zlacker

If you go to, say, France, you'll find that healthcare isn't free at the point of use and that the system is much more private than in the UK. I believe this is so in many other European countries, too.

So public/NHS vs private/US system is a false dichotomy, and "free at the point of use" is a red herring.

Looking at the reactions, this whole threads does exemplifies what the OP said about the NHS being a "religion".

>>mytail+(OP)
Same with Canada, they have public health insurance run by provinces which private hospitals bill to. While the UK has a giant national public hospital system run across an entire country (NHS England, NHS Scotland etc).

>>dmix+51
The UK has NHS trusts that run hospitals etc. For a limited period of time - just a few years -, the trusts in England were reporting to NHS England. NHS England is being abolished.

These ca. 200 trusts operate with a great degree of operational independence, though they are public entties.

The distinction is important because they are what makes the scale manageable, and it also provides resilience.

>>vidarh+S7
The distinction is important because they are what makes the scale manageable, and it also provides resilience.

Though it also leads to inconsistency and the "postcode lottery" problem where the quality of treatment a patient receives for a specific condition can be extremely variable depending on where they live.

>>mytail+(OP)
I guess you're talking about healthcare for the unemployed or non-residents or non-French people, because if you're employed there is additionnal and mandatory healthcare. There's still basic free healthcare if you don't yet fit well in the system but it's like for example to remove a tooth instead of clean it and reconstruct it.

>>domini+da
No, I am talking about everyone.

> because if you're employed there is additionnal and mandatory healthcare

Yes, if you are employed in the private sector there is now mandatory additional private health insurance to cover what public healthcare does not.

Healthcare isn't free at the point of use in any case. Things may be automatically paid/reimbursed as the case may be. Private sector is much more involved than in the UK, too, starting from GPs who are all private practices.

The point is that it's not because you have to pay at point of use or because things are more private that you end up like in the US. This is an FUD argument against change.

>>Silhou+Z8
That's true, but now mitigated at least to some extent by the right to choose (though people are woefully unaware of this, and GP's in my experience never ask so you need to bring it up if you have issues with your local hospital - the NHS could do better at requiring this; in some cases I've been given links to pick treatment provider after being referred, and it'd be nice if that was the norm).

But it's better to have management failings contained to individual trusts, that are monitored, than to have these failing affect the system as a whole. Not least because it does allow patients going elsewhere as a last resorts.

>>mytail+(OP)
It's not a "religion" to have people disagree with you on philosophical points.

In addition, I'd say most of this thread is a bunch of people debating what issues there are with the NHS (I don't see anyone claiming there aren't any) with some people for it, and some against it.

A fair few people believe that it is the duty of the state to care for individuals, and that one right that people have is free access to healthcare.

If someone expresses that viewpoint I don't think it's fair to say that they're being religious or dogmatic about it, just like it wouldn't be fair for people to argue that your view (which I assume is for a more privatised healthcare system) is religious or dogmatic, it's a simple disagreement.

>>mytail+De
All the GP practices in England are private businesses working under contract to the NHS. Most people don't notice since the majority of services are covered under that contract.

https://www.kingsfund.org.uk/insight-and-analysis/long-reads...

>>harvey+hz
Yes they are but they are indeed service providers as you mention.

That's quite different from a private practice (like a solicitor here) that you pay directly and/or that seeks payment from health insurance.

>>mytail+(OP)
I moved to Finland from the UK and found exactly the same thing you mentioned in France. Plus extra layers of beauracracy (there's no national health service, there are public hospitals that send a bill to the public insurer and you get a bill for an excess unless you are absolutely down-and-out. Either way, a nice job program for public administrators). Prescriptions are far more expensive than the UK (your co-pay on them is something like €600 a year)

One nice perk though is that [private, corporate] jobs offer cushy health insurance as part of the deal as standard really so you can go and see one of the many private doctors in their offices at your choice and leisure.

>>mytail+zK
There are a great many things that the NHS pays practices for on a unit basis which is very much like them seeking payment from an insurer. The system has a far lower administrative cost than the USA model but the contract management process still looks more like a plate of spaghetti and not a circuit diagram.