A good post with a lot in it. I don't know enough about the Beveridge/Bismark thing to comment. But any system must have a way of handling the very poor and quite poor who realistically could not afford to pay for their lifetime care. How do you make that work?
Any healthcare system would work well if there were no freeloaders and pisstakers. I've not been to casualty for a few years now luckily, but if you ever go, it's not a cross-section of society. It's very heavily skewed towards the bottom end. Rough as Fuck would descibe most of the waiting room . I don't know if it's their chaotic lives, drug/alcohol use or what. It usually looks like they just don't have the intelligence not to injure themselves in stupid pointless ways. How do Bismarkian systems handle this without just punting them outside to bleed on the pavement?
The bit I've quoted I just wanted to add my experience:
GP - I've had from very very good to half arsed patronising mediocre . They really are variable independent surgeries.
A&E - Pretty good. Though as I alluded to above, don't ever injure yourself late on Friday night..
Acute problems like broken limbs - Or serious acute medical stuff like serious heart disease or fix this right now cancer. Pretty good, in the trusts I've had experience of .
The part they do generally suck at is this middle ground of "serious , but not requiring immediate intervention" . E.g.
Weird pains that might be something minor ...
...But actually turn out to be cancer.
Oh if only we'd caught it sooner you wouldn't be fucked.
What Like, 18 months ago when I first tried to get it seen to you mean ?
Yes
