Defend Private Healthcare

Dental filling: 25 €, get 17,80 € Back. I'm not complaining.

There is still a free choice of which dentist to go to. You go to the one that makes you feel at ease and does the best job.

I dunno if the doctors and dentists think this system is great however. Who doesnt want to earn more ?
 
Darat said:
Still waiting for arguments as to why a private system is innately superior to a public funded system.
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Has anyone claimed it is?

I would also question whether there is any conflict between a private system and a public funded system. After all the NHS is public funded, but that does not mean that there are not elements of it that are private - for example most GP's are self-employed (or partners in a small partnership) and employ staff / manage costs to make their business profitable - i.e. they operate a private business.

The thread appears to be about whether it is ethical for anyone to provide medical services for profit. Most GP's in the NHS do so.
 
D'rok said:
(2) and (4) are illegal in Canada (but not for dentists or other providers of non-public services). Doctors that provide publicly insured services must conform to (3).
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As a hypothetical, say I needed a non-urgent appointment with a doctor. Could I pay to get an appointment when it suited me (say an evening or weekend appointment) as opposed to having to take time off work to attend? It appears from what you have posted that this would be illegal.
 
Jaggy Bunnet said:
As a hypothetical, say I needed a non-urgent appointment with a doctor. Could I pay to get an appointment when it suited me (say an evening or weekend appointment) as opposed to having to take time off work to attend? It appears from what you have posted that this would be illegal.
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In Australia you might be lucky and find a late night medical centre that charges no fee on top of the government payment or you might have to pay an excess. Is that the situation in Scotland?
 
Jaggy Bunnet said:
I would also question whether there is any conflict between a private system and a public funded system. After all the NHS is public funded, but that does not mean that there are not elements of it that are private - for example most GP's are self-employed (or partners in a small partnership) and employ staff / manage costs to make their business profitable - i.e. they operate a private business.
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Without smart enough rules I find it easy enough to imagine that there could be a conflict, with private healthcare supply crowding out state supply. The combination of both "works" in the UK because laws disallow that.

The thread appears to be about whether it is ethical for anyone to provide medical services for profit.
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It isn't unethical per-se but there are important sources of market failure that present themselves in for-profit healthcare--which are more significant than in other markets (that can be less tightly regulated)--the principal/agent problem, asymmetric information (adverse selection) and moral hazard to name a few.
 
gtc said:
In Australia you might be lucky and find a late night medical centre that charges no fee on top of the government payment or you might have to pay an excess. Is that the situation in Scotland?
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No, in Scotland you are registered with a specific GP practice and can only get an appointment at that practice. There are out of hours services but they are very much focussed on urgent treatment.

There is much talk at the moment about having "extended hours" available (covered by the NHS) - it appears that this amounts to a requirement to provide an additional 3 appointments per 1,000 patients per week. So on average each patient can have one extended hours appointment roughly every six years.

http://www.sehd.scot.nhs.uk/pca/PCA2008(M)04.pdf

http://www.scotland.gov.uk/News/Releases/2008/09/09133207

I do not see an ethical problem with a GP offering Saturday morning appointments for an additional fee to be paid by the patient rather than for an additional fee paid by the NHS.
 
Francesca R said:
Without smart enough rules I find it easy enough to imagine that there could be a conflict, with private healthcare supply crowding out state supply. The combination of both "works" in the UK because laws disallow that.
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Why is state supply important? If the service is free at the point of delivery, who cares if the person providing it is employed by a quasi-government body (NHS trust), a small private, for-profit partnership (GP services) or a large multinational company (independent sector treatment centres)?
 
Jaggy Bunnet said:
Why is state supply important? If the service is free at the point of delivery, who cares if the person providing it is employed by a quasi-government body (NHS trust), a small private, for-profit partnership (GP services) or a large multinational company (independent sector treatment centres)?
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The amount of profit a physician or company make should not be linked to how much treatment a patient consumes based on their advice.

The profit motive has no place in the ethical (or economic) provision of health care.
 
Jaggy Bunnet said:
As a hypothetical, say I needed a non-urgent appointment with a doctor. Could I pay to get an appointment when it suited me (say an evening or weekend appointment) as opposed to having to take time off work to attend? It appears from what you have posted that this would be illegal.
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Extra-billing is explicitly prohibited by the Canada Health Act. "Two-tiered" health care (where those with means can buy services unavailable to those without) is a non-starter here.

But your hypothetical is a non-issue. You could just go to your local clinic that is open in the evenings and on weekends. There's several a few minutes away from me right now. They aren't unusual.
 
Ivor the Engineer said:
The amount of profit a physician or company make should not be linked to how much treatment a patient consumes based on their advice.

The profit motive has no place in the ethical (or economic) provision of health care.
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So you oppose the existing GP model present throughout the UK NHS?
 
D'rok said:
Extra-billing is explicitly prohibited by the Canada Health Act. "Two-tiered" health care (where those with means can buy services unavailable to those without) is a non-starter here.
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Thanks for clearing that up.

But your hypothetical is a non-issue. You could just go to your local clinic that is open in the evenings and on weekends. There's several a few minutes away from me right now. They aren't unusual.
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Could you clarify, are these clinics designed to provide "routine" medical services (e.g. if you need a vaccination prior to travelling abroad on holiday) or are they intended to deal with urgent cases only? The UK model is currently very much the latter, with some steps being made towards the former.
 
Jaggy Bunnet said:
Why is state supply important? If the service is free at the point of delivery, who cares if the person providing it is employed by a quasi-government body (NHS trust), a small private, for-profit partnership (GP services) or a large multinational company (independent sector treatment centres)?
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In the limiting case, all suppliers move to the "for-profit" sector and charge what they like (the consumer has no incentive not to consume the service because the government pays). Health care remains universal but at the cost of a disastrous deterioration in public finances.
 
Ivor the Engineer said:
Because private physicians can rely on someone else to help a person in need of medical care who cannot pay their fee?
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How about those who choose to train as engineers rather than as doctors? Are they not equally guilty of relying on someone else to help a person in need of medical care?
 
Francesca R said:
In the limiting case, all suppliers move to the "for-profit" sector and charge what they like (the consumer has no incentive not to consume the service because the government pays). Health care remains universal but at the cost of a disastrous deterioration in public finances.
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Given that we currently have pretty much all GP services provided in the "for-profit" sector, do you consider that this has already happened?

If not, what has prevented it and why would that not apply to other areas of healthcare?
 
Jaggy Bunnet said:
Could you clarify, are these clinics designed to provide "routine" medical services (e.g. if you need a vaccination prior to travelling abroad on holiday) or are they intended to deal with urgent cases only? The UK model is currently very much the latter, with some steps being made towards the former.
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Definitely "routine". These types of medical clinics are staffed by General Practitioners, and patients go to them for all basic medical services. From there, a patient may get referred to a specialist if necessary (at a hospital or a special clinic). For an urgent problem I would go directly to the emergency room of a hospital.
 
D'rok said:
Definitely "routine". These types of medical clinics are staffed by General Practitioners, and patients go to them for all basic medical services. From there, a patient may get referred to a specialist if necessary (at a hospital or a special clinic). For an urgent problem I would go directly to the emergency room of a hospital.
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I'm jealous. Hopefully we will get to that stage one day.

In the meantime, I see no ethical problem with a GP who is meeting his contractual obligations under his contract to supply the NHS with services choosing to offer an additional service that is not covered under that contract directly to patients willing to pay for it.
 
Jaggy Bunnet said:
I'm jealous. Hopefully we will get to that stage one day.

In the meantime, I see no ethical problem with a GP who is meeting his contractual obligations under his contract to supply the NHS with services choosing to offer an additional service that is not covered under that contract directly to patients willing to pay for it.
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Don't be too jealous. Our constitutional order (federalism, with health care under provincial jurisdiction) means that we can never have a truly nationalized system. We're stuck with a patchwork system run by the provinces and (under)funded by the feds and plagued by power struggles between the two levels of government.
 
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