Politics

[Christmas Tree 4725]

Can you provide a link to support your second sentence? Curious as to what you mean.

 

What I mean is both political parties will continually try to get out of having to pay for the NHS. This may be selling off responsibility for cleaning, catering or in the case above, passing a hospital directly over to to a private company.

 

More and more things will be available privately and more and more people will choose that option.

 

We already have two tier health care and this will only increase as each government tries to reduce the burden.

 

The fact that Labour initiated significant parts of the privatisation agenda, most notably setting up a commercial directorate within the Department of Health and rolling out the disastrous independent sector treatment centres, should tell you all you need to know about this being party political.

 

As bad as each other.

Edited September 5, 2012 by Christmas Tree

[Renton 21614]

Don't agree. I don't know anyone who wasn't shocked by the massive changes set out in the white paper; nobody saw it coming and it was hardly mentioned in the Tory manifesto. Wholesale privatisation is not inevitable and is mainly ideological. It will cost us more, be less equitable, and will not lead to better services except for the very rich.

[Christmas Tree 4725]

Don't agree. I don't know anyone who wasn't shocked by the massive changes set out in the white paper; nobody saw it coming and it was hardly mentioned in the Tory manifesto. Wholesale privatisation is not inevitable and is mainly ideological. It will cost us more, be less equitable, and will not lead to better services except for the very rich.

 

Thats up to you, but I can imagine the outcry you would have made if a Tory government had handed over a hospital to the private sector or allowed GP's to opt out of after hours care, paving the way for the private sector to sneak in.

[Park Life 71]

Don't agree. I don't know anyone who wasn't shocked by the massive changes set out in the white paper; nobody saw it coming and it was hardly mentioned in the Tory manifesto. Wholesale privatisation is not inevitable and is mainly ideological. It will cost us more, be less equitable, and will not lead to better services except for the very rich.

 

Totally agree. It's the holy grail for the insurance companies who are queing up to make a killing like here in Germany. The moment you enter the system here they hit you with a battery of wildly expensive tests and any add ons they can bill...Most of it completely unnecessary.

 

ParkyJnr had an accident in the park when out with other children and with thier guardians so didn't have her card with her as me and mum weren't there. She was taken to hospital in an ambulance and taken care of. We thought nothing of it. Two weeks later they sent us a bill for 380 euros! it's a joke here. Compare that to the care parkyjnr and Mrs P received in the past when we were in England...All free no questions asked just a little red sticker on the forms we signed. End of.

[Renton 21614]

 

 

Thats up to you, but I can imagine the outcry you would have made if a Tory government had handed over a hospital to the private sector or allowed GP's to opt out of after hours care, paving the way for the private sector to sneak in.

 

I don't remember this, have you got links?

[Christmas Tree 4725]

Totally agree. It's the holy grail for the insurance companies who are queing up to make a killing like here in Germany. The moment you enter the system here they hit you with a battery of wildly expensive tests and any add ons they can bill...Most of it completely unnecessary.

 

ParkyJnr had an accident in the park when out with other children and with thier guardians so didn't have her card with her as me and mum weren't there. She was taken to hospital in an ambulance and taken care of. We thought nothing of it. Two weeks later they sent us a bill for 380 euros! it's a joke here. Compare that to the care parkyjnr and Mrs P received in the past when we were in England...All free no questions asked just a little red sticker on the forms we signed. End of.

 

Not that beastly girl again

[Christmas Tree 4725]

I don't remember this, have you got links?

 

Give over

 

Google circle NHS or out of hours care.

 

Quite a few Labour ministers now doing very well working for private medicine.

[Park Life 71]

Not that beastly girl again

 

 

They're best mates now.

 

Anyway I'm the wrong person to get into this as I think all public transport should be free as well. ALL OF IT.

[Park Life 71]

Give over

 

Google circle NHS or out of hours care.

 

Quite a few Labour ministers now doing very well working for private medicine.

 

At policy level there is very little difference to these two imposters as you well know. Both are lickspitles of big business and corporate interests (thank Tony Blair for that). We need more local Govt. which is historically more immune to national policy ravages and has the interests of the community at heart....

[Meenzer 15524]

Anyway I'm the wrong person to get into this as I think all public transport should be free as well. ALL OF IT.

 

They're trying that out in Tallinn, I heard. For residents only, though. Mind you, the trains in cities like Hamburg and Berlin might as well be free for how often you get checked.

[Park Life 71]

They're trying that out in Tallinn, I heard. For residents only, though. Mind you, the trains in cities like Hamburg and Berlin might as well be free for how often you get checked.

 

Liepzig are doing it and it is mooted going to happen on the Ubahn in Berlin. As you say we're rarely checked anyway.

 

Not only is it a weapon against congestion, it would fall in line with all the green bugbears.

[ChezGiven 0]

 

 

Totally agree. It's the holy grail for the insurance companies who are queing up to make a killing like here in Germany. The moment you enter the system here they hit you with a battery of wildly expensive tests and any add ons they can bill...Most of it completely unnecessary.

 

ParkyJnr had an accident in the park when out with other children and with thier guardians so didn't have her card with her as me and mum weren't there. She was taken to hospital in an ambulance and taken care of. We thought nothing of it. Two weeks later they sent us a bill for 380 euros! it's a joke here. Compare that to the care parkyjnr and Mrs P received in the past when we were in England...All free no questions asked just a little red sticker on the forms we signed. End of.

That's a very misleading post. First of all if when you enter into the system, you are given lots of tests and add ones, that's a cost to the Sick Fund and a revenue to the provider. It's fee for service financing which as you say leads to over utilization of resources but not to profit the Sick Fund. The very first form of welfare health was in Germany, Biszmark used the insurance model to introduce the world's first welfare state. There are 7 countries in Europe who use the Social Insurance models, all of them devote a higher proportion of GDP to healthcare and have better outcomes.

 

The second point which is misleading is your bill. You presumably passed on your details and this was reimbursed 100% by either your private or Public Sick Fund? If you are employed, you get billed and you get 100% reimbursed. In this Sick Fund you get access to better services in the elective setting. In the Sick Find for unemployed, everything is 100% covered but the services might be lower. I understood that Germany like France made the employers pay the Sick Funds or Mutuelles on your behalf, taxes may be slightly higher too but you don't 'pay' anything at the end of the day as everything is reimbursed. There are multiple reasons why Social Insurance models perform better than top down national budget systems.

Edited September 5, 2012 by ChezGiven

[Renton 21614]

 

 

Give over

 

Google circle NHS or out of hours care.

 

Quite a few Labour ministers now doing very well working for private medicine.

 

From what I can tell Circle took over Hinchingbrooke In 2011? Well into the coalition.

 

Looks likes a failed experiment too. Will lessons be learned.

 

Anyway, I'm not just talking about isolated providers here. I'm talking about wholesale privatisation and mandatory payment through insurance. Can you not spot the difference?

[Renton 21614]

 

That's a very misleading post. First of all if when you enter into the system, you are given lots of tests and add ones, that's a cost to the Sick Fund and a revenue to the provider. It's fee for service financing which as you say leads to over utilization of resources but not to profit the Sick Fund. The very first form of welfare health was in Germany, Biszmark used the insurance model to introduce the world's first welfare state. There are 7 countries in Europe who use the Social Insurance models, all of them devote a higher proportion of GDP to healthcare and have better outcomes.

 

The second point which is misleading is your bill. You presumably passed on your details and this was reimbursed 100% by either your private or Public Sick Fund? If you are employed, you get billed and you get 100% reimbursed. In this Sick Fund you get access to better services in the elective setting. In the Sick Find for unemployed, everything is 100% covered but the services might be lower. I understood that Germany like France made the employers pay the Sick Funds or Mutuelles on your behalf, taxes may be slightly higher too but you don't 'pay' anything at the end of the day as everything is reimbursed. There are multiple reasons why Social Insurance models perform better than top down national budget systems.

 

Which outcomes are better? They may be more responsive with better 'hotel' facilities but I'm unaware of any metrics that show they get better value for their bigger spend. Except for cancer maybe, which is likely to be due to our gatekeeper system and is/was rapidly catching up.

[Park Life 71]

That's a very misleading post. First of all if when you enter into the system, you are given lots of tests and add ones, that's a cost to the Sick Fund and a revenue to the provider. It's fee for service financing which as you say leads to over utilization of resources but not to profit the Sick Fund. The very first form of welfare health was in Germany, Biszmark used the insurance model to introduce the world's first welfare state. There are 7 countries in Europe who use the Social Insurance models, all of them devote a higher proportion of GDP to healthcare and have better outcomes.

 

The second point which is misleading is your bill. You presumably passed on your details and this was reimbursed 100% by either your private or Public Sick Fund? If you are employed, you get billed and you get 100% reimbursed. In this Sick Fund you get access to better services in the elective setting. In the Sick Find for unemployed, everything is 100% covered but the services might be lower. I understood that Germany like France made the employers pay the Sick Funds or Mutuelles on your behalf, taxes may be slightly higher too but you don't 'pay' anything at the end of the day as everything is reimbursed. There are multiple reasons why Social Insurance models perform better than top down national budget systems.

 

Yes we passed on the details and were reimbursed. I was trying to show what happens if you're not covered in Germany ie You get a massive bill (this was just a couple of grazed knees ffs!)

 

I'm not an expert on the topic and am well aware you have in-depth knowledge, but my gut instinct (and incidentally talking to Germans) they'd rather not stump up the 250e a month (employer part payment) or self-empolyed/own business 400-500euro a month.

 

I won't accept that the 4th and 5th richest countries in the world can't have free healthcare at source. And like the debacle of water and rail privatisation I'd rather not see another area which we have prided ourselves on with regard to fair play handed over to the for profit vultures.

 

Mrs P loves the NHS even though care here is faster and probably better quality wise.

[Christmas Tree 4725]

 

From what I can tell Circle took over Hinchingbrooke In 2011? Well into the coalition.

 

Looks likes a failed experiment too. Will lessons be learned.

 

Anyway, I'm not just talking about isolated providers here. I'm talking about wholesale privatisation and mandatory payment through insurance. Can you not spot the difference?

 

Circle took over in 2011 but signed, sealed, delivered under Labour.

 

Re your last point, Hunt has not said we should move to full scale privatisation and mandatory insurance.

 

The overriding point however as I have said a few times is that both parties keep increasing the levels of privatisation in the NHS.

 

 

[Park Life 71]

Circle took over in 2011 but signed, sealed, delivered under Labour.

 

Re your last point, Hunt has not said we should move to full scale privatisation and mandatory insurance.

 

The overriding point however as I have said a few times is that both parties keep increasing the levels of privatisation in the NHS.

 

Your self-employed high risk group you'd be paying about 400e a month here. Would that be alright?

Edited September 5, 2012 by Park Life

[ChezGiven 0]

 

 

Yes we passed on the details and were reimbursed. I was trying to show what happens if you're not covered in Germany ie You get a massive bill (this was just a couple of grazed knees ffs!)

 

I'm not an expert on the topic and am well aware you have in-depth knowledge, but my gut instinct (and incidentally talking to Germans) they'd rather not stump up the 250e a month (employer part payment) or self-empolyed/own business 400-500euro a month.

 

I won't accept that the 4th and 5th richest countries in the world can't have free healthcare at source. And like the debacle of water and rail privatisation I'd rather not see another area which we have prided ourselves on with regard to fair play handed over to the for profit vultures.

 

Mrs P loves the NHS even though care here is faster and probably better quality wise.

 

No one is not covered in Germany, if you're unemployed, you go on the Sick Fund for unemployed. You never see the part payment to the Sick Fund when you are employed as its taken at source from your income.

[Park Life 71]

"Chronically expensive...

 

Inefficiency is as big a problem as injustice. Keeping Germany healthy is chronically expensive: this country has the fourth highest health expenses in the world and the compulsory individual fees, be they state or private, carry on rising faster than inflation.

The average state health insurance contribution is €500 a month, which is split between employee and employer – while the self-employed pay everything themselves, unless they’re lucky enough to be in the Künstlersozialkasse for freelancers in creative professions But both state and private health insurance companies have increased their premiums in recent months as rising unemployment has put more pressure on the welfare state."

 

Yet however much the contributions grow, they never seem to be enough for Germany’s ravenous healthcare system. It demands vast sacrifices, and in the past few years, the government has been forced to inject more and more tax money into the system: from 2008 to 2009, its contribution to the newly devised Gesundheitsfond (“health fund”) – a centralized pot into which everyone’s healthcare contributions are paid – doubled from €1.5 billion a year to €3 billion. The idea that healthcare should be at least partially funded by tax money is a central plank of more left-minded policy – the notion that everyone contributes and everyone gets basic healthcare, and that competitive capitalist model isn’t necessarily the most effective way to keep people alive.

 

In Europe, Britain’s National Health Service, for all its flaws, is still the model example of an entirely tax-financed system. The last round of German reforms, brought about during the SPD-CDU coalition government in 2007, was a gesture in this direction. Even Rösler’s new plan requires a significant tax contribution, as low earners would receive an extra health allowance which would have to be financed by tax money. But Bormann is not convinced such a system would work in Germany.

Edited September 5, 2012 by Park Life

[Meenzer 15524]

No one is not covered in Germany, if you're unemployed, you go on the Sick Fund for unemployed. You never see the part payment to the Sick Fund when you are employed as its taken at source from your income.

 

Not really - there's a hole in the system when it comes to people who are self-employed/freelance, for a start. Statutory health insurance membership is based on regular payments and hence requires regular income, which doesn't always tally with the pattern of self-employed work, hence lots of people opt out of the system rather than be faced with another monthly bill they can't meet simply because their work is heavily geared towards one season or one part of the economic cycle. Which means massive one-off bills if they do become ill (I can testify to a €500 charge just to see a specialist for five minutes, for example). An NHS-style system funded by taxation on income as and when it occurs is obviously far more favourable to the non-9-to-5-ers out there.

[ChezGiven 0]

 

 

Not really - there's a hole in the system when it comes to people who are self-employed/freelance, for a start. Statutory health insurance membership is based on regular payments and hence requires regular income, which doesn't always tally with the pattern of self-employed work, hence lots of people opt out of the system rather than be faced with another monthly bill they can't meet simply because their work is heavily geared towards one season or one part of the economic cycle. Which means massive one-off bills if they do become ill (I can testify to a ¤500 charge just to see a specialist for five minutes, for example). An NHS-style system funded by taxation on income as and when it occurs is obviously far more favourable to the non-9-to-5-ers out there.

You can't opt out of the system, the 2007 reforms led to mandatory insurance for everyone. You actually qualify for the private schemes if you are self employed, which are much better and restricted to people with the ability to pay for them. In either public or private you can use the contibutons to offset income tax.

 

The only two variables that matter at the individual level are net income after tax including health and access to services. The top rate of tax is 45% on income over 250k, contributions to insurance are limited after a certain income level. It's progressive though and all tax deductible. If you are on a low income, married with kids, you get exceptional cover and immediate access to services. The overall burden of income and healthcare tax is about the same as the income tax burden in the uk. I believe it can be more favorable in Germany if you are married with kids in Germany, giving you for the same income as a Brit, more disposable income and better services.

 

The only variables that matter at the system level are fairness and efficiency, the German system balances thes two well.

[Park Life 71]

A recent article in Stern magazine exposed the massive temptations doctors come under to over-treat private patients. Mike, a 33-year-old privately insured Berliner hurt his knee while playing squash. “I said ‘privat versichert’ and it was of course no problem getting an appointment with a ‘booked out’ orthopedic specialist pretty much right away. The problem was escaping his over-zealous care. First he prescribed me expensive knee braces, custom shoe inserts, then physiotherapy. Soon, it was surgery – which he would be performing himself at a private clinic…” A second doctor said the operation was unnecessary. Mike resumed his weekly squash game. His knee got better, “by itself.”

[Park Life 71]

Finland looks cushty:

 

"I moved here last year from Finland and am originally from the Netherlands. In finland, health insurance is really simple: you pay what amounted to 60 euros per month for me and you get a so-called kela card that you use to identify yourself with in hospitals and health care centers. That's it. 60 euro. Full coverage against the basics. The annual cost for health insurance in the Netherlands is around 1200 euro for the so called base insurance, which as the name suggests covers the essentials.

 

When I joined here in Germany I was in for a shock. First I had to choose between private and public, a system that was abandoned a few years ago in the Netherlands. Secondly, my health insurance bills are about 9 times as high, with no obvious advantages in terms of coverage. I suspect a mix of inefficiency and the pharmaceutical industry milking the government through price fixing and other practices. 9 times as high: somebody is getting rich here without working for it."

 

 

Yes Chez I'm gonna cut and paste you to death.

Edited September 5, 2012 by Park Life

[ChezGiven 0]

The medical profession in Germany is another question entirely. Have you ever read the story of Grunenthal and Thalidomide? The essential thesis is that the medical profession in Germany, key players in implementing the holocaust, saw patients as they saw prisoners in the camps, as subjects to be experimented on. Grunenthal's horrendous crimes are part explained by the continuation of this sick culture in the post war period.

[ChezGiven 0]

 

Yes Chez I'm gonna cut and paste you to death.

Don't, there's nothing more annoying.

 

FYI the Finn who pays 60 euros also contributes via his income tax, which is extortionate. He doesn't mention that.