Collapsing under the onslaught?

By Clear Memories

As the current UK government appears to be starting to wake up (http://www.dailymail.co.uk/news/article-2353411/All-foreigners-face-charged-thousands-pounds-BEFORE-use-NHS.html ) and realise that Labour not only decided to flood the UK with aliens, they sought to both create a migrant magnet and bankrupt the indigenous in the process. It seems they are trying to do something about it. Of course, with Doctors refusing to become an arm of the Border Agency and so many aliens embedded in the NHS, they’ll have little effect.

Having now thoroughly settled into my newly adopted home, viewing the UK from afar and listening to the travails of my elderly Father and in-Laws, might I offer a few observations on the steady decline of that final bastion of nationalised industries, the NHS. Bear in mind, my daughter is a highly qualified Doctor and has worked in both systems.My first observation on the NHScollapse is the outrage this week imposed on my in-Laws. Ma-in-Law needs regular injections, so rather doddery 76 year old Pa-in-Law has been taught how to do it. This not diabetes, far mre serious. Neither are keen, but no option was offered. This to an ex-serviceman who has worked all his life, typical salt of the earth – effectively, do it yourself or go without. I listen to their litany of minor complaints, no single one of any note in itself, but the whole becoming the dispiriting, demoralising centre of their lives through advancing years and the need to interface with a system that they effectively created but which now disregards them and appears to push them aside in favour of exotic foreigners.

Over here, things are a little different. Firstly, there is Medicare, the basic Health System but seen by all as the basic. If you can afford it, you pay for Private Insurance (or your Employer does) and, unlike the UK, the system recognises that you will cost Medicare less, so you get a tax rebate! In the UK, if your Company pays, they treat it as part of your income and tax it as a benefit. No incentive there then. Also, if you’re under 30 and don’t take out private insurance, your tax increases on the perfectly logical basis that, over time, you will cost Medicare more.

So, to the Doctor. First, produce your Medicare card. No card, $50-ish up front or go away. Some Doctors charge more and some charge anyway leaving you to reclaim it. This tends to define their clientele (basically all the rich buggers) but also keeps their surgeries free of single Mothers and the elderly seeking a social club. By the way, repayments are only made into your bank account. So, you have a simple card that identifies you. It could be forged, but, coupled with the Doctors software, it will bring up your records (all are Computerised). Thus, if you present with a dodgy card, it is likely that, as soon as the record pops up (or not!), you’ll be exposed. In my case, I needed an X-ray. Imaging services are privatised. So off you pop to the imaging centre, in the local shopping plaza (kind of wierd at first – imagine the sight, Tescos, Evans’, Poundland, X-rays-R-Us, Bloodtest-U-Like, Boots …..) Same deal, present your card, pay up, get X-rayed, system identifies you, money reappears in your bank account. Wait for the X-ray, return to the Doctor with it, start all over again. Whole thing done in less than a day, no waits, no actual cost. No way to exploit things. And Doctors are paid per patient, so they have a vested interest in (a) dealing with you as quickly and effectively as possible and (b) not dealing with those not entitled – they won’t get paid!

At Hospital, much the same procedure. On arrival, you will be asked for your Medicare card. No card, the Purser will arrive and they will ensure you are either reciprocally covered (all Brits, for example, are covered, as are Aussies in the UK), you have insurance or you have a credit card. None of these and you will get sufficient treatment to send you back to your own Country (and will be blocked from future entry into Australia until you have paid for that). People have similar gripes as the UK – costs, waiting lists and so forth – but, frankly, they have little to complain about compared to the NHS.

At the risk of repetition, the card itself, although the key to the system, contains only basic information, not even a photograph. It applies to the family, so my wife and I are both on the same card. The ‘Big Brother’ loons need not get excited as the card carries very little data (it’s not even a ‘smart’ card, just the old-style magnetic swipe, you only need to carry it when treatment is required. The card only demonstrates your entitlement by commencing/enabling the cross-reference processes to other information and thus forgeries, other than complex and medically-relevant identity theft, are pointless. Remember, all emergencies are dealt with immediately with no question. If you can make the Doctor, you can remember your card. If you do forget it, you have to pay but you can claim the money back afterwards and, again, refunds are only to the bank account linked (within the system) to that card. A valid point, this latter, because Bank Accounts are quite hard to get here.

Further, a tight visa system and good border controls limit who enters the Country. The sick and pregnant are excluded. Old? Prove you’re fit enough not to cost us money and are insured against being a liability. And frankly, what is wrong with that? (Here’s a thought. Why not require the airlines flying these health tourists into the UK to ensure visitors have adequate health insurance before flying and charge the airlines for treatment if it turns out they don’t? If they argue, seize their planes. You could write off a large part of the NHS burden by selling off a few African or Middle Eastern aircraft second hand.)

So the systems and procedures exist and could easily be applied to stop the billions that are being robbed from the NHS. Doctors can be paid by results, by effort. Why should you be limited to one Doctor? Why shouldn’t you see the guy who, by repute, does a good job and actually speaks English well? If he’s too busy, why shouldn’t he be able to increase his charges and either make more money or see fewer people? My daughter now works for a ‘private’ clinic, the general business model here. That means it is just like a UK GP’s, with the benefit you can walk in off the street and be seen more or less immediately. The Clinic is operated (and the building and infrastructure) owned by a private individual. All the Doctors are self-employed, effectively paying a rent to cover the building cost and administration. For each Client consultation, the nation pays the Clinic, they subtract their costs and pay the Doctor. All per patient. So the Doctor has an incentive to be quick and efficient (negligence insurance is a bugger! and ensures the Doctors are professional in the first instance), the Receptionist is scrupulous that the patient is entitled as, if they’re not, the Clinic don’t get paid (but the Doctor does)

It seems the UK has to do something or the NHS will simply collapse and having experienced both systems, at a number of levels, they could do a lot worse than have a good look at the system here. The Australian Government pays $2340 per capita on health, whereas the UK pays $2919. On the other side of the coin, Aus. spends 32%, against the UK’s 16.1% (of the total spend) as private spend. (Data from the Guardian, so most probably as biased as f**k) From my experience, they get more for their money. Just as an aside, the fees payable to migrate to Australia, whilst designed to cover the administrative costs of the process, also (effectively) become your back-dated contribution to join the system. For two, that is $86,000 plus a 10 year, returnable bond of $14,000 that is the first point of call if you require financial support from the Country.