We are developing the social individualist meta-context for the future. From the very serious to the extremely frivolous... lets see what is on the mind of the Samizdata people.
Samizdata, derived from Samizdat /n. - a system of clandestine publication of banned literature in the USSR [Russ.,= self-publishing house]
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Samizdata quote of the day Take my advice, never trust a politician. When a politician tells you they are going to look after your child’s education, it’s perhaps time to go private – or even to home educate. When a politician tells you they are going to ban guns – expect vast increases in gun crime. When a politician tells you they are going to ban dangerous drugs – watch out for your community being awash with these substances. My heart sinks when politicians get involved in anything. Invariably, they promise the earth, coercively tax you out of your hard earned money, and then they deliver bugger all when you really need the service.
– Helen Evans in the Nurses for Reform blog today (I thought it might liven up)
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Who Are We? The Samizdata people are a bunch of sinister and heavily armed globalist illuminati who seek to infect the entire world with the values of personal liberty and several property. Amongst our many crimes is a sense of humour and the intermittent use of British spelling.
We are also a varied group made up of social individualists, classical liberals, whigs, libertarians, extropians, futurists, ‘Porcupines’, Karl Popper fetishists, recovering neo-conservatives, crazed Ayn Rand worshipers, over-caffeinated Virginia Postrel devotees, witty Frédéric Bastiat wannabes, cypherpunks, minarchists, kritarchists and wild-eyed anarcho-capitalists from Britain, North America, Australia and Europe.
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MY problem with NICE is not that the government is giving bad advice, but that it cost so much to give it. Each treatment guideline in NICE cost about one million pounds to write.
The advice they give is actually pretty sensible, and overall, if doctors followed NICE to the letter, they’d probably do more good than harm compared with the current situation.
People object to NICE advising the NHS not to pay for very expensive drugs that have a low chance (and we are often talking fractions of a percentage, relative to current treatment) of a positive outcome. But, that’s an entirely sensible position. No health insurance plan covers all treatments, likewise the NHS doesn’t cover all treatments. You don’t pay lower premiums if you happen to need an uncovered treatment, and you don’t pay lower tax if you happen to need a treatment NICE doesn’t recommend.
NICE attempts to recommend on a health per money basis. Expensive things with a small health benefit get the axe. Insurance companies recommend on a free market basis. In this instance, I’ll take NICE, because a casual glance at the US indicates the market in health insurance policies there hasn’t resulted in very attractive coverage for the amount of money paid.
You taking NICE is fine by me, J… what pisses me off is that I also have to take it. I use the NHS because I am forced to damn well pay for it even if I shell out for private medical care.
Good point. I would like to add that undersdtanding politicians is hard for the “average joe” to do. It’s often hard to understand lower life forms.
“what pisses me off is that I also have to take it”
Indeed. In the same way it would be nice if those who didn’t use the state school system didn’t have to pay for it, it would be nice if those who didn’t use the state health system didn’t have to pay for it.
There is a difference, in that the NHS benefits greatly from its size and its uniformity, whereas state education appears to derive no benefit from being state run. In other words, if half the UK population went to private school, the remaining half would get education not worse than they do today. The same would probably not be true in healthcare.
I think the point is moot in any case. The UK is obviously moving away from the NHS as we knew it 20 years ago, and is moving towards some kind of national health insurance which will then buy healthcare from a free market. This is being done because modern healthcare is unmanageable – better for the people to hate their HMO or insurer, as they do in the US, than to hate their government, as they soon will do in the UK.
Likewise, better for nurses to complain about evil insurance companies not letting them treat patients, as they do in the US, than for them to complain about evil government departments doing the same….
“The UK is obviously moving away from the NHS as we knew it 20 years ago, and is moving towards some kind of national health insurance which will then buy healthcare from a free market.”
Astounding. How in the world does one bend double like a safety-pin like that and then manage a keyboard in that shape?
Low comedy.
J: There is a difference, in that the NHS benefits greatly from its size and its uniformity
I even if this was true the NHS may benefit, the patient does not …
J. wrote:
‘ . . . because a casual glance at the US indicates the market in health insurance policies there hasn’t resulted in very attractive coverage for the amount of money paid.’
Huh?
That’s a pretty casual glance, I’d say.
American consumers have a vast range of choices in health insurance, with every possible combination of benefits vs premiums. From the NHS-like Blues, all the way to the new generation of high-deductible offerings, complete with income-tax-free components, you can buy just about any level of health insurance you want. Including the one choice which no Briton has, namely, no health insurance at all – which can be a very attractive choice for some customers.
Unlike the NHS, where one-size-fits-all.
If the complaint is that US health-care premiums are too high for the coverage offered, well, that is a different matter, of course. But the types of premiums that are charged in the US are simply the price of having the biggest and best healthcare system in the world. If you want same-day MRI’s, bypass surgery available 24/7 and helicopters idling on the pad to pluck you off the freeway and into a trauma centre – that’s what it costs. And, apparently, this is what the majority of US consumers want.
llater,
llamas
If people want government health care in the United States than can go to (for example) the local county hospital.
Indeed in the State of Louisiana a large scale system of State hospitals was set up (I believe) before the N.H.S. – should someone wish to die horribly he is quite free to go to one of these hospitals.
To be fair, in the United States government does seem to be very bad at organizing anything (even worse than governments are in other lands) – it is not a question of Democrat or Republican, it is government (at all levels) that can not do things.
Have a look at the voting going on as I type this. Long lines (a one hour wait for Jim Talent to vote in Missouri -and he is the Senator), “voting machines” that do not work (one Republican Congress lady in Ohio found that she could not vote), voting lists that contain much larger numbers of names than people who live in the State (Missouri again – even subtracting the thousands of people that the leftist “ACORN” organization invented) – and so on.
This is all in spite of vast amounts of money spent on the voting process. Would you really like these people in charge of all medical care? Not an empty question – this is what Mrs Clinton (and many other Democrats) are still planning.
By the way government buying medical care is not a “free market” – it sounds like Medicare and Medicaid. These schemes have not only exploded in cost (in 1965 both together cost 5 billion Dollars – now they cost HUNDREDS OF BILLIONS OF DOLLARS) but have also helped push up costs in what remains of private medical care (as have the endless government regulations – such as the ones on insurance companies that forbid them to take account of many things that any rational insurance company would take account of).
Do not get me wrong, American medical care is better than British (otherwise people would not go from Britain to America for treatment – it would be the other way round), but to call American medical care a “free market” is absurd.
NICE isn’t about rationing. NICE is the golden calf of the pharmacuetical industry, starving age-old and proven, but un-NICE tested products out of the system-NICE recommends everyone’s got to have (end of story). Check its track record.
Then audit, always remember to audit, because that retains jobs for the boys and girls …
I agree about the NHS with Llamas and Paul Marks and most people in the UK are woefully misinformed when they criticise the US ‘system’ because not everyone is covered by insurance, as if this means people dying on the streets. After all, very few people in the UK are covered by insurance – the NHS doesn’t offer any of the contractual guarantees of an insurance policy – you are guaranteed almost nothing.
However, the US system isn’t so great. Both the UK and th US suffer from producer capture compared, for example, with most European systems. Medical practitioners run a cosy monopoly and we pay through the roof. That’s why the UK and the US have by far the best paid medics. The tax-deductibility in the US distorts the market and makes this even worse. I’d argue that bothe the UK and US situations probably make us devote far more to medical care than a true free market would.
In any case, we have to get over the idea that medical systems have very much to do with health care – they don’t. Good health, in most cases, is down to sanitation, housing, diet, exercise, etc.. There may be lots of advanced treatments available in th US, but do US citizens live any longer? In fact, US life expectancy is lower than most other advanced countries. The value of medical care is also much reduced by the fact that you have to factor in the possibility of misdiagnosis, mistakes, adverse drug reactions, hospital-acquired infections, poorly evaluated treatments, the incentive on medical staff to overtreat, etc.. More people may be helped by medical care than are harmed, but there is a substantial % risk that it will be anything but beneficial.
In any case, Paul, if you want to avoid the NHS in the UK, you are generally much better off going to the rest of Europe, India, etc. where you can get high quality medical care for a fraction of the US or UK price.
Quite so HJHJ – even “Newsweek” had a story a couple of weeks ago about inexpensive high quality care in such countries as India.
Indeed I have heard about it before – although (of course) there are bad hospitals in such countries as well. As ever “let the buyer beware” – it is the ture function of “consumer groups” to check such things as quality (rather that getting side tracked into campaigns for governent regulations – which increase costs but do NOT increase quality of care).
And yes I should have mentioned the scandal of Doctor licensing – a scam that Milton Friedman exposed more than half a century ago, but which is still going strong.
I apologize for my oversights.
MAXIDEX WARNING
I had eye surgery and in the post-op pack was MAXIDEX ( DEXAMETHASONE) drops by AALCON LABS.
Two days later I was BLIND
Use Google and enter EPOCRATES MAXIDEX REACTION to verify