“Drop the Health Bill”

[UndercoverElephant]

We keep spending on stuff. Only a small proportion of our wealth is devoted to care of the elderly.

Avoided the issue with all the adeptness of a politician, Biff. The problem is that not only is that proportion set to increase, but that the more money you throw at it, the bigger the problem gets. This is not like education, or even unemployment benefits. If you pay to support somebody who is out of work, another unemployed person does not suddenly pop into existence.

It is the ultimate bottomless pit for throwing money into.

After we've stop buying cars and TVs and tickets to football matches and foreign holidays in jet planes and nail varnish and roses in February, then tell me we can't afford health care for the old folks.

So we should destroy British football in order to delay facing the reality of a problem that will stilll occur anyway? That's cultural vandalism, Biff.

When you've got a plan to stop the problem getting ever bigger the more money you throw at it, then you can tell me it is worth the price of destroying other parts of British culture.

[JavaScriptDonkey]

We keep spending on stuff. Only a small proportion of our wealth is devoted to care of the elderly. After we've stop buying cars and TVs and tickets to football matches and foreign holidays in jet planes and nail varnish and roses in February, then tell me we can't afford health care for the old folks.

Hmmm.....but why should we provide health care *free* for the older generation?

Surely they should have arranged their financial affairs so that they would have paid enough tax into the system so that when the time came there were enough resources to go around without relying on the next generations picking up the bill?

It is the baby boomer generation that should pay off the debts they incurred and for all the benefits they receive.

I don't expect my grandchildren or yours to fund my dotage.

[energy-village]

I don't expect my grandchildren or yours to fund my dotage.

We aren't just individuals, there is such a thing as society. Your grandmother may be my next door neighbour, your son may be my employee etc.

The NHS is a relatively cheap system in percentage of GDP. But it's going to get more expensive and as a country we're going to get poorer.

So we are going to have the healthcare of a poorer country, but that doesn't mean we need to adopt an 'every person for themselves' privatised system. In any case it is very likely we can't afford such a system.

We need a sustainable system that the country can afford and – yes – we should strongly encourage people to look after themselves which requires better health education, disease prevention and taxes on unhealthy lifestyles.

Finally, we should stop pumping healthy animals with daily antibiotics, unless it is some sort of ruthless scheme for reducing the surplus human population.

[biffvernon]

Hmmm.....but why should we provide health care *free* for the older generation?

Surely they should have arranged their financial affairs so that they would have paid enough tax into the system so that when the time came there were enough resources to go around without relying on the next generations picking up the bill?

Well, to go back to the mother-in-law, she was assured through her fifty odd years of working life that by paying National Insurance (or her stamp, as she puts it) she would receive the care she is now getting. As far as she is concerned the system is working as promised. She is a content lady.

[biffvernon]

We keep spending on stuff. Only a small proportion of our wealth is devoted to care of the elderly.

Avoided the issue with all the adeptness of a politician, Biff. The problem is that not only is that proportion set to increase, but that the more money you throw at it, the bigger the problem gets. This is not like education, or even unemployment benefits. If you pay to support somebody who is out of work, another unemployed person does not suddenly pop into existence.

It is the ultimate bottomless pit for throwing money into.

After we've stop buying cars and TVs and tickets to football matches and foreign holidays in jet planes and nail varnish and roses in February, then tell me we can't afford health care for the old folks.

So we should destroy British football in order to delay facing the reality of a problem that will stilll occur anyway? That's cultural vandalism, Biff.

When you've got a plan to stop the problem getting ever bigger the more money you throw at it, then you can tell me it is worth the price of destroying other parts of British culture.

So what's your solution, UE. Should we carry on watching footie and leave the elderly infirm to die without care?

[UndercoverElephant]

We need a sustainable system that the country can afford and – yes – we should strongly encourage people to look after themselves which requires better health education, disease prevention and taxes on unhealthy lifestyles.

But think through the logic here. The real sustainability problem we face here is the same demographic problem that makes a mockery of our pension system. You are advocating disease prevention and punitive taxes on unhealthy lifestyles. Let's say it works, and everybody gives up smoking. How does this affect our sustainability problem? Well, the money currently going into government coffers from the taxes on smoking disappears, and a lot of people don't die in their 70s from lung cancer who otherwise would have done, increasing the burden on the NHS.

This isn't solving the problem at all. It is making it worse.

Finally, we should stop pumping healthy animals with daily antibiotics, unless it is some sort of ruthless scheme for reducing the surplus human population.

Yes, that would be a good idea, but it won't stop the resistance building up. It will just slow down the process. I actually suspect a bigger threat is the widespread practice of just taking one pill in places like India, instead of completing a whole course. It is a cheap way of making somebody get better faster, but the long-term consequences are dire.

[UndercoverElephant]

So what's your solution, UE. Should we carry on watching footie and leave the elderly infirm to die without care?

I think we are going to have to take a different attitude to old age. I don't think we have any choice about this, no matter how ethically problematic it is. It is going to have to come down to priorities within the healthcare system, and I am afraid that the elderly infirm are never going to be at the top of that list. I think we are going to have to let people die, yes. The care should be in order to make the process as painless and dignified as possible, not to keep people alive for along as possible, especially when their quality of life is very poor.

The whole debate about people having to go to Switzerland to take their own lives legally is absurd. I think it demonstrates what is wrong with our current attitude. We put animals out of their misery, but we insist on keeping humans alive no matter how miserable their lives are. Why? Because of our irrational fear of death? A hangover from religion?

Perhaps we just find the whole notion of suicide very disturbing.

[energy-village]

We need a sustainable system that the country can afford and – yes – we should strongly encourage people to look after themselves which requires better health education, disease prevention and taxes on unhealthy lifestyles.

But think through the logic here. The real sustainability problem we face here is the same demographic problem that makes a mockery of our pension system. You are advocating disease prevention and punitive taxes on unhealthy lifestyles. Let's say it works, and everybody gives up smoking. How does this affect our sustainability problem? Well, the money currently going into government coffers from the taxes on smoking disappears, and a lot of people don't die in their 70s from lung cancer who otherwise would have done, increasing the burden on the NHS.

This isn't solving the problem at all. It is making it worse.

Finally, we should stop pumping healthy animals with daily antibiotics, unless it is some sort of ruthless scheme for reducing the surplus human population.

Yes, that would be a good idea, but it won't stop the resistance building up. It will just slow down the process. I actually suspect a bigger threat is the widespread practice of just taking one pill in places like India, instead of completing a whole course. It is a cheap way of making somebody get better faster, but the long-term consequences are dire.

By your logic we ought to be encouraging unhealthy lifestyles, so that there will be less elderly people to burden the NHS. Also by this logic you should be horrified I suggested we stop 'pumping healthy animals with daily antibiotics' for the same reason.

I'm suggesting we run the NHS on a lower budget and do things in a more simple way AND we encourage healthy living and preventative medicine – this as an alternative to bringing in a complex system of middlemen, privatising everything, having an 'us and them' system, and the whole thing collapsing at some point in the not-too-distant future.

I could mention over-population, but I'll save it for another thread. In brief I don't believe the answer is making the population sickly, buggering up the NHS and reducing the effectiveness of antibiotics.

[UndercoverElephant]

By your logic we ought to be encouraging unhealthy lifestyles, so that there will be less elderly people to burden the NHS.

Not necessarily encouraging them, no. I'm just pointing out that if your proposed solution to the problem worked as intended, it would actually make the problem worse.

Also by this logic you should be horrified I suggested we stop 'pumping healthy animals with daily antibiotics' for the same reason.

Again, I am not suggesting we deliberately make things like this worse.

I'm suggesting we run the NHS on a lower budget and do things in a more simple way AND we encourage healthy living and preventative medicine – this as an alternative to bringing in a complex system of middlemen, privatising everything, having an 'us and them' system, and the whole thing collapsing at some point in the not-too-distant future.

I obviously agree with you about the middlemen.

I could mention over-population, but I'll save it for another thread.

I think this is related to the overpopulation issue, but only indirectly. It is really a flaw in the system, which was designed in an era when retirement was normally quite short. We have not updated that system (NHS or pensions) to account for the reality that people are living much longer. We are belatedly increasing the retirement age, but this has other implications, since every older person who keeps working into their 70s is keeping somebody younger out of work (and therefore not contributing taxes or saving for their own retirement.) There are also some jobs which a 70 year old cannot physically do any longer.

[energy-village]

UndercoverElephant,

I don't want to go too far off-topic, but ...

Although we are living longer these days, I'm not sure that our period of ill health prior to the Grim Reaper is getting longer. [This is only a hunch, happy to be corrected.] It is that period of ill health, when we are not mentally and/or physically able to work that is crucial. Anything that increases that – yes – is an issue.

I agree the pension age needs pushing up to adjust for us living longer.

I'm not sure that work is limited in the way you suggest, i.e. an older person staying on must be keeping a younger person out of a job. Perhaps it would be if we all worked in the public sector. Increasing the availability of part-time jobs – and making work more flexible should help; there are ways of achieving this.

For the future the most important thing that has to change is our expectations; this covers what the NHS (or any other health system) can do for us, and more generally our hopes for our living standards. We may have to live more simply – and learn to enjoy that.

[UndercoverElephant]

I don't want to go too far off-topic, but ...

Although we are living longer these days, I'm not sure that our period of ill health prior to the Grim Reaper is getting longer. [This is only a hunch, happy to be corrected.]

It has got to be the case that the older people get, the more prone they become to the normal afflictions of old age, of which there are many and I don't need to tell you what they are. Most of those afflictions do not kill, or at least not very quickly.

I agree the pension age needs pushing up to adjust for us living longer.

I'm not sure that work is limited in the way you suggest, i.e. an older person staying on must be keeping a younger person out of a job.

How can it be any other way? There's only so many jobs.

Perhaps it would be if we all worked in the public sector. Increasing the availability of part-time jobs – and making work more flexible should help; there are ways of achieving this.

That just shifts the problem around a bit without making it any smaller. Yes, there are more jobs, but they are all paying less money.

For the future the most important thing that has to change is our expectations – this covers what the NHS (or any other health system) can do for us – and what we expect materially. We may have to live more simply.

Undoubtedly.

[energy-village]

It has got to be the case that the older people get, the more prone they become to the normal afflictions of old age, of which there are many and I don't need to tell you what they are.

In days past we were knackered and "old" at 40, today many people with a decent diet and healthy lifestyle can enjoy better health into their 70s or longer. It is why I said diet, health education and preventative medicine are vital.

How can it be any other way? There's only so many jobs.

Not really. How is it the number of jobs in the UK virtually doubled in the decades after WW2, as women took up employment? Where did those jobs come from?

Plus we could reorganise what we have. You probably agree there is no shortage of work that needs to be done? You might also agree that we have a lot of people working long hours and many people not working. There is much that could be done.

Yes, there are more jobs, but they are all paying less money.

Like I said our expectations need to change and we may have to live more simply.

[biffvernon]

So what's your solution, UE. Should we carry on watching footie and leave the elderly infirm to die without care?

I think we are going to have to take a different attitude to old age. I don't think we have any choice about this, no matter how ethically problematic it is. It is going to have to come down to priorities within the healthcare system, and I am afraid that the elderly infirm are never going to be at the top of that list.

But we do still have choice. We choose to watch the footie and buy all the other stuff. There are loads of things we use out energy on that could be abandoned before we abandon old people. Caring for vulnerable people will always be top of the priority list.

[UndercoverElephant]

It has got to be the case that the older people get, the more prone they become to the normal afflictions of old age, of which there are many and I don't need to tell you what they are.

In days past we were knackered and "old" at 40, today many people with a decent diet and healthy lifestyle can enjoy better health into their 70s or longer. It is why I said diet, health education and preventative medicine are vital.

Except for the fact that it is improvements in things like diet, health education and lifestyle which has caused people to start living for 15-20 years longer. Your "vital solutions" are in fact the cause. The better become our diet, education and preventative medicine, the more "elderly infirm" there will be.

How can it be any other way? There's only so many jobs.

Not really. How is it the number of jobs in the UK virtually doubled in the decades after WW2, as women took up employment? Where did those jobs come from?

Globalisation. At that point in British history, we were exporting most of what we made while accepting severe austerity at home because we were importing relatively little for our own consumption. That was the only way we could keep on top of our enormous debts.

Plus we could reorganise what we have. You probably agree there is no shortage of work that needs to be done? You might also agree that we have a lot of people working long hours and many people not working.

We are discussing a very good example - lots of old people are going to need to be looked after. No shortage of work to be done there - much of which is physically or emotionally demanding. The problem is this: who is going to pay for it?

[energy-village]

Globalisation. At that point in British history, we were exporting most of what we made while accepting severe austerity at home because we were importing relatively little for our own consumption. That was the only way we could keep on top of our enormous debts.

We may just have to agree to disagree on a few points.

Except perhaps that the future may be a little like the past you describe. Export anything we can - and endure severe austerity at home.

As I said before our expectations need to change and we may have to live more simply.