[Closed] Life expectancy vs Per capita Healthcare funding

Looking at that distribution, you could almost fit a curve which is steeper earlier on, but then begins to dip around AUS and actually reduces towards USA, giving a sweet spot at around the 3,000 mark

LOOOTS of factors involved here though!

For all those who hark on about privatisation and a US centric model.

Forgive me, but I don't think I've ever actually heard anyone, anywhere, proposing a U.S. centric model of healthcare for the UK

Can you point us to any sources for such a claim please?

ninfan is right youd never find someone stupid enough to think that was a good idea,
no one would vote for it and even if you searched for the most corrupt corporate shills in the land I doubt youd even be able to find 2 such politicians , unless..........................................

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ninfan - Member
Forgive me, but I don't think I've ever actually heard anyone, anywhere, proposing a U.S. centric model of healthcare for the UK

Can you point us to any sources for such a claim please?

I presume FF's point was more subtle than that and more about creeping privatisation of the NHS. On the US model, Simon Steven is currently head of the NHS and he used to (amongst other things, including advising the Labour Govt) be high up in United Health Group, a massive private healthcare provider in the US.

Forgive me, but I don't think I've ever actually heard anyone, anywhere, proposing a U.S. centric model of healthcare for the UK

Just because they're not publicly stating thats what they're doing, doesn't mean its not [i]exactly [/i]what they're[i] actually[/i] doing

As with any politician - don't listen to what they say, look at what they do.

Can you point us to any sources for such a claim please?

http://www.mirror.co.uk/news/ampp3d/nigel-farage-wants-ditch-nhs-4620726

I also suspect that most of the Tories would like to move towards a US model, but won't say so in public as they're not that stupid.

Just because they're not publicly stating thats what they're doing, doesn't mean its not exactly what they're actually doing

+1

[url= http://www.gapminder.org/world/#$majorMode=chart$is;shi=t;ly=2003;lb=f;il=t;fs=11;al=30;stl=t;st=t;nsl=t;se=t$wst;tts=C$ts;sp=5.59290322580644;ti=2013$zpv;v=0$inc_x;mmid=XCOORDS;iid=phAwcNAVuyj1jiMAkmq1iMg;by=ind$inc_y;mmid=YCOORDS;iid=phAwcNAVuyj2tPLxKvvnNPA;by=ind$inc_s;uniValue=8.21;iid=phAwcNAVuyj0XOoBL_n5tAQ;by=ind$inc_c;uniValue=255;gid=CATID0;by=grp$map_x;scale=log;dataMin=194;dataMax=96846$map_y;scale=lin;dataMin=23;dataMax=86$map_s;sma=49;smi=2.65$cd;bd=0$inds=;example=75 ]Gapminder[/url] is a wonderful resource for these sort of graphs - showing them over time as well.

So nobody actually seems to be saying what was claimed in the first place!

Regardless, it remains a non sequitur to suggest that any talk of "creeping privatisation" or "insurance based model" means any parallel with the U.S. whatsoever

If you look on the graph at that cluster around Britain there are a whole myriad of differing systems, with various levels of privatisation of supply and delivery of healthcare, and national or private health insurance, all of them much of a muchness, and the NHS, for all its benefits, does not stand out as any sort of miraculous outlier from the rest of the pack, so what does it have over and above ereywhere else?

Yeah, the American system is crap for a whole variety of reasons, but the NHS seems to be no better that most of the rest....

That chart doesn't actually "say" anything

You'd be wrong to try and correlate spending with life expectancy. The US has for example very high death rates from firearms and road deaths as well as more medical conditions like hearth disease, primarily due to poor diet. Also for example in India you have a very poor country which explains high mortality especially amongst children, however it's not the fact they spend less on medicine which causes, its simple things like clean water and food quality.

The French have an insurance based model by the way. As for the US system being "crap" they certainly don;t think so and regard their health provision as far superior to ours. I am not saying they are right but you have to accept that they have world class health care available to many.

😆

@kimbers, by the way explain to me the reason for the stat quoted on the Fox piece

5yr survival rate for prostate cancer: US 100%, Canada 99%, UK 70%

Lets be clear I am not in favour of a full blown US system here but we don't have the right solution either, as per the piece again (and common knowledge) the NHS is 3rd largest employer in the world after the Chinese Army and the Indian Railways. It's bloated and inefficient with far too many administrators and does not enjoy the economies of scale that it should.

You'd be wrong to try and correlate spending with life expectancy

You can't be wrong correlating things. You just need to be careful drawing conclusions as a good correlation is not necessarily the same as proving causation.

the NHS is 3rd largest employer in the world

I really don't see the relevance of this. Being a large organisation does not automatically imply anything, unless you are ideologically opposed to large organisations...

Looking at that graph you could easily argue that an almost 50% reduction in spending, would result in very little (any!) difference in Life Expectancy. So there we go, lets cut some NHS budgets.

Reality is it doesn't tell you much at all, because as previously mentioned the wider environment has a huge impact on health.

Looking at that graph you could easily argue that an almost 50% reduction in spending, would result in very little (any!) difference in Life Expectancy.

Would you expect anything else? The most common serious diseases always get dealt with first. No one is going to worry about 5 year survival rates from rare cancers when people are still dying of tetanus etc...

5yr survival rate for prostate cancer: US 100%, Canada 99%, UK 70%

Given the (rather well documented) difficulty that some people have in finding health insurance in the US I find that figure of 100% survival rate beyond five years highly dubious.

Edit. A very quick google search indicates that the 100% rate is for those who have the cancer diagnosed. Given the number of people who don't have health insurance then a comparison between the UK and the US is meaningless as by definition in the US you are not going be treating "poor people" as they won't get a diagnosis in the first place.

Given the (rather well documented) difficulty that some people have in finding health insurance in the US I find that figure of 100% survival rate beyond five years highly dubious.

It may well be of those diagnosed which ignores all the homeless who just die on the streets and never get diagnosed with cancer or never live long enough to get cancer...

Do these figures include Glasgow?

"Forgive me, but I don't think I've ever actually heard anyone, anywhere, proposing a U.S. centric model of healthcare for the UK

Can you point us to any sources for such a claim please? "

Section 75 of the Health and Social Care Act explicitly removes the exemption from competition that the Lisbon Treaty provided to health care provision.

All GP services in the UK are provided by the private sector. There is no such thing as an NHS GP

THe ISIS reguslations within the Health and Social Care Act are there specifically to enable US companies to bid for NHS work. Thats how Lockheed Martin are currently bidding to provide Family Healthcare services.

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The French have an insurance based model by the way. As for the US system being "crap" they certainly don;t think so and regard their health provision as far superior to ours. I am not saying they are right but you have to accept that they have world class health care available to many.

Well they're definitely not right are they - what a weird argument.

@kimbers, by the way explain to me the reason for the stat quoted on the Fox piece

5yr survival rate for prostate cancer: US 100%, Canada 99%, UK 70%

its fox news and its all made up? the 100% figure shouldve been a clue

fortunately jambalaya Ive spent the last 15 years working in cancer research so should be able to help you

1st of all, there is no way its 100%, that is quite obviously rounded up i believe the actual touted figure is about 98*%?
2ndly the USA has by far the highest diagnosis rates of prostate cancer anywhere in the world
but why??

the main test for prostate cancer is a serum test for Prostate Specific Antigen and while it is a very useful tool it is not very accurate and also picks up several other benign prostate conditions and prostate cancer itself is very poorly understood, famously on autopsy 80% of all men over 70 are seen to have prostate cancer yet most (70%) are asymptomatic
and there is much scientific debate about the usefulness of serum PSA as a screening method
Cancer treatment is not pleasant and false +ve PSA tests lead to a lot of distress uneccesarily
infact several major studies have shown that PSA screening as its carried out in the USA has no health benefits whatsoever
just search PSA screening on pubmed, filter for reviews only;
http://www.ncbi.nlm.nih.gov/pubmed

of course in a system where the healthcare industry is all about making the providers rich is there an incentive for treating people for scary diseases that dont they dont have?

* Ive also worked in america with welfare kids from the inner city and am sure that a large chunk of the population is excluded from those statistics, considering how hard it was for them to get access to antibiotics or even diagnosis for simple ailments like ringworm

As for the US system being "crap" they certainly don;t think so and regard their health provision as far superior to ours

Who exactly are they asking there then? I reckon if you asked the (poorer) 50% of the American population that has no health insurance, if they thought it was far superior to a system funded by universal taxation to provide for everybody, you might get a slightly different answer. Even bearing in mind that a lot of them are half-wits who actually believe what they see on Fox News!

Face facts... as with most things the Tory's do, they want to base it absolutely and completely on the American Model. They don't know any different. Its their idaelogical default position. Its American Capitalism, therefore by definition it must be absolutely bloody wonderful!!!!

Well, yeah... it tends to be if you're rich. If not.....

They simply want to monetarise the provision of healthcare, so themselves and their chums can funnel off yet more public money into their own grasping parasitic pockets, and if healthcare system as we presently know it (free at the point of delivery) suffers, or even falls apart, then who really cares? Not us! We've all got expensive private care and will get the best treatment whatever happens

Looking at that distribution, you could almost fit a curve which is steeper earlier on, but then begins to dip around AUS and actually reduces towards USA, giving a sweet spot at around the 3,000 mark

I dunno, I'd put it steeper and flatten off sooner, but that would put us well under the line.

Well they're definitely not right are they - what a weird argument.

I've got a couple of American coleagues who've imigrated. Both had health plans through their employers which is pretty much the default over there. Both aknowlage that the NHS is good, but they reckon they paid less* in the USA and got better service**.

Given the (rather well documented) difficulty that some people have in finding health insurance in the US I find that figure of 100% survival rate beyond five years highly dubious.

*difficult to calculate, as our tax is paying for the NHS for ~18 years before and ~25 years after we work and pay tax, so the tax is probably ~double.

** same day appointments, no waiting lists and nice fresh hospitals.

http://www.economist.com/news/books-and-arts/21598622-furious-debate-over-screening-prostate-cancer-help-or-harm

http://nypost.com/2014/03/01/why-the-prostate-cancer-test-is-useless/

you can see why prostate cancer is the perfect political scare story for amoral scumbags like Glen Beck and Daniel Hannan

Both had health plans through their employers which is pretty much the default over there.

Not for half the population, it isn't.

Would you expect anything else? The most common serious diseases always get dealt with first. No one is going to worry about 5 year survival rates from rare cancers when people are still dying of tetanus etc...

Looking at your graph I could save 50% of the total health care bill and get a worst a 1 year reduction in Life Expectancy. Think what we could do with Life Expectancy if we took that money, and used it to improve education and build bike lanes.

All the graph really shows to me is that generally it matters little in Western Countries how healthcare is funded. If anything it proves the NHS isn't remotely sacrosanct and there is room for improvements.

FF, are sure you posted the correct graph? The one posted doesn't seem to relate to your opening point.

Binners, whose manifesto or behaviour are you referring to? You did see the news this week that contradicts this view. When other departments face stringent cuts because health is ring-fenced, remember these comments.

But the observation re actions versus words is an important one - just look at the Scottish referendum debate for a good example of that.

The idea that the NHS has got to be either wholly private or wholly public is a non starter. Never has been, never will be.

One of the biggest threats to the NHS is the fact that it has this enormous body of static expensive hospitals that are fast become redundant. Hospitals are great for acute instances of disease. Shame then that the health care needs of the population are fast become completely the opposite of that, chronic lifestyle derived ill health. People smoke, drunk, eat too much and take little exersize. These things are best prevented and cured in a primary setting, by GP services and therapists, and nurses and so on. GPs have now got control over their budgets, do you a) tell your patient he needs an ultrasound, make an appt with the local hospital, wait 6 weeks, or b) engage the services of a private firm that will come to the practice every couple of weeks, and do the test and hand back the result there and then...

The acid test for any private provision is: does it improve the outcome significantly for my patients and the wider community whilst costing the same or less.

Giant local "do everything" hospitals should be consigned to the bin. Most care should be preventative, with specialised National treatment of specifics ailments. If that's a mix of private and public care, then so be it, as long as it costs about the same, and the outcome for patients is better, who the hell cares.

Currently the NHS spends more on Bariatric surgery than it spends on prevention of obseity. Madness.

but its obviously not ringfenced thm

http://www.bmj.com/content/348/bmj.g2274

waiting times accross the board have increased
the cost £3bn top down reorganisation has to come from somewhere
and the farming out of more work to private providers means that profit is being taken off the top of that money thats allegdly going into healthcare
and osbornes pledges are just pre-election sweetners thatll never happen

The acid test for any private provision is: does it improve the outcome significantly for my patients and the wider community whilst costing the same or less.

...and not reducing the availability of care to anyone.

THM - I'm extremely suspicious about them putting that much money in, while at the same time fundamentally altering it's structure. So that a lot more of that money will, instead of going to public provision, be skimmed off in profits instead. In a lot of cases by companies with some pretty dodgy links to the Tory Party.

gonefishin, in reality waiting times are down, non attendance rates are lower (give people an appt when they want rather than when you can see them, and surprise surprise they turn up). There's no incentive to turn away patients, as most private care within the GP services is contract, rather than fee based, we offer a better service than private (but in reality NHS) consultants can do, and there's no wealth discrimination or separate queuing.

Don't get me started on ultrasound. Why is that stuck in hospitals, it's not a complex technique nor expensive or need long wait times.

Ultrasound is the type of technique that should be routine in GP surgeries.

[i]It's bloated and inefficient with far too many administrators and does not enjoy the economies of scale that it should. [/i]

I won't disagree with the initial part of that sentence but having just worked in the NHS for a year (after a lifetime of the private sector) can I suggest that the standard 'too many Managers and Administrators' comment is a far too simplistic and just jumps on the usual Red-Top headline as IME/IMO it's major failings are political interference, inability of clinicians to see past their own noses, annual budgets, dead-mans-shoe recruitment/promotion policies and GP's feathering their nests.

The impression I got was that everyone get's it through their employer, and those that don't can buy it. The unemployed, retired etc get it the government and they're no longer allowed to refuse (or charge extra for) pre existing conditions.
*difficult to calculate, as our tax is paying for the NHS for ~18 years before and ~25 years after we work and pay tax, so the tax is probably ~double.

** same day appointments, no waiting lists and nice fresh hospitals.

Load of people in the US, even fully employed, have no health insurance. I've met mtbers over there who've had broken collar bones fail to heal properly because they didn't have insurance and just left them to heal alone. That sort of thing is not uncommon. Similarly, insurance companies often refuse to treat specific condiitons for a range of reasons leaving the person without treatment.

The US is a great place to be if you have money. Much less so if you don't.

Oh and talking about what insurance actually costs, I've looked into working there and while cost of living is cheap, insurance isn't - again, fine if you're well off, not if you're not.

The profit issue is another straw man though

A lot of the biggest private healthcare providers in the US (and indeed the biggest one in the UK too) are run on a not for profit basis

'Not for profit' doesn't mean that people's pockets don't get lined.

one of the issues with treatment costs in US is pricing models. If you pay for your own care it costs [u]far[/u] more than if it was billed to your insurer (they get preferential rates). I suspect that insurance via an employer costs them less than it would cost an individual. All comes back to the point that it's a great system if you're in a good job and well paid but many people don't get the same level of service.

[i]'Not for profit' doesn't mean that people's pockets don't get lined. [/i]

+1

The USA is just a really poor example - and nobody would seriously use it as a example on which to base healthcare reform, unless you had financial interest in selling healthcare services or insurance.

There are plenty of examples of mixed economy public/private insurance/provision in developed countries that make for a much better debate. I still favour universal public insurance (ie tax funded) and public provision for all but peripheral services and I'm happy to have that discussion with anyone - but offering the US as an example is making the argument too easy...

I had ultrasound in a little NHS specialist unit - so not in hospital or doctor's surgery.

List of MPs taking cash from healthcare companies.....

1. David Cameron – Prime Minister
Handed a peerage to nursing and care home tycoon Dolar Popat, who has given the Tories more than £200,000 in donations.

2. Andrew Lansley - Former Health Secretary & architect of privatisation
Received a £21,000 donation in Nov 2009 from John Nash, the former chairman of Care UK.

3. Harriet Baldwin – Tory whip
Former executive at JP Morgan, a major player in private healthcare.

4. Greg Barker – former Energy Minister
Held shares in Quester VCT 5 plc ,a venture capital firm with multiple investments in healthcare companies.

5. Henry Bellingham
Former director of Lansdowne Advisory Ltd, which has shares in private healthcare company Circle.

6. Jake Berry
Has registered interests in legal firm Squire Patton Boggs, which workd with multiple NHS trusts on PFI and PPP programs.

7. Graham Brady
Former advisor to PA Consulting, a management consultancy company which has worked with the NHS’s new Clinical Commissioning Groups.

8. Simon Burns – former Health Minister
Attended an oncology conference paid for by Aventis Pharma - a five-day trip to the US funded by a leading drug firm.

9. Nick de Bois
Was the majority shareholder in Rapier Design Group, an events management company heavily involved with the private medical and pharmaceutical industries.

10. Steve Brine
Received almost £15,000 in donations from James Lupton, the chairman of investment bankers, Greenhill Europe which has a global network of corporate relationships in the healthcare sector.

11. Aidan Burley
Received six bottles of wine from Hitachi consultants for a speech in 2011. Hitachi Consulting UK built an online ‘portal’ for NHS commissioners to help them monitor performance.

12. Damian Collins
Spent almost a decade working for marketing agency M&C Saatchi, whose clients include PPP healthcare, AXA insurance, Astrazeneca, Pfizer and Merck

13. David Davis – former shadow home secretary
Received a payment of £4,250 for a six-hour speaking engagement for private health insurance company Aviva.

14. Jonathan Djanogly
Received £1,900 from Huntleigh Healthcare Ltd, which manufactures medical and orthopaedic equipment and instruments.

15. Richard Drax
Received £14,000 in a series of donations from Derek Luckhurst, chief executive and owner of care home group Agincare.

16. Iain Duncan-Smith – Work and Pensions Secretary
Has shares in hygiene technology company Byotrol plc, which sells products to the NHS.

17. Philip Dunne
Was a non-executive director for investment firm Baronsmead VCT 4 plc, which had multiple investments in private healthcare companies.

18. Michael Fallon – Defence Secretary
Former director of Attendo AB, - a Swedish private health company.

19. Mark Field
Was a board advisor to Ellwood and Atfield; a recruitment firm which recruit for NHS positions and private healthcare.

20. Liam Fox – former Defence Secretary
Received £5,000 from investment company IPGL Ltd, who purchased healthcare pharma company Cyprotex.

21. George Freeman
Has shares in Hill House Assets Ltd, formally private health firm 4D Biomedical Ltd.

22. Mike Freer
Provided marketing advice to Care Matters, a financial planning company for care homes.

23. Richard Fuller
Worked for L.E.K consulting, which has six ‘partners’ in European healthcare.

24. Richard Graham
Received £3,000 from asset manager Crispin Odey, a major investor in Circle.

25. William Hague – Leader of the Commons
Received a £20,000 donation from MMC Ventures, which parts owns The Practice plc which runs 60 GP surgeries.

26. Philip Hammond – Foreign Secretary
Beneficiary of a trust which owns a controlling interest in healthcare and nursing home developer Castlemead Ltd.

27. Mark Harper
Received £5,000 from asset manager Crispin Odey, a major investor in Circle.

28. Nick Herbert
Received £15,000 in donations from Caroline Nash, wife of former Care UK chairman John Nash.

29. Jeremy Hunt – Health Secretary
Received £32,920 from hedge fund baron Andrew Law, a major investor in healthcare firms.

30. Margot James
Had a key role at marketing giant WPP Group, which had a long list of healthcare clients.

31. Sajid Javid – Culture Secretary
Received £11,000 from Moundsley Healthcare Ltd last year.

32. Jo Johnson – Downing Street policy adviser
Received £6,000 from asset manager Crispin Odey, a major investor in Circle.

33. Kwarsi Kwateng
Worked as an analyst for for Crispin Odey’s hedge fund Odey Asset Management.

34. Mark Lancaster
Former adviser to property venture capital firm Company Palmer Capital Partners Ltd, a funder of Danescroft Commercial Developments, which has worked in the healthcare sector.

35. Dr Phillip Lee
Has worked as a freelance or Medical Solutions Ltd, which provided medical cover for events.

36. Oliver Letwin – former shadow chancellor
Was a non-executive director of N.M. Rothschild Corporate Finance Ltd, which invests heavily in healthcare.

37. Peter Lilley
Non-Executive director of management software firm Idox plc, which provides services to the NHS Health Libraries Group and NHS Education for Scotland.

38. Tim Loughton
Received £350 for training sessions with Cumberlege Connections, a political networking firm that works “extensively” with the pharmaceutical industry.

39. Mary Macleod
Was a senior executive at Andersen Consulting/Accenture, which has profited from big PFI deals.

40. Francis Maude – Cabinet Office Secretary
Was a director of PR firm Huntsworth plc, which was part of lobbying group Healthcare Communications Association.

41. Maria Miller – former Culture Secretary
Former director of Grey’s Advertising Ltd, an advertising and brand company which worked extensively with clients in the healthcare sector.

42. Andrew Mitchell – former International Development Secretary
Was a strategy adviser to global management firm Accenture, which has worked extensively with private healthcare companies and the NHS.

43. Penny Mordaunt – Communities Minister
Worked for lobbying firm Hanover, where she had a range of healthcare clients.

44. Brooks Newmark – former Charities Minister
Partner in the Allele Fund, which invests in healthcare startups.

45. Jesse Norman
Received £5,000 from asset manager Crispin Odey, a major investor in Circle.

46. Stephen O’Brien
Received payments totalling £40,000 from Julian Schild, whose family made £184million in 2006 by selling hospital bed-makers Huntleigh Technology.

47. George Osborne - Chancellor
Received donation through Conservative Campaign Headquarters from Julian Schild – see above.

48. Priti Patel – Treasury Minister
Worked for lobbying firm Weber Shandwick, which does PR for big healthcare and pharmaceutical firms.

49. John Redwood – former Cabinet Minister
Advised the private equity company which runs Pharmacy2u, the UK’s largest dedicated internet and mail order pharmacy.

50. Jacob Rees-Mogg
Partner of Somerset Capital Management LLP, which has healthcare investor Redwood Emerging Markets Dividend Income Fund as a client.

Load of people in the US, even fully employed, have no health insurance

And when you do have it, it's limited to a certain sum. And prenatal care and childbirth is not usually included.

it's major failings are political interference, inability of clinicians to see past their own noses, annual budgets, dead-mans-shoe recruitment/promotion policies and GP's feathering their nests.

+ 1

Not surprised at kimbers post either.

Kimbers you should add those MPs who have visited their GPs, that would be equally helpful.

Knowing (to an extent) some of those listed, the links are tenuous at best in many cases. People worked at JP Morgan * or Odey or Landsdowne. Knock me down. Privatisation Pirates the lot of them.

* given bLair's salary at JPM, does that mean he is the most guilty of them all. Ba*****! 😉

This comes highly recommended for those who want a serious read on the issue: http://www.dannydorling.org/books/unequalhealth/

One of the problem's with OP's graph (plus those like it on gapminder) and the debate about the US is scale. Averaging for an entire country is meaningless in the context of healthcare provision where we find massive differences in life expectancy from one part of a city to another: http://life.mappinglondon.co.uk

And prenatal care and childbirth is not usually included.

That really shocked me - $20k I was told to have a child 😯

But I do agree with the post above, the US is an awful example. The question really should be how it compares with say France or Germany. FWIW, having dealt with one of those for a relative, I wouldn't say that it was great - the amount of bureaucracy is incredible when you're used to going to an NHS doctor and then a specialist as necessary without having to fill in forms.

As an aside my wife was doing clinical experience last week using ultrasound as a diagnostic tool for non pregnancy issues. It is really cheap to do and quick non invasive and risk free. The alternative ways of seeing inside the body are not. She asked why there is not much American literature on such a useful procedure , the reason they don't do it in America because you can bill more for the alternatives.

In any profit driven health care there will be a risk that the prime function will be profit making not service delivery.

I don't think we should be reducing healthcare to statistics and the bottom line.

For me it is more about the sort of society I want to live in. That is a society that will gives universal healthcare free at the point of use to its members and where the services are provided by publicly owned or non profit organisations.

I think that's fair comment in some ways but the numbers do have to be discussed. Healthcare costs are going up (as we live longer and can cure more health issues but often with more expensive drugs/treatments) and it needs to be funded in some way (because oft touted efficiency savings will never amount to anything significant).

I would happily pay more tax (within reason) to ensure a continued free at poi service but many wouldn't. Without discussing the costs or what will be delivered, it'll never happen because so many are misinformed about how relatively well the NHS does in terms of costs compared to other countries.