Author Topic: We are so lucky in the UK  (Read 5362 times)

PhilB

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We are so lucky in the UK
« on: March 26, 2019, 06:39:34 AM »
Last week my eldest son had to be rushed off to hospital for emergency surgery.  All went well and he received great care.  Afterwards I got to thinking how much more stressful the whole thing would have been if we'd been in the US - on top of worrying about him, I'd have been worrying how big a hole paying for it would make in my FIRE budget.  Gotta love the NHS.

stuartkuz

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Re: We are so lucky in the UK
« Reply #1 on: March 26, 2019, 07:08:00 AM »
I was able to do the RE in my late 20s because of being together with a Scandinavian women. When the family's health and safety are ensured you have the FREEDOM to choose your lifestyle. In my 40s, I had no problems paying 45% in taxes to share the freedom.
P.s. After returning to the US, portions of the same security would have cost even more, some were not  available.

ExitViaTheCashRamp

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Re: We are so lucky in the UK
« Reply #2 on: March 26, 2019, 08:32:49 AM »
I've never needed to use another countries healthcare system - but can say when my family have needed emergency medicine -- the NHS were outstanding. My wife and my youngest would be dead without the NHS... and we didn't need to worry about paying or the length of stay in the hospital.

daverobev

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Re: We are so lucky in the UK
« Reply #3 on: March 26, 2019, 10:27:52 AM »
Not just that, but:

Generous tax allowances and generally no tax returns. Mild weather. Good consumer protection generally. Low gun rates.

Lots of issues, but yeah.

Fig

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Re: We are so lucky in the UK
« Reply #4 on: March 26, 2019, 10:29:41 AM »
I'm so very grateful for the NHS. I have more experience than I'd like of the US system - my husband is American (now also a British citizen) but we can never live there as he wouldn't find adequate medical cover for his health conditions, which the NHS covers without question. He was also taken to hospital in Mexico last week and it was hell for various reasons, including the potential financial impact. Everyone deserves good health care but we are indeed the lucky ones.

Glad your son is recovering well :)

FireSeekerLondon

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Re: We are so lucky in the UK
« Reply #5 on: March 26, 2019, 11:11:16 AM »
We are indeed so, so lucky.  I have a chronic illness and over the last couple of years have had goodness knows how many tests and time from various doctors, not to mention hours of my GP's time and empathetic support. 

I also once was working in Italy for a couple of months and had to go to hospital to be treated for an infection.  I'll miss my EHIC card when/if it goes :(

paperclip

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Re: We are so lucky in the UK
« Reply #6 on: March 26, 2019, 12:18:18 PM »
I have some friends who simply cannot have an income due to chronic / mental illness. I can't imagine them faring well in a private healthcare system.

For whatever reason (and I don't mean this in an aggressive way), the UK is becoming increasingly overweight and sick. I don't think that a public health service can sustainably accommodate a populace where ~30% of its citizens are obese, especially when it's already under other pressures such as an aging population and increasingly expensive treatments.

Providing additional funding for the NHS is often talked about by our political parties, but to me this is a non-solution as higher taxation just burdens society in other ways. We need to re-calibrate our society in such a way that promotes and encourages a healthy lifestyle. How you do that, I have no idea. It's a hell of a problem. But without tackling it, I'm not convinced that the NHS will survive in its current state.

Fig

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Re: We are so lucky in the UK
« Reply #7 on: March 26, 2019, 12:35:18 PM »
I worry about the future of the NHS too. The cost of treating diabetes alone looks set to reach unsustainable levels, let alone other consequences of poor public health.

(Edited for typo)
« Last Edit: March 26, 2019, 12:49:52 PM by Fig »

ExitViaTheCashRamp

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Re: We are so lucky in the UK
« Reply #8 on: March 26, 2019, 12:47:47 PM »
You have got it the wrong way around though, there should be a hefty tax on healthy food and gyms. Healthy people live into their 90's with ever increasing numbers of expensive drugs and care provision. Fat people die of heart attacks, liver failure e.t.c. before they reach 60 and don't get to draw their state pension.

 Someone mentioned insulin, Google the the price of it - was reported a little while ago that the NHS massively overpays at something like £450 per YEAR. State pension pays out more than that in 3 weeks !
« Last Edit: March 26, 2019, 12:54:14 PM by ExitViaTheCashRamp »

never give up

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Re: We are so lucky in the UK
« Reply #9 on: March 26, 2019, 01:08:22 PM »
I’m very sorry you’ve had a tough week PhilB but glad it ultimately went well. I hope the recovery continues in the same manner.

Yes we are very lucky here. We’ve got some problems but I wouldn’t want to live anywhere else.

paperclip

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Re: We are so lucky in the UK
« Reply #10 on: March 26, 2019, 01:20:11 PM »
You have got it the wrong way around though, there should be a hefty tax on healthy food and gyms. Healthy people live into their 90's with ever increasing numbers of expensive drugs and care provision. Fat people die of heart attacks, liver failure e.t.c. before they reach 60 and don't get to draw their state pension.

That's a hilarious point which I never considered before, but it definitely has its own weird logic. I found this paper (based in the UK) which backs up your point: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2225433/

From the paper: "The study found that although annual health-care costs are highest for obese people earlier in life (until age 56 years), and are highest for smokers at older ages, the ultimate lifetime costs are highest for the healthy (nonsmoking, nonobese) people. Hence the authors argue that medical costs will not be saved by preventing obesity."

I don't know how in-depth the analysis gets. I can imagine for instance that healthy people are probably more productive and contribute more in taxation, or that if the population were healthier you could raise the retirement age (such that there's effectively more tax money to go around for extra funding). But it certainly isn't as linear a problem as I first thought.

PhilB

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Re: We are so lucky in the UK
« Reply #11 on: March 27, 2019, 12:33:41 AM »
You have got it the wrong way around though, there should be a hefty tax on healthy food and gyms. Healthy people live into their 90's with ever increasing numbers of expensive drugs and care provision. Fat people die of heart attacks, liver failure e.t.c. before they reach 60 and don't get to draw their state pension.

That's a hilarious point which I never considered before, but it definitely has its own weird logic. I found this paper (based in the UK) which backs up your point: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2225433/

From the paper: "The study found that although annual health-care costs are highest for obese people earlier in life (until age 56 years), and are highest for smokers at older ages, the ultimate lifetime costs are highest for the healthy (nonsmoking, nonobese) people. Hence the authors argue that medical costs will not be saved by preventing obesity."

I don't know how in-depth the analysis gets. I can imagine for instance that healthy people are probably more productive and contribute more in taxation, or that if the population were healthier you could raise the retirement age (such that there's effectively more tax money to go around for extra funding). But it certainly isn't as linear a problem as I first thought.
So the real problem is the people who take care of their health, don't pay their fair share of VAT by avoiding consumerism and reduce their direct tax by contributing to pensions and retiring early.  I hope you're all ashamed of yourselves.

PhilB

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Re: We are so lucky in the UK
« Reply #12 on: March 27, 2019, 12:48:34 AM »
I’m very sorry you’ve had a tough week PhilB but glad it ultimately went well. I hope the recovery continues in the same manner.

Yes we are very lucky here. We’ve got some problems but I wouldn’t want to live anywhere else.
I've had even more stark evidence of how lucky we are in the past.  I was diagnosed 10 years ago with a form of leukaemia that had had a 3 to 5 year life expectancy, before the recent discovery of a new drug which was looking very promising.  I spent a lot of time hanging out on a US based forum learning about the disease and was really shocked to find that most US people on there were literally more worried about how to pay for the drug than whether it would work.
I'm glad to say the drug worked for me and further drugs have since come on line to make the condition entirely manageable for the great majority of patients.

dashuk

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Re: We are so lucky in the UK
« Reply #13 on: March 27, 2019, 07:48:22 AM »
We need to re-calibrate our society in such a way that promotes and encourages a healthy lifestyle. How you do that, I have no idea. It's a hell of a problem.

It's not that complicated. Put Dutch levels of investment into walking and cycling infrastructure. Stop massively subsidising private motoring.

As a byproduct to trying to reduce obesity you also improve CO2 emissions, local air quality, road deaths, children's mental health, etc, etc.

TacheTastic

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Re: We are so lucky in the UK
« Reply #14 on: March 27, 2019, 10:51:32 AM »
You have got it the wrong way around though, there should be a hefty tax on healthy food and gyms. Healthy people live into their 90's with ever increasing numbers of expensive drugs and care provision. Fat people die of heart attacks, liver failure e.t.c. before they reach 60 and don't get to draw their state pension.

 Someone mentioned insulin, Google the the price of it - was reported a little while ago that the NHS massively overpays at something like £450 per YEAR. State pension pays out more than that in 3 weeks !

I think the route that the government is trying to take is to phase out state pensions by enforcing contribution. to workplace pensions.

PhilB

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Re: We are so lucky in the UK
« Reply #15 on: March 27, 2019, 10:55:57 AM »
We need to re-calibrate our society in such a way that promotes and encourages a healthy lifestyle. How you do that, I have no idea. It's a hell of a problem.

It's not that complicated. Put Dutch levels of investment into walking and cycling infrastructure. Stop massively subsidising private motoring.

As a byproduct to trying to reduce obesity you also improve CO2 emissions, local air quality, road deaths, children's mental health, etc, etc.
How are you calculating that there is a massive subsidy?  A quick glance at the numbers suggests total public spending on roads is not much over £10 billion pa, but road tax, fuel tax and VAT on fuel brings in about £38 billion pa.

SpreadsheetMan

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Re: We are so lucky in the UK
« Reply #16 on: March 27, 2019, 11:44:47 AM »
You have got it the wrong way around though, there should be a hefty tax on healthy food and gyms. Healthy people live into their 90's with ever increasing numbers of expensive drugs and care provision. Fat people die of heart attacks, liver failure e.t.c. before they reach 60 and don't get to draw their state pension.

 Someone mentioned insulin, Google the the price of it - was reported a little while ago that the NHS massively overpays at something like £450 per YEAR. State pension pays out more than that in 3 weeks !

I think the route that the government is trying to take is to phase out state pensions by enforcing contribution. to workplace pensions.
No, I think it is targeted at reducing pension credit and housing benefit.  The level of contribution would have to be massively higher to totally replace SP and benefits.

dashuk

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Re: We are so lucky in the UK
« Reply #17 on: March 27, 2019, 01:47:27 PM »
How are you calculating that there is a massive subsidy?  A quick glance at the numbers suggests total public spending on roads is not much over £10 billion pa, but road tax, fuel tax and VAT on fuel brings in about £38 billion pa.

Because building roads is not the only way in which private car use costs the economy.

Try:

http://ipayroadtax.com/no-such-thing-as-road-tax/when-will-drivers-start-paying-the-full-costs-of-motoring/

Longer read:

https://www.ippr.org/files/images/media/files/publication/2012/08/war-on-motoring-myth_Aug2012_9542.pdf



daverobev

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Re: We are so lucky in the UK
« Reply #18 on: March 27, 2019, 03:08:55 PM »
How are you calculating that there is a massive subsidy?  A quick glance at the numbers suggests total public spending on roads is not much over £10 billion pa, but road tax, fuel tax and VAT on fuel brings in about £38 billion pa.

Because building roads is not the only way in which private car use costs the economy.

Try:

http://ipayroadtax.com/no-such-thing-as-road-tax/when-will-drivers-start-paying-the-full-costs-of-motoring/

Longer read:

https://www.ippr.org/files/images/media/files/publication/2012/08/war-on-motoring-myth_Aug2012_9542.pdf

I didn't read the second, but in the first it has a chart listing the externalities.

Excess delays, accidents, and physical inactivity are things already paid for by the motorist, not the government, surely?

I'm in favour of increasing tax to directly pay to fix the environment, but those other things seem... odd.

PhilB

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Re: We are so lucky in the UK
« Reply #19 on: March 27, 2019, 03:52:41 PM »
How are you calculating that there is a massive subsidy?  A quick glance at the numbers suggests total public spending on roads is not much over £10 billion pa, but road tax, fuel tax and VAT on fuel brings in about £38 billion pa.

Because building roads is not the only way in which private car use costs the economy.

Try:

http://ipayroadtax.com/no-such-thing-as-road-tax/when-will-drivers-start-paying-the-full-costs-of-motoring/

Longer read:

https://www.ippr.org/files/images/media/files/publication/2012/08/war-on-motoring-myth_Aug2012_9542.pdf

I didn't read the second, but in the first it has a chart listing the externalities.

Excess delays, accidents, and physical inactivity are things already paid for by the motorist, not the government, surely?

I'm in favour of increasing tax to directly pay to fix the environment, but those other things seem... odd.
Odd is putting it mildly.  Make up some random numbers and you can 'prove' anything.  In the first one it is telling that they have two goes at proving motorists don't pay their way.  First they just compare VED to the cost of roads, ignoring fuel taxes.  Secondly they ignore VED and compare their wider 'costs' to just the fuel taxes, with the great majority of their costs being a ransom number for the cost of 'congestion' and the fuel tax number being based on everyone averaging better than 60 mpg.
There are very valid arguments to be made for why we should be deliberately taxing motoring as a way of discouraging car use, but flagrant attempts to cook the books just detract from them and bring the whole anti-car lobby into disrepute. 

dashuk

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Re: We are so lucky in the UK
« Reply #20 on: March 28, 2019, 03:09:05 AM »
Excess delays, accidents, and physical inactivity are things already paid for by the motorist, not the government, surely?

No, they're paid for by the NHS, which is how we got onto this point in the first place.

paperclip

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Re: We are so lucky in the UK
« Reply #21 on: March 28, 2019, 03:35:55 AM »
So the real problem is the people who take care of their health, don't pay their fair share of VAT by avoiding consumerism and reduce their direct tax by contributing to pensions and retiring early.  I hope you're all ashamed of yourselves.

That's what the data says. To address this, I propose we establish a tax on all green foods and ban gym memberships.

While we're at it, let's relax the age restrictions on smoking and alcohol. Better to get 'em early.

PhilB

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Re: We are so lucky in the UK
« Reply #22 on: March 28, 2019, 04:32:28 AM »
Excess delays, accidents, and physical inactivity are things already paid for by the motorist, not the government, surely?

No, they're paid for by the NHS, which is how we got onto this point in the first place.
Well a lot of the cost of the accidents is borne by the motorist through car insurance premiums.  More to the point, you can't just cherry pick which incidentals to include and which to exclude in your analysis.  If you want to start bringing in things like the costs of congestion and inactivity, then it's only fair to also bring in the contributions to GDP from the whole industry around making, selling and maintaining cars and roads, plus all the taxi drivers, delivery drivers, etc, etc.
Any honest analysis would clearly show that the state gains a net economic benefit from motor transport and it's just silly to create spurious calculations to support taxing drivers more.  The arguments we should be using are exactly the same ones we use to tax the bejeesus out of smokers.

Chuck Ditallin

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Re: We are so lucky in the UK
« Reply #23 on: March 28, 2019, 06:02:09 AM »
The NHS at least attempts to recover costs of treating RTC casualties through the insurance of the at-fault party. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/748156/nhs-injury-cost-recovery-scheme-2018-2019-guidance.pdf

frugledoc

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Re: We are so lucky in the UK
« Reply #24 on: March 29, 2019, 07:15:30 AM »
The NHS is great but the British public are destroying it because it is FATPOA (free at the point of abuse).

The plastic bag charge has shown how tiny financial “nudges” can change the public’s behaviour and a similar tactic is needed if the NHS is to survive.

DOI: NHS consultant


PhilB

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Re: We are so lucky in the UK
« Reply #25 on: March 29, 2019, 08:45:38 AM »
The NHS is great but the British public are destroying it because it is FATPOA (free at the point of abuse).

The plastic bag charge has shown how tiny financial “nudges” can change the public’s behaviour and a similar tactic is needed if the NHS is to survive.

DOI: NHS consultant
My worry there is that there will be a percentage of people who will be put off seeking care when they urgently should by that financial 'nudge'.  My son's problem was time critical and resulted in getting a surgeon out of bed to operate.  There are already a fair percentage of cases with that condition where people don't seek help quickly enough resulting in irreparable damage.  The prospect of a charge would, I am sure, increase that problem.
My hope for the future of the NHS is for there to be a big role for AI in triaging to find those who really do need to see a professional.  That could bring the twin benefit of getting more people to seek help early, but screening out the great majority who don't need medical intervention.

frugledoc

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Re: We are so lucky in the UK
« Reply #26 on: March 29, 2019, 12:11:59 PM »
Obviously this is not relevant to your experience phil :)

The British public need to learn self responsibility.  Saying they will present late because don’t want to pay a small charge is paternalistic.

Modern life and the U.K. government have infantilised us all and now everybody expects everything,  and immediately.

poppydog

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Re: We are so lucky in the UK
« Reply #27 on: April 04, 2019, 11:10:07 AM »
I agree with the OP- warts and all, I think the UK is great and I wouldn’t want tipoffs live anywhere else.  My heart goes out to some of of our US friends on here who have real health care worries which impact their ability to retire.  Don’t get me wrong, I love the USA and love to visit there, but I wouldn’t swap our NHS for a privatised system.

NorthernMonkey

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Re: We are so lucky in the UK
« Reply #28 on: April 04, 2019, 11:52:48 AM »
The NHS is ace. I'll quite happily pay the increased tax to pay for it.


BookLoverL

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Re: We are so lucky in the UK
« Reply #29 on: April 04, 2019, 01:35:43 PM »
I love the NHS. Thanks to the NHS, I got my Tourette's Syndrome diagnosed for free (plus travel costs to the hospital I guess), and now the pill I take to manage it, which makes my life a hell of a lot better, just went up to £9 for about 2 months' worth. Can't imagine paying thousands like they do in the US...

Regarding whether there should be a small charge, I think maybe there could be a nominal charge of £1 applied for non-emergency type things, but anyone where there's any doubt at all about whether it's a non-emergency, they'd have to waive the charge anyway possibly. Just throwing ideas out there really. I also think maybe they could do a little less of the "keep clearly brain-dead patients who are going to eventually die anyway on life support on expensive machines for months on end" type of thing, and move them to hospice care instead, but maybe I'm secretly heartless and that's just me who thinks that. ;)

InterfaceLeader

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Re: We are so lucky in the UK
« Reply #30 on: April 21, 2019, 04:08:41 AM »
My Dad recently needed ambulance+2 days in hospital+tests+medicine. So lucky to be able to just DO that and not worry about the financial impact.

I would gladly pay more tax to fund the NHS. I do think we should provide an option for euthanasia though. I watched my poor grandmother, formidable and amazing woman, get dementia and gradually become a barely-human wreck. There was definitely a point at which keeping her alive was cruel, not kind. I know those decision are complex and nuanced, and it's hard to know where the line is, but I would cheerfully describe situations in which I would take euthanasia over other options, especially once aged 75+.


Hula Hoop

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Re: We are so lucky in the UK
« Reply #31 on: April 21, 2019, 05:08:59 AM »
I also once was working in Italy for a couple of months and had to go to hospital to be treated for an infection.  I'll miss my EHIC card when/if it goes :(

Just FYI - here in Italy, emergency medical treatment is always free.  No need for an EHIC card or anything else.  Americans are always astounded by this.

I'm an American living in Italy and one of the reasons we stay here is the abominable health care situation in the US.  I have had serious health issues and major surgery.  I can only imagine how much that would have cost if I'dstill lived in the US.

 

Wow, a phone plan for fifteen bucks!