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Yet another less than bright idea from the government

The sky is darkening from all the kites being flown at the moment, but the latest monstrosity is the prospect of denying healthcare to people who have made 'bad life choices', with smokers and the overweight the yawn-inducingly predictable targets. More here.

Fine. Before following that particular powder trail, what prospect of a refund to those who have been paying into the system and then are denied healthcare? Or allowing people to opt out, perhaps? The internal logic of socialised medicine has long pointed to the possibility of the state taking it upon itself to lecture us on our choices, in the 'public interest', and there is no obvious break point as to those choices which are 'legitimately' ours, or 'legitimately' those of the health commissariat. Stand by for a National Food Service, and just imagine quite how awful a Dept of Food menu for the week would look.....

Anyway, some other areas of healthcare where the patient is the best cost avoider: pregnancy, STDs, sporting injuries, car accidents (And hey, use public transport, it will save the planet...), drug addiction, anything alcohol related, RSIs, back pain, diseases contracted abroad, food poisoning etc etc etc.

And indeed, we could follow Belloc's logic:

"Lord Finchley tried to mend the Electric Light
Himself. It struck him dead: And serve him right!
It is the business of the wealthy man

To give employment to the artisan".
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Anonymous peter hitchens said... 6:21 pm

As an obese alcoholic with genital warts, im a worried man.  



Anonymous verity said... 6:37 pm

It's the same old tune, but I'll hum it one more time: Dump. The. N.H.S. It's an open door to government control over every other aspect of your life.

Socialised medicine, like anything else touched by the mortmain of socialism, is a screaming failure. The amount of money that is squandered is truly repulsive. Surely the fact that the NHS has over a million employees should tell the British public that this is not a manageable project.

And good point, Croydonian: are they going to give those people their money back?

Everyone should be responsible for that most basic issue of life, their own health! Once you've handed that over to "the government", you have abdicated.

The NHS and ID cards. God, I am so glad I am not there!  



Anonymous Anonymous said... 7:48 pm

I see the light at the end of the tunnel though. The fact of what they are trying to do will defeat the project in the end. For it is a augean task, beyond the control of even the mighty Labour party.

The more they drill into the ideological socialism that backs the NHS, the clearer it will be to people that thiscannot work. Do they really want to lose the fat, smoking, pregnant classes? THese are a large chunk of their core voters.

Either way they lose. They punish their own supporters or they finalise the ideological car-crash.

The end is nigh.  



Anonymous verity said... 7:57 pm

"... they finalise the ideological car-crash." Nice imagery, CU. I really like it.  



Blogger Croydonian said... 9:20 pm

Indeed. I doff my hat CU.  



Anonymous Anonymous said... 9:42 pm

Yes he `s a clever bugger isn`t he that CU.


Last year 30% of the trusts were in deficit and the total out of pocket was £512,000,000. Closures have indeed affected STDs and the crisis is caused by poor management , wage rises and a failure to address unlimited demand .With targets flung at trusts with no experience they fiddle the books and cut the wrong things , training for example . Rather sweetly key unit closures have clustered away from NuLab marginals and I simply do not believe there has been no political interference .

It was always a combustible combination a brand that is close to a religion with years of hate mongering from Nye Bevan onwards insulating it form any non political treatment. By the way did you see the list of great Britains with Nye Bevan in and no Chuchill grrrrrrrr). Ally this with an administration with no purpose but short terms political expedience and priceless demand alone would have done the job

So what does Labour do . They will not disturb the bed of weeds , those are there captive voters , they will not introduce real reform , that would hand over the argument they live on. Instead they cast around for ways to limit demand that are politically flyable . They pick on the Fattys ( insert predictable Prescott joke ) , the smokers and so on and son . They sell the real capital of the country , its freedom to pay for there immoral wish to cling onto power like a evil child clutches his muddy football

“My ball my ball!!!”

The moral iniquity of this is virtually limitless . Denying the working classes health care ? Robbing tax payers on false pretences . I would be able to buy a policy worth in the region of £250,000 for myself alone with the money my “free” health care costs . Where does it go and what are the limits of the states role. No-one will ask.

Again and again by disengaging with real debate and living in the land of the focus group the worse possible decisions are made . I can see David Cameron’s problem, here adjusting the NHS is tippy toe territory for the Blues but I think he can afford to be braver . I went on the NHS campaign and many many people from within the organisation reported horror stories of waste and managerial catastrophe.
I think they may well be ready for some truth and I am going to have to join Mr C in giving Miton Freidman a cuddle . Some limited market economics must be introduced as a part of developing the constituency for scrapping the large parts of the Service in its current form. A child can see it is not sustainable and the pretence of virtuously withholding health ….ironically …makes me feel SICK


I will never say this to anyone. . This message will self destruct in four seconds ……………………….


1 2 3 4



“ Yes of course you can trust us with the NHS” Beam ”Why thank you we need every vote !”  



Anonymous Anonymous said... 9:49 pm

VERITY- Dump the NHS equals , don`t elect me. There is point in saying that and there never will be .Not here.

People see dead bodies in the street and well heeled policy holders tipping up the corpses with their spats , saying to little Tarquin "See what happens if you negelect to pay your premiums " .

This is not something you can sell . Promise.


Interesting thought that both housinmg and health the great post war social advances are coming of the rails . There is such a perception lag  



Blogger Croydonian said... 9:57 pm

The NHS is the holiest of holy cows, but I do wonder how long people who have choice as active consumers will continue to accept the NHS model. My leading insight into the NHS is that not some, not most, but EVERY woman I know who has given birth in an NHS hospital has a horror story.

I do not think that a health system free at point of demand is going to stop being popular, but there are better models where we are not approaching the medical business like mendicants. One of these days I will do a post about the Israeli system, which works on compulsory insurance, but has three competing companies.  



Anonymous newmania said... 10:04 pm

C - The care my wife recieved was superb and so was the after care. I , by contrast , have not heard a bad word about our local hospital.

It is one of the better ones but I think you are barking uo the wrong tree.

Its only a feeling i have but when you finally get to the care it is usally pretty good .The cost delay and avaiability are where the corners are cut

( I have no stats though)  



Anonymous newmania said... 10:07 pm

BTW C The Guardian is covering your Privacy scare today . That paper seems to follow you like a lost dog. I keep noticing Croydonianisms in it .  



Anonymous peter hitchens said... 10:25 pm

Im going to be serious for a change.
The NHS is a disgrace, unlike verity I am all for the concept, however it is badly run, for the simple reason that it is run for the benefit of those that work for the NHS not for the benefit of the patients.
Too many Nurses tend to be big fat arsed idiots who have been built up to believe that they are pseudo doctors rather than people whose duty is to "care" for patients by wiping arses and keeping the wards clean and hygienic and administering TLC not prescribing drugs.
Go to any hospital ward and you will see them sat about guzzling food and chatting in the nurses station, there are some exceptions but not many.
It doesn't take a degree to wipe up bodily fluids or hold somebody's hand.
All a result of socialist "everybody gets a prize" bollocks.
like everything in this country it is beyond reform until society collapses and is rebuilt.  



Blogger Welshcakes Limoncello said... 10:44 pm

You've a good point regarding a refund there! And, as you imply, where does such "logic" end? Do those in power ever consider that they, themselves, might drive a person to drink ?!  



Anonymous newmania said... 10:46 pm

Quite so Peter. Our wonderful nurses are not wonderful . Our wonderful policemen are even worse .
The only thing is I `m not wonderful either and while I would not dare suggest Verity isn`t (wonderful) I suspect the same goes for everyone else.

If you pay people to do nothing useful then that is excatly what they will do.


Your arguement about too many chiefs is a systemic disaster for the police. Why can you never see a policemans but you cannot avoid seeing a traffic warden.

The police is , in my opinion , the most self serving public servivce of all and many policement agree.


In a slightly different way the welcome apocalypse is something Conservatives guiltily hope for evrytime they see a wobble in the economy. I don`t think we are going to have long to wait . Nu Lab are literally selling of the family Silver now . It reminds me of the end of Midland Bank  



Anonymous verity said... 10:50 pm

Newmania - I agree that saying 'dump the NHS' is another way of saying "Don't vote for me or my party." But it is so foul. All these people dying of MSR because of the filthy conditions. Even newborn babies are getting it. Mixed wards!!!!! And that old lady whose daughter saw maggots crawling up her breathing tube into her nose! Waiting a year for treatment. Rationing treatment. How dare they!!!

France consistently comes in level pegging with America at No 1 spot for health care. And it is very cleverly managed. Like, I assume, Israel, from what Croydonian said above, it is nationalised, but it is also free market.

For example, if your doctor wants you to have an xray, he writes out a prescription and gives it to you. You then take it to the laboratory of your choice - the one that's been recommended by your friends or has a good general reputation. The government pays the lab. Meanwhile, all the labs compete in terms of cleanness, friendliness - yes, as Croydonian will attest, the French can be friendly, in an icy kind of way, efficiency, ease of getting an appointment.

They develop the Xray while you are getting dressed and a doctor takes you into a little room with your xray pinned up and explains it to you. He/she then puts it in an envelope and gives it to you.

You then take it back to your doctor (or, if you feel your doctor misdiagnosed you, you take it to another doctor). If you have to go into hospital, they ask which hospital you want to go into. And you can probably get in within a few days or a week.

Everything it patient choice and it works a treat. Care is very good indeed.

I must say, although I am a raging capitalist and want to see us pay for everything directly - not through government and taxes -, the French system is very intelligently thought out and it works. (They really are skillful at doing huge projects. The British are not. There's a sloppiness of thought and low expectations.)  



Anonymous peter hitchens said... 11:01 pm

Mr Mania
The Hitchens are loaded ,cocked and locked and stocked up with dried foods, water filters , propane canisters,Antibiotics and gold coins.
Not joking, I forsee a huge crash on the horizon.
survivalist Hitchens also reccomends a small diesel car , diesel is easy and legal to store and if it runs out we all know that bio diesel is easy to make.  



Blogger Croydonian said... 11:07 pm

Exactly. As noted, the estranged Mrs C gave birth in France, and I had my arm twisted into seeing French sawbones once or twice, and the attitude difference is the astonisher - the quacks etc want your business and will treat you as a potential repeat customer, not as a captive market which is just manufacturing inconveniences through the sheer fact of one's existence and healthcare needs. On the downside, Pa C died in a French hospital, and while the care was all that one could hope for, he died in a departement other than where he was registered, and therefore it became a 'federal' matter. My mother did not need to have gun-toting plod barking out questions at her while still at the hospital, frankly.

I've also had the amusement of pointing out to a French quack that his fly was undone.  



Anonymous Anonymous said... 11:12 pm

NHS - too much time spent deciding on whether single girls can have IVF on the state.

Our newly trained nurses and doctors emmigrate to Australia because there are no jobs here. these have been filled with the alumni of teaching hospitals in Lagos and Manilla.

A sad state of affairs for the us all. NuLab's appraoch of the economically illiterate expansion of demand by encouraging false hope is wicked. The new modus operandi of blaming people is just a typical marxist dialectical appraoch to a problem they can't solve.

Under major the Tories seemed to be getting a grip on the mixed market appraoch. Blair has dragged us back a generation with populist posing. I see Andrew Lansley, shadow minister, has little innocative to say. No doubt gagged by the Cameroonies.  



Blogger Croydonian said... 11:23 pm

The curious thing is that Gauls et al have much the same life expectancy as we do, but the system / process seems just a tad more foucused on the consumers rather than the producers.  



Anonymous Anonymous said... 11:37 pm

C- yes well you have to factor in the fact that the French don`t wash. They get lots of germs ..( don`t drink the water)


PHITCH , I dont know if I would be sorry. I will be bringing a small bowl of sugared almonds and hoping you let me into the compound.Meanwhile.VERITY and CU

Mixed market solutions

Well this is so interesting . Take education . I have spent the past couple of days with my brother while he moans about the problems of being a teacher . He previously worked at Paribas (banque)
This is what he tells me
1 You cannot fire bad staff
2 You cannot discipline long-term under performing staff
3 good staff are disillusioned
4 Good staff are not supported and cannot give discipline
5 Membership of the NUT is regarded as compulsory in case of malicious legal attack
6 Exams based on modular course work are a joke and top schools have abandoned them altogether for French ones ( I think)
7 Offsted inspections are easy to fix
8 Key worker grants are defrauded

And so it goes on .Two things are obvious . You cannot abandon public education but accountability thought market models is essential .In fact until you tackle this you are moving the furniture around .
Over the years voucher systems have been suggested by they have “foundered on the rocks” of the NUT and the detail”

I have always wondered how a mixed market scheme might operate in practice and if such things are running abroad I am curious to say the least. My sense is that the CU road crash can only be avoided by such an approach to social support of all sorts but I had assumed it would be impossible in practice.

I tend to stop at the channel and avoid foreign but are you saying the French are …cough cough ..better at something than we are .This is bad news , I only keep going there to check we are still best. Seriously though mixed market models have to be the right direction all the Conservatives say about the NHS , for example , is that they would do the same thing better . Feeble hardly covers it .

I know a chap who as a management consultant and I used to say ,“What on earth could anyone running a business possibly learn from you.?“ He said well we turn up from outside run our models and have our chats . The report we produce helps to break the deadlock so the company can do what they knew they had to anyway. Maybe we should get some government Consultants in from France and America to do an audit of best practice?


HAVE you seen the figures out on crome and public expenditure on solving it.Mixed market appraoch the Police please.Why are there no policemen on the street and 1000 traffic wardens per driver ?

AS I SUSPECTED!!!!!  



Anonymous verity said... 11:38 pm

OK, I have been persuaded that the British are delusional about the quality of the NHS (I had my non-violent, but "grumbling" appendix out when I lived in Singapore and I was checked into the hospital on the day I told my surgeon to go ahead. The hospital was spotless. And guess what! There were matrons! And those nurses were beyond respectful of her. The "wards" - actually, a series of private rooms - were run like a hotel. Clean, clean, clean. Choice of food. TV. Free private phone.

India is the new place to go for ops. There are private hospitals (frankly, I'd go for the food alone) that American insurer Blue Cross/Blue Shield will pay for and the NHS will also pay for, in India. Interestingly, although not surprisingly, in international tables, India has a tiny edge over the US in cardiac bypass ops. Something like a quarter of one per cent, but still ...  



Anonymous newmania said... 11:46 pm

rats I `ve got to pack ....away for a day or two.  



Anonymous verity said... 11:58 pm

Although a privatised police force isn't viable - the poor would be excluded and people who are vulnerable through no fault of their own - i.e., they're OAPs, not jobless louts on "disability" benefits - the closest thing to local accountability, and I know I have Croydonian's vote on this, is an elected chief of police.



By and large (there are some failures; it's a vast country), this works. The police chief wants to keep his job for the next four years, and the four years after that, so his department has to keep on performing to the satisfaction of the voter. (Also, if he gets voted out, what a career-killer, eh?)

It also, of course, dissolves nationalised central control. A creature like Iain Blair would be impossible with elected police chiefs who serve the voter, not a political master. In fact, as they learn very quickly, their political master is the voter.  



Blogger Croydonian said... 12:06 am

I suppose if I had to summarise my way of looking at the world, and how I want to interact with it, it would be to say that I wish to let the market determine the minutiae of daily life and for voting to determine the bigger issues.

The estranged Mrs C was a teacher in the French state system, and I could (and will...) relate all manner of hair raising tales about l'education nationale, but right now it is late.  



Anonymous newmania said... 12:15 am

Verity you could out source vast areas of policing easily . It has often been suggested but is fiercely resisted by the police . I did not mean buying your own personal protection. I was developing PHITCHES point about overpayment of falsely qualifed public sector workers when a company would pay at the level of skill required.


The police do not want to be plodding around like traffic wardens they want to be in helicopters and they do not want a paralell service provider showing them up.

BTW:Just picked up your further lyrics

Swoon.  



Anonymous Anonymous said... 7:17 am

A point to ponder:

Steel used to be a centralised state owned industry
Electricity used to be a centralised state owned industry
Car Manufacture used to be a centralised state owned industry
Coal Mining used to be a centralised state owned industry
Airlines used to be a centralised state owned industry
Telecoms used to be a centralised state owned industry

We used to produce expensive steel, endure regular power cuts, drive cars that kept breaking down, produce the worlds most expensive coal, we didn't fly at all (unless we were rich) and a new telephone line took 6 months to install.

So we learned a lesson. A centralised state owned industry does not perform.

With all due respect to those working in these sectors, not one of them is as complex as health care, and none is as important as Education.

So why do we still manage the two things most important to us, using a system of management that we learned doesn't work over 30 years ago?  



Blogger Rigger Mortice said... 10:52 am

someone earlier sadi the NHS 'seems to be run for the benefit of the staff not the patients' and they were right.Full stop.  



Blogger Rigger Mortice said... 10:52 am

oh and Serf,as ever,you're on the money  



Anonymous Anonymous said... 11:22 am

someone earlier sad the NHS 'seems to be run for the benefit of the staff not the patients' and they were right.Full stop.

just as the coal industry was run for the miners, and the car industry for the workers.

Its an inescapable result of any state run operation.  



Anonymous verity said... 3:19 pm

So how would we solve the policing problem without abandoning people who couldn't pay?

A thought, there really should be very few people who couldn't pay if we insisted everyone get a job. (This would also cut down on the fictional "need" for immigrants.)

When I lived in Texas, they closed the whole department I worked in in one of the big banks. We were all down at the unemployment office the following morning, exchanging tips. In Texas, you only get unemployment for eight weeks. Then you're off the public purse and on your own. I asked the man behind the counter what happened if one hadn't found a new job by then and he said, "Oh, most people seem to manage. They may take something and keep on looking, but they manage." Pragmatic.  



Anonymous peter hitchens said... 3:25 pm

So how would we solve the policing problem without abandoning people who couldn't pay?

Lynch mobs!
It used to work and could work again.  



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