hard way. And as a result, I will never vote Lib Dem again so long as I live.
And the Conservatives are the ones who actually instrumented those policies you dislike.
Lib Dems went for electoral reform in the gambit of making it a more representative democracy; a gambit which lost.
"Give me your backing on this and I'll give you the other thing" is a pretty common compromise.
I'm sorry about your student loans, but were I in the same position, I would have made the same gambit.
Who do you vote for in that situation?
Yes I don’t agree with the Iraq war. But Labour didn’t run an election campaign based on not going to war in Iraq before getting elected and then going to war in Iraq. Or in the case of what the Lib Dems did, going to war with Iraq plus another two countries on top (200% increase). Iraq had no part to play in the election. I can’t comment on the NHS part because I don’t know specifically what this ground work is you’re talking about.
> And the Conservatives are the ones who actually instrumented those policies you dislike.
This is bullshit, it was a minority coalition government, if both parties didn’t vote for it it wouldn’t have passed. The Lib Dems are equally as responsible as the tories.
> Lib Dems went for electoral reform in the gambit of making it a more representative democracy; a gambit which lost.
This is one take. The other is that the Lib Dems voted for what was in the best interest of the Lib Dems (had they have won) and dropped all their other principles and pledges to the people that voted for them.
All the parties are rotten but as I say, I will never vote for the Lib Dems because of the direct consequences their decisions have had on my life. And I don’t think that makes me a hypocrite.
My key point here is that, while I understand you feel betrayed, the other parties are quite literally breaking their pledges left and right.
The main difference is that it seems to get not that much media attention.
That you wouldn't vote for someone who made a compromise against their values: but might vote for a purported anti-semite[0] or an actual racist homophobe[1] is disquieting.
[0]: Corbyn being accused of being an anti-semite is of course a load of tosh spun by the right wing media machine
[1]: https://www.theguardian.com/politics/2017/sep/30/boris-johns... & https://www.independent.co.uk/news/uk/politics/boris-johnson... & the numerous comments regarding "letter boxes"
https://www.statista.com/statistics/298465/government-spendi...
The Lib Dems?
The best time to start training more doctors and nurses is ten years ago. The second best time is today.
Combine this with providers incentivised to provide as much healthcare as possible at the highest possible markup, and insurers incentivised to deny as much care as they can ... and you have what always looks (from the other side of the Atlantic) like a gigantic life-and-death financial nightmare.
https://fee.org/articles/the-idea-that-the-us-has-a-free-mar...
I'll take an adequately funded NHS, thanks.
>> leaves millions without any access to healthcare
Absolutely, 100% completely false.
>>can result in bankruptcy as a result of an illness or accident
This is true, however contrary to the social stigma bankruptcy can be a good thing for many. In the US Medial Bankruptcy is often made inevitable by various government regulations that prohibit creative solutions by providers.
Perhaps virtually everyone has access to health care, but certainly millions opt out at the cost of their own well-being because they can’t afford it. There have been times in my life when I have.
My reasons for opting out have nothing to do with finances, it would get exactly the same amount of care if it was free.
The common refrain is that they can go to a hospital, except an emergency room is not going to help chronic conditions.
Any idea that a majority of these people are choosing to have no coverage, goes against all research on this topic.
Ok I'll be more specific: "leaves millions without insurance and since they're usually low-income and therefore cash-poor, unable to get any adequate access to healthcare". Is that really, meaningfully any different from what I said?
I have to say, the words "bankruptcy can be a good thing" is going to be bouncing around my head for a while. I don't know how less regulation could help these people, and I'm a little bit horrified thinking what kind of creative solutions these providers would come up with ...
This is still false, infact the most impacted group by medical costs is the Middle Class not the poor. People too "rich" to be on public assistance programs like Medicade but too poor to afford a medical emergency and work for employers that either do not offer insurance, or have poor coverage.
>>the words "bankruptcy can be a good thing" is going to be bouncing around my head for a while.
I have known more than a few people that have gone through bankruptcy and it was the best thing they could have ever done. One mistake people often make is waiting tooo long to declare bankruptcy. Bankrupcy is a legal tool designed to provide aid to people who find themselves in too much debt, there are all kinds of things built into that system to assit people. It really is not a punishment. For example most people do not realize that they can Keep their primary residence and primary transportation even after declared Bankrupcy. People have this vision that is you file for Bankrupcy *protection* the police are going to come take all your things and put you on the street.
>>I'm a little bit horrified thinking what kind of creative solutions these providers would come up with ...
One thing that is prevented by Regulation is Medical Coop's several have been tried but they can not navigate the regulations to make them workable. Non-profit Member owned Coops would be a great thing for medicine, just has it did for Utilities in many regions of the US.
When even companies like Walmart can not make low cost medical services work directly as a result of regulation you know there is an issue.
I kind of feel like you're trolling me a bit, if I'm honest.
Would you agree that subsidies and regulations increase prices?
Why?
Or I guess I should ask what other requirements of life should be completely under the governments control? Should Government run farms and give you food for free? Should government build homes and issue them to people?
I have never been clear why healthcare is uniquely something that must be provided by government but other things are not.
If you think the government should provide everything you need to live like they were a parent or nanny well then we have completely and incompatible views as to what a government should be
The government do provide assistance for food for those in need, and they are right to.
> Should government build homes and issue them to people?
Local governments in most developed countries build homes and issue them to the needy. And I believe this is correct.
You've obviously deployed exaggeration to try to make these things sound ridiculous ("...completely under the governments control..." and "...live like they were a parent or nanny...") but really none of this is controversial, they're pretty common, mainstream beliefs.
I believe that a government should work to better the lives of the citizens it governs. This includes things like providing education, healthcare, road and rail infrastructure among other things you probably wouldn't like. I am quite sure we have incompatible views as to what government should be and that we both believe the other's vision of an "ideal" country would actually be a dystopia. However some of the happiest, healthiest and best-educated countries operate pretty close to my ideal.
This is always the comeback to that question. The US provides food assitance and Medical Care Assitance to low income people via many many many government programs, very expensive government programs
That is NOT the same thing as NHS, which completely takes over and provides the care. Food Assistance gives people with out income money to go buy the resources on the open market. Medicade gives people with out income money to go by resorces on the very regulated US health system
This is not an analog to NHS or other government run single payer health systems
So again I ask, not about providing social safety net, but should the government completely take over farming and housing like the NHS and other government provided programs do for health services
>>This includes things like providing education, healthcare, road and rail infrastructure among other things you probably wouldn't like
Correct, Government is incompetence personified. The incentives for government programs do not include providing quality services at the most value. Driving on my roads, going to the government schools I went to, and seeing first hand what "government housing" is has cemented the fact that government provides poor quality services at extremely high costs
>>However some of the happiest, healthiest and best-educated countries operate pretty close to my ideal.
That is very debatable, and not really supported by hard data
> Should Government run farms and give you food for free?
Probably not, the existing system works ok enough. They can maybe help the poor a bit more so they're not dependent on food banks (free school lunches was a recent controversy that shouldn't have been)
> Should government build homes and issue them to people?
I answered and you didn't like this but - yes and they should build more. I'll give you a little bonus and answer what you wanted to ask - "Should the government be the sole central authority providing housing?". Probably not, the housing market works ok enough in general. However they can maybe help the poor a bit more by building more council housing, not doing so is has directly contributed to making housing unaffordable for many.
And to bring us back to the original topic:
> Should the government have setup a national healthcare system back in 1948?
Yes - in the wake of WW2 there was no existing, competitive alternative that served the needs of providing quality, affordable healthcare to the populace. The NHS went on to deliver and then some. Plus with ~70 years of hindsight we see that in spite of a decade+ of brutal austerity, the NHS still costs less and delivers better outcomes than privatised systems like the USA has. It was the right thing to do, it is the right thing to do.
Also you seem to think they’ve shut out private providers altogether. This isn’t true, private healthcare exists if you want quicker access to some elective or non-urgent procedures or treatments.
Re your final point - this is very interesting. I'd like to know what countries you think I'm talking about, and if your libertarian (I think I'm right in saying this?), small government setup is anywhere close to implemented somewher right now or if it's purely theoretical/fantasy.
There's loads of reasons to dislike NHS care and it's genuinely weird that people who are so against the NHS never manage to hit on something real, and instead resort to stuff that's simply fiction.
NHS England spends billions commissioning care from private providers. That's why we have Priory Group, Cygnet, Operose, etc etc all providing care. (And in the case of cygnet and priory, often poor quality care).
And patients have a right to chose where to get their care - that's what chose and book is.
People who don't understand the NHS think it's a single organisation -which is what you've done here- and that's not correct. Patients have a choice of where they get elective care. NHS England commissions specialist services, and 42 ICSs commission the bulk of regular services. They're not allowed by law to have a preference for NHS providers, so if a private provider can do it for the money they should put a bid in. That commissioned care is provided by about 200 - 220 NHS trusts. NHS Trusts include ambo services, acute hospitals, community hospitals, mental health care, and community care. These NHS trusts are independent organisations that have their own boards of directors and their own accounts and they can compete against each other to provide services to particular regions. This does not include primary care which is provided by GP surgeries.
Which are and have always been private businesses operating as NHS contractors - this was actually the concession the post-war government had to make in order to get the British Medical Association onboard with the NHS. And recent surveys indicate GPs are against any change to their private status.
And how exactly would that have improved this discussion with "phpisthebest" who seems to be against the very idea of insurance altogether, given that they have the means to take care of all their healthcare needs in cash (for now), and who thinks that everyone else should really see bankruptcy as a sort of spiritually cleansing and enriching experience?
If you're going to argue against fundamental human rights like "right to life" then you're going to have to do better than the arguments you're using here.
>Medicaid is the largest source of funding for medical and health-related services for people with low income in the United States, providing free health insurance to 74 million low-income and disabled people (23% of Americans) as of 2017,[3][4][5] as well as paying for half of all U.S. births in 2019.[6] It is a means-tested program that is jointly funded by the state and federal governments and managed by the states,[7] with each state currently having broad leeway to determine who is eligible for its implementation of the program. As of 2017, the total annual cost of Medicaid was just over $600 billion, of which the federal government contributed $375 billion and states an additional $230 billion.[6] States are not required to participate in the program, although all have since 1982. In general, Medicaid recipients must be U.S. citizens or qualified non-citizens, and may include low-income adults, their children, and people with certain disabilities.[8] Along with Medicare, Tricare, and ChampVA, Medicaid is one of the four government-sponsored medical insurance programs in the United States.
No, I'm not sure why this set of false alternatives keeps popping up. There's no need to read those implications into the comment. It was succinct and to the point.
The comment seemed to be observing a failure in resource (medical professionals) allocation on the part of the central planners.
We don't need to get into the weeds of what is communism or neoliberal third-positionism.
I think the problem with the "third way" and with "communism" vs "neo-liberalism" is that they are all not focused on anything it's just a way to create a new "tribe". Conservation of Nature and worries about environmental decline used to be an elitist right wing conservative topic. Now its a leftist topic. Its not really about the topics, its about drawing lines in the sand and saying: "We from the left/right/third way, stand firmly behind this line! Who is with us?" It is just a way to define a group that can be used to gain power.
Its a simple fact of how markets work. A free market is just an ideal, just like democracy, open borders and justice. It is not some law of the universe. In fact: countries that profit most of their markets are countries that highly regulate them. These countries include the US, China, South Korea, Zwitserland, Norway and Dubai. But not: Mozambique, Venezuela, Sudan, Russia, Haïti. <-- these countries dont have functioning markets because there is too much unregulated behavior, too much corruption.
The once shining example of Socialism that has now collapsed as socialism always does is "capitalist" now that it has failed? that is rich right there.
Russia is more or less the same... A Collapsed socialist state that never really adopted free markets, sure they adopted some aspects of capitalism but only because after the inevitable collapse of socialist policies the people in power divided up all everything of value between themselves and their friends. That is not capitalism either.
Free market is from the liberal ideology, and is like "well separated market with rationnal actors will take the most appropriate decision according to available information automatically". Basically.
Capitalism however: "an economic and political system in which a country's trade and industry are controlled by private owners for profit." And this is the Oxfor dictionnary definition because i don't want to misconstrue or be accused of bias.
I don't see how one replace another, in any situation. Sorry. You can very well have free market in a socialist country. More than that: in an anarchist country (which doesn't and would never exist, this is more than highly hypotetical), free market is the default and would need fewer regulation, as power in a market couldn't be leveraged to gain advantages in others.
you literally can not.
Free markets are one form Capitalism, All Free markets are Capitalistic, but not all Capitalist Systems are Free Markets. Other Capitalist non-free Market systems include things like Corporatism, Welfare State, Oligarchic, etc
That seems pretty uncontroversial.
There is, however, a large contingent of private companies profiteering from this situation; as the NHS was forced to buy things from private hands.
More money will not fix this mandated profiteering.
Example with France: https://www.leparisien.fr/societe/mortalite-autant-voire-plu...
It's a bit late, though, to complain about a consequence of lockdown now.
The article literally talks about this, and it doesn't seem directly related to COVID. Part of it is no doubt delayed diagnoses which led to terminal cases, inability to get care for mental health, and overtaxed and underfunded health systems.
That's a terrible comparison though. In the US, about 3.3m people die each year. That's almost 60% of the total population of Denmark. A Denmark dies in the US every 18 months.
But that's just what you get when you compare a city with the population of a country that is a hundred times its size.
Tom Scott has a great video on it: https://www.youtube.com/watch?v=8YUWDrLazCg
EDIT: Decide to swap the examples to British cities, inkeeping with what you said about apples/oranges; which people may be less familiar with; but hopefully it gives the sense of scale.
"It's a large number" isn't useful when it's a percentage of an even larger number. ~1% of people die each year. Larger cities or nations will obviously have higher absolute numbers -- but what does that tell us besides that more people live there? If you can't visualize 120,000, can you visualize 67,000,000? Would "We'd losing a population the size of Aarhus if our population was the size of 100 Aarhuses" really make things clearer than saying "about 1% of the population dies in any given year"?
There are a total number of people who have died who wouldn't have otherwise.
It's not about "what is the delta" it's about imagining a literal city full of people who have died prematurely.
In terms of absolute numbers, "7%" is high, but not enough to really evoke any emotion in the reader.
How would you prefer to convey emotion to the fact that people's family members are no longer with us because of an economic policy which doesn't actually save the country money and has more in common with religion than economic science.
That's the thing though, there's always a city full of people who die, and it's pretty much always prematurely if you ask anyone that cared about them. There's no reason to help people visualize the actual number because the actual number is irrelevant. Would a 7% increase in the death rate be less shocking in Denmark even though it'd just be five villages and not half a city in absolute numbers?
Looking at absolute numbers to visualize things that are relative confuses people, because you'll need to play weird games when you want to get your point across but your population is 5m. "If we had 50m citizens, this would be half a city" is weird, people will rightfully say "but we don't, what are you talking about?"
I don't believe news should be aiming to convey emotion, or be manipulating. I also don't believe that the "how many football fields is that?" approach to news is useful.
This is likely the biggest problem we face right now. People don't care or don't want to hear anything "negative". We call it toxic positivity.
I dont know how big of a driver this is tbh. It seems more that a lot of people committed (publicly) to opinions and are unwilling to even consider to have incomplete, or even wrong views. While in practice the overlap to toxic positivity is likely large, i think it misses that the cause is likely emotional/ego driven. So that people arent so much attached to positive narratives but their narratives?
Or what do you think the causes are?
edit: Never mind, should have just googled for toxic positivity. Thanks for the term!
https://www.statista.com/statistics/298465/government-spendi...
https://tradingeconomics.com/united-kingdom/government-spend...
It's an epidemic, and it's killing males and females who should be in the prime of their lives.
Surely you can see that the goal posts have been shifted from the days of “the vaccine is our road back to normalcy” and similar mantras when they first were pushed?
It was originally touted as the solution. Many people who were silenced, fired, or worse, were silenced from objecting with the idea that “this isn’t a solution, I’d rather not”
And now we’re saying it was a rousing success, yet it isn’t enough at the same time…
The doublespeak is astounding
Long covid is real, and statistically significant. Heart and blood stream involvement issues with covid have also been apparent from the start. Put that together and any uptick in heart attacks, strokes, etc. might well be longer term consequences of Covid, and put that together with overloaded health systems, and not just in the UK.
It's not just a flu.
So I think if they was a relevant uptake in COVID cases that would be news everywhere
Relevant charts from the BBC and FT (Financial Times) reveal the pressure on the UK's health service:
- Annual changes in health spending in the UK (BBC): https://ichef.bbci.co.uk/news/976/cpsprodpb/16A6D/production...
- Deep lasting cuts to UK health spending (FT): https://twitter.com/jburnmurdoch/status/1606223936848629760/...
- Waiting hospital lists (FT): https://twitter.com/jburnmurdoch/status/1606223967903260673/...
This twitter thread from FT journalist John Burn-Mordoch is an damning and eye-opening look at NHS statistics (Dec 2022):
"Nominal healthcare expenditure rose by 7.4% in 2021 and was £54 billion greater than spending in 2019, before the COVID-19 pandemic"
So probably no increase, pandemic billions are gone and no one will see them again
The rest service itself probably had a cut with the inflation, and increased processes and bureaucracy to manage
Covid, Covid vaccines or not, excess deaths should be falling because the excess deaths of previous years should mean a deficit of excess deaths in the following years.
Something has gone deeply wrong and the Govt is doing nothing and leaving the underlying causes to BBC speculation.
These figures should also be analyzed properly by age group, something the BBC journalists are clearly not interested in even though they have the resources to do.
Of course this data reflects the actual lockdowns experienced and not any what-if of the impact of death rates if we continued covid without lockdown.
1. https://www.ons.gov.uk/aboutus/transparencyandgovernance/fre...
Absolute madness. The system is bursting at the seams. It appears that the UK is breaking apart in so many different ways; the budget, health system, education, etc.
I'm not sure a change of government will solve all of this.
so the smart kids, who might have chosen medicine chose other fields. economics at play - allocation of scarce resources.
the only thing that keeps NHS humming in terms of doctors / nurses is due to those professions being recruited from 3rd world countries.
Welcome to my TED talk. Wear a mask.
At least - that’s what they said when it came out and they demanded everyone take it.
Plus with all the boosters, combined with the general trend of dwindling intensity of viruses in a population over time, one should expect this effect to be even more dramatic
Yet here we are, talking about covid like it’s April 2020. How it’s so devastating of a virus, like we’ve gained nothing in fighting it since then
Funny how literally any metric can be used to justify covid madness
Alternative explanation. You only see the heart inflammation in young men because its unusual. In older people you already have it because of age so extra inflammation could go undetected.
Why COVID-19 is considered to be a respiratory disease
Medical professionals and researchers have been studying the link between COVID-19 and vascular symptoms since the beginning of the pandemic [..] These observations led to several hypotheses that COVID-19 was a vascular disease with respiratory symptoms and not a respiratory disease.
Studies in 2020 and 2021 supported this theory. These studies concluded that although people with mild to moderate COVID-19 only had respiratory symptoms, COVID-19 was primarily a vascular disease. However, additional studies published later in 2021 and into 2022 have contraindicated these findings. New studies indicate that COVID-19 doesn’t attack the vascular system at all.
While this data on its own can't tell us it's the vaccine protecting people from dying - there are too many complicating factors - if vaccines were driving excess deaths we would expect this to be the other way around."
You can pedantically argue whether this is a "cut" or not, but that's not the issue. Nor is the issue how much the NHS asks for. The issue is there is less money per health-care-incident to provide care.
> this is likely to have been driven in part by activities in response to the coronavirus (COVID-19) pandemic, such as testing and tracing services and the implementation of the vaccination programme.
Yes, if we include the many billions spent on faulty test and trace and broken PPE -the corrupt spending that went to pals of the Tory party- we see an increase in health spending.
Guess what happens to the amount of health care funding if you ignore the corrupt spend on PPE?
According to Statista:
Bed capacity is significantly lower than at the turn of the century, but more damage was done there by Labour than the Tories [1].
The numbers of nurses has steadily increased in the last twenty years under both Labour and the Tories [2].
So if there are many more nurses per bed than there were twenty years ago, why is patient safety one of the issues they are currently in dispute with the government over?
I don't know the answer to this, but I think we need to know. It is, like teachers, that nurses are spending so much time on non-clinical bureaucracy that the don't have time to nurse?
[1] - https://imagizer.imageshack.com/img922/4302/M6SgVh.png
[2] - https://imagizer.imageshack.com/img923/7041/40e6JF.png
Low fat diets high in refined carbs disrupting the absorption of k, d, e, a. sugary beverages with zero fiber, 3 meals and 5 snacks a day so your insulin levels never come down even at night sometimes. Your body can never repair itself or stop storing fat instead of using them. 3 meals and 5 snacks a day= zero ability to distinguish cravings and real hunger. Being told to gobble 5+ fruits a day by every dietician. Fruits bear in the winter, we live in climate controlled buildings. Why are we gobbling so much fructose from 5+ fruits a day.