ChezGiven

Parky, who organises the distribution of bread in Hamburg? Which one person is responsible? In Russia, there was one organisation responsible (with one person being the head of that organisation) and people had to queue to get it, why dont you have to queue in Hamburg (other than to wait to get served)? Canada has 70% public and 30% private 'funding' and almost all services are 'provided' by private organisations, some of which are non-profit, some of which are for profit. What's your point?

Try backing that statement up. Evidence against that statement - Russia Evidence for that statement - ? Also, by making people take out social insurance, then individual contributions are related to income and preferences. How you can conclude this leads to less money in the system is beyond me, when systems organised like this pour 3 to 4 times more money per head into them? The problems with 'totally' private systems are ethical not financial!! All we need is a blend of the two. Anyway, the thread title was deliberately provocative in the run up to the organisations 60th birthday and the forthcoming report from Lord Darzi. There will be loads of announcements and guff in the next few weeks that wont change the fact that unless we find more money, you'll be no more likely to get the CAT scan, the operation early or access to life-saving drugs than someone from Poland, Hungary or the Czech republic. Who spend far less than us...

I'm not sure what you're saying.

Some interesting perspectives in here. Fop, there is a course at INSEAD in Paris run by their Healthcare management people dedicated to 'patient led services' where the individual is encouraged to take full responsibility for their health. Many Nobel prize winning commentators believe it is the only way forward for people to partake in the decision making process and pay directly for the services they use. You already do pay in the form of tax, so why not as dedicated payment from your salary? The reason why i mentioned Singapore is that they designed a system that takes the best of the insurance based systems whilst providing a safety net for the poor. There is absolutely nothing stopping us from reforming the system in a similar way and the low population you mention is irrelevant. Its much harder to centralise (ie NHS) for large populations than to break it all up into autonomous, private and publicly owned institutions. Our nations size is an argument in favour for public/private mix, not the other way round. You'll have noted that British Breast cancer and Non-small cell Lung cancer sufferers were denied the chance to have Avastin today, a drug freely available in France, Germany, Spain and Italy. Not here though, as the system cant afford it. The NHS is the opposite extreme to a pure private market. Neither work properly, the answer is in the middle.

Presumably you think Life Insurance policies are immoral then?

The SMC is even tighter than NICE.

Why cant we slowly move to a Singaporised system instead?

Like the German, French, Spanish or even Singapore systems? Dont worry, i have and as far as Sicko is concerned, didnt it state like you did that we have the best health care system in the world? Yet when you look at cancer mortality statistics produced by the Karloniska institute, it shows that the UK is shite compared to the rest of the world. http://news.bbc.co.uk/2/hi/health/6956446.stm Have a look at the graph at the bottom. I think we need to change our system and we that we would all be better off if we did. It's not a national health service anyway - what about the differences that exist in the way NHS Scotland is run and funded? You'd open up a can of worms right now in terms of the whole constitutional debate if you went anywhere near deconstructing the NHS in England and replacing it with a system of compulsory health insurance instead. But that is where we're heading anyway - there is an absolute inevitability about the NHS being broken up and sold off. And the biggest concern of all has to be about the ageing population and how younger working-age folk are going to pay for the domicilary and nursing care required for the new gerentocracy. Free personal care for the elderly has been contentious up here in Scotland. How would you provide adequate healthcare for the elderly without a "national health service" safety net? I agree with all of that and particularly the point about it not being an NHS anymore. Which was the point in the OP. If the NHS are going to allow patients to make top-up payments as announced last week, what is the next logical step for someone concerned about the risk of incurring this cost? I'd be thinking about taking insurance out on it, wouldnt you? Knowing you could insure yourself against the cost of an event that 1 in 3 of us will get?

Like the German, French, Spanish or even Singapore systems? Dont worry, i have and as far as Sicko is concerned, didnt it state like you did that we have the best health care system in the world? Yet when you look at cancer mortality statistics produced by the Karloniska institute, it shows that the UK is shite compared to the rest of the world. http://news.bbc.co.uk/2/hi/health/6956446.stm Have a look at the graph at the bottom. I think we need to change our system and we that we would all be better off if we did.

Had a spilff with Liam in the beer garden of The Steeles* on Haverstock Hill which was my old local in London. He was funny. They both used to drink in there on the odd occasion. The first album is excellent and caught the moment quite well. *Trivia fans will be interested to know that the pub scene in Goal was also filmed in there.

As an book-balancing measure, yes absolutely. As a clinical judgement, meh. As a patient welfare issue, fuck off. Whichever way you look at it the name is spin at its worst, just ask any low grade dementia sufferer. The acronym comes from the 90's when it was an idea kicking about whitehall for introducing a body to 'advise' the NHS on cost-effectiveness and was originally the Nat Ins of Cost-effectiveness. The idea developed but the acronym changed. I dont think they meant it as spin at the time. The UK system is inefficient and wasteful and involves pre-planned annual spending. The system cant afford treatments and so needs to restrict and ration. Its a part of life, unless you change how its organised.

Cheers, will source that later...

The NHS should remain free at access to anyone who needs it. I shan't be moved on this Chez by any of your 'clever talk'. We'll see about that... Its not free anymore, there are people paying for drugs who can afford them and being treated normally for all other services and there are people dying who cant afford to pay for them. This is pragmatic not dogmatic.

NICE is rational, its the system that needs to change.

http://blogs.guardian.co.uk/music/2008/06/...2008_album.html Free Glastonbury album from the Grauniad.

Last week, a fundamental sea change in the UK's health policy occured when Alan Johnson, the health secretary, reversed the existing decision to stop patients paying for their own drugs. Over the past 3 or 4 years, there have been numerous cases of patients being prepared to pay out of their own pocket for drugs not available on the NHS. The NHS policy was to then say that the patient had 'opted out of the system' and that they would then have to pay for all the costs of their care, including diagnostics hospital stays etc as well as the costs of the drugs. This was policy as one of the reasons we have an NHS is because of the desire to have a system with equal access for all. If you allow patients to pay, only those who can afford it will be able to and you therefore have a two-tier system which goes against the principles of the NHS. This has now been reversed as it was seen as fundamentally unethical to deny the right of someone who is willing and able to pay to access drugs that are not approved for use in the NHS (mostly on the basis of their cost). Now, this begs the question, isn’t it time to privatise the NHS and introduce a system of insurance that people can choose?

Isn't metacritic just the views of people who read pitchfork though?

Ginger based cocktails are very refreshing and a good livener.

Sitges is fairly rainbow-striped and that's nearby, I think. Sounds horrendous mind. It's meant to be quite nice actually. I take it that means there's a life outside the gay bit. Sounds less horrendous all of a sudden. The beach is much better than the one downtown, thats the main attraction.

You could have been a contender Alex! Ended up a bum though. That reads two ways.

In Bruges. Thought it was quite funny.

Gay or straight?

Its all Israel's fault anyway, you should have heard Obama's speech to the Israeli lobby, sounds like they are the ones who control US foreign policy in the region. On another note, my personal axis of evil : I raq'd one up, I Korea'd out of control and I ran away from my problems.

Used to? True, you cant get enough fudge fingers.

I used to enjoy a finger of fudge.