Your ‘points’ have not only been dealt with by me but also, indirectly in there own discussion, the points of Bob B and the a & e charge nurse, like many of your ilk, your head is pretty firmly buried in the sand on this one, as you cling to personal political prejudice, which is cool but you’re doing so you’re only proving the lack of correlation between fact and your opinion.

You are trying to have your cake and eat it, using public health care systems that utilises, to a small degree, private service, which the government regulate and oversee to such high levels that it is only private in name but is rather a wing of the public healthcare program.

The fact that you have to pick out these elements in order to hold up your flagging point speaks volumes and as many, many others here have pointed out; in a universal healthcare system, profit has no place. You cannot point to 100% successful universal private healthcare systems because there are none because they quite simply would not work.

You are clutching at straws and shifting your argument to picking out small elements of private.

The truth of the matter is and I am not alone here in pointing this out, profit has no place in the health and wellbeing of a society’s citizens. Your blinkered desperation is just that and all you have been doing for some time here is re-iterating not debating; never mind ducking out of inconvenient rebuttals from numerous commentators here.

Just Visiting (if Only):

One down side of using pompous and ridiculous non de plumes to hide behind as you comment here anonymously, is that they are liable to be used against you. As are real names of course, the number of times people have made presumptuous personal attacks on me based on my name but I am not in need of running to mummy and calling for deletion or apologies. Shite Talker can man up or bugger off, as can you sir. And although you may share his free-market delusions, that doesn’t stop them being unworkable shite.

Oh and JV, leaving a comment in thread purely to point this out is a waste of everyone’s time, I hope this will be your last in this thread unless you have something on topic to say, otherwise it will be dragged off course by your ‘contribution’.

I’m surprised that there is so little like-for-like comparison of private v public sector productivity.

The right-wing and Tories love to compare (flawed) public sector productivity data against the average for the private sector to say “Isn’t the public sector shit. Aren’t the workers lazy?” yet are unable to compare state schools with private schools or the NHS with private healthcare. Feels fairly meaningless to compare schools educating children with financial services or making widgets…

Several private sector industries e.g. construction have had productivity performance that is not as good as (the flawed and incomplete) public sector productivity stats. For those who are interested in measuring productivity and understanding the area (rather than making childish ideological points) a good ONS article is http://www.statistics.gov.uk/elmr/07_07/downloads/ELMR_July07_Goodridge.pdf

I note that there has been no attempt by right-wingers to challenge your estimates. Instead the argument seems to be that your findings are a special case as the public sector is definitionally inefficient.

Calling someone ‘shit talker’ on a serious forum like LC is out of order.

I don’t care if your view was that they were talking rubbish – it was an abusive comment.

An apology is called for.

In the Netherlands, all insurance plans are owned and operated by private companies. So are the hospitals and clinics. It may not be totally free market, but it’s more free than our system, and their health care is better… QED.

“Same goes for France, their healthcare system is built on public money and government regulation and tight government controls, it is not a private sector healthcare system.”

You haven’t explained why the existence of for-profit hospitals in the mainstream system hasn’t caused poor people to be dying in the streets.

“And Germany, that is the home of the world’s oldest universal healthcare system!”

Cool, if you like Germany’s system, why not adopt it? Don’t answer that, I already know why.

“You have offered no rebuttals at all to the detailed questions put to you on private sector healthcare at 23 and 26,”

There was no question put to me in Post 23. I have answered the question put to me in Post 26, by providing France’s for-profit hospitals, Germany’s competing sickness funds and the Netherlands’ private insurance and hospitals as evidence for privatisation being a good thing.

“you’ve lost the argument because it shows you have little else to attack on.”

Calling me Shite Talker was a supplementary attack then, I presume?

“Your claim that I’m trying to conceal spending data demonstrates that you either don’t understand the issues and data sources or that you are trying yet another propaganda smear of any NHS critic” – no, I fear it is you that does not understand the issue, or at least you have remained silent on Powerhouse Charter (a source you have cited many times) after it was pointed out to you that even THEY acknowledged that their own data must be handled with ‘caution’ and that they had failed to develop a robust system of primary data collection.

In fact I have NEVER claimed the NHS is the optimum model of health care, this is purely an attribution made by you against me (calling me propagandist, etc).
Ironically you complain that I have not read your comments ‘carefully’, then accuse me of a position I have never put forward.

So let me spell it out for you.
International comparisons are nowhere near as straightforward as Swedish consumer groups would have you believe – you have never really been able to convince me that you fully understand why this should be so (I might be wrong, of course, but that is certainly my impression).
The NHS is being privatised by stealth – I think the country needs an open and honest discussion about these developments (and sometime before they shut down more A&Es or hand out yet another contract to a private provider).
If there is to be an alternative model lets try and find some robust evidence to support it, not to mention some degree of support from the patients who will actually using it.

I suggest you re-read CAREFULLY my post @33.

Some west European countries spend a smaller proportion of national GDP than does Britain – and I posted @15 above a (highly reputable) source for OECD data relating to national public and private spending in OECD countries on healthcare as percentages of national GDP. And those are the best comparative data going. Your claim that I’m trying to conceal spending data demonstrates that you either don’t understand the issues and data sources or that you are trying yet another propaganda smear of any NHS critic.

The CEO of the NHS has recently said that the annual NHS budget can be cut by 15 to 20% without that affecting patient care – evidently spending is therefore not a constraint on NHS performance – see the link @33.

You have still not accounted for the identified falling productivity in the NHS following the government’s splurge in spending on the NHS nor for the lamentable safety record of the NHS. Other media reports have said that about 10% of patients a year are harmed by NHS treatments

More spending on the NHS can – and has been – absorbed in higher staffing costs without corresponding increases in patient outcomes:

“”BRITISH doctors now earn more than their counterparts on the Continent, according to a new study. It has revealed that hospital consultants’ salaries increased by more than 30% between 2000 and 2004. British consultants and GPs are now better off than medical specialists in France, Germany and Denmark.”
http://www.timesonline.co.uk/tol/news/uk/health/article758105.ece

There is still the fundamental question about why no other west European country has sought to emulate the NHS by creating another massive state-owned edifice with a verging-on monopoly on the provision of national healthcare services. The fact is that Frank Dobson clamped down on competition on healthcare so I could no longer go to the nearest and most convenient NHS hospital for tests. How do all those other west European countries manage with competition between healthcare providers?

You haven’t commented, even once, on the historical difference in GDP when comparing the NHS to the big 3, France, Germany and Switzerland – how much cash over the last 40 years does this amount to?

It sounds like you are content to ignore such critical variables – now why is that?

No – I think that denying the possibility of making valid comparisons between national healthcare systems is just another twist on the regular propaganda effort to whitewash the NHS regardless.

The greater longevity rates in most other west European countries, the lower infant mortality rates, the better cancer survival rates, the larger numbers of physicians per head of populations are all substantive reasons for considering the NHS is fairly mediocre in performance compared with healthcare services in other west European countries – as the Health Powerhouse, an independent Swedish think-tank, finds in its regular annual surveys.

And I seriously question whether public spending differences are the main explanation, partly because some west European countries are spending lower percentages of their national GDP on healthcare but also because of this recent news report:

“The National Health Service can make the £15bn to £20bn of savings needed during the next three years without damaging the quantity or quality of care – indeed while even improving the latter – according to David Nicholson, the NHS chief executive.”
http://www.ft.com/cms/s/0/6fba7dfe-e683-11de-98b1-00144feab49a.html

If £15bn to £20bn can be cut from the annual NHS budget of c. £105 billions without that making much difference to the quality of patient care, that doesn’t suggest to me that spending levels are the main constraint on getting better performance from the NHS. Besides that, we have this discomforting fact:

“The NHS has seen a year-on-year fall in productivity despite the billions of pounds of investment in the service, latest figures show. The data from the Office for National Statistics showed a fall of 2% a year from 2001 to 2005 across the UK.”
http://news.bbc.co.uk/1/hi/health/7610103.stm

And this:

“Almost 4,000 NHS patients in England died last year following ‘safety incidents’, in which some aspect of their care went wrong. A further 7,500 patients suffered severe harm as a result of accidents or botched medical treatment.”
http://www.independent.co.uk/life-style/health-and-families/health-news/why-hospital-is-a-dangerous-place-to-be-1799083.html

For example you mention heart problems – would it surprise you to learn that the NHS is actually a world beater when it comes to management of heart attacks?
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1488784/

And when you say cancer – which cancer are you talking about?
Can you provide any meaningful data on the alleged differences?
As I mention elsewhere, cancer constitutes over 200 different diseases, are the Dutch, to cite one country you admire, better at managing all 200?

Of course France gets the usual name check, but have you ever tried to total up the HUGE differential in health spending over the last 40 years?
Comparing France to the NHS expenditure, expressed as a % of GDP for the following years is as follows;
1960 France = 4.2 (of GDP) ….. NHS = 3.9
1990 France = 8.9 ………………..NHS = 6.0
1998 France = 9.6 ………………..NHS = 6.9
http://content.healthaffairs.org/cgi/reprint/19/3/150.pdf

Needless to say France are still spending more on health to this very day (11% vs 8.4% in 2007)
http://stats.oecd.org/Index.aspx?DatasetCode=HEALTH

Penny starting to drop?
How can we begin to compare one system against other without WEIGHTING this sizeable historical difference in spend?
We are simply not comparing like with like – so how do we interpret complex health data, which is of variable quality to begin with?

Same goes for France, their healthcare system is built on public money and government regulation and tight government controls, it is not a private sector healthcare system.

And Germany, that is the home of the world’s oldest universal healthcare system!

You can’t have your cake and eat it. You’re clutching at straws, using example of government run healthcare with some, heavily controlled elements of private sector investment as beacons of private sector working, when you can point to no private sector healthcare system that is not backed up, regulated and supported by public funds and works at the behest and control of the government.

It is perfectly acceptable to spell partizan with a z, also, as soon as you start attacking spelling (incorrectly, ouch, ego bruise and you don’t even know what it means), you’ve lost the argument because it shows you have little else to attack on.

You have offered no rebuttals at all to the detailed questions put to you on private sector healthcare at 23 and 26, you’re ducking because you don;t have anything aside from blind prejudice.

I can indeed:

Look at health care in the Netherlands. The WHO ranked them above us in health care quality and access – well, the Dutch system is as privatised as you can get. Private health insurance, private hospitals competing for profit – shock horror!

How about France, with it’s for-profit hospitals? Best health care in the world.

Germany, with it’s sickness funds which are operated independantly of the government? Better than the NHS by far.

Look at these three health care systems, then argue either:
a) They are not private (they are more private than the NHS)
b) They are not better (but the WHO disagrees)

You obviously do not know what “partisan” means (heck, you don’t even know how to spell it!). I have not mentioned political parties at all, and that’s what partisan means.

“We differ hugely on solutions but you have no evidence and no rebuttal to the stack of evidence that points out how ineffectual and divisive private sector is for the healthcare system.”

Tell me, what about Britain’s top-down, monolithic, beaurocratic health care system pleases you?

Is it the high rate of death from heart problems?
Is it the low cancer survival rates?
The high waiting times?

European health care avoids these problems, because of market reforms. Please explain to me, then, how market reforms are bad.

Because there is ALREADY a mismatch between the demand for health care (which grows exponentially with every new drug and technology) and supply which as we all is know is constrained in a number of ways (bed availability, doctor to patient ratio, etc, etc) – so how can we justify diverting even more money away from patients and into the pockets of the already wealthy shareholders?

Simple question – can you produce ANY evidence that the private sector produces higher standards when we compare like for like, rather than the self-selecting, and relatively affluent group with a single pathology (usually) who use the likes of BUPA?

And what you are pandering is not pure, partizan prejudiced nonsense about the free-market being the cure for all evils?

We differ hugely on solutions but you have no evidence and no rebuttal to the stack of evidence that points out how ineffectual and divisive private sector is for the healthcare system.

Go and find profit elsewhere, not in the weak the sick and the terminally ill.

That’s not a fact, that’s an opinion. Why shouldn’t profit be part of healthcare, like it’s part of 60-70% of our economy?

The American system is appalling. Public spending on healthcare as a percentage of America’s GDP is similar to that in Britain but Americans spend about as much again on private healthcare. For about 15% or so of America’s GDP, average life expectancy is marginally lower than in Britain and the infant mortality much higher.

The best examplars of healthcare for Britain are found among other west European countries, not the American system.

This news report on the World Health Organisation’s first ranking of national healthcare systems was in the Independent of 21 June 2000:

“The first attempt to rank the world’s health systems by how well they meet the needs of their populations has put the UK in a disappointing 18th place, behind France, Italy and other European nations. . . The US spends more than any other country on health as a proportion of its gross domestic product but ranks only 37th, below Chile, Morocco and Israel.”
http://www.independent.co.uk/life-style/health-and-families/health-news/unresponsive-nhs-ranked-18th-in-world-712332.html

And …….
[15] “Those of us who are fairly familiar with the accessible comparative data and briefings on national healthcare systems are getting more than a little fed up with all the propaganda being pumped out”.

This can only be regarded as “comparative data” in the loosest sense of the word, even the report authors admit on p27 (7);
“The first and most important consideration on how to treat the results is: with caution!
The Euro Health Consumer Index 2009 is an attempt at measuring and ranking the performance of healthcare provision from a consumer viewpoint.
The results definitely contain INFORMATION QUALITY PROBLEMS.
There is a shortage of pan-European, uniform set procedures for data gathering”.

If I was trying to compare hospital A with hospital B for management of heart attacks (say) but prefixed comparison with an admission that my results should be treated with ‘caution’, and that I was offering a ‘consumer viewpoint’ (rather than hard clinical data) and that I did not even have any reliable system of gathering data in the first place I would rightly be laughed out of the building.

Or lets say we were trying to compare A&E’s across Europe.
How on earth would you do that – by waiting times …….. when data is massaged to appease managers (allegedly) or the system is gamed to meet one target but at the cost of creating problems elsewhere?

Do you honestly think complex phenomena, like the sum of every individual’s treatment experience can be represented by an aggregate number?

Cancer is the condition that is usually cited when these comparative exercises are trotted out, but don’t forget cancer arises from over 200 different diseases and even if some patients in some countries did live slightly longer, are we simply talking about an extra few months with disseminated metastases? – if so it would be an accomplishment with mixed blessings.

You think there should be profit in healthcare, I do not and it is on that fundamental core issue that the problem stands.

Expensive? In America you can get health insurance for as low as $56 per month. That’s not expensive. The only reason health insurance is expensive in some states is because of excessive government regulation.

The average yearly income in America is $46,000, compared to our $35,000. Plus Americans get to keep more of their salary (lower taxes). Plus everything is cheaper in America (no national VAT). Even if health insurance is more expensive in America, they have more money in their pockets to spend on health care then we do.