Random musing

I don't know the answer, but I think Barack is trying to put this into place now so that everyone can get affordable healthcare.

Not every country believes that universal healthcare is the best option. I have some sympathy for that. In principle, it's fabulous, but in practice, it's a nightmare of inefficiency and monopoly. In a place like the US, competition is encouraged, free markets prevail and people make real value judgements about what they want and which services they want to access. Of course, the downside there is the massive free fall in the insurance business. In the UK, we clog up doctor's surgeries with small sniffles because it's perceived as free.

There doesn't have to be one or the other though; many countries operate a healthcare system in the middle ground.

I suspect it's because the NHS is such a huge expense and America is a gizillion times the size of the UK. Having something like the NHS is the exception rather than the rule across the world. We are so ruddy lucky!

But even though a bigger country, that would mean more tax to contribute towards a nhs no? Or am I being incredibly naive

I think there's a huge cultural difference also between the US and UK. Those of us who grew up with the NHS are more likely to think fondly of it at least in principle, even if we have gripes with particular facets of it (administration, waiting times etc). But people in the US tend to have a much more individualistic ethos, where you take care of your own family and it's shameful to have to rely on the state for anything. There's also a much bigger emphasis on choice and 'freedom', i.e. the freedom to choose your doctor, choose between different brands of prescription drugs etc.

Given that the UK is joint 13th in terms of life expectancy and 25th in terms of infant mortality, why would anyone want to replicate our healthcare system? You'd better off following the lead of Japan, who don't have an NHS....

I believe they do JoJo. As an aside, I know your H is diabetic too, did you know that the strips that go into a blood tester (which I'm assuming your H uses too?) cost £20 a box?! Considering there is only 50 in a box, we would be bankrupt if there was no NHS in this country!

**Not my view and for the purposes of debate only**

Why should I have to pay to subsidise your husband's health care needs? Can I please have my money back? Because, no offence, I'd rather pay for my 23 year old daughter to have a smear test.

Does anyone know why diabetics get free prescriptions but asthmatics don't?

Yep, I think this is the commonly held view in America. Why should I pay for someone else's healthcare? I work hard to support my family, others should do the same.

**also not my actual view**

I don't formally know but I'd hazard a guess that the total health burden associated with diabetes is far higher than that associated with asthma. People with diabetes are likely to suffer recurrent, multiple and systemic health issues. They need a higher level of medical care across multiple disciplines to remain healthy. The cost of all this would, I suspect, be too great for people to carry.

At a guess possibly because of the cost of the consequences of untreated diabetes i.e. sight problems, lower limb problems etc

I'd also like to know (unless it't changed recently) why people on what was incapacity benefit get no help with prescriptions yet those on jobseekers allowance get their's free? Why should lazy layabouts* get free medicine? *I mean those on jobseekers who are a lazy layabout not those genuinely out of work!

FTLOMB got there before me & as ever said it so much better!

Does lifestyle, diet and culture not play a bigger part in those league tables? rather then the quality of health care? I know we are a nation of unhealthy eaters, binge drinkers and have the highest rate of teenage pregnancys in Europe. (Not that im pro or con NHS?? )

A guess: Incapacity benefit is a wage replacement, therefore you are expected to pay for things as if you were a wage earner. JSA is not a wage replacement, it's a subsistence allowance and, as such, you are recognised as not being able to afford anything over and over the basic cost of living, hence free prescriptions.

Yeah that would make sense. Asthmatics tend to just die if things get that bad. Hardly any cost to the tax payer whatsoever.

I was looking at it from the wrong angle (cost to me rather than cost to the govt) - i.e. if I didn't buy my £130 a year pre-payment certificate I would be spending approximately £40 a month on Asthma related paraphernalia.

Oh, I'm sure the factors influencing these figures are very diverse. However, if you had a brand new country and wanted to institute some kind of health care provision, I don't really see a convincing medical or economic reason for a UK-style National Health Service.

I have just read that a Salbutamol inhaler costs the NHS £75 - how much do you pay for it?

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I obviously pay the prescription charge per inhaler. I wasn't trying to make out I didn't get a good deal. The point I was making is that I was looking at the justification for free prescriptions from the wrong angle.

How can asda afford to sell them without a prescription at £7 a pop then?

I think how the prescription charges work is a bit bizarre in general.

Although my current GP has given me a repeat prescription for antidepressants, previous ones haven't (I guess to ensure I will see the GP every month, and won't try to overdose). That means paying £7 a month. When I used to take Metformin for PCOS, they gave a prescription for three months worth of pills, so I was only paying £7 every 3 months. Doesn't really make much sense that 3 times as many pills still costs the same amount?

Always always from a POV of cheapest for the government...

I understand where you are coming from, but my H has got Type 1 diabetes which has no known cause (As far as I know), it isn't something he has brought on himself through poor diet or exercise. I also think your point about the complications from diabetes if not managed well would cost the NHS so much more.

Also, didn't realise that asthmatics had to pay for their own prescriptions

**not my view and for the purposes of debate only**

So?

The right wing American view is that it's your bad luck and not my problem to have to pay for it.

The thing is with the prescription charge is that while some medications cost less than the prescription fee, others cost more (some a lot more!)

With brittle asthmatics who need an ITU admission (very rare, so don't worry!), their cost will cost the NHS £1000s. It's not that anyone is more important, it's that diabetics potentially have huge long term problems that cost the NHS millions, and these can be avoided if their illness is controlled. i'm guessing that they get more compliance from patients if their medication is free?

Is ITU intensive care? Only been admitted to intensive care once. Hospital maybe 15-20 times for stays of 2 to 5 days but admittedly not for about 7 years now.

I just think because it isn't something he has caused himself (same as asthmatics etc), it would be unfair for him to have to pay for all the associated medication he needs for a medical condition he has been lumbered with. He is fit and healthy and takes no other medication other than insulin. I'm trying to make this more general but I think I'm failing!

Peanut L & L I can't really comment on what you are saying as I was talking about this country and the fact we do have a 'free' NHS. I realise if we lived in America it would be a different story

Blimey Kharv, I think interesting is the wrong word here but my H has only ever been hospitalised once for his diabetes in all the years he has had it. Personally I think other long term medical conditions should get free prescriptions, and was unaware until today that you had to pay for inhalers

ETA sorry I realised that sounded bad! I didn't mean you had caused it yourself if you see what I'm saying, I was trying to compare diabetes to asthma but badly I think!

**not my view and for the purposes of debate only**

Lots of people get rough deals in life. He gets insurance, that will pay his medical care.Or his costs are paid for by compulsory savings from his wages. It's juts unlucky that his savings go on a chronic health condition, mine are stored for future use.

(I am arguing this as if we don't have an NHS).

Glad you haven't needed an ITU admission for many years, Kharv!

I'm just guessing on the NHS logic btw, rather than saying I agree with it. I suppose I could argue that all long term conditions should warrant free prescriptions, but then a) when does a short term condition turn into a long term condition? b) how do you make up that cost to the NHS? c) if you pay only for those related to the condition to make things easier on budgets, how do you differentiate between the condition and other, non related conditions? (i.e. prescribing antibiotics for a chest infection. Is it the asthma that's caused the infection? Nope. Will it affect the asthma? Probably.)

It's hard.

As a complete aside from America, I knew England payed for prescriptions but i cant believe its that much!! I'm glad I live in Scotland, over the last couple of months I've had anti anxiety tablets, anti biotics and co codamol for pain (not all at once mind you!) I have had loads of prescriptions this year, I would be broke!!

I haven't really got an answer! If we didn't have an NHS then obviously he would have to pay for all his medication via insurance or otherwise. But I think Nursey hit the nail on the head when she said that maybe free prescriptions mean more people take better care of themselves. I imagine of people had to pay you would get a lot of people cutting corners which would then cause further complications.

What would your answer would be if we had no NHS and either yourself or you H had a long term health issue? (I'm trying see what your answer would be if I'd asked you the same question you'd just asked me)