NHS 101 please!

[Luci]

I should learn a lot about the NHS for my possible interview so...

Could anyone please explain how the NHS works? As far as I've heard they're in big trouble and could become bankrupt because it's for free?!! How is that possible?? that's insane... Who would come up with a system where healthcare is just for free... I just can't wrap my head around it... it must cost the government a FORTUNE!

I just started working for a dutch health insurance company and had to learn everything there is to know about health care and insurances and of course, the dutch system isn't perfect, but it's definitely not in trouble either!
So are those things I heard true? And what's the idea behind the NHS? I'll be looking on wikipedia and googling and stuff, but it's always nice to hear it from different people. What are your views on the NHS? Good points/ bad points??

merci beaucoup!

[Kinkerz]

I should learn a lot about the NHS for my possible interview so...

Could anyone please explain how the NHS works? As far as I've heard they're in big trouble and could become bankrupt because it's for free?!! How is that possible?? that's insane... Who would come up with a system where healthcare is just for free... I just can't wrap my head around it... it must cost the government a FORTUNE!

It isn't free! The tax payers of this country fund it, aswell as the police, the fire service, and education (well, most of it).

You get free health care on your point of arrival, but the tax payers are putting money into it all the time.

[jcarver1]

It DOES cost the government a fortune, which is gained through tax. Any govenment service is paid through tax, but these are becoming fewer and fewer (post office,railways...) Private companies where you have to pay for healhcare, like BUPA, are allowed in britain, but you still have to pay your taxes so essentially you are paying for the NHS AND your private healthcare. Recently they have started to consider "top-up" schemes, whereby you are able to pay for private heathcare without forfeiting your right to NHS care.


Can someone help me with the whole structure and pros and cons of the NHS (as mentioned above) ? I dont really get, district hospitals, and care trusts and that kind of thing and how they all fit together.

[Singh.Simran]

It is bloody expensive - well over £100,000,000,000/annum, but for the provision this is universally regarded as very good value for money, and is in no real danger of going under - no british political party could get rid of or significantly decrease the NHS without suicide, and the government, inept as it is, does preside over one of the biggest economies in the world to prop it up with.

[Luci]

we do it this way: we have a basic insurance which is mandatory for every legal dutch citizen (few exceptions) and costs about 70 pounds a month (from the age of 18 on). In the basic health insurance you find all the necessary things, like having to go to the doctor, hospital, etc. Then you can get extra insurances for which you'll pay a couple of pounds extra, which will insure you for e.g. physiotherapy, glasses, vaccinations, that kind of thing.
And then you also have dental insurances which are for free until 22yrs
I believe an average dutch person pays about 900 pounds a year... (yep, it's expensive..... students can get it slightly cheaper) but that's not where it ends! No... we also have to pay tax! which is 6.5% of your income!
And of course, not everything is paid for you for 100%, no, of course not! sometimes you also have to pay a bit yourself. For example if you get medications, sometimes you have to pay a bit yourself as well, and that could go up to €500 a year if you're picky.
and then there are a few more complicated little things, but those are not worth mentioning.
Moneywise there's 33,000,000,000 euro's for about 16million people going around. at least the government pays for all the kids...
Belgium has a better system, and cheaper!

[AimsRJ]

well over here it is paid through 'national insurance contributions' which comes out of every working person's wage in addition to 20% tax (40% if you earn a reasonable amount- but not that much I think its about £34k and they take 40% it is scandalous). That works out for most people more than £70 a month.
But, you then get pretty much everything free (except prescription charges, opticians, dental contributions). Does your insurance premium go up if you claim on it a lot in NL? ie does it cost more the iller you are?

[Singh.Simran]

If you earn 34k, they don't take 40%. In fact under the current uk taxation structure it's impossible to take a full 40% - although it can get negligably close. Rookie error.

[ben_]

It is bloody expensive - well over £100,000,000,000/annum, but for the provision this is universally regarded as very good value for money, and is in no real danger of going under - no british political party could get rid of or significantly decrease the NHS without suicide, and the government, inept as it is, does preside over one of the biggest economies in the world to prop it up with.

Singh Simran, I fear you are being a little optimistic. The state is taking steps to dismantle and privatize the NHS - within a generation, two at the most. The infrastructure for LIFTs (Local Improvement Finance Trusts) is already in place. These are essentially methods of channelling private investment into primary healthcare. They are the next phase of PFI for the NHS. I know this because I am involved with it at work on a daily basis - much to my regret.

If you look at the way the state has forced PCTs to go to private finance in order to obtain funding for infrastructural improvements - often at usurious rates - it's hard to avoid the conclusion that it is a deliberately run long-term project to destroy the NHS as a financially viable institution. The service is in debt to private organizations to the order of tens of billions of pounds. This is not a debt the government will service forever.

[Hughman]

But as said, the political party that decides to do that will be promptly destroyed in the next election/revolution.

[ben_]

Hughman, that is largely irrelevant to the future of the NHS. Both parties now pursue a similar line on this issue. Or do you imagine the Tories would be more generous to the NHS than Labour?