Talk Morgan Forums Community The Malvern Arms Thought for the day - revisited

There is no doubt that the present pension/benefits position is unsupportable and probably getting worse.

The question is "why"?

The financial model is complex, to say the least, particularly when analysing the NHS. For the moment I'm going to ignore everything else.

I appeared in the 1950s and comparing medical care then and now much has changed as a result of technology and chemistry. The result is that we can do much more to keep people fit and healthy, but we can also keep people alive in a state where they may have a good quality of life but continuous costly care. When I was young these people died.

So, to provide the level of care people want I believe there are only 2 options:

Either a 2 tier health service where those who can pay get a better service or we all pay a lot more., one way or another.

When "State Pensions" arrived it was expected that on average payment would last for less than 10 years. Most people who benefited were those in non professional roles where the work was physically hard. The professional workers were expected to make their own provision, which they mostly did. The NHS was funded using a similar model.

Now workers are mostly "professional" in that they use their mind, not their body and so bodies don't break the way they did. Instead bodies are abused...poor diet, no exercise, use of drugs, etc, etc.

The real problem is that "middle class professionals" now expect the state to look after them and don't take responsibility for themselves.

We need to change expectations and have everyone but the low paid and non professionals take responsibility. The present Government is trying to do this, with some success. But there is much to do.

Firstly the idea of "retirement" needs to be destroyed. I'm 62 and still working, and mostly enjoying it. I'd like to reduce to part time and possibly take on useful charity work, such as mentoring young people who are trying to build their own business. But I think that there should be financial incentives to both employers and individuals to do this. Everyone capable of contributing should do so, an active person keeps the cost to the public purse down and is likely to live longer.

And as to immigration...anyone who comes here and works and pays taxes is welcome. So no benefits for 6 months and in the first 5 years if a person is unemployed for more than 6 months they are sent home. I think Australia has got the balance about right.

Sunday morning rant over....

Agree with everything there Peter

I would be against a two tier NHS with different levels of service - I think there should be one high quality tier of service for all but those with the means to do so should pay more with a complete reorganisation of the income tax system.

I would like to see everyone earning an income no matter how small having paying a bit of tax towards the NHS because otherwise how will people value something they never pay for

We are living longer as a result of lifestyle and medical advancement. I may not like the idea but if my life expectancy has inceased by 10 years, it isn't unreasonable to either contribute more towards one's own retirement at 65 or earlier, or be prepared to work longer. My grandparents in the 1960s acted, looked and therefore were old. As a 60 year old, I'm fit enough and sufficiently agile mentally to contribute and work. I just wish the rewards were higher but hey ho!

Agreed Peter. Pensions are a minefield. I became a pension trustee to try to understand it. Now the rules change again until the next lot get in.

Blair & Brown killed DB schemes by stealth taxing the dividends & putting the pension liability on the balance sheet.

In Holland we had a great mix of private & public health cover using the same facilities so it can be done.

In South Wiltshire the NHS and rivate co-exist quite well. We have Salisbury & District NHS Hospital that isn't bad, does acute stuff really well. About a mile away is New Hall Hospital. Privately owned it does elective surgery, the non acute stuff. Same surgical teams. Abut 50% of their work is as a sub-contractor to the NHS, about 50% funded by "top up" insurance.

So, if you need a hip replaced the NHS will do it, when they get round to it. You will stay in the private hospital, where they ask if you want the NHS menu or the private one. The private one is £15.00 a day extra, but the food is good.

But if you want a single room, not a room with 3 beds, and if you want to set the date to suite you, eat well and have a glass of wine with your evening meal, then either you or your insurance company pays.

The other difference is that on NHS tarif you get a hip from a smal list that "NICE has approved. Privately the surgeon can chose what fits your needs from a much woder range. Caroline had both hips done privately when she was in her late 40s early 50s. The NHS hip option would have lasted 10 to 15 years, then need replacing. The private one cost about 10 x the NHS approved one, but is designed to last 30 plus years. They probably won't need replacing.

The NHS doesn't look at anything as a business would. In Caroline's case a simple discounted cash flow calculation whould have shown that over 40 years the expensive option actually is the lowest all up cost. As someone said, they know the cost of everything and the value of nothing.

The problem is in the title. National Health Service. It isn't a Service, it is a badly run "nationalised industry", like BL. In my view, as in Germany, all points of delivery should be run as private businesses, regulated and conforming to an audited quality management system, but able to fail.
The Government Insurance simply pays the agreed tariff.

Can you imagin a "National Garage Service" with no real choice where you service your Mog, or who does it?