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Thread: US healthcare expenditure to hit 20% of GDP

  1. #31
    Senior Member GGT's Avatar
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    Quote Originally Posted by Aimless View Post
    Your account is a little misleading but nevertheless I'm going to launch a new product that sells aspirin together with nice single origin espressos.
    I could probably afford that, out of pocket. Will that fix my arthritis? Or should I buy some of those copper-infused garments? /sarcasm

  2. #32
    Senior Member RandBlade's Avatar
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    Aspirin isn't cheap? Can buy it, paracetamol and ibuprofen for pennies a box here.

    https://groceries.asda.com/product/a...s/910002246310
    Quote Originally Posted by Ominous Gamer View Post
    Being upset is understandable, but be upset at yourself for poor planning, not at the world by acting like a spoiled bitch during an interview.

  3. #33
    Senior Member RandBlade's Avatar
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    Quote Originally Posted by Aimless View Post
    This argument of yours is even more asinine in this thread than it was the last time you made it.

    What the graph shows is that the Tories presided over the longest stretches of sustained funding squeezes in the past several decades, from which the NHS has struggled to recover. It is stupid to point to "record levels" of funding as a defense because 1. the record levels were not reached primarily due to the Tories, and 2. because these "record levels" do not match the NHS's needs. The NHS's needs have not risen primarily due to avoidable costs such as administrative overhead etc (although more on that later) but due to largely unavoidable costs associated with an aging population and increases in cost of treatments, diagnostic procedures, etc. Many NHS trusts have been required to make completely unrealistic cuts under the Tories and the only "record levels" appropriate to talk about in this discussion are record levels of underfunding and understaffing.

    That said, some portion of the cost increases may indeed have been avoidable, and the Tories are largely to blame for this as well, because of the role they played in sabotaging cost-effective primary care, mental health services etc. In addition, they were responsible for the Health and Social Care Act of 2012, a reform that set the NHS on the path to assuming some of the less beneficial characteristics of the US healthcare system (mirroring similarly harmful but less incompetently implemented legislation in Sweden) such as increased overhead, poorer coordination, misallocated resources etc. This legislation--and its farcical implementation--has been criticized in the strongest terms by all major groups of British healthcare professionals, for good reason, and the Tories are wholly responsible for its failure.

    The Tories have also been responsible for greatly exacerbating the NHS's chronic and now catastrophic staffing shortages. They are responsible for this in several ways: through their general defunding; through their specific defunding of staff training (eg. through defunding bursaries absolutely vital to student/trainee nurses); through their policies that have caused burnout and dissatisfaction leading to fewer workers; through their foolish pledge to cut immigration to the tens of thousands; through their decision to leave the EU and their incompetent implementation of that decision. Again, pointing to "record levels" on various metrics is a stupid way to defend these clowns; the NHS's staffing needs increase with the growing needs of the population, and recruitment must also compensate for attrition due to retirement, changing jobs etc. Training and recruiting takes both more time, more money and a larger pool, and the Tories have ensured that the NHS has neither.
    No it doesn't. It shows the Tories consistently spending a higher amount on the NHS than Labour ever did.

    Yes Labour expenditure spiked at 7.59% (a one off and the only time ever it was higher than under the Tories). However that is rendered moot unless you are completely economically illiterate because that was only funded by a pre election spending splurge that ran the deficit to over 10% of GDP, worse even than Greece. A deficit of £175bn. So any spending that year wasn't funded it was maxed out credit card debt.

    In 2016/7 (most recent figures) under the Tories the spending is 7.26% which compares with 6.38% a decade earlier and 6.99% in Labours last pre election year.

    Any talk of funding without taking into account the fact that 2010 was not a funded year is completely economically illiterate. So the Tories percentage is properly funded higher than it EVER has been before the Tories regained office. Not just in plain monetary terms but in percentage of GDP too.

    Edit: Also worth noting that the Tories are keeping it consistently higher than it ever was before not just spiking it in election years only.

    EDIT2: Its also delightfully ironic to see you bemoan pledging to cut unskilled migration (while keeping doctors and nurses migration protected) as exacerbating NHS shortages then saying in the same breath that a growing population needs more healthcare. Of course it does. Thanks to net migration we have over a million more people than we did before and that's rising still by hundreds of thousands a year exacerbating demands on the NHS. But thankfully we are measuring expenditure by percentage of GDP and not cash terms so that is already taken into account.
    Last edited by RandBlade; 08-14-2018 at 01:24 PM.
    Quote Originally Posted by Ominous Gamer View Post
    Being upset is understandable, but be upset at yourself for poor planning, not at the world by acting like a spoiled bitch during an interview.

  4. #34
    Senior Member Enoch the Red's Avatar
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    Quote Originally Posted by RandBlade View Post
    Aspirin isn't cheap? Can buy it, paracetamol and ibuprofen for pennies a box here.

    https://groceries.asda.com/product/a...s/910002246310
    You can get brand name, similar strength aspirin for under a penny a tablet here - not sure what GGT is talking about. You can pay even less if you buy generics.
    Last edited by Enoch the Red; 08-14-2018 at 04:28 PM.

  5. #35
    Senior Member RandBlade's Avatar
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    You can even get bigger boxes with more than 16 tablets.
    Quote Originally Posted by Ominous Gamer View Post
    Being upset is understandable, but be upset at yourself for poor planning, not at the world by acting like a spoiled bitch during an interview.

  6. #36
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    Aspirine may not be the best example, but the trickery described exists, and has caused existing medication to jump in price dramatically.
    Greece shows us that there is a kind of politician worse than the ones that break their election promises; the ones that keep their election promises.

  7. #37
    SEÑOR Member Aimless's Avatar
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    Its also delightfully ironic to see you bemoan pledging to cut unskilled migration (while keeping doctors and nurses migration protected) as exacerbating NHS shortages then saying in the same breath that a growing population needs more healthcare. Of course it does. Thanks to net migration we have over a million more people than we did before and that's rising still by hundreds of thousands a year exacerbating demands on the NHS. But thankfully we are measuring expenditure by percentage of GDP and not cash terms so that is already taken into account.
    Do you know why I often tell you read posts properly before replying to them?

    It's because you're an extremely sloppy reader.

    For example, in the post you quoted, I said "aging population". I did not say "growing population". They mean completely different things. One refers to the size of the population, while the other refers to the composition of the population. All other things being equal, a population with a higher proportion of elderly and very old people will have greater healthcare needs than a similarly sized population with a lower proportion of elderly and very old people.

    The impact of EU migration has been beneficial to the extent that a greater proportion of non-British EU citizens in the UK are doctors (rough estimate around 3.7 per 1000 compared to 2.8 UK average), and the non-British EU citizens in the UK are overall much younger and healthier, most of them productive tax-paying working age adults.

    Quote Originally Posted by RandBlade View Post
    No it doesn't. It shows the Tories consistently spending a higher amount on the NHS than Labour ever did.

    [...]

    In 2016/7 (most recent figures) under the Tories the spending is 7.26% which compares with 6.38% a decade earlier and 6.99% in Labours last pre election year.

    Any talk of funding without taking into account the fact that 2010 was not a funded year is completely economically illiterate. So the Tories percentage is properly funded higher than it EVER has been before the Tories regained office. Not just in plain monetary terms but in percentage of GDP too.

    [...]

    Edit: Also worth noting that the Tories are keeping it consistently higher than it ever was before not just spiking it in election years only.
    I'm sorry for using the word "asinine" so often these days but that truly is asinine. Every UK govt. must (roughly speaking) spend more on the NHS than the preceding govt. in order to just maintain the status quo because the numbers and proportions of the elderly and the very old in the UK are increasing, and healthcare is getting more expensive. The graph shows that, under Thatcher, Cameron and May, the Tories have reduced and/or constrained spending on the NHS, in addition to the other harmful changes I listed that you conveniently ignored.

    Yes Labour expenditure spiked at 7.59% (a one off and the only time ever it was higher than under the Tories). However that is rendered moot unless you are completely economically illiterate because that was only funded by a pre election spending splurge that ran the deficit to over 10% of GDP, worse even than Greece. A deficit of £175bn. So any spending that year wasn't funded it was maxed out credit card debt.
    Why, you could've made a killing by just shutting down the NHS during the peak of the global recession! Why didn't Labour do that??

    Perhaps because they recognized that shortsighted short-term austerity has long-term negative consequences.
    “Humanity's greatest advances are not in its discoveries, but in how those discoveries are applied to reduce inequity.”
    — Bill Gates

  8. #38
    Senior Member RandBlade's Avatar
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    Quote Originally Posted by Aimless View Post
    Do you know why I often tell you read posts properly before replying to them?

    It's because you're an extremely sloppy reader.

    For example, in the post you quoted, I said "aging population". I did not say "growing population". They mean completely different things. One refers to the size of the population, while the other refers to the composition of the population. All other things being equal, a population with a higher proportion of elderly and very old people will have greater healthcare needs than a similarly sized population with a lower proportion of elderly and very old people.
    Actually you didn't simply write that. This is what I was quoting: Again, pointing to "record levels" on various metrics is a stupid way to defend these clowns; the NHS's staffing needs increase with the growing needs of the population ... now unless you think that a growing population has no extra illnesses, births etc then yes the growing needs are reflected on both issues. Both of my daughters were born on days where the local hospital's maternity wards were full - was it the ageing population that caused the maternity wards to be so busy? Or do younger, working-age people tend to be the ones having kids?
    The impact of EU migration has been beneficial to the extent that a greater proportion of non-British EU citizens in the UK are doctors (rough estimate around 3.7 per 1000 compared to 2.8 UK average), and the non-British EU citizens in the UK are overall much younger and healthier, most of them productive tax-paying working age adults.
    Which is why I'm pro-immigration. However immigration is a big part of the "growing needs of the population"
    I'm sorry for using the word "asinine" so often these days but that truly is asinine. Every UK govt. must (roughly speaking) spend more on the NHS than the preceding govt. in order to just maintain the status quo because the numbers and proportions of the elderly and the very old in the UK are increasing, and healthcare is getting more expensive. The graph shows that, under Thatcher, Cameron and May, the Tories have reduced and/or constrained spending on the NHS, in addition to the other harmful changes I listed that you conveniently ignored.
    No the graph shows that Cameron and May are consistently spending more than Blair and Brown did. An unfunded one-off election year spike with a £175bn deficit is not what Brown consistently spent nor is it was Blair ever spent. Furthermore unless GDP is static even if the percentage remains the same, real healthcare spending is rising in line with GDP growth.
    Why, you could've made a killing by just shutting down the NHS during the peak of the global recession! Why didn't Labour do that??
    Actually Labour did propose cutting NHS spending. The only parties to have ever cut NHS spending are the Labour Party and the SNP. Labour went into the 2010 election claiming that Cameron's pledge to protect NHS spending from cuts was "irresponsible" and wouldn't be honoured, it continued to call protecting the NHS budget irresponsible after the election.
    https://metro.co.uk/2010/06/17/burnh...g-cuts-395729/

    In 2015 like 2010 it was the Tories who pledged more NHS spending, not Labour: https://www.independent.co.uk/news/u...-10182796.html

    The devolved Welsh Labour Assembly and Scottish SNP Parliament both cut NHS spending at the same time as the English Tory-led Coalition was increasing it. The Labour and SNP cuts to spending will have a small but actual reduction in the overall UK proportion since the Tories were responsible only for the English figure.
    Perhaps because they recognized that shortsighted short-term austerity has long-term negative consequences.
    Nope, increasing deficits during boom times leads to catastropic consequences when a recession hits and you've already maxed out the credit card. That's the problem with socialists, eventually you run out of other people's money.
    Quote Originally Posted by Ominous Gamer View Post
    Being upset is understandable, but be upset at yourself for poor planning, not at the world by acting like a spoiled bitch during an interview.

  9. #39
    SEÑOR Member Aimless's Avatar
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    I cannot figure out whether you're just stupid or if there is some other reason you apparently cannot see the difference between "growing needs of the population", "aging population" and "growing population". Most people would just acknowledge they made a mistake, but you're doubling down, as if you expect me to believe you didn't incorrectly claim that I said something I clearly did not say. This is ridiculous. Get a grip man.
    “Humanity's greatest advances are not in its discoveries, but in how those discoveries are applied to reduce inequity.”
    — Bill Gates

  10. #40
    Senior Member RandBlade's Avatar
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    You referred to growing needs and a million extra people does indeed grow needs. You may not have used the exact words but then I didn't put it in quotation marks either. I thought you were intelligent enough to be making a good point that the million more people we have now requires more expenditure than then.

    If I overestimated you and you didn't mean that then I apologise. If you actually believed a million extra people could live here without needing extra treatments of any sort then I'm sorry I gave you more credit than you deserved.

    But good to realise you understand you're barking up the wrong tree financially.

    PS the greatest change to our demand on the NHS in the last 7 years is quantity of people not age. The median age in the UK has gone up by 0.6 years while the population has gone up by 10%
    Last edited by RandBlade; 08-15-2018 at 11:56 PM.
    Quote Originally Posted by Ominous Gamer View Post
    Being upset is understandable, but be upset at yourself for poor planning, not at the world by acting like a spoiled bitch during an interview.

  11. #41
    SEÑOR Member Aimless's Avatar
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    Oh my god. You actually are an idiot
    “Humanity's greatest advances are not in its discoveries, but in how those discoveries are applied to reduce inequity.”
    — Bill Gates

  12. #42
    Senior Member RandBlade's Avatar
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    You actually are economically illiterate aren't you?
    Quote Originally Posted by Ominous Gamer View Post
    Being upset is understandable, but be upset at yourself for poor planning, not at the world by acting like a spoiled bitch during an interview.

  13. #43
    Senior Member GGT's Avatar
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    I was being sarcastic about taking OTC Aspirin for my self-diagnosed arthritis, but it's no joke when it comes to insurance coverage for pre-existing conditions.
    Instead of starting a new thread, let's continue the debate about healthcare expenditures in this one.

    Open enrollment in the "Obamacare" health insurance market exchange started 11/1, but I haven't looked at it yet. I've been trying to buy my own health insurance since 2001, and it's been a huge, constant struggle. It didn't do much good that I got an exemption from the individual mandate (before that was reversed), because I was still at risk for medical bankruptcy if diagnosed with diabetes, cancer, or dementia.

    So, where's this great, comprehensive, affordable healthcare....as promised by Trump and the GOP?

  14. #44
    SEÑOR Member Aimless's Avatar
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    Oh wow, I had forgotten all about this, perhaps the dumbest RB take of the year:

    Quote Originally Posted by RandBlade View Post
    PS the greatest change to our demand on the NHS in the last 7 years is quantity of people not age. The median age in the UK has gone up by 0.6 years while the population has gone up by 10%
    The median age of the UK is uninteresting, because it obscures detail and is not particularly informative when it comes to analyzing demand on public healthcare services. What is interesting is population structure, specifically the proportions--and the absolute number--of the population that fall into categories with distinctly different healthcare needs. Out of convention, when it comes to looking at health economics, research focuses on the proportions & numbers of those aged over 65, as well as octagenarians (usually 85+), nonagenarians and (increasingly) centenarians, with specific age bands varying over time and between countries. That is because their healthcare needs--and the cost of providing their healthcare--differ greatly from the needs and expenditures of eg. children, adolescents, adults in their 30s and middle-aged adults. Even though some of these cohorts now show higher rates of healthy aging, these groups have a greater burden of illness, including chronic illness, and they are much more likely to suffer from conditions that are both much more costly to treat and lead to significant disability.

    You're a hopelessly sloppy reader and a sloppy thinker, but I did try to clarify this for you:

    All other things being equal, a population with a higher proportion of elderly and very old people will have greater healthcare needs than a similarly sized population with a lower proportion of elderly and very old people.
    Less than a fifth of the UK's population are aged 65 and over, and yet they account for two-fifths of the NHS's costs despite deliberate under-funding that impoverishes the elderly, leaves millions with unmet needs and saddles close to a fifth of the population with the task of providing unpaid care.

    Even in this group, there are stark differences between those in their 60s/70s and those in their 80s/90s/100s. The latter still constitute a small proportion of the population, but they are also rapidly increasing; while the overall proportion of the population aged 65 and over rose by almost a fifth in ten years (2005-2015), the proportion of those aged 85 and over rose by nearly a third. Among the younger elderly we see costs increasing at disproportionate rates partly because of the rapid growth in the availability of new, expensive but valuable treatments for ailments that affect them at much higher rates, such as various forms of cancer. Among the very old, we see similarly disproportionate cost-increases due to the sharp increases in prevalence of dementia and its associated health problems, combined with greater life expectancy even for those with dementia.

    On average, an 85-y-o person in the UK costs the NHS 6-7 times as much as a 30-y-o. On average, healthcare expenditure is roughly similar for toddlers and younger adults (slightly higher for toddlers). The population of the UK has grown, but the impact on demand that can be ascribed to general population growth due to births as well as due to the immigration of healthy working-age adults pales in significance to the impact on demand that can be ascribed to the rapid changes in the age structure of the population (for which "the aging of the population" is a common and convenient shorthand)--changes that are obscured by uninformative statistics such as the median age.
    “Humanity's greatest advances are not in its discoveries, but in how those discoveries are applied to reduce inequity.”
    — Bill Gates

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