On an unrelated, but very important subject, if you want to help stop Trident replacement, please ask your MP to sign EDM 96. It is sponsored by Jeremy Corbyn and is supported mainly by Labour and LIberal Democrat MPs.

http://www.parliament.uk/edm/2012-13/96

Thank you.

I think you’ve missed the elephant in the room.

The health of people in poorer areas typically deteroriates at an earlier age than the health of people in richer areas. Hence they die younger. Hence if 20% of people in Affluenton are over 75 (say), but only 15% of people in Squalorville are over 75, that tells you absolutely nothing about the proportion of people in each area who are nearing death and so likely to have greater healthcare needs. It could be that the residents of Squalorville typically enjoy poor health from their mid-60s onwards and often die before ever reaching 75, while residents of Affluenton tend to stay healthy 5 years longer and die 5 years later. In which case we should be comparing the proportion of over-70s in Squalorville with the proportion of over-75s in Affluenton.

The relevant question to ask is not “How many people in this area are over such-and-such an age?” but “How many people in this area are within (say) five years of their life expectancy?”

(…it’s not quite as simple as this, I guess, because plausibly the typical costs of treating people who get ill and die in their 80s are higher than the typical costs of treating people who get ill and die in their 70s, due to higher rates of dementia in the over-80s, say… but more argument/evidence is needed than just “older population = greater health care needs”. Maybe there are other expensive-to-treat diseases that are more prevalent in poorer areas where people die younger.)

Maybe we could stop habitually refering to the elderly as ‘people…nearing death,

I’m sure Mr Cotterill’s morbid referral to the elderly as ‘nearly dead’ originates in an attempt at humour, just as I’m convinced that the mirth of such language resides entirely in his own head. Marx taught us that mordant humour is often one of the best defences against swinish capitalism and the best examples of this can be found at every turn in ‘Capital’ as well as many of his other works; perhaps Mr Cotterill should occupy himself in reading these in place of his blogging. I’ve seen greater subtlety and wit in barely-passing undergraduate essays and if this disrespectful and nasty screed is an example of the resurgent left in the UK, we’d best prepare for a decade in opposition.

@ 4 JC

“I’m sure Mr Cotterill’s morbid referral to the elderly as ‘nearly dead’ originates in an attempt at humour, just as I’m convinced that the mirth of such language resides entirely in his own head.”

There’s a serious point about triage being made here, though. If you have a choice between saving an 80-year-old for a predicted five years of life, or a 20-year-old for a predicted 50 years of life, the answer is pretty clear.

There’s a serious point about triage being made here, though. If you have a choice between saving an 80-year-old for a predicted five years of life, or a 20-year-old for a predicted 50 years of life, the answer is pretty clear.

For a utilitarian maybe.

@ 6 Shatterface

“For a utilitarian maybe.”

OK, how would you call it?

OK, how would you call it?

I wouldn’t be able to as I don’t subscribe to a philosophy which can assess the worth of a life mathematically. From a utilitarian perspective the life of a healthy, well loved 80 year old may have greater utility than that of a violent, crack addicted loner who may or may not pull his life. There are so many elements to ‘utility’ that you never know when you’ve factored them all in to your calculation.

From a utilitarian point of view channeling public money towards wealthy old peolle might well have greater utility than to poor young people.

Which is one of the reasons I’m not utilitarian.

@ 8 Shatterface

Hang on. Are you objecting to the current system but refusing to say what you’d prefer in its place? TBH this sounds like you’re sneering at people who have to make hard decisions for ” assessing the worth of a life mathematically” but have no idea what you would do in their stead. If you can’t come up with an alternative then it’s not valid criticism, it’s just posing.

@ Shatterface

“Maybe we could stop habitually refering to the elderly as ‘people…nearing death”

Fair enough – scratch ‘nearing death’ and replace with ‘approaching the end of their lives’.

Some reference to the end of life is needed, though, to make the point that people in different areas typically approach that point at different ages, and so focusing *only* on age is a mistake.

@ Chaise

“If you can’t come up with an alternative then it’s not valid criticism, it’s just posing.”

Logic fail. People are perfectly entitled to point out the flaws in a philosophical position without offering their own alternative. Which is just as well, or silence would reign in philosophy seminars the world over.

I thought him referring to us coffin dodgers as nearly dead rather witty.

Hang on. Are you objecting to the current system but refusing to say what you’d prefer in its place?

No, I’m objecting to your claim that ‘If you have a choice between saving an 80-year-old for a predicted five years of life, or a 20-year-old for a predicted 50 years of life, the answer is pretty clear – which, for the reasons, I gave, it isn’t. There are factors about quality of life, and the contribution that person makes to society, and the potential value of that life if circumstances change – all of which show you can’t base a judgement simply on an estimation of how much life someone has already ticked off.

TBH this sounds like you’re sneering at people who have to make hard decisions for ” assessing the worth of a life mathematically” but have no idea what you would do in their stead. If you can’t come up with an alternative then it’s not valid criticism, it’s just posing.

No, its a criticism of those who think you can make ‘hard decisions’ based on simplistic assumptions.

@ 11 G.O.

“Logic fail. People are perfectly entitled to point out the flaws in a philosophical position without offering their own alternative. ”

Context fail. We are talking about *what should be done*. If you say X shouldn’t be done, you have to propose something else, even if that’s simply “don’t do X, carry on as before”. Obviously here that would mean not giving out any treatment at all.

@ 13 Shatterface

“No, I’m objecting to your claim that ‘If you have a choice between saving an 80-year-old for a predicted five years of life, or a 20-year-old for a predicted 50 years of life, the answer is pretty clear”

OK, it’s muddier than I made out.

“No, its a criticism of those who think you can make ‘hard decisions’ based on simplistic assumptions.”

And yet you’re not saying what criteria we should use. So you sit on your lofty perch and criticise the simplistic nature of those simplistic doctors who are simplistically saving people’s lives.

@ Chaise

“If you say X shouldn’t be done, you have to propose something else, even if that’s simply “don’t do X, carry on as before”.”

Sure, but Shatterface never said you *shouldn’t* save the 20-year-old. He just said the choice isn’t as clear as you’re suggesting.

@ 16 G.O.

“Sure, but Shatterface never said you *shouldn’t* save the 20-year-old. He just said the choice isn’t as clear as you’re suggesting.”

But he’s getting on his high horse about “putting a value on human life”. It’s this thought-terminating phrase that you can use to make things like triage sound all cold and callous. People who use it never seem to follow up with “so therefore we should pick patients at random” or “therefore we shouldn’t treat anybody”. It’s not clear what they actually want; they’ve just managed to express the existing system in a cold-sounding way. Well, pah.

Sarah Palin pulled much the same trick when she talked about “death panels”: i.e. a system that would decide who lived and who died (!!!!) that was proposed as an alternative to a system where people just died.

In reality, the increased cost of elderly people now fits into the realms of social care, particularly for the dementia type diseases, the cost of the actual medicines is relatively low. Over the years governments have managed, by smoke and mirrors, to change the criteria of health care to social care, and by doing so, have withdrawn funding for things such as respite care and help with things such as bathing and feeding,

This has impacted most on relatives/spouses, who will continue to give the care regardless of the lack of help, the wealthy middle-class can afford to employ private help but not the poorer working-class families.

The reason why so many people are now living longer is less to do with medicine and healthcare and more to do with other environmental factors such as clean water and better living accommodation and a welfare state which (well for now) guarantees freedom from starvation.

I haven’t seen any recent figures for health and social care but I would guess that any increase in healthcare for the elderly is easily paid for by the reduction in the social care budget.

17. Chaise Guevara

Sarah Palin pulled much the same trick when she talked about “death panels”: i.e. a system that would decide who lived and who died (!!!!) that was proposed as an alternative to a system where people just died.

Actually no. America’s life expectancy ought to tell you that people do not just die. What she was talking about was taking the decisions of who lives and who dies out of the hands of people and their insurance companies, and giving it to a government run panel instead. Which is actually an issue. As can be seen by the fact that the NHS is cheap partly because they do things like refuse cancer treatment for the old.

This is because most of the healthcare budget is NOT spent on those bits of care related to people being nearly dead; the biggest part of the budget is in fact spent on that percentage of the population which happens to need it at a point or points in their life before their nearly dead point.

Yes but in Britain women live to nearly 80 on average while men are not far behind. Which is not caused by half of all women reaching 160 and the other half dying in childhood. It is caused by most women reaching retirement age at least. Which means most people die when they are old. Which means if we spend money on people in the last six months of their lives – and over half of all NHS spending will be so spent – we will be spending it mainly on old people. We will also spend some on 20 year boys who drive their cars into traffic lights and 36 year old women who have taken too many sleeping pills, but not much. Most of it will go for the oldies.

Which kind of kills your argument don’t it?

Take a look around any hospital. It’s got people in it who are clearly not nearly dead, and who are receiving healthcare which is, on he whole, more expensive to provide than the care provided to the nearly dead.

The expensive cases are not usually in hospitals but in care facilities of other sorts. Dementia costs a lot. People who are not old and are not giving birth are, by and large, cheap. They do not consume a great deal of health care. It is people who are old who cost so much. This is why smokers are saving us money. They die cheaply relatively young. Not because they don’t get cancer or have heart attacks but because they tend not to live long enough to get Alzheimers.

SMFS: post 19 is wrong on three points, which is impressive as you were only making two points.

1) US life expectancy is 25th out of 30 OECD countries despite the US medical system providing the world’s most advanced treatments, highlighting the fact that people without insurance *do*, in fact, just die. If I were fully insured, I’d rather be treated for a serious medical condition in the US than anywhere else. *At the same time*, people without insurance frequently die of easily preventable conditions that could and elsewhere would be treated at minimal cost.

2) The ‘death panels’ would only apply for people who currently aren’t insured, and hence would have otherwise just died.

3) There is no real consumer choice in US health insurance, being a state-sponsored cartel. When it comes to the difference between a bureaucratic institution deciding whether I live or die with minimal input from me, and a bureaucratic institution deciding whether I live or die with minimal input from me, I’m not particularly arsed about the ownership structure.

The husband of a US blogger I follow recently developed young-onset cataracts. She ended up having a blog appeal to raise the $10k required for his operation. That’s a 31-year-old man who would have been left, under the current US system, to spend the rest of his life blind for the want of the level of spending that would keep a nearly-dead insured cancer patient alive for a couple of days.

Whatever relativist nonsense clowns like Shatterface might spout, all budgets are necessarily limited, and a system like the UK one where the $10,000 is spent on stopping people with their lives ahead of them from going blind is clearly and objectively better than one that keeps people who are nearly dead alive for an extra few days. Anyone who disagrees with that is, frankly, beneath contempt.

I am an elderly person. I am not near death. I don’t think my age should disqualify me from treatment should I need it to prevent me nearing death. It really disheartens me when young critics of the government assume that (a) they will never be old (b) that old people are another species and (c) that old people are all Tories. No, no, and no.

21. john b

SMFS: post 19 is wrong on three points, which is impressive as you were only making two points.

Thank you. I work at it you know.

1) US life expectancy is 25th out of 30 OECD countries despite the US medical system providing the world’s most advanced treatments, highlighting the fact that people without insurance *do*, in fact, just die.

Well yes and no. Part of that is self-inflicted. America has a lot of interesting behaviours many of which reduce your lift expectancy. Part of it is just counting. In much of Europe, Germany for instance, a baby that dies a few days or even weeks after birth is not counting as a deceased infant but as a stillbirth. It keeps their figures nice and low. America, and to the best of my knowledge the UK, does not. A dead baby is a dead baby. Which drags the average down somewhat.

However the figures are so close it hardly matters. The US life expectancy at birth figure is something like 78. Canada’s, with socialised medicine and all, is about 81. There isn’t a lot in it and much of the difference is probably caused by the behaviour of African-Americans.

If I were fully insured, I’d rather be treated for a serious medical condition in the US than anywhere else. *At the same time*, people without insurance frequently die of easily preventable conditions that could and elsewhere would be treated at minimal cost.

Frequently does not belong in that sentence. Sometimes they may. I doubt it though.

2) The ‘death panels’ would only apply for people who currently aren’t insured, and hence would have otherwise just died.

If the government pays or otherwise controls health care, they will have to set up something like NICE. It will inevitably apply to everyone.

3) There is no real consumer choice in US health insurance, being a state-sponsored cartel. When it comes to the difference between a bureaucratic institution deciding whether I live or die with minimal input from me, and a bureaucratic institution deciding whether I live or die with minimal input from me, I’m not particularly arsed about the ownership structure.

You says so. Doesn’t make it true. But if you can’t be arsed some other people can. This is just what Eric Fromm called the flight from freedom.

john b

The husband of a US blogger I follow recently developed young-onset cataracts. She ended up having a blog appeal to raise the $10k required for his operation. That’s a 31-year-old man who would have been left, under the current US system, to spend the rest of his life blind for the want of the level of spending that would keep a nearly-dead insured cancer patient alive for a couple of days.

Whatever relativist nonsense clowns like Shatterface might spout, all budgets are necessarily limited, and a system like the UK one where the $10,000 is spent on stopping people with their lives ahead of them from going blind is clearly and objectively better than one that keeps people who are nearly dead alive for an extra few days. Anyone who disagrees with that is, frankly, beneath contempt.

Did he go blind? I am guessing he didn’t. What do you think? How many people in the USA go blind because they can’t afford a relatively trivial sum for an eye operation? For that matter, how do you know this blogger was even going blind and you weren’t just taken in a sting?

I agree all budgets are necessarily limited. The UK does have its own oddities like in this case they probably would have operated on one eye but not the other. As one eye is enough. Few extra days? That is not what people are getting. Besides, when people are dying, even a few extra days can mean a lot. I would not want to put a price on the value for money that relatives get out of that extra six months, or two months, or even a few days. I know someone whose Father died the day before he was due to fly back home. He claims to be broken up about it. A few days would have meant a lot to him. And if he could have paid, he probably would have.

19

The elderly are not refused cancer treatment per se, it is based on clinical assessment and whether such intervention would be the ‘best’ for the person concerned. Indeed this same criteria will be made for children and working age adults. Certainly, in the US, where insurance and/or the very wealthy may be given drugs/treatments that are no better than placebo, the customer is always king. Trouble is, this increases insurance premiums which can put them out of reach of the average person.

24

I am sure you will find the odd isolated incident where someone may have ‘had a few more days’ if given certain drugs, however, you are not in a position to clinically assess that person, it may be that there are paradoxical side-effects of certain treatments eg, drugs which could increase life expectency but actually brings about death. And most people would like to hold on to someone they love but, that person is suffering, where would you place the decision to treat or not to treat?

23
Well said

@ 19 SMFS

“Actually no. America’s life expectancy ought to tell you that people do not just die. ”

Christ, SMFS, read between the lines. I wasn’t claiming America had no HC system before the Coming Of Obama. I was referring to people who couldn’t get insurance and couldn’t afford to pay for treatment themselves.

“What she was talking about was taking the decisions of who lives and who dies out of the hands of people and their insurance companies, and giving it to a government run panel instead. Which is actually an issue.”

I could query why a government-run panel is so much worse than an insurance-run panel. But I don’t need to, because apparently unbeknownst to Palin. Obama didn’t ban health insurance or private payment.

“As can be seen by the fact that the NHS is cheap partly because they do things like refuse cancer treatment for the old.”

I’d be happy to make it more expensive and have more people eligible for treatment. But once the budget is set, you need triage. And that’s not always a case of “two people need a kidney, we only have one, who gets it?”, it’s also part of deciding where overall budgets are sent, as with the OP.

@ 23 Briar

“I am an elderly person. I am not near death. I don’t think my age should disqualify me from treatment should I need it to prevent me nearing death.”

Nobody’s saying it should. We’re saying it should be a factor considered when dividing limited resources. So in some cases it might be the deciding factor, just like in some cases I might be passed over for treatment because I smoke.

‘The challenge for the Left therefore, in addition to opposing the specifics of Lansley’s plan is to set out how it forms part of a wider strategy of Tory deception’ – there has been almost universal opposition to Lansley’s plans for the NHS since the coalition took over, but one of the major problem left wingers face is that an alternative, and distinct vision for the way health services are provided simply does not exist amongst todays tory lites (aka NuLab).

Post-Blair socialism has become a dirty word for the likes of Ed & Co – did anybody see this very good article by Own Jones?
He says, ‘the irony of it all is that socialism, of a sort, is actually flourishing in Britain – for wealthy people like Beecroft. The taxpayer bailed out the banks that caused the crisis, allowing them to carry on much as before, courtesy of public money. Private companies such as “welfare-to-work” business A4e leech off the state, as do private contractors throughout our public services. Indeed, our NHS is set to become an even more lucrative opportunity (at taxpayers’ expense) for private health care firms like Care UK than it was under New Labour’.
http://www.independent.co.uk/opinion/commentators/owen-jones-if-socialists-really-did-run-the-show-working-people-would-benefit-7786007.html

25. steveb

The elderly are not refused cancer treatment per se, it is based on clinical assessment and whether such intervention would be the ‘best’ for the person concerned. Indeed this same criteria will be made for children and working age adults.

Well no. You think you can simply make a statement and people will believe you? They were denied treatment. They were even denied screening – some Trusts were found not to offer breast cancer screening to the over 60s even though some two thirds of all deaths from breast cancer are in this group. How is that in the best interests of the patient? I am sure doctors rationalise their decisions. Doesn’t mean it is true.

Certainly, in the US, where insurance and/or the very wealthy may be given drugs/treatments that are no better than placebo, the customer is always king. Trouble is, this increases insurance premiums which can put them out of reach of the average person.

Then they need to find a plan which doesn’t.

I am sure you will find the odd isolated incident where someone may have ‘had a few more days’ if given certain drugs, however, you are not in a position to clinically assess that person, it may be that there are paradoxical side-effects of certain treatments eg, drugs which could increase life expectency but actually brings about death. And most people would like to hold on to someone they love but, that person is suffering, where would you place the decision to treat or not to treat?

That is an interesting question. Nor is it an odd isolated incident. There is often something someone can do. Whether they should is another matter. I think that doctors ought to approach this on a case by case basis with the best interests of the patient in mind. How about you? Not say that someone is over 65 and so is probably better off dead anyway.

This is just the result of government funding of medical care. The Roman Emperors had to pass laws to prevent slave owners freeing and dumping their slaves once they were too old to work. I am inclined to think their health care was none too good either. The British government is happy with its livestock while they are economically viable. Once they aren’t working, they are just useless mouths to feed and so the government wants to make the economically rational decision. I guess this argument revolves around whether you think economically rational decisions are things governments do or not.

Chaise Guevara

Christ, SMFS, read between the lines. I wasn’t claiming America had no HC system before the Coming Of Obama. I was referring to people who couldn’t get insurance and couldn’t afford to pay for treatment themselves.

I know. And if there was a significant number of them it would depress their average life expectancy. It is not depressed. Thus it is not a problem.

I could query why a government-run panel is so much worse than an insurance-run panel. But I don’t need to, because apparently unbeknownst to Palin. Obama didn’t ban health insurance or private payment.

Yet. The government-run panel is worse because you can’t change plans. You don’t like your insurance company, you can.

I’d be happy to make it more expensive and have more people eligible for treatment. But once the budget is set, you need triage. And that’s not always a case of “two people need a kidney, we only have one, who gets it?”, it’s also part of deciding where overall budgets are sent, as with the OP.

Indeed. So we pay for sex change operations and cutting the legs off people who think they should only have one, not to mention vast sums on people who think they should be mentally ill when they aren’t, but we don’t pay for breast cancer screening for the over 60s.

I am all for triage. But I am also all for letting people decide how much that extra time is worth to themselves and their families and if need be paying for it. The government will never have enough money to pay off all the useless mouths that want to feed at the trough. But people will make sensible decisions with their own money. They should be allowed to.

29

What makes your statements more believable than my own?
You do not know why people? were denied treatment, you are not a clinician and, of course, anyone can make accusations against medical staff but they are unable to respond due to confidentiality issues
Doctors do make decisions based on individual assessments (how could they do any other)

You may be right about decisions taken on breast cancer screening but it’s not doctors who make those decisions.

Certainly as we age our bodies become more frail and this would be a factor which is taken into account, especially with reference to surgery, but it is the physiological condition which would be the determining factor rather than age. Indeed, people who are heavy smokers or are obese are often assessed as being at too higher risk for surgery. My mother has recently undergone a kneecap replacement and she is 86.

Of course, you can always elect to have private healthcare, if you are rich you can pay, if not take out private insurance, but if you become unhappy with one plan (possibly because you have needed to claim for treatment) just try changing to a different one.

people nearing death, well your nearing death the day your conceived, but of course if your blown up by bomb in labours Iraq war your nearing death. It was labour which said the elderly are not nearing death quick enough because they wanted them to work for longer.

nearing death real new labour

@ SMFS

“I know. And if there was a significant number of them it would depress their average life expectancy. It is not depressed. Thus it is not a problem.”

Well, I’m sure that rings true to the sociopaths among us.

“Yet.”

Dun-dun duuuun!

“The government-run panel is worse because you can’t change plans. You don’t like your insurance company, you can.”

The problem is that you probably won’t be able to afford a plan that is as comprehensive as NHS coverage. If they even exist.

“Indeed. So we pay for sex change operations and cutting the legs off people who think they should only have one”

Oh, what a surprise, the guy who takes pleasure from being callous doesn’t take mental health seriously.

“not to mention vast sums on people who think they should be mentally ill when they aren’t”

No idea what this means.

“but we don’t pay for breast cancer screening for the over 60s.”

Do we not? There’s probably a good reason. You’re getting very close to those idiots who claim it’s sexist that we spend less money on testicular cancer than breast cancer.

“I am all for triage. But I am also all for letting people decide how much that extra time is worth to themselves and their families and if need be paying for it.”

If you can’t afford comprehensive HC then the decision isn’t yours to make.

” The government will never have enough money to pay off all the useless mouths that want to feed at the trough. ”

Urge to Godwin… rising.

“But people will make sensible decisions with their own money. They should be allowed to.”

There you go again, pretending everyone is loaded. Get back to reality, SMFS.

30. steveb

What makes your statements more believable than my own?

Because I am not making ex cathedra statements I cannot back up.

You do not know why people? were denied treatment, you are not a clinician and, of course, anyone can make accusations against medical staff but they are unable to respond due to confidentiality issues
Doctors do make decisions based on individual assessments (how could they do any other)

How do you know what I am? The usual suspects did a study recently and were shocked, just shocked, that old people were systematically discriminated against. We can’t know why any one doctor does it, but when all of them in a Trust do it to all old people, it looks bad.

You may be right about decisions taken on breast cancer screening but it’s not doctors who make those decisions.

Who said it was?

Chaise Guevara

Well, I’m sure that rings true to the sociopaths among us.

Or those who can count.

The problem is that you probably won’t be able to afford a plan that is as comprehensive as NHS coverage. If they even exist.

Probably? Come on. We all pay for the NHS. We mostly pay through VAT. That is, it is the middle class who pay. Actually there are very few of us who could not afford to pay a similar level of coverage.

Oh, what a surprise, the guy who takes pleasure from being callous doesn’t take mental health seriously.

You keep need to make stuff up don’t you? You have no idea what I take pleasure in and I don’t think that was me not taking people who want their legs cut off seriously.

Do we not? There’s probably a good reason. You’re getting very close to those idiots who claim it’s sexist that we spend less money on testicular cancer than breast cancer.

Very few people die of testicular cancer so there’s probably no point. A lot of people die of prostate cancer and we don’t spend money on that. Which as it happens I do think is sexist. There is probably a good reason. Like the NHS thinks old people are a waste of time and money.

If you can’t afford comprehensive HC then the decision isn’t yours to make.

Which is, I am sure, a real dilemma in Africa. But not really in Britain.

There you go again, pretending everyone is loaded. Get back to reality, SMFS.

Well no that is not what I was doing but as it happens, everyone is. By world standards. Rich enough to pay for insurance if they wanted to.

33

You cannot back any statements made about the clinical treatments of people, you would need to know a great deal of information about each individual and the risk/prognosis. You are just making spurious claims based on second hand opinions made by observing what is not understood. And I know that you are no clinician by some of the daft comments you make.

What is clear is that this government have reduced the funding for social care which directly affects the elderly and their families, this has nothing to do with health or those employed within the NHS.

And, the NHS has just performed a sex-change operation on a 76 year old, that’s because it has been deemed clinically safe and appropriate, note the age was not a factor.

SMFS seems to think german engineers, or even martians should have a go a running the NHS (@46).
https://liberalconspiracy.org/2012/05/22/incidents-like-this-shame-us-all/

He was less keen on NHS nurses taking a punt on running german engineering firms, and I can’t remember what his position was with regard to nurses flying hi-tech alien spacecraft – he seems to be way out there when it comes to balmy ideas about how to run health services?

@ 33 SMFS

“Or those who can count.”

Can count, thanks. For some reason that doesn’t lead me to see human lives as irrelevant.

“Probably? Come on. We all pay for the NHS. We mostly pay through VAT. That is, it is the middle class who pay. Actually there are very few of us who could not afford to pay a similar level of coverage. ”

Bollocks. Look at the American system. A lot of people couldn’t get coverage at all because of a pre-existing medical condition. Those that could frequently found that they weren’t covered for some diseases, or past a certain max payout, or that their claim was rejected on a technicality. Why do you expect it to be different here?

“You keep need to make stuff up don’t you? You have no idea what I take pleasure in”

It’s pretty clear that you enjoy being “hard-nosed” in the “send those 10 year old vandals to a hard labour camp” kind of way.

“and I don’t think that was me not taking people who want their legs cut off seriously.”

So what’s your objection to NHS sex change ops, then?

“Very few people die of testicular cancer so there’s probably no point. A lot of people die of prostate cancer and we don’t spend money on that. Which as it happens I do think is sexist. There is probably a good reason. Like the NHS thinks old people are a waste of time and money.”

It’s called triage, go look it up instead of throwing out this ridiculous emotional crap.

“Which is, I am sure, a real dilemma in Africa. But not really in Britain.”

See above. It’s a shame you decided to comment on this from your position of dreadful ignorance.

“Well no that is not what I was doing but as it happens, everyone is. By world standards. Rich enough to pay for insurance if they wanted to.”

So someone on the minimum wage in Britain can afford better insurance than a middle-income American? Interesting. How does that work?

34. steveb

You cannot back any statements made about the clinical treatments of people

I can point out what surveys have found. Which I did.

What is clear is that this government have reduced the funding for social care which directly affects the elderly and their families, this has nothing to do with health or those employed within the NHS.

It is not remotely clear to me. Why do you think so?

And, the NHS has just performed a sex-change operation on a 76 year old, that’s because it has been deemed clinically safe and appropriate, note the age was not a factor.

Great. So the elderly can get sex change operations but not cancer treatment. I suggest one of the problems with state run health care is an insane set of priorities.

35. the a&e charge nurse

SMFS seems to think german engineers, or even martians should have a go a running the NHS

If they can do a good job, why not? The NHS is not a job creation scheme. It is a means of delivering good quality health care. If the Germans can do it better why not let them?

36. Chaise Guevara

For some reason that doesn’t lead me to see human lives as irrelevant.

No but it does seem to lead to the same smug conclusion that only the Left cares

Bollocks. Look at the American system. A lot of people couldn’t get coverage at all because of a pre-existing medical condition. Those that could frequently found that they weren’t covered for some diseases, or past a certain max payout, or that their claim was rejected on a technicality. Why do you expect it to be different here?

Sorry but a lot? How many is a lot? The NHS won’t cover you for certain diseases. Cancer for instance, if you’re old. NICE works on the basis of a max pay out. No I don’t. It is exactly the same here but without the choice.

It’s pretty clear that you enjoy being “hard-nosed” in the “send those 10 year old vandals to a hard labour camp” kind of way.

So you admit to making it up. You have no idea what I enjoy.

It’s called triage, go look it up instead of throwing out this ridiculous emotional crap.

Says the boyo who claims only he cares about humanity. It is not triage to say old people can go and die in a ditch. Especially when they are given sex change operations. Nor is it triage to say that prostate cancer is not politically important so we will ignore it. Worst of all, it is not triage to say HIV is politically important and ACT-UP will beat up anyone who says otherwise and so hugely expensive drugs have to be provided to people with HIV.

See above. It’s a shame you decided to comment on this from your position of dreadful ignorance.

See above where? You have not remotely made the case.