[Miscellaneous]

Sorry, you've lost me.

Seems clear enough to me, Joe.

[JoeC]

Then I shall sleep easy.

[defcribed]

..

Of course it's free. Every single person in this country is entitled to avail themselves of the services on offer, .....

.. before urgently needed treatment, true. However, after such treatment, or if it is not urgently needed, providers have the right to ask, or to present a bill. Until very recently providers have not bothered, because the administrative overheads (and possible litigious risks) of the prior 'triage' and subsequent billing were clearly far greater than any likely sum to be saved or recovered. However, under recent political pressure, notably from some tabloids ranting about alleged but unproven 'health tourism', some providers (eg major London hospitals) have started billing those not entitled to free. I have no idea whether this change has been cost-effective for them.

Perhaps I should have said every single entitled person, which as it happens is most people.

Frankly it staggers me that attempting to bill those who may not be entitled to free healthcare in the UK (i.e. non-residents) is a relatively new and controversial thing.

[defcribed]

Of course it's free....

....Of course we all pay for it (well, those who pay tax do)

Sorry, you've lost me.

It's quite simple Joe. My argument is an economic one. In the absence of a cost, demand for a valuable good or service tends to infinity.

Here's an example.

You set up a stall selling bacon butties in Hyde Park or similar.

Only you don't sell them, you give them away. The stock of bacon, bread, butter and sauce (brown, never red) is provided by central government funding - for whatever unlikely reason.

Because the bacon butties are free and good quality the queue is always longer than you can possibly deal with. This is entirely logical and expected. If you were selling them rather than giving them away, you could set the price so as to keep demand (the queue length) at a manageable level.

The fact that the costs come from general taxation revenue so some (or all) of those who consume your bacon butties will have indirectly paid for them may be an interesting point worthy of note. However, it's entirely irrelevant to the supply/demand situation that causes such a long, unmanageable queue at your stall on a day-to-day basis.

The free bacon butty stall is the NHS.

[Flyin'Dutch']

The fact that the costs come from general taxation revenue so some (or all) of those who consume your bacon butties will have indirectly paid for them may be an interesting point worthy of note. However, it's entirely irrelevant to the supply/demand situation that causes such a long, unmanageable queue at your stall on a day-to-day basis.

The free bacon butty stall is the NHS.

The NHS is free ar the point of care and what care people get is mainly based on their needs - contrary to popular believe few people consume healthcare just because they can.

Different systems are available but has been written many a time they are not cheaper and don't necessarily deliver better care, and they usually don't address the greatest health care needs.

If you have information which shows a system that works better, please share it here as we are all keen to learn.

Running a healthcare system for a nation is more difficult than a bacon butty store, or as The Donald found out, a crooked real estate emporium.

[JoeC]

I find your analogy over simplistic as it leads to the only conclusion that paying at the point of delivery will be the solution.

causes such a long, unmanageable queue

If you were a manager then you would know how many could possibly turn up and then sort your supply chain out and finances to deal with this. Unmanageable? How about some triage?

Forecasting, managing, having the right funds in the right place at the right time are all part of the real-world complex solution.

Just because something is difficult to get right doesn't mean it shouldn't be pursued.

[romille]

Something I have often wondered is how does the NHS determine entitlement, how does the GP know that the person sitting in front of them is who he/she says they are. When I visit an AME they expect me to produce photo ID, whereas when I pay one of my very infrequent visits to my GP they never ask any questions. Given that in the 20+ years I have been registered with my local practice I have had less than 10 appointments and never seen the same health practitioner more than once how would they know if I sent a doppelganger?

[defcribed]

The NHS is free ar the point of care and what care people get is mainly based on their needs - contrary to popular believe few people consume healthcare just because they can.

Different systems are available but has been written many a time they are not cheaper and don't necessarily deliver better care, and they usually don't address the greatest health care needs.

If you have information which shows a system that works better, please share it here as we are all keen to learn.

Running a healthcare system for a nation is more difficult than a bacon butty store, or as The Donald found out, a crooked real estate emporium.

I don't pretend to have a system that works better. I'm just pointing out the simple economic rule which governs this, and any other valuable good or service that gets given away for free.

It's a financial black hole. It doesn't matter how many billions your pour into it, it will always need more. The law of diminishing returns sees to that. An early healthcare advance was to have doctors wash their hands between handling corpses and delivering babies. That cost almost nothing and made an enormous difference. We've now gone through all the other 'low cost, big difference' changes, nearly all the 'high cost, big difference' changes and we're deep into the 'high cost, small difference' changes. We spend tens of thousands of pounds extending lives by a matter of months. That's the law of diminishing returns in action.

At some point someone needs to ask the bold question of some healthcare advance or other "is it worth it?"

[defcribed]

Something I have often wondered is how does the NHS determine entitlement, how does the GP know that the person sitting in front of them is who he/she says they are. When I visit an AME they expect me to produce photo ID, whereas when I pay one of my very infrequent visits to my GP they never ask any questions. Given that in the 20+ years I have been registered with my local practice I have had less than 10 appointments and never seen the same health practitioner more than once how would they know if I sent a doppelganger?

As far as I know, by and large it doesn't.

Nearly all of the UK population is entitled to free healthcare. It would probably cost more to screen entitlement at each use than it would save in not giving free healthcare to those not entitled.

[Flyin'Dutch']

GP practices are now required to check registered address and personal details on registration.

Living in the UK is the rite of passage.

Other systems are available but increase the costs and administrative burden will outweigh the benefits. They would probably require a manager and there are, according to the opinion espoused on here by some, already too many of those in the NHS.

Or we can put a police officer/immigration officer at every NHS outlet but there are too few out there already, according to some.

[romille]

GP practices are now required to check registered address and personal details on registration.

Living in the UK is the rite of passage.

Other systems are available but increase the costs and administrative burden will outweigh the benefits. They would probably require a manager and there are, according to the opinion espoused on here by some, already too many of those in the NHS.

Or we can put a police officer/immigration officer at every NHS outlet but there are too few out there already, according to some.

So I could send my seriously ill, visiting Aussie born cousin who is male and a similar age along in my place and he could receive expensive free treatment? Given that I can book an appointment on line and notify my presence at the surgery by using a touch screen I can only imagine that fraud is rife as it seems to be in most government run organisations. He might even be given free vaping supplies and nicotine patches!

[Flyin'Dutch']

So I could send my seriously ill visiting Aussie born cousin who is male and a similar age along in my place and he could receive expensive free treatment? Given that I can book an appointment on line and notify my presence at the surgery by using a touch screen I can only imagine that fraud is rife as it seems to be in most government run organisations. They might even be given free vaping and nicotine patches!

You could try.

But he would be committing fraud.

Just as you could speed.

You can stop both by deploying a different system.

But that costs money-

You just have to decide what you want to spend 'your' money on.

I suspect that prescribing nicotine patches in the long run is more beneficial to the UK PLC* than putting a copper in every NHS outlet.

*reduced health care cost and increased and longer tax take by being more healthy for longer.

[kanga]

.. I can only imagine that fraud is rife as it seems to be in most government run organisations. ..

any evidence that it is (in either case) ?

[romille]

You could try.

But he would be committing fraud.

Like that is going to cause people that do these sort of things to lose sleep.

All I know is there would not be many private health care providers that would be so open to such fraud!

[Paultheparaglider]

Something I have often wondered is how does the NHS determine entitlement,

As far as I know, by and large it doesn't.

Nearly all of the UK population is entitled to free healthcare. It would probably cost more to screen entitlement at each use than it would save in not giving free healthcare to those not entitled.

Having lived many years in Hong Kong which has an identity card system, we could do the same. Although I accept this hasn't proved politically acceptable here, it worked very well over there, and had many benefits. It is used for travel, health, banking, and much more.

I'd be more than happy to have one in this country.