On Sun, 14 Nov 2004 11:42:08 -0000, ":::Jerry::::"
wrote:


"Andy Hall" wrote in message
.. .
On Sun, 14 Nov 2004 02:13:13 +0000 (GMT), "Dave Plowman (News)"
wrote:

In article ,
Andy Hall wrote:
With the exception of services such as defence, emergency services,
judiciary and others of that ilk, there is no need for government
involvement beyond making sure that there is directed funding for
those unable to make their own arrangements to be able to obtain them
- e.g. healthcare and education vouchers.

Why not privatize things like defence? After all, it's a major profit
maker for the private sector. Regardless of how efficient they are. And
they often aren't.

True, but it's normally something where the delivery has to be
co-ordinated on a national level for operational reasons in time of
conflict. That's why I also excluded emergency services. The
judiciary represents a method of maintaining a stable society -on an
distant basis, a part of democracy itself and so a special case.


But basic services such as health, education and


These are prime services that should be outside government control in
terms of delivery.




Beyond that, I see no reason for national or local government to have
an involvement in delivery in areas like healthcare, education and
pretty much everything else.
All of these when government operated do a poor job of customer
service and are poor value for money for the user and the taxpayer who
is funding it.,

You'd have to define 'poor value' For the rich maybe. For the poor,
invaluable. And that's what a decent society should be about, IMHO.

I think that it's poor value if compare with hospitals and primary
care in other countries. If I want appointments for diagnosis and
treatment in the public sector I have to wait until it suits them and
then be expected to be grateful for what I get.

You always will have to do that, unless you run your own health care system,
if yopu want an apointment on Monday the 1st and 10:30 you won't get it if
someone else has already reserved it, the problem is not enough mony is
spent (or it;s being spent in the wrong places) within the NHS.

The problem is the existence of the NHS. Obscene amounts of money are
being spent on what is an outdated wet dream.

It should be shut down and replaced with privately operated healthcare
delivery operations. THese could be individual hospitals or more
systemised versions of care such as HMOs are in the US. There are
advantages and disadvantages of both.

Regarding getting appointments, I have always been able to get an
appointment for private consultation and treatment within either a
required week or for more obscure and non urgent things within two or
three weeks. I have the choice of going elsewhere if I want to do
that.



Look at the Frinch health service, one of the best in europe (and free at
the point of use), but the French tax payer has to dig a bit deaper.

They charge for GP and other services at point of use.

If the
back room admin waste was cut away, such as the internal market, and the
runing of the hospital / wards were placed back into the hands of front line
staff (in the most) more mony would bve advailible for front line staff and
or more hospitals etc.

A far better solution would be for the whole delivery to be taken out
of the public sector altogether.



snip

I completely agree that a decent society should have a means of
providing healthcare for all, including the poor and vulnerable. I
was careful to say that.

No you didn't, you made a point of making it a charity, something that you
would need to be eligible for rather than a rite...

I know what I said. You chose to read something else into it. I
did not mention or imply the word charity and was very careful to say
that there should be a voucher system to make sure that everybody does
get money to spend on healthcare. What I don't want is the
government operating the delivery and I do want the ability to spend
my heathcare provision where I want and to top it up if I wish.



In other words, everybody should receive "money" in the form of
vouchers or equivalent to spend on healthcare and on education.

So you want yet another layer of HMG interference !

No I don't. It's perfectly simple. Close the NHS. Provide people
with vouchers or equivalent means of payment for healthcare services
at a place of their choice. Allow them the freedom to add to their
healthcare provision if they wish.



Unfortunately I do think that some method of control is needed because
there will be peoplw who given money instead would spend it on other
things and not cover themselves.

Perhaps there should just be an opt out system for people like you, if you
need health care then you ring for your private doctor, even if it's an
emergency, even to the point of not being scrapped up off the road ?

That isn't what I said either. I exempted operation and
coordination of emergency services. It's reasonable for coordination
purposes to have them regionally operated by the government.
However, there is no reason why the medical facilities backing them up
need to be state operated at all.




Everybody should be provided with enough voucher cover to get at least
as good a service as they get today and probably better because of
there being more providers being encouraged into the sectors.

There is, it's called the NHS, or private medical insurance.

The point is that the government should not be in the delivery
business because it demonstrably doesn't work with the NHS.

Private medical insurance normally only covers acute conditions and is
a financial arrangement, not a means of delivery. If the delivery is
also outside state control and people can choose where they purchase
the services, the better organisations will attract better staff and
more customers and will ultimately be more successful.
THe poor quality middle management of the state megalith would be
forced out of the sector as it should be.



People wishing to top up their voucher with money or insurance because
they'd like a private hospital room or an appointment at a different
time or a more suitable school should be able to do so. As it is
today, to exercise choice in education I have to pay twice and for
healthcare three times.
I'm not saying that I mind contributing to the common good, simply
that I would like a choice on what I derive from that common good and
to actually get something in return for my payments.


You do, you get a free basic service, if you choose not to use it and pay
for an alternate service then that *is* real personal choice and you are
exercising it.

The point is that if I do use an alternative service then I am freeing
up resources in the state operated facility. Therefore the
government should contribute an equivalent amount to the cost that
would have been incurred in the state facility towards my private
healthcare requirement. This is not asking to receive anything more
from the state than anybody else would get.
As it is, that doesn't happen and moreover there is tax and national
insurance to pay on the private insurance premiums. That is not
reasonable.



--

..andy

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