Yeah, health tourism is a pretty minor issue; more important is the incentive and information structure of such a system - for all concerned, be they bureaucrats, doctors, nurses or patients.
Like any system based on centralised planning, incentives to economise on the scarce resources or make tough decisions are poor and often perverse, and the ability to do so is non-existent because you don't have price signals and consumer choices conveying the necessary information - which no bureaucratic metric or target can provide. To top the whole thing off, you then whack a tragedy of the commons on the demand side and you've got a recipe for perpetual disaster.
And of course, it always manifests itself in the less glaringly obvious ways. If you have a heart attack, you'll probably have little issue with the emergency care you receive; if you've got a rare type of cancer that nobody's heard of, or a chronic skin disease, you'll find it more lacking. If you've got a life threatening neck injury, you'll probably be well looked after, but need a knee operation and you'll have to live with the pain for a while. It's always the long term, less severe or obscure things where the service is at it's worst.
The point that really needs to be understood is that the NHS's problems are not just a case of bad management or underfunding - it's a case of impossible management and bad incentives by nature. It's not unique or abnormal but the same results from the same policies; the NHS fails because central planning cannot work. I might also point out that to understand that is to understand that such a criticism is to credit to those making it work as well as it does, not condemn.
What's truly astonishing is the sacred cow status of the NHS. Heck, even the French (!), not renowned for being radical right-wingers, don't have the bizarre attitude found over here.
A couple of topical Delingpole podcasts: https://www.podbean.com/media/share/dir-a7etz-43db59chttps://www.podbean.com/media/share/dir-iyuub-445d385Current: Discovery 3 06MY (55 reg) HSE Auto Zambezi Silver Allisport Fast Road Intercooler, V8 Brakes, Silicone IC Hoses, EGRs Blanked, Remapped, De-Cat pipe, FBHIC
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7th Nov 2018 3:41 pm
RRSTDV8
Member Since: 07 Apr 2014
Location: Here
Posts: 13563
The NHS, like the Police, suffer from policies implemented to reduce central Govt costs elsewhere. Both are spending large amounts of time and money dealing with social care issues. These are not things either should be dealing with. They are supposed to be dealt with by Local Authorities but those same organisations have been starved of the necessary resources by successive Governments (Tory and Labour).
The NHS has become a dumping ground for everyone that noone else wants/can afford to deal with. The NHS should be about medical care - operations and medicine and stuff, not dealing with drunks and druggies, the homeless and the geriatric. These groups should be offered the help they need elsewhere.Visiting from rrsport.co.uk
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7th Nov 2018 5:45 pm
Moo D3 Decade
Member Since: 13 Aug 2010
Location: UK
Posts: 14436
The NHS needs to send out tough love. If you drink too much, smoke, have a poor diet and lifestyle then your care will be limited until you address these issues. T2 diabetes is avoidable and reversible but consumes at least 10% of the NHS budget.
There is a huge cavern between peoples expectations of what is possible verses the reality. People need to take more responsibility for their own health.D4 HSE EU6 (Known as Jeeves)
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7th Nov 2018 6:39 pm
RRSTDV8
Member Since: 07 Apr 2014
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Posts: 13563
Diabetes costing £1bn pa for prescriptions alone (nearly 1 in 20 of all prescriptions are for diabetes treatment). Estimated £10bn pa total cost for diabetes with associated issues.
https://www.bbc.co.uk/news/health-46139595Visiting from rrsport.co.uk
2012 RRS SDV6
2008 RRS TDV8
"When you fire that first shot, no matter how right you feel, you have no idea who's going to die! You don't know who's children are going to scream and burn. How many hearts will be broken. How many lives shattered. How much blood will spill, until everybody does what they were always going to have to do from the very beginning: SIT DOWN AND TALK!"
8th Nov 2018 4:59 pm
Pelyma
Member Since: 06 Jan 2005
Location: Patching, Sussex
Posts: 15496
My MIL isn’t overweight, exercises and watches what she eats and has T2 diabetes. Can you please tell me how she can cure herself as she would dearly love to get back to normal.DS3 TDV6 HSE - Silver with Alpaca (old one) Gone
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8th Nov 2018 5:08 pm
Rescue01
Member Since: 14 Jan 2008
Location: Aberdeen
Posts: 2519
My MIL isn’t overweight, exercises and watches what she eats and has T2 diabetes. Can you please tell me how she can cure herself as she would dearly love to get back to normal.
Its not the height of the fall but the sudden stop at the bottom that hurts!!
8th Nov 2018 5:34 pm
RRSTDV8
Member Since: 07 Apr 2014
Location: Here
Posts: 13563
T2 Diabetes in older people happens - getting old messes with stuff, sadly, and one of things that becomes a greater risk is diabetes.
T2 Diabetes in younger people shouldn't really be happening but seems to be. That's the point.Visiting from rrsport.co.uk
2012 RRS SDV6
2008 RRS TDV8
"When you fire that first shot, no matter how right you feel, you have no idea who's going to die! You don't know who's children are going to scream and burn. How many hearts will be broken. How many lives shattered. How much blood will spill, until everybody does what they were always going to have to do from the very beginning: SIT DOWN AND TALK!"
8th Nov 2018 7:10 pm
Pelyma
Member Since: 06 Jan 2005
Location: Patching, Sussex
Posts: 15496
So at what age are you “old enough” to be worthy of medication? Presumably below this age you’re just a waster with no self control?DS3 TDV6 HSE - Silver with Alpaca (old one) Gone
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9th Nov 2018 6:19 am
Ken
Member Since: 20 Feb 2006
Location: Here
Posts: 10865
My Wife is Blind and a T1 since the age of three guess I'll get her put down
I'll let you lot tell her truly there are Muppet's on here that makes my blood boil
9th Nov 2018 7:40 am
professorpool
Member Since: 19 Mar 2012
Location: Woking
Posts: 3213
Anecdotal evidence doesn’t help debate and discussion. This is one of the problems with the NHS debate and I guess until this cycle ends no party/politician is going to be able to solve it.D3 07 SE - still going strong
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Allisport Fast Road Intercooler, V8 Brakes, Silicone IC Hoses, EGRs Blanked, Remapped, De-Cat pipe, FBHIC
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