A privately run system would eventually *NOT* offer an equivalent service to the NHS. Profit motive kills equal health care. Period.

I don't think that privately run healthcare automatically diminishes the service offered, but I think it is ridiculous that people think that healthcare is something that the government *shouldn't* involve itself in. It seems to me like overseeing the general wellbeing of the populous is the one of the most easily defined purposes of government, at least in the Western world.

I don't want to turn Britain into America.

I want to abolish healthcare altogether so that the weak perish and the strong survive.

Banana state passports for a banana state country - Congratulations! That fits well.

Merry Christmas everyone btw. :)

"I want to abolish healthcare"

Aaannnd that's quite enough. I'm not prepared to waste another second on a self-professed Nazi who wishes to abolish civilization.

Muted.

Really, Jamie, you do get a tad over excited by these comic forum personae. I'm half convinced you thought Al Swearagen's (or whatever his name was) act was genuine

It would be interesting to see the difference in various mortality rates/life expectancy etc in the US split up by standard income brackets... I suspect that dollar for pound, the US still get worse outcomes.

@Octavious, what you want to have is a system which encourages preventative measures, and health education.

So doctors (GPs) having the time to educate their patients and communities on preventative measures.

I think the uninsured in the US are massively incentivised towards emergency treatment, which typically is more costly and less effective.

I suspect the NHS is on the right side of this, and elderly people who go to the doctor to have someone to listen to them need alternatives in their community, rather than fucking up a good medical system.

@ Ora

It depends what you mean by preventative. Some measures, such as vaccinations, teaching kids how to lift properly, regular PE etc. I fully support. Measures such as discouraging children from climbing trees or making rope swings, far less so. A few more broken bones is an excellent price to pay for a fuller childhood.

In terms of things like smoking, education and labelling etc are good. The mega tax on the addicted, on the other hand, is no better than the actions of criminal drug dealers.

I think preventative would include things such as regular sessions to check a baby's weight and cognitive progress and a letter from your GP on your 60th birthday inviting you in for a check-up.

Indeed... Do Yanks not get stuff like that?

Honestly, what a drama queen. Can Jamiet not read or something? I said I wanted to abolish healthcare, not civilisation, and I never professed to being a nazi - I just made light of the fact that other people have condemned me as one.

Automatically, no. Eventually, yes.

If you put profit motive into any industry, it leads to a decline in quality of service. At a certain point, the CEOs will cry "We must cut costs!" and the most expensive procedures will be eliminated and people will die. Or they'll cry "We must raise prices!" and some will not be able to afford prices that private providers can legally demand.

And if private companies don't like the law, they'll lobby to change it, or destroy it.

Do you not remember British Rail, Jeff? The trouble with publicly owned services is that there is never enough investment. No matter what government is in charge, when it comes to budget time and the question of what to spend money on comes up, politics trumps good sense every time. Things like the railway, roads, water companies etc always lose out to health, education and tax cuts. The only way sufficient funding is delivered is when the business is cut off from the other arms of government, and that only happens with privatisation.

Health care is one of 2 or 3 sectors where the public sector can work, and that's because it's always at the top of the tree. Because of that privatisation of the NHS is more trouble than it's worth. But generally speaking, if you want service run properly you have to take it out of politics.

British Rail died a noble and necessary death and was reborn like a phoenix rises from the ashes.

Transportation is one sector in which public investment in infrastructure is important for commerce and safety during disasters. I live near San Francisco, so I understand this on every level--we've got it all. But the transit agencies continually try to kill the goose that lays the golden egg and disguise their intentions. Just this past week the transit authority for the SF-Oakland Bay Bridge, one of the busiest in the world with almost 300,000 vehicles per day using it, floated the idea to raise the toll to $9 during rush hour "to ease congestion." Soon enough, when enough car drivers switch to public transit, they'll raise fares for BART (subway) and bus "to ease congestion" just the same. It's a racket.

But health care and utilities such as water and electricity are indispensable for living in a modern society and have single routes for delivery. Government must step in for these or they will leave their citizens to be preyed upon by crisis opportunists.

Those who blindly chant Adam Smith's mantra and want the invisible hand of the market to solve all problems have been sold a bill of goods.

Government must step in, yes, but as a regulatory authority rather than service provider. Create a set of rules and enforce them, and let the private sector operate within those rules. As soon as you put the government in charge of actually running anything you get chronic underfunding and inefficiency, pretty much every time.

Octavious believes all railways should be torn up and abolished. His views on how the rail network should be operated are largely irrelvant, since he believes it should not operate at all.

Regulatory capture is a thing. Some people will always try to take advantage of other people. Witness, American health care.

The cost of an ambulance call out in the UK is about £630 - according to NHS figures. Not a million miles away from the US figure.

Just because I don't think that railways are a particularly effective mode of transportation doesn't mean that my opinion on how best to run them is irrelevant. Once again, Jamie, you're talking nonsense.

I thought you muted the thread jamiet. You LIED again!

COMING THIS SPRING

Ticket to Ride: Westeros!

Think he muted me, not the thread. Not sure why. I'm told my rascally ways are endearing.

Go away Brad.

I muted CroakandDagger

@"In terms of things like smoking, education and labelling etc are good. The mega tax on the addicted, on the other hand, is no better than the actions of criminal drug dealers."

It is a great revenue stream for the state, but yes i'd agree it isn't so great... While i agree with things like regular physical exercise etc.

So yeah, i agree with several things, like vacinations. But i think you've missed the thrust of what i was thinking of.

Examples would include, not going to see your doctor with a minor ailment until it is very serious, and then going to the emergency room. This typically incurs a greater cost when early trestment would have been a more effective use of resources.

And this can happen when the cost of going to the doctor is prohibitively high. (Its not all there is pushing costs up in the US but is a contributing factor..)

Well, yes, but in my suggestion the emergency room carries a charge and the doctor is free for ten shots or so, so that pretty much tallies with us both.

Well in my suggestion, i'm rather vague because i don't know the details for how to best implement things, you'd probably want to study the system out there at the moment and use what works best.

For infrastructure and utilities, i really like the idea of state investment and private companies running the services which use said infrastructure.

So you can have the state build a new rail line, raise and invest the capital, and then allow several competing private companies bid to pay for the privilege of operating on this rail line.

You can have public-private partnerships raise capital together if the returns are high enough to attract private investment; and you can have competing corporations trying to provide the best service while out-bidding each other for access to the govt infrastructure...

Not possible for every utility, but it is a mixed system which should solve most roi issues.