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Originally Posted by Brianne http://www.askaboutmoney.com/showthread.php?p=649260#post649260
Health care is an endless demand curve and all this talk about the private system being efficient is just that.........talk.
The private system doesn't deal with major accidents, old people with dementia and multi disease who are waiting on suitable nursing homes. The private system doesn't have the orthopaedic lists f.......d up for the next two days because joy riders or drunken drivers or plain road traffic victims need urgent operations and automatically jump the list.The private system can pick and choose, the public system can't.
They operate on you in the private system but if things go really wrong, where do you end up.......back in casualty at 3 am being looked after by the public system.
Agreed
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I dont know about this one. There is no reason why A&E couldnt be put out to tender on the basis that whoever wins the tender has to deal with whatever injuries present themselves on a given day. There is an element of risk in this given that there will be quiet times and peaks, but, there is a lot of data on the accident rates available and so a company can price the extra costs associated with the demand risk. This is not an impossible service for a private sector organisation to provide - remember that most of the public health service A&E departments in Dublin are privately owned (Beaumont, Mater, St James, St Vincents) and are already doing this job in the context of the aforemention "Railtrack UK" monopoly situation. These hospitals are already coping with whatever is thrown at them. I dare say that if there was competition and the business was tendered, we would probably get a more efficient service at cheaper cost.
The argument is always made that private A&E would cut corners to save costs. I dont believe this as people would die thus pushing their mortality rate above norms. If too many people die, they'd lose the contract, so it is more profitable in the long run for them to provide a high level of care in order to keep the lucrative contract. Using my "hospitals must do procedures to make a profit argument" earlier in this thread, if A&Es were paid on a volume related basis rather than a lump sum basis, it would be in their interests to give better care as it would earn them more money. In terms of medical costs, the main difference between A&E and any other type of medicine is the demand risk - you cant schedule A&E whereas you can schedule other injuries. And demand risk CAN be priced.
How would competition in this respect work. Lets see, there is a really serious car accident. I can picture the scene 3 competing ambulances attend to the scene who ever gets there first wins the "unit". Or if I break my leg I decide to go to the most efficient Aand E based on published mortality rates for a and es. Crazy. Trying to blindly fit what works as competition in the private sector does not take into account the complexity of providing quality free health care for people.
So is mortality rate the sole metric you'd use to measure success on the contract?
Done transparently and competently, the privatisation of healthcare could lead to a better and more accountable service than that currently provided by the HSE for the same cost.
How would competition in this respect work. Lets see, there is a really serious car accident. I can picture the scene 3 competing ambulences attend to the scene who ever gets there first wins the "unit". Or if I break my leg I decide to go to the most efficent Aand E based on published mortality rates for a and es. Crazy. Trying to blindly fit what works as competition in the private sector does not take into account the complexity of providing quality free health care for people.
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This mulitple ambulance argument is always used as a scaremongering tactic by socialists.
This model actually works quite well in a lot of public service sectors around the world
Why do you see transparency competence and accountability as something exclusive to the private sector. Plenty of examples from the private sector where there is anything but, by the way.
And there are close to zero examples of where it applies to the public sector - certainly wrt accountability and transparency!Why do you see transparency competence and accountability as something exclusive to the private sector. Plenty of examples from the private sector where there is anything but, by the way.
You do not really understand the complexity of this situation if you are seriously trying to equate the provision of a transport to the provision of health care
People make out healthcare to be to complex and difficult to be run by the private sector. The reality is that a lot of the major public service hospitals in Ireland ARE private sector owned (Beaumont, St. Vincents, St James, Mater), so this statement has been disproven.
Are you really trying to get us to believe that a private sector organisation can run a service better with a monopoly/cartel situation that it can without? Can you give any examples of where a private sector monopoly/cartel has given better service in any sector of business?
What particular aspects of healthcare delivery make it more difficult for a private sector organisation to deliver as opposed to a public sector organistion? Can you state them? Volume and demand is not the correct answer as the public (did you mean private)sector also has to deal with them.
do you believe the state should pay for the health care of those who cannot afford to pay?
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Originally Posted by csirl http://www.askaboutmoney.com/showthread.php?p=651004#post651004
People make out healthcare to be to complex and difficult to be run by the private sector. The reality is that a lot of the major public service hospitals in Ireland ARE private sector owned (Beaumont, St. Vincents, St James, Mater), so this statement has been disproven.
And according to anyone who asks not very efficently.
You see the proviision of health as a market place where the rules of profit and loss etc applies. If you dont then your not really talking about privatision in the sence I unnderstand it. In a privatised system, privately owned health care providers will charge insurance companies for services and insurance companies will levy the cost of this onto consumer in terms of policies.
However you do not see that monolopies do not have to exist within the public sector. there can be competition between hospitals in the public sector. Along much of the saME CRITERIA that you are suggesting. the difference being that the ultimate motivation is making patients better not making profit.
Depends on the reason they cannot afford to pay.
If someone has a genuine disability, then the State should pay, but I do not believe that the State should pay for people who are capable and able to work, but choose not to. People have to take a certain amount of personal responsibility for their circumstances. In most cases when you talk about paying for health care, you are really asking the question as to whether or not health insurance should be paid for. Its easy to state that very few people could pay for a complex operation costing €100,000's, its less easy to argue that very few people could pay a few hundred euro per annum for the insurance policy that would pay for such an operation.
Precisely - due to having a monopoly/cartel. Do you not think that these hospitals would up their game if they faced the prospect of losing their public sector contracts to a competitor if they did not improve?.
. It may surprise you, but whether public or privately funded, economics do apply to healthcare.?.
. You argue that a private sector organisation may determine that it is not worth offering a particular service because it costs too much. A public sector organisation e.g. HSE, Dept of Finance, may also make the same decision and seem to be doing so with increasing frequency as the economy slows down. Public health is not immune from being shut down for budgetary reasons as the 1980s would prove. The public service always has to balance the additional charge to be passed onto the taxpayer in the form of higher taxes against the benefit of providing the service.
In your market driven eutopia there will always be a certain amount of unemployed people. That is an economic fact.
Even in your own example above you say that their should only be one And E per area.
Yes economics applies of cource but if there is a decision to be made between cost and making someone better then the community have a responcibility to ensure the former.
Whether thr cutting of essential health services happens in the publlic or private sector still makes it immoral and absolutly wrong. See I believe the provision of health care is also essentially a moral issue and responcibiliy for the community.
Yes but usually a lower percentage than in your socialist utopia. .
With contracts for running the A&E renewed every five years. Poor performance against the competition (i.e. other companies competing for contracts, possibly running other A&E units in other areas) will result in a loss of existing contract and consequent job losses.
At any price? If that is the case why not assign every family in the country a live-in doctor? .
Basic healthcare is something that every citizen of the state should be able to avail of. It should be within the means of the state to provide this to everybody who cannot afford it. At the moment despite massive funding the public sector cannot guarantee a basic level of care. You yourself have admitted that you consider it necessary to purchase private health insurance to provide a decent health care service for your family. What makes you so confident that additional funding to the public health care system will allow you to happily no longer avail of private health insurance? How much extra tax will this require? Who will pay the extra tax and just how much damage to our already faltering economy will this do? Remember we have already flirted with high taxation in this country and the result was grinding poverty, widescale tax evasion and mass emigration.
Why is it so hard to imagine a completely privatised health system? The huge advances in medical technology, surgical procedures, drugs and treatments available today are almost invariably provided by private companies pursuing a profit-driven agenda. How much harder then can it be to run the hospital that provides these services?.
What is so fundamentally different about healthcare that people feel it cannot be left to the private sector? Is it any more complex than other services that people every day entrust their lives to the private sector to provide such as air travel? I cannot help but feel that much of this is propaganda driven by unions trying to defend work practices that are no longer prevalent in the rest of society.
argument, I suggest this is you being idological not me. What am I arguing for?Good quality health care avalible to all citizens regardless of thier ability to pay taking into account the complexity of issues of ppoverty, and the need for social justice and equity. Is essentially a question of morality.propaganda driven by unions trying to defend work practices that are no longer prevalent in the rest of society
csirl, Room305; Keep banging away and they might see logic trumps ideology.
As has been pointed out numerous times to you on this thread to little avail, you can have a socialised medical system provided by the private sector (e.g. France or Sweden)..
All NHI funds are legally private organizations responsible for the provision of a public service. In practice, they are quasipublic organizations supervised by the government ministry that oversees French social security.
Smaller funds with older, higher-risk populations (e.g., farmers, agricultural workers, and miners) are subsidized by the CNAMTS, as well as by the state, on grounds of what is termed “demographic compensation.” Retirees and the unemployed are automatically covered by the funds corresponding to their occupational categories. In France, the commitment to universal coverage is accepted by the principal political parties and justified on grounds of solidarity—the notion that there should be mutual aid and cooperation between the sick and the well, the active and the inactive, and that health insurance should be financed on the basis of ability to pay, not actuarial risk.
Are you saying you favour this system as opposed to a purely privatised system?
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