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UK Politics: The Overton Defenestration


Hereward

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On 05/09/2016 at 1:26 AM, Mathis said:

Where do you get this?

The last several decades of history. The Tories try to run the NHS into the ground, Labour recovers it, the Tories get back in and do the same thing again.

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Also, whats the big deal about privitising healthcare? As long as it is available to everyone, why does it matter who provides it?

In the United States, people pay more money per-person in taxation on healthcare, but then have to pay private insurers on top of that. It's a hideously inefficient and ludicrously more expensive system. Other countries have somewhat better systems but none have the straightforward efficiency of the NHS when it's being funded to its needs (which it is not at the moment).

A free-market, private healthcare system run for profit is inherently incompatible with the idea of the best health services being provided to the patient. Those countries that do make it work do so by enforcing strong regulations and limitations which are simply never going to be put in place by a Conservative government committed to a free market, maximised-profit system.

Our major problem is that we are combining a free-at-the-point-of-service health care system with very low taxation, very low wages (and hence much reduced tax income) and a shitload of stuff we really shouldn't be paying out for (tax credits, due to the very low wages, and maintaining nukes). It's kind of mind boggling that the UK isn't doing much worse than it is.

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So, could Labour run on a platform of vote us in and we'll cancel Brexit? Effectively making for a second referendum. And if they did, would they win? The referendum was non-binding except to the extent that the Conservative party bound itself to the outcome. Or once you invoke article whatever is it a non-stop one way train?

They could run on that platform but probably wouldn't win. Even Smith has been keen not to do that, only committing to a referendum on the EU exit deal (which is not a second referendum on leaving the EU itself, but instead on implementation). In doing so, he is actually just fulfilling current legal requirments: the 2011 European Union Act legally requires a referendum before any material treaty change in our relationship with Europe. The presumption is that the Tories will repeal that act, but they have as yet made no move to do so.

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2 hours ago, Werthead said:

The last several decades of history. The Tories try to run the NHS into the ground, Labour recovers it, the Tories get back in and do the same thing again.

 


Another way to look at it is that Labour spends too much money leading to the need for fiscal retrenchment under the successor governments. This, combined with the demographic pressure on the NHS, has led to problems with funding.
 

2 hours ago, Werthead said:

 

In the United States, people pay more money per-person in taxation on healthcare, but then have to pay private insurers on top of that. It's a hideously inefficient and ludicrously more expensive system.

This is like a mirror image of the Republican position during the debate over Obamacare, being wilfully obtuse about what is even under dicussion. Nobody in government is suggesting that the US healthcare system is something to emulate.

 

2 hours ago, Werthead said:

Other countries have somewhat better systems but none have the straightforward efficiency of the NHS when it's being funded to its needs (which it is not at the moment).

Based on what?
 

2 hours ago, Werthead said:

Those countries that do make it work do so by enforcing strong regulations and limitations which are simply never going to be put in place by a Conservative government committed to a free market, maximised-profit system.


Who is even advocating for a free market, private healthcare system without strong regulations and limitations? I have real problem with this; the NHS needs to be improved, but any reform is met with a primal scream of outrage at some imagined mass sell off anything and everything.

 

2 hours ago, Werthead said:

Our major problem is that we are combining a free-at-the-point-of-service health care system with very low taxation, very low wages (and hence much reduced tax income) and a shitload of stuff we really shouldn't be paying out for (tax credits, due to the very low wages, and maintaining nukes). It's kind of mind boggling that the UK isn't doing much worse than it is.


No argument on the nukes, but tax credits are a more progressive way to alleviate poverty than a high minimum wage. One of the true successes of the Blair years IMO.

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9 minutes ago, Mathis said:


the NHS needs to be improved, but any reform is met with a primal scream of outrage at some imagined mass sell off anything and everything.

 

In terms of organisation, I'm not sure it does (or at least not especially so compared to other systems). We spend less per capita on health than most other first-world nations and the NHS still ranks amongst the most efficient systems in the world. It really does seem to be more an issue of funding than flaws in the system itself.

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4 minutes ago, Liffguard said:

In terms of organisation, I'm not sure it does (or at least not especially so compared to other systems). We spend less per capita on health than most other first-world nations and the NHS still ranks amongst the most efficient systems in the world. It really does seem to be more an issue of funding than flaws i the system itself.

Having said that, people have been complaining about the NHS for decades, at what point is it going to become efficient, what is actually stopping it. There seems to be perception that if you have something seriously wrong with you then the NHS will actually do a good job of helping you. The minor issues which are not highest priority tend to get shoved to the bottom of the queue and you end up having quite a poor experience. Personally I've not had much need for the NHS luckily, but when I have I was quite shocked about the level of buracracy and waiting times. 

As well as that GP waiting times have become unbelievable. I have been told numerous times that I cannot get a GP appointment even a month in advance. That is simply unacceptable.

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22 hours ago, Mathis said:

Who is even advocating for a free market, private healthcare system without strong regulations and limitations? I have real problem with this; the NHS needs to be improved, but any reform is met with a primal scream of outrage at some imagined mass sell off anything and everything.

Naturally they are not "advocating" that, they know that being open about it would indeed cause outrage. They are merely trying to hand over chunks of the NHS to those US companies that make so much money out of the US system (and taking lucrative contracts with those same companies as soon as they leave office). Also they have been trying to quietly push through a "free trade" deal that will make it impossible ever to get those bits of the NHS back.

As for them managing, even if they wanted, to impose "strong regulations and limitations" on companies they have outsourced to? Don't make me laugh.

 

19 hours ago, Hereward said:

What makes you believe that? Previous increases in funding have gone largely to increased wages, which might increase productivity, but not necessarily.

A good case could be made that much of previous increases have been spent on hiring layers of expensive management and creating a costly and wasteful "internal market" system.

 

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On 6 September 2016 at 9:13 PM, Channel4s-JonSnow said:

As well as that GP waiting times have become unbelievable. I have been told numerous times that I cannot get a GP appointment even a month in advance. That is simply unacceptable.

Mine's ok. Sure, if you phone up out of the blue and try to get an appointment you'll be waiting weeks. But if you turn up when the door opens at 8am, you can get an appointment on the day. Maybe another practice near you does a similar thing? Of more concern to me is the waiting room; two massive flatscreens devoted to showing public health propaganda written in comic sans, seemingly designed by a child. FFS, put the damn news on at least one of them.

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1 hour ago, VarysTheSpider said:

Mine's ok. Sure, if you phone up out of the blue and try to get an appointment you'll be waiting weeks. But if you turn up when the door opens at 8am, you can get an appointment on the day. Maybe another practice near you does a similar thing? Of more concern to me is the waiting room; two massive flatscreens devoted to showing public health propaganda written in comic sans, seemingly designed by a child. FFS, put the damn news on at least one of them.

Same for my GP. At least a month waiting list if you phone (and also the annoying "phone at 8.30 please"....*lines busy* 8:32 "sorry no appointments today, phone tomorrow at 8:30") but walk down and wait and you usually get seen in the first hour or so (due to no shows or being ahead of schedule). Our waiting room isn't so fancy as your though ;) 

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Another way to look at it is that Labour spends too much money leading to the need for fiscal retrenchment under the successor governments. This, combined with the demographic pressure on the NHS, has led to problems with funding.

The NHS has an amount of money it needs to operate effectively and the government either provides that money, ensuring it operates at a  level fit for purpose, or it doesn't, and the NHS starts underperforming. Working in the NHS for a few months earlier this year, it was interesting to learn that the equipment maintenance and procurement budget for the year had been reduced to 75% of what was required. The hospitals had informed the government that they required £4 billion to replace ageing and broken equipment and maintain what they had. The government said tough shit and gave them £3 billion. So that's £1 billion worth of everything from x-ray machines to doctors' laptops that's just not going to be bought or replaced.

New Labour installed a top-heavy bureaucratic system into the NHS, but one of the results of that was that waiting times came tumbling down, more doctors and nurses were hired, hospitals was expanded and rebuilt and new equipment was purchased. The previous occasion I worked for the NHS was in 1997-99 and I saw the Children's Ward matron almost break down and cry when they told her they could finally remodel the children's play room so it no longer looked like something out of Stalinist Russia. They'd apparently spent twenty years trying to get it done. During the following decade they doubled the size of the hospital, which had been ludicrously small for a town the size of Colchester (it's still a lot smaller than it should be, but it's at least made progress). So funding the service adequately resulted in real-term improvements.

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This is like a mirror image of the Republican position during the debate over Obamacare, being wilfully obtuse about what is even under dicussion. Nobody in government is suggesting that the US healthcare system is something to emulate.

Apart from Jeremy Hunt, who in Direct Democracy (2005) asserted that the NHS was "irrelevant to the 21st Century" and advocated that it should be replaced by an explicitly US-style insurance scheme.

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Based on what?

By the NHS being an under-staffed, under-resourced institution where services are being shut down and denied and a huge chunk of its workforce is organising strike action.

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Who is even advocating for a free market, private healthcare system without strong regulations and limitations? I have real problem with this; the NHS needs to be improved, but any reform is met with a primal scream of outrage at some imagined mass sell off anything and everything.

Jeremy Hunt (for one). He's the guy in charge of the health service.

And yes, the NHS needs to be reformed. It needs to be funded adequately, it needs more doctors and more nurses, the pointless internal competitive hoops that it has to jump through need to be removed and the supply chain needs to be monitored and assessed for overspending.

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No argument on the nukes, but tax credits are a more progressive way to alleviate poverty than a high minimum wage. One of the true successes of the Blair years IMO.

Tax credits represent the taxpayer subsidising the wage bills of private companies who choose not to pay their staff to an adequate level. It should not be necessary and costs the taxpayer a monumental amount of money.

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Having said that, people have been complaining about the NHS for decades, at what point is it going to become efficient, what is actually stopping it.

When it actually gets the resources it needs, which it came close to under New Labour (even if they also messed around with it unnecessarily). It also depends why you mean by "become efficient". Waiting times - which came down a lot under the previous regime - may be annoying, but when you consider you are getting thousands of pounds worth of medical treatment for free (well, not for free as you've paid through it for tax for your entire life, but anyway) they can be borne.

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What makes you believe that? Previous increases in funding have gone largely to increased wages, which might increase productivity, but not necessarily.

Increased wages means more people and more existing, experienced staff who will remain in their roles for longer. Decreased wages or fewer people mean that the service cannot be staffed (as we've seen with the 5 day/7 day mess: the NHS is currently underfunded for 5 days, so it cannot go to 7 days without spreading its resources past the breaking point).

Under the New Labour years there was increased wages, increased productivity and a more efficient service, so that seemed to work quite well. It might be that too much money was spent on bureaucracy (especially the several reorganisations of the organisation) but overall the experiment of funding the service adequately to get an adequate service paid off.

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Did anyone watch the Labour leader debate last night?

I found it highly depressing to be honest, because it simply highlighted how irrelevant they both were, arguing over a party who are going nowhere in the near future. One question from a UKIP supporter brought the reality of how far Labour are from the general opinion running through the country. 

Guardian seems to think that Corbyn wiped the floor with Smith, but I don't think either came out of it looking great, Corbyn looked quite battered to me to be honest, feeling like he had to constantly defend himself. 

 

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7 hours ago, Channel4s-JonSnow said:

Did anyone watch the Labour leader debate last night?

I found it highly depressing to be honest, because it simply highlighted how irrelevant they both were, arguing over a party who are going nowhere in the near future. One question from a UKIP supporter brought the reality of how far Labour are from the general opinion running through the country. 

Guardian seems to think that Corbyn wiped the floor with Smith, but I don't think either came out of it looking great, Corbyn looked quite battered to me to be honest, feeling like he had to constantly defend himself. 

 

Yea, it was crap.

I think Corbyn is a terrible leader but it doesn't come across so much in that kind of debate. Smiffy boy, on the other hand, really needed to impress and didn't, so Corbyn ended up doing well.

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The more I see of Smith, the more I wonder how many Labour MPs are kicking themselves for picking him over Eagle. I mean, she's not the world's most charismatic or skilled politician, but Smith is... well, not impressing.

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3 hours ago, Maltaran said:

The Visegrad Group seems to be threatening to veto any Brexit deal which doesn't allow free movement of labour

It's OK because Boris is going to turn up on a yacht to negotiate with them:

http://www.independent.co.uk/news/uk/home-news/brexit-trade-deals-should-be-held-on-royal-yacht-britannia-boris-johnson-jake-berry-royal-boat-a7313101.html

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What Werthead said on the NHS. There's a good report out from 2014, too, that basically puts the British system at the top overall of a cross comparison with Germany, France, Switzerland, the United States, Sweden, Norway, New Zealand, Australia, and The Netherlands. It's just very good overall at what it does, and even more so when you factor in how low it costs per capita. 

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