"Just like that" : Libertarian Party health policy
Our aim is to enable people to hold their healthcare provider to account and, if found wanting, have the freedom to take their business elsewhere. This cannot be done while the State is the monopoly provider who takes payment, commissions, runs and administers that monopoly. We do not envisage a mass sell-off of State assets, but a switch to independent not-for-profit and private entities competing openly. There are a number of ways to effect the migration from State monopoly to an insurance-based system, and the available options are currently being reviewed by the Party. The Libertarian Party believes strongly in honouring commitments, and this will extend to long-term care for the elderly and mental health services.It is early days for the Libertarian Party. Funding healthcare is the single biggest problem facing the western world and so the party must be allowed time to formulate detailed policies. But the portends are not good. Already they make some fundamental errors.
We will commission an investigation into existing PFI contracts to ensure that they are legal and were entered into with due diligence and in the interests of the taxpayer.
You cannot apply market economics to the provision of universal health care. Universal health care is not an economic proposition. It is an indulgence. An expensive indulgence which has to be funded by taxpayers. You can make a profit by selling sophisticated health care to the rich but you can only make a loss by providing the same health care for the poor. Successful entrepreneurs are driven by the profit motive. An independent “not-for-profit” organisation will not survive unless it is government subsidised and thus insulated from the realities of the market. And if it is so insulated, no private company can compete against it.
An insurance based system merely substitutes a private, profit driven company for a government run organisation. Doctrinally motivated health care economists will argue for one or the other, but there is no moral, or economic, absolute. Take a look at this article in Fortune magazine which describes the anomalies thrown up by a private insurance based system.
We need a fresh start, free of doctrinal absolutes. Above all, we need to admit the fact that no country can afford to provide the full range of modern health care for all its citizens. Health care has to be rationed. We need a front end charge, appropriately safety netted, to stop the worst of the abuse. We need to find a politically acceptable way to explain to the citizens that they can no longer have it all “for free”. Free health care was always an illusion, buttressed by the NHS with its ludicrous "free at the point of entry"mantra. The illusion has had dire consequences. It has fuelled the demand for health care to unsustainable levels.
The choice is simple. Acknowledge the inevitable and take control or bury your head in the sand, pretending all is well, as stealth rationing and the surreptitious erosion of health care standards allow the NHS to lapse into a two tier system in which only the rich can access good medical care.
The choice is simple. Acknowledge the inevitable and take control or bury your head in the sand, pretending all is well, as stealth rationing and the surreptitious erosion of health care standards allow the NHS to lapse into a two tier system in which only the rich can access good medical care.
Labels: Libertarian Party, rationing health care, USA health care funding
34 Comments:
Spot on Sir.
I love the two extremes of the argument though.
The socialists believe we can have it all on the state and that rationing isn't neccessary.
While the free marketeers believe a brilliant system will appear by magic if private enterprise is allowed to flourish.
Both extremes are foolish.
As you rightly point out, it's time for some honesty, we cannot have it all.
"You cannot apply market economics to the provision of universal health care."
The French, German's. and Spanish all have insurance based systems for providing health care which employ market economics and which are arguably better than our sysytem of state funded health care. The Adam
Smith Institute propse just such a change,
http://www.adamsmith.org/publications/health/road-map-to-reform:-health-2007112094/
e
You may be right about the marginal superiority of the French, German and Spanish system as economic models, but they face exactly the same problems as us though they are at different spots on the time line.
France is about where we were ten years ago. Don't know much about Germany.
But, with respect, like the Libertarian Party, your approach is wrong. This obsession with "process" in Health care is serving only to camouflage the inherent impossibility of providing all the modern medicine has to offer to all. There is no "process" or economic system that can so deliver. It would need a magician.
Before we consider "process" we must define some achievable ends - and that means some tough decisions.
John
Absolute twaddle. You can have universal care without having it all funded by tax.
Just look at the Swiss system. Privat e or not for profit provision of all health supply, and the same for the insurance.
Your assertion that you can only get this via taxation is just by the existance of this system that works is shown to be false.
Then the state does what it should do. Just pay the insurance of those that can't afford it.
The NHS is just one of the problems in the UK. It kills tens of thousands. The government does nothing because it would mean paying compenstation to the victims.
The largest problem is the 8 trillion in state pension provision. As the ratio of workers to pensioners changes, that goes tits up.
"the marginal superiority of the French, German and Spanish system"
more than just marginal surely, at least in terms of quality of service.
BBC, French Health Care Best in the world,
http://news.bbc.co.uk/1/hi/health/799444.stm
"You cannot apply market economics to the universal provision of bread. Universal bread supply is not an economic proposition. It is an indulgence. An expensive indulgence which has to be funded by taxpayers. You can make a profit by selling sophisticated ciabatta and bagels rich but you can only make a loss by providing standard bread to the poor. Successful bakers are driven by the profit motive. An independent “not-for-profit” bakery will not survive unless it is government subsidised and thus insulated from the realities of the supermarket. And if it is so insulated, no private company can compete against it.
An insurance based system merely substitutes a private, profit driven company for a government run bakery. Doctrinally motivated health care economists will argue for one or the other, but there is no moral, or economic, absolute. Take a look at this article in Fortune magazine which describes the anomalies thrown up by a private insurance based system.
We need a fresh start, free of doctrinal absolutes. Above all, we need to admit the fact that no country can afford to provide the full range of bread for all its citizens."
Sorry doc, did I misquote? After all, if something as basic as bread (or milk) can be left to the vagaries of the market, surely appendicetomies could as well?
This post has been removed by the author.
I was thinking along the same lines when I read http://news.bbc.co.uk/1/hi/england/cambridgeshire/7318247.stm
Just why should Philip Galloway be entitled to free medical treatment for his injuries?
think your comments are a bit unfair - why not wait until the policy is worked up, and see what it actually says?
Given that the NHS manifestly doesn't work, and that those who might want to spend more of their own money on healthcare (however misguided you or are might think they are, surely that should be their right in a free society) are prevented from doing so (e.g. they can't buy their own drugs and have them administered by the NHS), we need to think about alternatives.
At least the Libertarian Party has the honesty to have pointed this out - rather than the usual BS that 'the NHS is the envy of the world'. As far as I can tell, it's only envied in non-OECD countries...
Interestingly, most European countries with a successfull healthcare policy also have fairly good social/public health policies as well. The two cannot be separated.
"You cannot apply market economics to the universal provision of bread. Universal bread supply is not an economic proposition. It is an indulgence. An expensive indulgence which has to be funded by taxpayers. You can make a profit by selling sophisticated ciabatta and bagels rich but you can only make a loss by providing standard bread to the poor. Successful bakers are driven by the profit motive. An independent “not-for-profit” bakery will not survive unless it is government subsidised and thus insulated from the realities of the supermarket. And if it is so insulated, no private company can compete against it.
An insurance based system merely substitutes a private, profit driven company for a government run bakery. Doctrinally motivated health care economists will argue for one or the other, but there is no moral, or economic, absolute. Take a look at this article in Fortune magazine which describes the anomalies thrown up by a private insurance based system.
We need a fresh start, free of doctrinal absolutes. Above all, we need to admit the fact that no country can afford to provide the full range of bread for all its citizens."
Sorry doc, did I misquote? After all, if something as basic as bread (or milk) can be left to the vagaries of the market, surely appendicetomies could as well?
++++++++
Thank you mandarin blog central. Like you, I have put the argument forward that food, which is even more important then health care, should be free at the point of entry to the supermarket. And yet it is not. Why not?
You can't narrow it down to bread. It has to be ALL food.
So, you tell me, why is it not "free at the point of entry" to the supermarket?
John
think your comments are a bit unfair - why not wait until the policy is worked up, and see what it actually says?
Given that the NHS manifestly doesn't work, and that those who might want to spend more of their own money on healthcare (however misguided you or are might think they are, surely that should be their right in a free society) are prevented from doing so (e.g. they can't buy their own drugs and have them administered by the NHS), we need to think about alternatives.
At least the Libertarian Party has the honesty to have pointed this out - rather than the usual BS that 'the NHS is the envy of the world'. As far as I can tell, it's only envied in non-OECD countries...
+++++
I don't think it is unfair. I was hoping that the Libertarian Party was going to come up with some original thinking. Sadly not. It is going down the well-travelled cul de sac of assuming that, if only we could get the right "system" or "process" we could sort out health care economics
It is NOT the system.
The problem infinite demand for an ever more expensive commodity and an assumption by the people that that demand must always be met. And no politician dare say otherwise.
I had hoped for more.
John
I normally avoid commenting on posts that already have many replies, for fear of wading into a pointless argument, but I cannot help thinking that the disagreements here are far more apparent than real.
For a start I agree with Dr C, that universal (not comprehensive) provision can not be provided by a solely private-payer system, simply because some people will not be able to afford such (or much) healthcare, those with pre-existing chronic conditions that stop them working for example. How to deal with those people is issue one.
Second is the matter of comprehensiveness, where Dr C thinks (and I also agree) that prividing everyone with all healthcare is impossible. Free-marketeers agree, and so do social democratic governments in almost all of the OECD countries: France, Germany, Netherlands, Singapore, the Scandinavian countries, all have non-comprehensive universal coverage subsidised through taxes.
So what do we do? Well the Libetarians, and free marketeers (who I tend to agree with) think that a market will be the best solution for the provision of healthcare (for reasons already mentioned above), but we shouldn't delude ourselves that it is a panacea that will provide the kind of healthcare that is deemed publically, rather than privately desirable.
A sensitivity to the suffering of others gives a strong argument in favour of charitable (subsidised) provision of a basic universal standard of healthcare - and we need to get used to calling a spade a spade - charitable provision is just that, and is not a bad thing, but mixing up redistribution with provision just creates the opaque tangle we find ourselves in. The political danger is turning equality into an idol to the detriment of pragmatic improvement; or in reaction against that idolatary to forget about suffering in a fit of individualist zeal.
John
As I said, wait until you see the policy...
BB
Fair enough, my Lord
And if it is radical and forward looking, believe me I shall feature it prominently.
John
Shouldn't that be Fair enough your Grace?
Hmm
Interesting protocol question
They do have a seat in the H of L so they ARE My Lord Bishop... but I think you are right. In speaking to My Lord Bishop, I think I should have said Your Grace
From your ever humble Master Crippen
John
Hmm
Interesting protocol question
They do have a seat in the H of L so they ARE My Lord Bishop... but I think you are right. In speaking to My Lord Bishop, I think I should have said Your Grace
From your ever humble Master Crippen
John
Now I am getting anal about this. I was right. My Lord Bishop, or Bishop.
Your Grace is for Archbishops
Full advice on how to address the clergy here:
How to address the clergy
In offering the advice below, we do not intend to imply that other practices are necessarily to be discouraged (for example, the use of Father as in ‘Father Smith’). A good deal depends on circumstances, and, where a personal preference is known, it is usually good practice to follow it.
The following notes show acceptable current usage
on an envelope or formal listing
in starting a social letter or in speech, and
when referring to a member of the clergy
Category (a) is not open to much variation, owing to the formality of the context, but categories (b) and (c) will often vary according to circumstances. It is always acceptable to use the appropriate Christian name in place of initials (for example, the Revd Alice Smith). In the absence of any style or title conferred by a post, all deacons and priests are styled ‘The Reverend’, and all who have been consecrated bishop are styled ‘The Right Reverend’.
For abbreviations, see paragraph 13 below.
1 Deacons and Priests
The Reverend A B Smith
Mr/Mrs/Miss/Ms Smith (unless it is known that some other style is preferred--the title Vicar or Rector is acceptable only if the person so addressed really is the incumbent of the parish where you live or worship)
The Reverend A B Smith at the first mention, and Mr/Mrs/Miss/Ms Smith thereafter
Notes
1 The form 'Reverend Smith'or ‘The Reverend Smith’ should not be used in UK English. If the Christian name or initials are not known, the correct forms are
The Reverend-Smith, or The Reverend Mr/Mrs/Miss/Ms Smith
Mr/Mrs/Miss/Ms Smith
The Reverend Mr/Mrs/Miss/Ms Smith at the first mention, and Mr/Mrs/Miss/Ms Smith thereafter
2 There is no universally accepted way of addressing an envelope to a married couple of whom both are in holy orders. We recommend the style ‘The Reverend A B and the Reverend C D Smith’.
2 Prebendaries
The Reverend Prebendary A B Smith
Prebendary Smith
Prebendary Smith
3 Canons (both Residentiary and Honorary)
The Reverend Canon A B Smith
Canon Smith
Canon Smith
4 Archdeacons
The Venerable the Archdeacon of X
Archdeacon, or more formally Mr Archdeacon
The Archdeacon of X at the first mention, and the Archdeacon thereafter
Notes
1 In the case of an archdeacon (or dean/provost, bishop, or archbishop) in office, the style above is to be preferred. The personal name should be used only for the purpose of identification.
2 For an archdeacon emeritus, the correct forms are
The Venerable A B Smith
Archdeacon
Archdeacon Smith
5 Deans and Provosts
The Very Reverend the Dean/Provost of X
Dean/Provost, or more formally Mr Dean/Provost
The Dean/Provost of X at the first mention, and the Dean thereafter (see also note 1 to paragraph 4 above)
6 Bishops, Diocesan and Suffragan
The Right Reverend the Bishop of X, or The Right Reverend the Lord Bishop of X
Bishop, or more formally My Lord
The Bishop of X at the first mention, and the Bishop thereafter (see also note 1 to paragraph 4 above)
Notes
1 The use of ‘Lord’ before ‘Bishop’ is diminishing. It is a matter of individual preference whether it should be used.
2 The Bishop of London is a Privy Councillor, and has the style ‘The Right Reverend and Right Honourable the Lord Bishop of London’.
3 The Bishop of Meath and Kildare is styled ‘The Most Reverend’.
7 Assistant and Retired Bishops
The Right Reverend A B Smith
Bishop
Bishop Smith
8 Archbishops
The Most Reverend the Lord Archbishop of X
Archbishop, or more formally Your Grace
The Archbishop of X at the first mention, and the Archbishop thereafter (see also note 1 to paragraph 4 above)
Notes
1 The Archbishops of Canterbury and York, being Privy Councillors, also have ‘Right Honourable’ included in their style (for example, The Most Reverend and Right Honourable the Lord Archbishop of Canterbury).
2 The presiding bishop of the Scottish Episcopal Church is the Primus, and the correct forms are
The Most Reverend the Primus
Primus
Primus
3 A retired archbishop properly reverts to the status of bishop, but may be given as a courtesy the style of an archbishop.
9 Chaplains to the Armed Services
The Reverend A B Smith RN (or CF or RAF)
Padre, or Padre Smith
The Padre, or Padre Smith
10 Titled Clerics
Where a member of the clergy also holds a temporal title, this is always preceded in writing by the ecclesiastical one.
Barons (other than retired archbishops)
The Reverend the Lord Smith of Y
Lord Smith
The Reverend the Lord Smith at the first mention, and Lord Smith thereafter
Baronets
The Reverend Sir Alan Smith Bt
Sir Alan Smith or Sir Alan
The Reverend Sir Alan Smith at the first mention, and Sir Alan Smith thereafter
Knights
An ordained priest may be appointed to an order of knighthood, but will not normally receive the accolade or title. The appropriate designation will follow the name or ecclesiastical title, e.g. The Right Reverend the Bishop of X, KCVO. If he was knighted before he was ordained, he will retain his title.
11 Ordained Members of Religious Orders
The Reverend Alan/Alice Smith XYZ; The Reverend Brother Alan/Sister Alice XYZ
Father, Father Smith, or Father Alan; Brother Alan/Sister Alice
The Reverend Alan/Alice Smith; Father Alan Smith; Father Smith; Brother Alan/Sister Alice
Notes
1 A name ‘in religion’, shown in parentheses in the biographical entry, should be used in preference to the baptismal name or initials. Sometimes the surname is not used. In this Directory, however, the entry will be found under the surname, whether it is normally used or not, and, if appropriate, a cross-reference is given under the Christian name.
2 Some orders use ‘Brother’ and ‘Sister’ for lay and ordained members without distinction, along with Christian names.
3 It is customary to specify the religious order by giving the appropriate letters after the name.
12 Academics
When a member of the clergy holds more than one title, the ecclesiastical one is normally used.
Professor also Canon
The Reverend Canon A B Smith
Canon Smith, or Professor Smith, according to context
Canon Smith, or Professor Smith, according to context
Canon also Doctor
The Reverend Canon A B Smith (degree)
Canon Smith, or Dr Smith, according to context
Canon Smith, or Dr Smith, according to context
13 Abbreviations
The following abbreviations are in common use
Reverend: Revd or Rev
Father: Fr
Right Reverend: Rt Revd or Rt Rev
Prebendary: Preb
Venerable: Ven
Reverend, Right Reverend, Very Reverend, Most Reverend and Venerable, whether
Actually, with international wheat prices rising at a hefty rate soon bread will become much more expensive.
Do you know why it's cheap? Because its sold at a loss (or cost) by the supermarkets to ensure you come in the door to buy other things as well.
We have a system that protects us from bread problems.
Have you seen Egypt in the news...big problem...the people can't afford the bread so have to buy the gov subsidised bread.
So sure we can do free operations...as long as you can be fairly sure people will keep coming back for other things that cost more.
John, your ignorance of popular culture is worse than your pedantry. Bishop Brennan is or was an Irish Catholic bishop of course, with an eponymous role in the Father Ted episode "Kicking Bishop Brennan up the Arse". As such, Wikipedia tells me (and would they lie?) he would be addressed as "Your Grace", though if one were kicking him up the arse such fastidiousness in forms of address would be superfluous.
blimey sorry I asked
Ah! I didn't realise it was the Catholic, or Irish clergy, that we were discussing. What is "popular culture" by the way? I feel an oxymoron coming on. But back to the Catholic clergy. I have not yet had the chance to kiss the Pope's ring, but I believe the following resource may be helpful:
How to Address Catholic Clergy
This page deals with Roman Catholic ritual and custom; it is important to remember that other religions have their own rituals and customs. If you do not agree, that's OK.
[edit]Steps
Identify the clergyman's rank: Pope, Bishop, Priest, or Deacon.
Be aware of additional titles like "Doctor" or honorary titles, like "Monsignor."
Identify the form of address to be verbal or written.
Address Deacons verbally as "Mr. Last Name". If you are addressing a letter to a transitional deacon, use "Rev. Mr. Full Name". A transitional deacon is one who will be ordained a priest. Permanent deacons are addressed as "Mr. Last Name". Sometimes, a Deacon can be addressed, simply: "Deacon Last Name."
Address Priests verbally as "Father Last Name", or "Father First Name", as they would prefer. Some persons who are not Catholic prefer to address Catholic priests as "Reverend". In some parts of Europe,for example, in Italy, it is common even for Catholics to address a priest as "Reverendo" especially in the absence of any other title. "Reverend", while not originally a title, has become a title with usage and has been common in the U.S.A. for at least 40 years. It is only necessary to say the last name once, if at all, depending on the circumstances. After that, simply call him "Father". In writing a letter, address the letter to "The Reverend Full Name" and append any doctoral degree (like Ph.D. or D.D.) if the priest has such a degree. Do not address letters to priests as "Reverend Father". In the address field write "The Reverend Full Name, Doctoral Degrees only," if any. Begin your letter with "Dear Reverend Last Name" or "Reverend Last Name" for a greater degree of formality; or "Dear Father Last Name" or "Dear Father First Name" if the letter is informal.
Address Bishops verbally as "Bishop Last Name". It is optional to add his last name. If you say the Bishop's last name, do so only once. After that, simply address him as "Bishop". Address letters to "The Most Reverend Full Name, D.D.", then add any other doctoral degrees, if he has any. In conversation, a bishop may be addressed "Bishop" without name. It is preferable to use no name than to call the Bishop by his first name. Simply address him as "Bishop". In some cases, the most formal way to address a Bishop is "Your Excellency". The equivalent for Archbishops is "Your Grace". However, many senior clergy find this form of address embarrassing, and are extremely unlikely to insist upon it.
Address Cardinals verbally as "Cardinal Last Name" or "Your Eminence" without name. If you address the Cardinal as "Cardinal Last Name", do so only once. After that, address him as "Your Eminence". Address letters to "His Eminence, First Name Cardinal Last Name." If the Cardinal is a Bishop, add "D.D." and any other doctoral degrees he may have, after his last name.
Address the Pope verbally as "Holy Father" or "Your Holiness". Never say the Pope's name in a conversation with him. Address letters to "His Holiness Pope Benedict XVI."
Tips
In some places kissing the ring of a Bishop or Cardinal may be tolerated. If you insist on doing this, you may embarrass yourself. Most bishops will resist this form of deference. In such a case, just politely shake the hand of the bishop if he extends his hand to you. If you insist on kissing the ring of the bishop of the diocese in which you reside, it may be proper to genuflect with the left knee. Today, genuflecting to bishops is not a part of the usual protocol, and you will become most obvious, because most other people will not do this. One ought not to genuflect at all to a bishop that is not your diocesan bishop. A problem will exist if there is more than one bishop present. A sequence of bowing, then genuflecting, then bowing, etc. is awkward at best. Genuflecting to bishops originated when bishops were governors.
·In some countries kissing the hand of a priest is a custom with some people. However, you may find that you are the only one that does this, and you may embarrass yourself when others who are with you will not do this.
· In North America and Europe, Catholic Priests may be verbally addressed as "Reverend Last Name" or "Reverend Doctor Last Name" (if he has a doctoral degree). In the U.S.A. it is perfectly acceptable to call any Christian clergyperson, "Reverend". With any clergyman you should include a doctoral degree or any honorary title, e.g., The Reverend Dr. John Smith, Ph.D., or The Reverend Msgr. John Smith. Do not abbreviate "Reverend" unless you are writing an informal note, and always include the definite article "The" before "Reverend".
· The use of "Father" as a verbal title originated in Europe and was only used with priests who were members of a monastic order. It distinguished the priest-monk("Father") from a lay person-monk ("Brother") who was not a priest. In Italy, for example, a parish priest is called "Don First Name". "Don" means "Sir" or a polite "Mister" and is not a religious title. "Don" is a little informal, but it is respectful. It can be used with any man that you personally know.
· If a priest has the honorary title of Monsignor, call them "Monsignor Last Name" instead of "Father", following the same rules concerning verbal and written forms of address for priests.
· Never append designations of academic degrees that are less than doctoral (e.g. BA, MA, STB, STL). There is one exception. The author of a book or study may wish to indicate a master's degree (MA) or licentiate degree (STL) appended to his name as part of his identification as the author.
· A general rule is always to be formal. Familiarity is not proper with any clergyman unless you are a relative, and then, only in private. Informality is never proper in public or with anyone unless you are a relative or a close friend, and you are in private circumstances. If you are with your close friend who is a Bishop and you are in public, you must address him as "Bishop". The same model is used for persons with other professional titles, like "Doctor" or honorary titles like "Monsignor". Referring to your close friend who is a Bishop as "John" or "Marty" in public circumstances is improper, and it will embarrass you.
· Clergymen may not address anyone in an informal manner at any time except in private conversation and only if the persons involved are in an informal relationship. A clergyman must always address people with their proper title: Mr., Mrs., Dr., Reverend, Father, Monsignor, Bishop, etc. Clergymen may address young persons by their first name. In a formal setting, as in making wedding or baptism or funeral arrangements, the clergyman must address people in a formal manner.
· Catholic Bishops and Catholic Priests in audience with the Holy Father should follow the protocol prescribed before the audience. Bishops and Priests should act uniformly at a Papal audience. This means that if the first Bishop or Priest to meet the Holy Father genuflects to kiss the Papal ring, others should do the same. Do not initiate your own protocol. Follow the instructions given before the audience with the Holy Father.
[edit]Warnings
Do not address any clergyman by their first name without a title. This is never proper.
Never extend your hand to anyone you do not know and never to a person of superior rank. In American parishes many priests greet the parishioners after Mass, with or without physical contact. When in doubt, leave it out.
Unlike many I have faith in the world at large to come up with solutions to problems such as healthcare provision, but this can't happen until the state gets out the way. My own preference would be a system whereby while relatively young you pay for routine medical care, insure yourself against unlikely serious illness and save for the future. Then when in need of more expensive care in the future you can pay direct from your cash fund without involving insurers. Ideal solution, who knows? But as long as compulsory taxation for government provided healthcare continues you will never get a chance to try.
I'd be interested to know Dr Crippen's resource for the forms of address of clergy. I would recomment A & C Black's "Titles and Forms of Address". It's a long time since I referred to it but my recollection a lot less complicated than the above quotations. I'm pretty sure that most present day bishops (in the C of E at any rate) would prefer to be addressed informally as "Bishop John" or whatever rather than "My Lord" which is so archaic.
As an aside, has anyone noticed that some dentists are now referring to themselves as "Dr" rather than "Mr"?
Dr C you should try and get out more often.
Why don't things like cosmetic surgery (for those who just want it, not those who have been disfigured by operations, cancer, disease or accidents), ALL fertility treatments, sex changes, cosmetic dermatology, etc etc etc ie. non essential medical care go private? I cannot agree with payment for healthcare for all-even though I have always paid for mine, but I am young, healthy and have a good job and hence very lucky. But I do feel that ONLY essential medical care and treatment be subsidised through tax. If Charlie decides that he's always really been Charlene deep down, or Lisa decides she wants a baby at 45 years of age, or Dana decides she wants a nose job and bigger boobs or she'll get depression and Body dysmorphic Disorder, then they gotta pay. Charlie could suck it up until he's earned enough for his op, Lisa could adopt one of the many babies that desperately need a home, and Dana, again, has some motivation to work hard and save up for hers. I hate the way some of this crap can be paid for by taxpayers when it could be going towards improving, say, our cancer services. A committee should be set up that decides what ESSENTIAL EVIDENCE BASED treatments are available on the NHS. Everything else is paid for by the patient themselves if they want it.
I think that I need to point out that it is actually possible to totally abolish Income Tax and still fund the NHS to the tune of £105bn a year.
Firstly, Income Tax brings in £150bn a year and total state spending is in the region of £600bn a year.
I am one of the people working out the figures and there really is that much waste and unecessary spending done by the state.
Probably going against the wind here, but what do these, presumably affluent, people propose to replace Income Tax with? To my mind it's the only fair system, especially when taken at source. I'd prefer to up income tax and dramatically reduce VAT. It's natural enough to want to decide how to spend your own money, but let's face it, how many of us still tithe 10% to charity?
j
It's natural enough to want to decide how to spend your own money, but let's face it, how many of us still tithe 10% to charity?
Why would you, if the state is supposed to be covering all the bases? If the state wasn't, and you actually got to keep your earnings...
John,
I shall work up a response at The Kitchen when I have a second. However, there are several problems with your analysis, not least that you seem to believe that "the market" is a single system: it isn't.
Second, you absolutely contradict yourself; you acknowledge that we do, in fact, need a mutiply tiered system relating to ability to pay and then, in your final paragraph, you seem to criticise your own analysis.
If you doctors don't seem to be able to think rationally about this, why on earth should we value your opinion?
And we might let "the NHS to lapse into a two tier system in which only the rich can access good medical care." Well, yes; and we are all substantially richer than we were 60 years ago.
If I can get premium private medical insurance for less than £50 per month, I don't think that that's unaffordable, do you? It is substantially less than NI will cost most people (even those on low wages).
DK
Dr. Crippen,
In Funny Pseudonym's post lies the answer; I am forwarding something similar on the LPUK's policy forums on health.
"Funny Psuedonym said...
Actually, with international wheat prices rising at a hefty rate soon bread will become much more expensive.
Do you know why it's cheap? Because its sold at a loss (or cost) by the supermarkets to ensure you come in the door to buy other things as well.
We have a system that protects us from bread problems.
Have you seen Egypt in the news...big problem...the people can't afford the bread so have to buy the gov subsidised bread.
So sure we can do free operations...as long as you can be fairly sure people will keep coming back for other things that cost more."
So in medical terms you supply emergency care as a free service (carefully controlled from abuses; i.e. coming in with a stubbed toe to see a free doctor) and charge for the rest of treatments: GP visits, drugs, minor operations etc...
My basic thoughts though? Take Politicians out of medicine completely and allow the medics themselves to run our healthcare. If you think you will be eaten up; I doubt you could be eaten up by some nasty capitalist - too salty.
Thats kind of my philosophy for all things; take the politics out of it and you normaly end up with the most pragmatic solution that helps the most people.
You made a good point, although some commentators seem to have missed the wood for the trees a bit.Your life is so wonderful,Reading your article is a kind of enjoyment.Thank you.
Tactical Flashlights
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希望大家都會非常非常幸福~
「朵朵小語‧優美的眷戀在這個世界上，最重要的一件事，就是好好愛自己。好好愛自己，你的眼睛才能看見天空的美麗，耳朵才能聽見山水的清音。好好愛自己，你才能體會所有美好的東西，所有的文字與音符才能像清泉一樣注入你的心靈。好好愛自己，你才有愛人的能力，也才有讓別人愛上你的魅力。而愛自己的第一步，就是切斷讓自己覺得黏膩的過去，以無沾無滯的輕快心情，大步走向前去。愛自己的第二步，則是隨時保持孩子般的好奇，願意接受未知的指引；也隨時可以拋卻不再需要的行囊，一路雲淡風輕。親愛的，你是天地之間獨一無二的旅人，在陽光與月光的交替之中瀟灑獨行.......................................................................................................................................................................................................................................................................................................
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